The Journal of surgical research
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Systemic inflammatory response syndromes involving sepsis continue to have extremely high mortality rates. Inflammation is difficult to control when it spreads throughout the body and often progresses into multiple organ dysfunction, eventually leading to death. Cepharanthine (CE) is a plant alkaloid that possesses bioactive properties, with various known actions. In the present study, we investigated protective effects of CE in a lipopolysaccharide (LPS)-induced systemic inflammatory response model and examined underlying mechanisms. ⋯ These results suggest that CE exerts protective effects, at least in part, via NF-κB inhibition. CE may thus be a potential agent for treating systemic inflammatory response syndromes such as sepsis.
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Ischemia-reperfusion (I/R) contributes to acute kidney injury (AKI). On the other hand, anti-oxidative drugs help to prevent renal injury caused by I/R. The current study examined whether a new antioxidant, ETS-GS, inhibits reactive oxygen species (ROS) generation and thereby prevents renal I/R injury in rodent models. ⋯ Thus, ETS-GS lowered ROS levels in cultured cells, reduced serum NO levels, decreased renal MDA levels, and protected rats against I/R-induced kidney injury. Given these in vitro and in vivo findings, ETS-GS is a strong candidate for future exploration of therapeutic potential in various human I/R diseases.
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Clinical Trial
Sonographic optic nerve sheath diameter as an estimate of intracranial pressure in adult trauma.
Intracranial pressure (ICP) is currently measured with invasive monitoring. Sonographic optic nerve sheath diameter (ONSD) may provide a noninvasive estimate of ICP. Our hypothesis was that bedside ONSD accurately estimates ICP in acutely injured patients. The specific aims were (1) to determine the accuracy of ONSD in estimating elevated ICP, (2) to correlate ONSD and ICP in unilateral and bilateral head injuries, and (3) to determine the effect of ICP monitor placement on ONSD measurements. ⋯ Sonographic ONSD as a surrogate for elevated ICP in lieu of invasive monitoring is not reliable due to poor accuracy and correlation.
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The rates of post-discharge deaths after surgical procedures are unknown and may represent areas of quality improvement. The NSQIP database captures 30-d outcomes not included within normal administrative databases, and can thus differentiate between in-hospital and post-discharge deaths. ⋯ Approximately one-fourth of postoperative deaths occur after hospital discharge. There is significant variation across surgical procedures in the likelihood of postoperative deaths occurring after discharge. These data indicate a need for closer and more frequent monitoring of post-surgical patients. These data also call into question conclusions drawn from hospital-based outcomes analyses for at least some key diseases/procedures. This analysis demonstrates the power of the risk-adjusted 30-d follow-up NSQIP data, but perhaps more importantly, the responsibility of surgeons to monitor and optimize the discharge process.
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Interleukin-6 (IL6) is a major inflammatory mediator and one of the first cytokines produced after traumatic brain injury (TBI). This study evaluates early behavioral changes and acute inflammation after TBI in IL6 knock-out mice using electromagnetic controlled cortical impact. ⋯ IL6 deficiency after TBI is associated with poor behavior performance, and appears to affect expression of IL1β and, possibly, HSP70.