Journal of the American College of Surgeons
-
In summary, the Task Force does understand that change is difficult and, in the circumstance of the US health care environment, quite complex. Having acknowledged this, the Task Force firmly believes that if optimal resource standards are clear, providers will act in the best interests of their patients, infants, and children undergoing surgery in this circumstance. ⋯ This must be done while balancing the issues of access, staff, and the need to improve the value proposition. The Task Force is unanimous in its intent to advocate for this agenda.
-
Secretory immunoglobulin A (sIgA) is the principle antibody produced at the respiratory surface. Respiratory sIgA levels are increased early after injury in both human and laboratory animals; the mechanisms are uncertain. Stress hormones, including epinephrine (Epi) and norepinephrine (NE), increase early after injury. In addition, respiratory epithelial cells are known to be responsive to β2-agonists. We therefore studied the effect of Epi, NE, and albuterol on IgA transport in vitro. ⋯ Epinephrine is likely an early upstream signal in the enhanced IgA response at respiratory surfaces after injury.