Attenuation Of Stress Response Research Articles

Comparative evaluation of oral gabapentin versus clonidine as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anesthesia

Background:Laryngoscopy and endotracheal intubation (L and I) is associated with rise in blood pressure (BP), heart rate (HR), leading to adverse cardiological outcome especially in susceptible individuals. To compare the BP, HR during L and I as well as to evaluate the preoperative sedation status between oral clonidine (Group C) and oral gabapentine (Group G) as premedication for the patients undergoing major surgery under general anesthesia (GA).Materials and Methods:From April 2008 to December 2009; in a prospective, double-blinded, and randomized controlled study; 100 adult patients of either sex, aged 20-45, of American Society of Anesthesiologists status I and II scheduled to undergo major surgery of >1 hour duration, randomly allocated into groups C and G were pre treated with oral clonidine (200 µg) and gabapentin (800 mg) respectively 2 h prior to induction. Preoperative sedation was assessed 2 h after premedication administration. Hemodynamic parameters were noted just before induction, during L and I 1,3,5,7, and10 min after intubation. The results obtained were then analyzed with statistical unpaired “t” test and Chi-square test and compared.Results and Analysis:Preoperative sedation between two groups were similar but group C attenuated HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) more significantly before induction, during L and I, 1, 3, and 5 min, following L and I, while comparing with group G. Again gabapentin-reduced HR, BP, (SBP, DBP, MBP) significantly more at 7 and 10 min after L and I on comparison clonidine.Conclusion:Oral clonidine is equally effective in producing preoperative sedation in comparison to oral gabapentin, while on the contrary oral clonidine is more efficacious in reducing laryngoscopic stress response than oral gabapentin.

Modifications of glucocorticoid receptors mRNA expression in the hypothalamic-pituitary-adrenal axis in response to early-life stress in female Japanese quail.

Stress exposure during early-life development can programme individual brain and physiology. The hypothalamic-pituitary-adrenal (HPA) axis is one of the primary targets of this programming, which is generally associated with a hyperactive HPA axis, indicative of a reduced negative-feedback. This reduced feedback efficiency usually results from a reduced level of the glucocorticoid receptor (GR) and/or the mineralocorticoid receptor (MR) within the HPA axis. However, a few studies have shown that early-life stress exposure results in an attenuated physiological stress response, suggesting an enhance feedback efficiency. In the present study, we aimed to determine whether early-life stress had long-term consequences on GR and MR levels in quail and whether the effects on the physiological response to acute stress observed in prenatally stressed individuals were underpinned by changes in GR and/or MR levels in one or more HPA axis components. We determined GR and MR mRNA expression in the hippocampus, hypothalamus and pituitary gland in quail exposed to elevated corticosterone during prenatal development, postnatal development, or both, and in control individuals exposed to none of the stressors. We showed that prenatal stress increased the GR:MR ratio in the hippocampus, GR and MR expression in the hypothalamus and GR expression in the pituitary gland. Postnatal stress resulted in a reduced MR expression in the hippocampus. Both early-life treatments permanently affected the expression of both receptor types in HPA axis regions. The effects of prenatal stress are in accordance with a more efficient negative-feedback within the HPA axis and thus can explain the attenuated stress response observed in these birds. Therefore, these changes in receptor density or number as a consequence of early-life stress exposure might be the mechanism that allows an adaptive response to later-life stressful conditions.

Longevity of Daphnia and the attenuation of stress responses by melatonin.

BackgroundThe widespread occurrence of melatonin in prokaryotes as well as eukaryotes indicates that this indoleamine is considerably old. This high evolutionary age has led to the development of diverse functions of melatonin in different organisms, such as the detoxification of reactive oxygen species and anti-stress effects. In insects, i.e. Drosophila, the addition of melatonin has also been shown to increase the life span of this arthropod, probably by reducing age-related increasing oxidative stress.Although the presence of melatonin was recently found to exist in the ecological and toxicological model organism Daphnia, its function in this cladoceran has thus far not been addressed. Therefore, we challenged Daphnia with three different stressors in order to investigate potential stress-response attenuating effects of melatonin. i) Female and male daphnids were exposed to melatonin in a longevity experiment, ii) Daphnia were confronted with stress signals from the invertebrate predator Chaoborus sp., and iii) Daphnia were grown in high densities, i.e. under crowding-stress conditions.ResultsIn our experiments we were able to show that longevity of daphnids was not affected by melatonin. Therefore, age-related increasing oxidative stress was probably not compensated by added melatonin. However, melatonin significantly attenuated Daphnia’s response to acute predator stress, i.e. the formation of neckteeth which decrease the ability of the gape-limited predator Chaoborus sp. to handle their prey. In addition, melatonin decreased the extent of crowding-related production of resting eggs of Daphnia.ConclusionsOur results confirm the effect of melatonin on inhibition of stress-signal responses of Daphnia. Until now, only a single study demonstrated melatonin effects on behavioral responses due to vertebrate kairomones, whereas we clearly show a more general effect of melatonin: i) on morphological predator defense induced by an invertebrate kairomone and ii) on life history characteristics transmitted by chemical cues from conspecifics. Therefore, we could generally confirm that melatonin plays a role in the attenuation of responses to different stressors in Daphnia.

Role of intravenous esmolol, fentanyl and lignocaine for attenuation of stress response in tracheal intubation - a comparative study

Background Endotracheal intubation is an essential part of safe airway management but this stimulates the patient’s airway reflexes and predictably leads to haemodynamic derangement. Many drugs have been suggested in modifying in haemodynamic responses to laryngoscopy and intubation. Objectives To assess efficacy of three drugs - esmolol, fentanyl and lignocaine and to assess which one is more effective to attenuate haemodynamic response to direct laryngoscopy and endotracheal intubation. Methods A total number of 90 patients ASA class I and II were selected randomly as per inclusion and exclusion criteria in three groups, 30 patients in each group. Group A received esmolol 1.5mg/kg in the volume of 10ml (with distil water) 2min before intubation, group B received fentanyl 1.5mg/kg IV 5min before intubation and group C received lignocaine 1.5mg/kg IV 90 sec before intubation. Per-operative data were recorded at 1min, 2min, 5min and 10min after intubation. Results The mean heart rate, systolic, diastolic,mean arterial pressure before starting anaesthesia were similar in group-A (esmolol), B(fentanyl) and C(lignocaine). The mean values of heart rate and rate pressure product were significantly lower in group A(Esmolol) at 1 and 2 minute than group B(fentanyl) and at 1, 2 and 5 minute than group C(lignocaine). The mean values of systolic, diastolic and mean arterial pressure were slightly lower in group A(esmolol) at 5 minute than group B(fentanyl) and significantly lower at 1, 2 and 5 minute than group C(lignocaine). Conclusion Esmolol 1.5mg/kg is superior to lignocaine 1.5mg/kg for attenuation of haemodynamic response (HR, SBP, DBP, RPP and MAP) to laryngoscopy and endotracheal intubation and also superior to fentanyl for attenuation of HR and RPP. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19810 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 12-19

Effect of Thoracic Epidural Analgesia on Proinflammatory Cytokines in Patients Subjected to Protective Lung Ventilation During Ivor Lewis Esophagectomy

Background: Thoracic epidural analgesia (TEA) has a well-known effect on neurohormonal response. Attenuation of stress response by post-operative epidural analgesia has shown beneficial effects such as lower pain scores and less immunological alterations. Objectives: Investigation of the combined effects of TEA and protective lung ventilation on proinflammatory cytokines and patients’ outcome after Ivor Lewis esophagectomy. Study Design: A randomized controlled study. Setting: Academic medical center. Methods: Thirty patients of the American Society of Anesthesiologists (ASA) I and II were randomly allocated into 2 groups: G1 (n = 15) patients received general anesthesia and were mechanically ventilated with 9 mL/kg during 2 lung ventilations, reduced to 5 mL/kg and 5cm H2O positive end expiratory pressure (PEEP) during one lung ventilation (OLV) or GII) (n = 15) patients received TEA and the same general anesthesia and mechanical ventilation used in G1. Assessment parameters included hemodynamics, pain severity, total analgesic consumption, and measurement of interleukins (IL) (IL-6 and IL-8) at baseline time after anesthetic induction (TBaseline,); at the end of the abdominal stage of the operation (TAbdo,); 15 minutes after initiation and at the end of OLV (TOLV 15) and (TOLV End) respectively; one and 20 hours after the end of the surgical procedure (TPostop1 and TPostop20), respectively, and patient’s outcome also recorded. Results: There was a significant reduction in mean arterial blood pressure (MAP) and pulse rate in GII during the intraoperative period, at Tabdo, TOLV15, and TOLV End (P < 0.05). The mean of systolic blood pressure (SBP) values were significantly lower in GII over all 3 post-operative days (P = 0.001), and the mean diastolic blood pressure (DBP) showed a significant reduction in GII for 16 hours post-operatively (P = 0.001). The mean of heart rate values showed a significant reduction in GII over all 3 post-operative days in comparison to GI (P = 0.001). The mean resting and dynamic VAS scores were significantly reduced in GII at all time periods studied in comparison to G1 (P = 0.001). The daily PCA morphine consumption was markedly decreased in GII compared to GI in the first 3 days post-operatively (P = 0.001). There were significant reductions in blood level of IL-6 and IL-8 in GII compared to G1 over the entire study period (P < 0.05). There were no significant differences in post-operative adverse effects between the 2 groups (P > 0.05). The duration of stay in PACU was significantly decreased in GII (10 ± 2 days) compared to GI (15 ± 3 days) (P = 0.001). Limitations: This study is limited by its sample size. Conclusion: Our study concluded that TEA reduced the systemic pro-inflammatory response and provided optimal post-operative pain relief. Although there were no significant differences in adverse events, there was a trend towards improved outcome. Further clinical studies with larger numbers of patients are required. Key words: Esophagectomy, one lung ventilation, thoracic epidural analgesia proiflammatory cytokines

Selective histone deacetylase-6 inhibition attenuates stress responses and prevents immune organ atrophy in a lethal septic model

An overproduction of corticosterone during severe sepsis results in increased apoptosis of immune cells, which may result in relative immunosuppression and an impaired ability to fight infections. We have previously demonstrated that administration of tubastatin A, a selective inhibitor of histone deacetylase-6 (HDAC6), improves survival in a lethal model of cecal ligation and puncture (CLP) in mice. The purpose of this study was to characterize the effects of this treatment on sepsis-induced stress responses and immune function. C57BL/6J mice were subjected to CLP, and 1 hour later given an intraperitoneal injection of either tubastatin A dissolved in dimethyl sulfoxide (DMSO), or DMSO only. Blood samples were collected to measure the levels of circulating corticosterone and adrenocorticotropic hormone (ACTH). Thymus and long bones (femur and tibia) were subjected to hematoxylin and eosin staining, and immunohistochemistry was utilized to detect cleaved-caspase 3 in the splenic follicles as a measure of cellular apoptosis. All vehicle-treated CLP animals died within 3 days, and displayed increased corticosterone and decreased ACTH levels compared with the sham-operated group. These animals also developed atrophy of thymic cortex with a marked depletion of thymocytes. Tubastatin A treatment significantly attenuated the stress hormone abnormalities. Treated animals also had significantly lower percentages of thymic atrophy (95.0 ± 5.0 vs 42.5 ± 25.3; P = .0366), bone marrow depletion and atrophy (58.3 ± 6.5 vs 25.0 ± 14.4%; P = .0449), and cellular apoptosis in the splenic follicles (41.2 ± 3.7 vs 28.5 ± 4.3 per 40× field; P = .0354). Selective inhibition of HDAC6 in this lethal septic model was associated with a significant blunting of the stress responses, with attenuated thymic and bone marrow atrophy, and decreased splenic apoptosis. Our findings identify a novel mechanism behind the survival advantage seen with tubastatin A treatment.

Comparison of morphine and fentanyl in attenuation of Intra operative stress response under general anesthesia: A randomized double blinded study

Background: This randomized double blinded study was done to compare the effect of intravenous morphine and fentanyl in attenuation of stress response during surgeries under general anesthesia in adults. The attenuation of stress response was analyzed with changes in serum cortisol and glucose levels one hour after induction of anesthesia. Methods: Fifty consented healthy volunteers in age group 20-50, under ASA I and ASA II posted for elective surgery were included in the study. Two groups of 25 each, group M who received 0.2 mg/kg body weight of morphine and group F who received 2 microgram/kg body weight of fentanyl before anaesthetic induction were compared. The members of two groups were randomly allocated and double blinded using sealed envelope technique. Blood samples were collected for baseline glucose and cortisol in all the subjects. One hour after the administration of study drugs, which was given at the time of induction blood samples were collected for analysis of glucose and cortisol. The changes in blood glucose and serum cortisol levels were compared at the end of the study using independent samples ‘t’ test. Results: There was no significant difference in blood sugar levels in both groups at the end of 1 hour. But there was significant increase in serum cortisol levels in group F compared to group M. Conclusion: This study concludes that morphine is better than fentanyl in attenuation of Intraoperative stress by effectively controlling serum cortisol levels. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9796 Asian Journal of Medical Sciences 2014 Vol.5(4); 65-68

Brain proteomics identifies potential simvastatin targets in acute phase of stroke in a rat embolic model

Finding an efficient neuroprotectant is of urgent need in the field of stroke research. The goal of this study was to test the effect of acute simvastatin administration after stroke in a rat embolic model and to explore its mechanism of action through brain proteomics. To that end, male Wistar rats were subjected to a Middle Cerebral Arteria Occlusion and simvastatin (20mg/kg s.c) (n=11) or vehicle (n=9) were administered 15min after. To evaluate the neuroprotective mechanisms of simvastatin, brain homogenates after 48h were analyzed by two-dimensional fluorescence Difference in Gel Electrophoresis (DIGE) technology. We confirmed that simvastatin reduced the infarct volume and improved neurological impairment at 48h after the stroke in this model. Considering our proteomics analysis, 66 spots, which revealed significant differences between groups, were analyzed by matrix-assisted laser desorption/ionization-time of flight mass spectrometry allowing the identification of 27 proteins. From these results, we suggest that simvastatin protective effect can be partly explained by the attenuation of the oxidative and stress response at blood-brain barrier level after cerebral ischemia. Interestingly, analyzing one of the proteins (HSP75) in plasma from stroke patients who had received simvastatin during the acute phase, we confirmed the results found in the pre-clinical model. Our aim was to study statins benefits when administered during the acute phase of stroke and to explore its mechanisms of action through brain proteomics assay. Using an embolic model, simvastatin-treated rats showed significant infarct volume reduction and neurological improvement compared to vehicle-treated group. Analyzing their homogenated brains by two-dimensional fluorescence Difference in Gel Electrophoresis (DIGE) technology, we concluded that the protective effect of simvastatin can be attributable to oxidative stress response attenuation and blood-brain barrier protection after cerebral ischemia.

Epidural anesthesia and analgesia in the neonate: a review of current evidences

The role of single shot spinal anesthesia has been established in ex-premature infants at risk of apnea. However, use of epidural anesthesia in neonates is on the rise. In this systematic analysis, we have reviewed the current evidence on the safety and efficacy of the use of single shot and continuous epidural anesthesia/analgesia in neonates. Current clinical practice is guided by evidence based mostly on non-randomized studies, prospective/retrospective case series and surveys. Single shot caudal blockade as a sole technique has been used in neonates mainly for inguinal hernia repair and circumcision. Use of continuous epidural anesthesia through the caudal route or caudo-thoracic advancement of the catheter for major thoracic and abdominal surgery offers good perioperative analgesia. Other observed benefits are early extubation, attenuation of stress response, early return of bowel function and reduction of general anesthesia-related postoperative complications. However, risk of procedure-related and drug-related complications to the developing neural structure remains a serious concern.

Selective Histone Deacetylase-6 Inhibition Attenuates Stress Responses and Prevents Immune Organ Atrophy in a Lethal Septic Model

Selective Histone Deacetylase-6 Inhibition Attenuates Stress Responses and Prevents Immune Organ Atrophy in a Lethal Septic Model

Comparison of a single injection of morphine versus ketamine or neostigmine into the epidural space on postoperative analgesia and hormonal stress response after spinal anesthesia

Background In patients undergoing lower extremity orthopedic procedures who receive spinal anesthesia, an epidural injection of morphine, ketamine, or neostigmine has an effect on postoperative analgesia duration and hormonal stress response. Patients and methods We carried out a prospective, randomized study comparing the effects of addition of 0.6 mg morphine versus 50 mg ketamine versus 60 μg neostigmine into the epidural space in patients who received spinal anesthesia in terms of postoperative analgesia duration and hormonal stress response. Results There was marked prolongation in the postoperative analgesia (428 ± 257) and attenuation of the hormonal stress response in the morphine group compared with the other groups. Also, neostigmine led to prolongation of postoperative analgesia and attenuation of stress response but less than morphine (363 ± 119). Conclusion The preemptive morphine injection into the epidural space could attenuate hormonal stress response and led to prolongation in the postoperative analgesia period.

Caudal levobupivacaine-fentanyl achieves stress response attenuation and early extubation in pediatric cardiac surgery

Background Adequate postoperative analgesia coupled with stress response attenuation in children are vital parts of perioperative care. The present study was carried out to evaluate the efficacy of caudal levobupivacaine and fentanyl combination on stress response, postoperative analgesia, and extubation in pediatric cardiac surgery. Patients and methods Fifty patients, ASA II-III, 2-8 years old, undergoing elective cardiac surgical repair were allocated randomly to two groups: group L received 0.125% levobupivacaine at a volume of 1.8 ml/kg; whereas group LF received 0.125% levobupivacaine plus fentanyl 1 μg/kg up to a volume of 1.8 ml/kg. Results Intraoperative fentanyl consumption was significantly low in group LF compared with group L [1.56 ± 0.64 vs. 2.76 ± 0.52 μg/kg in group LF and group L, respectively, 95% confident interval (CI) 0.862-1.538; P P P P P P < 0.01). Blood glucose levels increased significantly relative to baseline in both groups, but the increase was significantly lower in group LF compared with group L. Conclusion Caudal levobupivacaine-fentanyl is effective in pediatric cardiac surgery; it attenuates the stress response with concomitant stabilization of hemodynamics. In addition, it provides adequate postoperative analgesia and early extubation.

Blue substrate modifies the time course of stress response in gilthead seabream Sparus aurata

Abstract Environmental enrichment may attenuate stress response of several vertebrates. In the case of fish, although their stress response is well investigated, the effect of structural complexity as a means of environmental enrichment on stress response is not widely studied. The present study aims to investigate the possible effect of structural enrichment (blue gravel substrate) on gilthead seabream Sparus aurata primary and secondary stress responses during confinement and after recovery. Fish (initial mass 20.3 ± 0.22 g; age 0 +) were reared in tanks with blue substrate (BS) or no-substrate (NS) for 75 days. Fish (triplicated groups) were subjected to 90 min of confinement stress and sampled at 30, 60 and 90 min of confinement, as well as at 2, 6 and 24 h after stress (recovery). Triplicate groups of BS and NS fish were left undisturbed (unstressed fish). During rearing BS fish had better growth performance and less aggressive behavior than NS fish. Plasma cortisol levels and brain neurotransmitters of BS and NS fish were increased during confinement. Cortisol reduction (after stress-induced increase) occurred earlier in NS fish (60 min) than BS fish (90 min), while cortisol levels recovered in 2 h in both treatments. Serotonin metabolite 5-HIAA levels and serotonergic activity (5-HIAA/5-HT) were recovered in 6 h in BS fish, while they remained elevated for NS fish. Dopaminergic system response to confinement showed a transient increase in BS fish (60 min), while no effect was observed in NS fish. Concerning secondary stress response, glucose levels of BS fish decreased after 6 h of recovery while NS fish were not affected. On the other hand, NS fish presented a reduction of triacylglycerides (60 and 90 min) during confinement, while BS fish response was not affected. Osmolality and plasma total protein levels increased at 30 min of confinement and returned to unstressed levels in 24 h in both treatments. Present results indicate that the presence of blue substrate did modify the time course of gilthead seabream stress response to confinement. The overall performance of fish reared with blue substrate suggests that they are in better fitness than fish reared in plain tanks. The efficacy of the blue substrate as environmental enrichment enhancing gilthead seabream welfare is further reinforced and strongly encourages for additional investigations.

Boldness and Stress Responsiveness as Drivers of Nest‐Site Selection in a Ground‐Nesting Bird

AbstractNest‐site selection involves trade‐offs between the probability of nest discovery by egg predators, danger to the incubating parent from predators and provision of an appropriate microclimate for incubation, and all three components are potentially influenced by nest concealment and distance to habitat edge. Personality traits also affect habitat choice, and the trade‐off hypothesis suggests that variable stress‐coping strategies may evolve because individuals prioritize either productivity (proactive coping) or survival (reactive coping), both of which cannot be simultaneously maximized. Applying this hypothesis to understand nest‐site selection by female eider ducks (Somateria mollissima), we predicted that bold individuals with attenuated stress responsiveness should select concealed nests further away from the shore, thereby promoting clutch survival at the potential expense of reduced escape opportunities for themselves. In testing this prediction, we controlled for individual quality (female body condition and breeding experience) and verified that individual stress responses and nest‐site preferences were consistent by analysing their repeatability. Finally, we analysed how the viable proportion of the clutch was related to nest‐site and female characteristics. Our prediction was supported: bold females [short flight initiation distance (FID)] and those with lower handling‐induced body temperature were found in concealed nests, and bold females and those with lower handling‐induced corticosterone concentrations occupied nests farther from the shore. The viable proportion of the clutch peaked at intermediate proportional nest‐cover and increased linearly with increasing nest distance from the shore. Stress coping styles may thus be related to nest‐site selection, but their fitness consequences may be manifested indirectly through the nest‐site characteristics.

Maternal-Preterm Skin-to-Skin Contact Enhances Child Physiologic Organization and Cognitive Control Across the First 10 Years of Life

Maternal-newborn contact enhances organization of the infant's physiological systems, including stress reactivity, autonomic functioning, and sleep patterns, and supports maturation of the prefrontal cortex and its ensuing effects on cognitive and behavioral control. Premature birth disrupts brain development and is associated with maternal separation and disturbances of contact-sensitive systems. However, it is unknown whether the provision of maternal-preterm contact can improve long-term functioning of these systems. We used the Kangaroo Care (KC) intervention and provided maternal-newborn skin-to-skin contact to 73 premature infants for 14 consecutive days compared with 73 case-matched control subjects receiving standard incubator care. Children were then followed seven times across the first decade of life and multiple physiologic, cognitive, parental mental health, and mother-child relational measures were assessed. KC increased autonomic functioning (respiratory sinus arrhythmia, RSA) and maternal attachment behavior in the postpartum period, reduced maternal anxiety, and enhanced child cognitive development and executive functions from 6 months to 10 years. By 10 years of age, children receiving KC showed attenuated stress response, improved RSA, organized sleep, and better cognitive control. RSA and maternal behavior were dynamically interrelated over time, leading to improved physiology, executive functions, and mother-child reciprocity at 10 years. These findings are the first to demonstrate long-term effects of early touch-based intervention on children's physiologic organization and behavioral control and have salient implications for the care practices of premature infants. Results demonstrate the dynamic cascades of child physiological regulation and parental provisions in shaping developmental outcome and may inform the construction of more targeted early interventions.

The effects of intravenous lidocaine infusion on hospital stay after major abdominal pediatric surgery. A randomized double-blinded study

BackgroundLidocaine attenuates the stress response to surgery when given intravenously. This study investigated the effect of perioperative lidocaine infusion on hormonal responses, bowel function and hospital stay after major abdominal surgeries in pediatrics.MethodsAfter obtaining the Research Ethics Board (REB) approval and written informed parental consent, 80 pediatric patients aged 1–6 years, ASA II, III scheduled for abdominal major surgery were randomly allocated into two groups, each of forty children. Twenty minutes before induction, children in placebo group received saline in a rate of 1.5 ml/kg/h and those in lidocaine group received lidocaine 1.5 mg/kg intravenously then infusion of 1.5 mg/kg/h up to 6 h postoperatively. Length of hospital stay and return of bowel function were reported. Plasma cortisol was recorded at baseline, 10 min after continuous infusion, 5 min after intubation and 10 min after extubation. Serum lidocaine concentrations were recorded 10 min after start of infusion, 10 min and 4 h after extubation.ResultsPatients in placebo group showed significant higher plasma cortisol concentrations (P = 0.001) in response to induction of anesthesia and extended postoperatively when compared to lidocaine group.Hospital stay was significantly less in lidocaine group (5 ± 2 days) compared to placebo group (7 ± 2 days; P = 0.03). Also, fentanyl (μg/kg/d) requirement was significantly less in lidocaine group (5.4 ± 2.9 on 1st postoperative day and 4.1 ± 2.6 on 2nd postoperative day) compared to placebo group (14.4 ± 2.5 on 1st postoperative day and 12.6 ± 3.3 on 2nd postoperative day). Moreover, return of bowel function was earlier in lidocaine group compared to placebo group (19 ± 6.2 h vs. 23 ± 3.65 h respectively).ConclusionIntravenous lidocaine infusion, started preoperatively and continued for 6 h postoperatively, attenuated stress response to major abdominal pediatric surgery. It also decreased hospital stay, opioid requirement and hastened return of bowel function.

Effect of Light at Night on oxidative stress markers in Golden spiny mice (Acomys russatus) liver

Light at Night (LAN) suppresses melatonin (MLT) production, and effects metabolism, hormone secretion, gene expression and enzyme activity. Changes in antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD), can be used as an indication for oxidative stress level. We assayed activity and expression of these enzymes in the liver of Acomys russatus exposed to LAN and treated with MLT. Short day (SD)-acclimated A. russatus, was exposed to 30min of LAN for two, seven or 21 nights. MLT impact was assessed simultaneously with two and seven nights of LAN exposure. GPx and SOD activities were measured. Gpx1 expression was evaluated by RT-PCR. There was a significant increase in GPx activity following LAN exposure for all acclimation durations, GPx activity was elevated after two nights of LAN and MLT treatment, Gpx1 expression was elevated by MLT after seven nights of LAN. SOD activity increased after two nights of LAN in MLT-treated A. russatus, GPx activity increased with the duration of LAN acclimation, indicating changes in liver redox status. Our results suggest that LAN is a stressor that influences oxidative stress. As in the other studies, MLT increases antioxidant activities, presumably attenuating stress response, in order to restore homeostasis.

The contribution of attenuated selection in utero to small-for-gestational-age (SGA) among term African American male infants

Natural selection conserves mechanisms allowing women to spontaneously abort gestations least likely to yield fit offspring. Small gestational size has been proposed as an indicator of fitness observable by maternal biology. Previous research suggests that exposure to ambient stress in utero results in more “culling” of small fetuses and therefore lower rates of small-for-gestational-age (SGA). However, African American women persistently have higher rates of SGA than non-Hispanic white women, despite experiencing more ambient stress. This paper tests whether attenuation of the stress response among highly stressed African American women, as suggested by the weathering hypothesis, may help to explain this apparent inconsistency. We apply time-series modeling to over 2 million African American and non-Hispanic white male term births in California over the period of January 1989 through December 2010. We test for the parabolic (i.e., “U” shaped) relationship, implied by an attenuated stress response, between unusually strong labor market contraction and the rate of SGA among African American term male infants, and a linear relationship among non-Hispanic whites. We find the hypothesized parabolic relationship among term male African American infants. As expected, we find a linear relationship between unexpected layoffs and the rate of SGA among term male non-Hispanic whites. These results are robust to sensitivity analyses. These results may help to explain the high rates of SGA among term male African American infants, despite greater maternal exposure to ambient stress during pregnancy.

Adaptive evolution of the lager brewing yeastSaccharomyces pastorianusfor improved growth under hyperosmotic conditions and its influence on fermentation performance

An adaptive evolution method to obtain stable Saccharomyces pastorianus brewing yeast variants with improved fermentation capacity is described. The procedure involved selection for rapid growth resumption at high osmotic strength. It was applied to a lager strain and to a previously isolated ethanol-tolerant strain. Fermentation performance of strains was compared at 15°P wort strength. A selected osmotolerant variant of the ethanol-tolerant strain showed significantly shorter fermentation time than the parent strain, producing 6.45% alcohol by volume beer in 4-5days with mostly similar organoleptic properties to the original strain. Diacetyl and pentanedione contents were 50-75% and 3-methylbutyl acetate and 2-phenylethyl acetate 50% higher than with the original strain, leading to a small flavour change. The variant contained significantly less intracellular trehalose and glycogen than the parent. Transcriptional analysis of selected genes at 24h revealed reduced transcription of hexose transport genes and increased transcription of the MALx1 and MALx2genes, responsible for α-glucoside uptake and metabolism. It is suggested that an attenuated stress response contributes to the improved fermentation performance. Results show that sequential selection for both ethanol tolerance and rapid growth at high osmotic strength can provide strains with enhanced fermentation speed with acceptable product quality.

Enhanced Recovery After Surgery (ERAS) programme versus conventional perioperative care in patients undergoing major intra-abdominal surgical procedures

Aim-Background Enhanced Recovery After Surgery (ERAS) programmes have been applied mainly in patients undergoing major lower gastrointestinal surgery, to attenuate stress response to surgery and enable rapid recovery. The aim of this study was to evaluate whether the implementation of ERAS care, as compared to traditional care, is associated with less morbidity (decreased incidence of major postoperative complications) and improved outcome in patients undergoing elective major upper and lower intra-abdominal surgery.