IMMUNE PROTECTIVE EFFECTS OF CYCLOOXYGENASE INHIBITION IN PATIENTS WITH MAJOR SURGICAL TRAUMA

Opioids comprise an important group of drugs used in cancer pain pharmacotherapy. In recent years, more and more studies have emerged indicating the potentially immunosuppressive effects of opioid analgesics and their serious consequences, including the risk of cancer progression. The identification of these risks has prompted a search for other effective, and most importantly, safer methods of perioperative analgesic management. Regional analgesia techniques, which allow for a significant reduction in opioid dosing and thus diminish the risk of immunosuppression associated with these drugs, seem to offer substantial hope in this respect. A number of studies available in the literature assess the effects of regional analgesia techniques on cancer progression; however, it is often difficult to interpret their results owing to several perioperative factors (such as surgical trauma, inadequate pain and stress relief, and hypothermia) which are also attributed immunosuppressive effects and tend to be implicated in increased risk of cancer progression. Further research is needed to verify the available data on both the potential adverse effects of opioids and the possible protective effects of regional analgesia techniques on cancer patients.

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817: Is Laparoscopic Radical Prostatectomy Less Invasive than Conventional Retropubic Prostatectomy: Results of a Prospective, Non-Randomized Study of the Surgical Trauma Associated with Both Techniques in 403 Cases

The Journal of Urology ◽

10.1016/s0022-5347(18)31057-7 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 272-273

Author(s):

Andreas Jurczak ◽

Sigrid Wagner ◽

Mario Zacharias ◽

Amir Hamza ◽

Paolo Fornara

Keyword(s):

Radical Prostatectomy ◽

Randomized Study ◽

Laparoscopic Radical Prostatectomy ◽

Surgical Trauma ◽

Less Invasive ◽

Retropubic Prostatectomy

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FDA Recognizes Adalimumab's Joint Protective Effects in Psoriatic Arthritis

Rheumatology News ◽

10.1016/s1541-9800(06)71542-3 ◽

2006 ◽

Vol 5 (12) ◽

pp. 19

Author(s):

ELIZABETH MECHCATIE

Keyword(s):

Psoriatic Arthritis ◽

Protective Effects

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Aetiology and Prognostic Implication of Severe Jaundice in Surgical Trauma Patients

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520310000519 ◽

2003 ◽

Vol 38 (1) ◽

pp. 102-108 ◽

Cited By ~ 10

Author(s):

K. J. Labori ◽

B. A. Bjørnbeth ◽

M. G. Ræder

Keyword(s):

Surgical Trauma ◽

Trauma Patients ◽

Prognostic Implication ◽

Severe Jaundice

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Melatonin reduces high levels of lipid peroxidation induced by potassium iodate in porcine thyroid

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000628 ◽

2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Paulina Iwan ◽

Jan Stepniak ◽

Malgorzata Karbownik-Lewinska

Keyword(s):

Lipid Peroxidation ◽

Oxidative Damage ◽

Membrane Lipids ◽

Chemical Properties ◽

Iodine Concentration ◽

Free Radical Scavenger ◽

Radical Scavenger ◽

Protective Effects ◽

Potassium Iodate ◽

Hormone Synthesis

Abstract. Iodine is essential for thyroid hormone synthesis. Under normal iodine supply, calculated physiological iodine concentration in the thyroid is approx. 9 mM. Either potassium iodide (KI) or potassium iodate (KIO3) are used in iodine prophylaxis. KI is confirmed as absolutely safe. KIO3 possesses chemical properties suggesting its potential toxicity. Melatonin (N-acetyl-5-methoxytryptamine) is an effective antioxidant and free radical scavenger. Study aims: to evaluate potential protective effects of melatonin against oxidative damage to membrane lipids (lipid peroxidation, LPO) induced by KI or KIO3 in porcine thyroid. Homogenates of twenty four (24) thyroids were incubated in presence of either KI or KIO3 without/with melatonin (5 mM). As melatonin was not effective against KI-induced LPO, in the next step only KIO3 was used. Homogenates were incubated in presence of KIO3 (200; 100; 50; 25; 20; 15; 10; 7.5; 5.0; 2.5; 1.25 mM) without/with melatonin or 17ß-estradiol. Five experiments were performed with different concentrations of melatonin (5.0; 2.5; 1.25; 1.0; 0.625 mM) and one with 17ß-estradiol (1.0 mM). Malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA) concentration (LPO index) was measured spectrophotometrically. KIO3 increased LPO with the strongest damaging effect (MDA + 4-HDA level: ≈1.28 nmol/mg protein, p < 0.05) revealed at concentrations of around 15 mM, thus corresponding to physiological iodine concentrations in the thyroid. Melatonin reduced LPO (MDA + 4-HDA levels: from ≈0.97 to ≈0,76 and from ≈0,64 to ≈0,49 nmol/mg protein, p < 0.05) induced by KIO3 at concentrations of 10 mM or 7.5 mM. Conclusion: Melatonin can reduce very strong oxidative damage to membrane lipids caused by KIO3 used in doses resulting in physiological iodine concentrations in the thyroid.

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Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽

10.1024/0301-1526.35.3.157 ◽

2006 ◽

Vol 35 (3) ◽

pp. 157-166 ◽

Cited By ~ 7

Author(s):

Hach-Wunderle ◽

Hach

Keyword(s):

Minimally Invasive ◽

Saphenous Vein ◽

Venous Insufficiency ◽

Great Saphenous Vein ◽

Varicose Veins ◽

Venous Pressure ◽

Stage Iii ◽

High Ligation ◽

Surgical Trauma ◽

Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

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