Epinephrine Concentrations Research Articles

Remifentanil reduces multiple organ and energy metabolism disturbances in a rat sepsis model.

The aim of this study was to observe the effects of remifentanil on organ damage and energy metabolism in lipopolysaccharide (LPS)-induced septic rats. A total of 45 clean-grade male Wistar rats (weight 270-320 g) were randomly divided into three groups: a control group, an LPS group, and an LPS with remifentanil treatment (LPS+REM) group. After 6 hours of modeling, the levels of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in lung and kidney tissues of rats in each group were detected by ELISA. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in lung and kidney tissues were determined, and the content of lactic acid, pyruvate and epinephrine in heart and kidney tissues were detected. Reverse transcription polymerase chain reaction and the Western blot test were used to detect the expression of pyruvate dehydrogenase kinase 4 (PDK4) in the myocardial tissue. We found that remifentanil treatment inhibited the levels of IL-6, TNF-α, and MDA in the lung and kidneys 6 h after the administration of LPS and increased the level of SOD activity. Treatment with remifentanil reduced the expression of lactic acid, pyruvate, and epinephrine in the heart and kidney tissues and attenuated the expression of PDK4 messenger RNA and PDK4 protein in the myocardial tissue. We concluded that remifentanil might inhibit the release of tissue inflammatory factors, regulate the body's energy metabolism, and ultimately protect the sepsis tissue damage caused by LPS.

English

BACKGROUND Direct laryngoscopy and endotracheal intubation frequently induce a cardiovascular stress response characterized by hypertension and tachycardia due to reflex sympathetic discharge due to laryngotracheal stimulation which leads to increased plasma nor epinephrine concentration. The response is transient occurring 30 seconds after intubation and lasting for less than 10 minutes. Laryngoscopy and endotracheal intubation are associated with undesirable haemodynamic response which is of little significance in healthy patients but may be detrimental in patients with systemic diseases like hypertension, ischemic heart disease, stroke, perforated eye injury, increased intracranial tension etc. There is a need to attenuate these haemodynamic changes to decrease the mortality and morbidity. This study is designed to evaluate the attenuation of the haemodynamic response to laryngoscopy and endotracheal intubation with available cost effective drugs (esmolol and lignocaine) which are routinely used. METHODS This was an observational study conducted in the department of anaesthesiology, Travancore Medical College, Kollam among 140 patients in the age group 18 to 65 years posted for elective surgery from October 2017 to September 2018. Patients who received lignocaine or esmolol as intravenous agent prior to the induction of anaesthesia were recommended to group ‘L’ and ‘E’ respectively. Blood pressure and heart rate was recorded prior to laryngoscopy as well as 1 minute, 3minutes, 5 minutes and 10 minutes after laryngoscopy and intubation. Collected data was tabulated and analyzed using appropriate statistical software (SPSS20). RESULTS The rise in heart rate, systolic BP, diastolic BP, and mean arterial pressure were better controlled by esmolol than lignocaine. CONCLUSIONS Intravenous esmolol 1.5mg/kg is found to be more effective in the attenuation of hemodynamic responses to laryngoscopy and endotracheal intubation than intravenous lignocaine 1.5mg/kg. KEY WORDS Laryngoscopy, Intubation, Attenuation, Cardiovascular Response, Lignocaine, Esmolol

Splenic size as an indicator of hemodynamics and prognosis in patients with heart failure.

The spleen is an important immune organ that releases erythrocytes and monocytes and destroys aged platelets. It also reserves 20-30% of the total blood volume, and its size decreases in hypovolemic shock. However, the clinical significance of splenic size in patients with heart failure (HF) remains unclear. We retrospectively analyzed the data of 206 patients with clinically stable HF gathered between January 2001 and August 2020 and recorded in a single-center registry. All patients underwent right heart catheterization and computed tomography (CT). Splenic size was measured using CT volumetry. The primary outcomes were composite cardiac events occurring for the first time during follow-up, namely, cardiac death and hospitalization for worsening HF. The median splenic volume and splenic volume index (SVI) were 118.0mL and 68.9mL/m2, respectively. SVI was positively correlated with cardiac output (r = 0.269, P < 0.001) and stroke volume (r = 0.228, P = 0.002), and negatively correlated with systemic vascular resistance (r = - 0.302, P < 0.001). Seventy cardiac events occurred, and the optimal receiver operating characteristic curve SVI cutoff value for predicting cardiac events was 68.9mL/m2. The median blood adrenaline concentration was higher in the low-SVI group than the high-SVI group (0.039ng/mL vs. 0.026ng/mL, respectively; P = 0.004), and the low-SVI group experienced more cardiac events (log-rank test, P < 0.001). Multivariate Coxproportional hazards regression revealed that a low SVI was an independent predictor of cardiac events, even when adjusted for the validated HF risk score, blood-brain natriuretic peptide concentration, blood catecholamine concentrations, and hemodynamic parameters. Splenic size reflects hemodynamics, including systemic circulating blood volume status and sympathetic nerve activity, and is associated with HF prognosis.

Effects of Acute Yohimbine Hydrochloride Supplementation on Repeated Supramaximal Sprint Performance.

The purpose of this study was to examine the effects of a single acute dose of yohimbine hydrochloride on repeated anaerobic sprint ability. Physically active females (n = 18) completed two separate repeated supramaximal sprint trials each with a different single-dose treatment: placebo (PL; gluten-free corn starch) or yohimbine hydrochloride (YHM; 2.5 mg). For each trial, participants consumed their respective treatment 20 min before exercise. Following a warm-up, participants completed 3 × 15 s Wingate anaerobic tests (WAnTs) separated by 2 min of active recovery. A capillary blood sample was obtained pre- and immediately post-exercise to measure blood concentrations of lactate (LA), epinephrine (EPI), and norepinephrine (NE). Heart rate (HR) and rate of perceived exertion (RPE) were measured following each WAnT. Findings showed that mean power (p < 0.001; η2 = 0.024), total work (p < 0.001; η2 = 0.061), and HR (p < 0.001; η2 = 0.046), were significantly higher with YHM supplementation versus PL. Fatigue index (p < 0.001; η2 = 0.054) and post-exercise LA (p < 0.001; d = 1.26) were significantly lower with YHM compared to PL. YHM resulted in significantly higher EPI concentrations versus PL (p < 0.001; η2 = 0.225) pre- and post-exercise while NE only increased as a function of time (p < 0.001; η2 = 0.227) and was unaffected by treatment. While RPE increased after each WAnT, no differences between treatments were observed (p = 0.539; η2 < 0.001). Together, these results suggest that acute YHM ingestion imparts ergogenic benefits which may be mediated by lower blood LA and fatigue concomitantly occurring with blood EPI increases. Thus, YHM may improve sprint performance although more mechanistic study is warranted to accentuate underlying processes mediating performance enhancement.

Cardiovascular effects of intravenous pimobendan in dogs with acute respiratory acidosis.

Acidosis decreases myocardial contractile and myofibrillar responsiveness by reducing the calcium sensitivity of contractile proteins, which could reduce the effectiveness of pimobendan. We aimed to assess the cardiovascular effects of pimobendan in dogs subjected to acute respiratory acidosis. Randomized crossover study with a 2-week washout period. University Laboratory. Six healthy research Beagle dogs. Anesthetized dogs were administered 2 doses of IV pimobendan during conditions of eucapnia (Paco2 35-40mm Hg) and hypercapnia (Paco2 90-110mm Hg). Eucapnia was maintained by positive pressure ventilation and hypercapnia was induced by adding exogenous CO2 to the anesthesia circuit. Heart rate (HR), systemic arterial blood pressure, cardiac output (CO), systemic and pulmonary vascular resistance (SVR and PVR, respectively), and pulmonary arterial pressure (PAP) were measured at baseline and 60min after administering 0.125mg/kg (low) and 0.25mg/kg (high) pimobendan intravenously. Blood gas and biochemical analyses were performed at baseline and at the end of the experiment. The median baseline blood pH was 7.41 (range: 7.33-7.45) and 7.03 (range: 6.98-7.09) under conditions of eucapnia and hypercapnia, respectively. The serum concentrations of epinephrine and norepinephrine and the HR, CO, and PAP were higher, and SVR was lower at baseline in hypercapnic dogs. Pimobendan dose-dependently increased CO in eucapnia (baseline: 3.6±0.2L/kg/m2 [mean ± SE], low: 5.0±0.4L/kg/m2 , high: 5.8±0.5L/kg/m2 , P<0.001) and hypercapnia (baseline: 4.9±0.5L/kg/m2 , low: 5.8±0.5L/kg/m2 , high: 6.2±0.5L/kg/m2 , P<0.001), and increased HR and decreased SVR and PVR under both conditions (P<0.001). In hypercapnia, the degree of increase or decrease of these cardiovascular measurements (except for PAP) by pimobendan was less than that in the eucapnic dogs. Pimobendan maintains function as an inodilator in anesthetized dogs with induced respiratory acidosis.

Risk factors, hematological and biochemical profile associated with colic in Delman horses in Gresik, Indonesia

Background: Horses are herd animals that have been domesticated in the last century. In several countries, an overview of risk factors and clinical evaluation in horses with colic has not been well‐described. This study aimed to evaluate risk factors and hematological profiles in horses associated with colic in Gresik, East Java, Indonesia. Methods: A cross-sectional study was performed during April - October 2019. A total of 115 horses were diagnosed based on physical examination, clinical symptoms, and rectal examination. A questionnaire was asked to the horse-owners to analyze the risk factors while the clinical examination was performed and blood samples were collected for pre-treatment and 14 days post-treatment. Hematological profile was evaluated from a whole blood sample. Serum cortisol, plasma epinephrine, and norepinephrine concentrations were also evaluated after separating the aliquots. Results: Of the 115 horses, 96 were diagnosed with colic. The horses with colic showed a significant association between cases with gender (p&lt;0.021), breed (p&lt;0.000), wheat bran feeding (p&lt;0.015), concentrate feeding (p&lt;0.003), anthelmintics administration (p&lt;0.000), gastrointestinal parasites (p&lt;0.000), dental diseases (p&lt;0.024), previous exposure to colic (p&lt;0.000), body condition score (p&lt;0.000), and access to water per day (p&lt;0.000). Based on whole blood and serum evaluation, there were ameliorated significantly on the hematological profile (p&lt;0.01), serum cortisol (p&lt;0.05), and plasma epinephrine (p&lt;0.01) at 14 days post-treatment. Conclusion: This study has identified factors associated with colic in Delman horses. The study provides crucial information to investigate cases of colic and to contribute the development of healthcare strategies during treatment and clinical evaluation.

Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury

BackgroundThe impact of changes in portal pressure before and after liver resection (defined as ΔHVPG) on postoperative kidney function remains unknown. Therefore, we investigated the effect of ΔHVPG on (i) the incidence of postoperative AKI and (ii) the renin-angiotensin system (RAAS) and sympathetic nervous system (SNS) activity.MethodsWe included 30 patients undergoing partial liver resection. Our primary outcome was postoperative AKI according to KDIGO criteria. For our secondary outcome we assessed the plasma renin, aldosterone, noradrenaline, adrenaline, dopamine and vasopressin concentrations prior and 2 h after induction of anaesthesia, on the first and fifth postoperative day. HVPG was measured prior and immediately after liver resection.ResultsΔHVPG could be measured in 21 patients with 12 patients HVPG showing increases in HVPG (∆HVPG≥1 mmHg) while 9 patients remained stable. AKI developed in 7/12 of patients with increasing HVPG, but only in 2/9 of patients with stable ΔHVPG (p = 0.302). Noradrenalin levels were significantly higher in patients with increasing ΔHVPG than in patients with stable ΔHVPG. (p = 0.009). Biomarkers reflecting RAAS and SNS activity remained similar in patients with increasing vs. stable ΔHVPG.ConclusionsPatients with increased HVPG had higher postoperative creatinine concentrations, however, the incidence of AKI was similar between patients with increased versus stable HVPG.

Assessment of efficacy of Local Anesthesia with 2 Different Concentrations of Adrenaline in patients undergoing mandibular third molar extraction

Background: Local anesthesia laid the fundamental foundation for pain regulation in dentistry. Hence; the present study was conducted for assessing the efficacy of Local Anesthesia with 2 Different Concentrations of Adrenaline in patients undergoing mandibular third molar extraction. Materials & Methods: 50 patients who were scheduled to undergo mandibular third molar extraction were enrolled and were uniformly divided into two study groups as follows: Group A: 2% lignocaine with concentrations of adrenaline being 1:80000; and Group B: 2% lignocaine with concentrations of adrenaline being 1:200000. Complete demographic details of all the patients were obtained. Pre-extraction examination of all the patients was done. Local anesthesia was delivered as per respective group and dental extractions were carried out under adequate aseptic environment. Postoperative results were recorded and compared. Results: Mean time of onset among patients of group A and group B was 3.52 minutes and 3.28 minutes respectively. Mean duration among patients of group A and group B was 158.5 minutes and 121.8 minutes respectively. Significant alteration in the pulse rate among the patients of group A was recorded. Conclusion: 1:80000 adrenaline concentrations showed significant rise in pulse rate. For the cardiac and elderly patients, 1:200000 adrenaline concentrations are recommended.

Effects of intraoperative hypothermia on stress hormon response in surgical patients

Background/Aim. Surgical stress itself, as well as hypothermia induced by general anesthesia and low ambient temperature, activates stress hormone response with changes in catecholamines and counter-regulatory hormones. The aim of this study was to investigate the acute hormone stress response in patients who underwent major surgical procedures and the efficiency of external and internal warming methods in alleviating these changes. Methods. The study included a total of 60 patients who underwent major open abdominal surgical procedures and were randomly divided into 4 groups: control non-warmed (C), externally warmed using forced-air warming mattress (W), internally warmed using intravenous amino acids (A), and warmed with a combination of external and internal method (A+W). Esophageal temperature was used as a measure of core temperature. Concentrations of epinephrine, norepinephrine, cortisol, prolactin, and testosterone were measured. Blood samples for hormone measurement were obtained at two time points for catecholamines ? 90 min before and 120 min after finishing the surgery, and at additional two-time points for cortisol, prolactin, and testosterone (24 and 48 hrs after surgery). Results. In the W and A+W groups, the temperatures did not significantly differ between time points but constantly decreased in the C and A groups, with a statistically significant difference between the anesthesia induction and the 120th min (35.61 ? 042 vs. 33.86 ? 0.71?C; p &lt; 0.000 and 35.81 ? 0.54 vs. 34.45 ? 0.41?C; p &lt; 0.000, respectively). Catecholamine concentrations in all groups showed a significant increase during surgery, with the highest values recorded in the non-warmed group (777.07 ? 800.08 after vs. 106.13 ? 89.63 pg/mL before surgery for epinephrine and 1,349.67 ? 984.16 vs. 580.53 ? 465.38 for norepinephrine, p &lt; 0.000). Concentrations of cortisol and prolactin also showed a significant increase at the same time point, with a tendency to normalize after 48 hrs. On the contrary, testosterone concentrations showed a decrease after 120 min without normalization throughout the entire period of observation. Except for testosterone, changes in all stress hormones were attenuated in warmed groups compared to controls. Conclusions. Regarding both features of surgical stress investigated in this study (hypothermia and stress hormone response), the combination of endogenous amino acid-induced thermogenesis and external air warming mattress is most effective in its prevention.

Does the presence and amount of epinephrine in 2% lidocaine affect its anesthetic efficacy in the management of symptomatic maxillary molars with irreversible pulpitis?

BackgroundThis was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis.MethodsThe trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as ‘no pain’ or ‘faint/weak/mild’ pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance.ResultsPlain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, χ2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine.ConclusionAdding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

Comparative Evaluation of Haemodynamic Changes in Patients Undergoing Surgical Removal of Bilateral Impacted Lower Third Molars using 2% Lidocaine vs 4% Articaine with 1:100000 Epinephrine Concentration: A Double Blind Randomised Study

Comparative Evaluation of Haemodynamic Changes in Patients Undergoing Surgical Removal of Bilateral Impacted Lower Third Molars using 2% Lidocaine vs 4% Articaine with 1:100000 Epinephrine Concentration: A Double Blind Randomised Study

Influence of Aerobic Exercise Combined with Forest Bathing on Immunocytes, Stress Hormones, VO2peak, and Body Composition in Elderly Men: A Randomized Controlled Trial

Background: Forest bathing and aerobic exercise are known to be factors that increase natural killer (NK) cell, but it is considered to provide a greater effect when the two factors are combined. To date, it has not been studied whether aerobic exercise combined with forest bathing can further increase innate immunocytes, including NK cell. Therefore, this study investigated the effect of aerobic exercise + forest bathing on NK cell and whether stress hormones (epinephrine and cortisol) are involved in this physiological process. In addition, this study tried to confirm whether the mixed effect of the two had a more positive effect on cardiorespiratory endurance as well as body composition in the elderly men. Methods: Thirty-two participants were randomly assigned to one of four groups: control group (CON, n = 8) which was not provided with any intervention, exercise group (EXE, n = 8) which performed treadmill exercises without phytoncide, phytoncide group (PHYT, n = 8) which was provided with phytoncide intervention, and exercise + phytoncide group (EXE + PHYT, n = 8) which performed treadmill exercises and was provided with phytoncide. Treadmill exercises and phytoncide exposures were performed for 45~60 min a day, 3 days a week for 12 weeks. Results: Compared with CON, (1) the leucocytes and lympocytes of EXE, PHYT, and EXE + PHYT showed positive changes. Specifically, total NK cells, NKT cells, and NKG2D + NK of the EXE + PHYT increased after 12 weeks of intervention. (2) The cortisol concentrations of EXE, PHYT, and EXE + PHYT showed decreasing changes, whereas the epinephrine concentration were significantly increased. (3) Although there were no changes in the muscle mass of EXE, PHYT, and EXE + PHYT, cardiorespiratory endurance was significantly increased in those groups. In addition, the body weight, fat mass, and fat percentage significantly decreased only in the EXE + PHYT. Conclusions: This study confirmed that forest bathing and aerobic exercise positively affected immunocyte function in elderly men. It also found that the improved results from forest bathing + treadmill walking were caused by an increase in cardiorespiratory endurance by increased epinephrine concentrations. In addition, this increased cardiorespiratory endurance can be interpreted as significantly reducing the body weight and fat in the group that participated in the exercise combined with phytoncide exposure.

Pivotal role of the sympathetic nerves of the human heart in mental stress responses and triggered cardiovascular catastrophes.

Mental stress can trigger cardiac catastrophes, explicitly evident during national disasters such as earthquakes. Activation of the cardiac sympathetic outflow and inhibition of the cardiac vagus are important mediating mechanisms. This manuscript describes efforts by the Human Neurotransmitters Research Laboratory of the Baker Institute in Melbourne to develop investigative methods to study the sympathetic nerves of the human heart, and to apply these in mental stress research. With laboratory mental stress, activation of the adrenal medulla was found to occur, accompanied by a regionalized sympathetic nervous response directed to the heart, but sparing the sympathetic outflow to the skeletal muscle vasculature. Patients with panic disorder are at increased cardiovascular risk. They exhibit high-level sympathetic activation during a panic attack, sometimes accompanied by coronary artery spasm. Patients with sudden ventricular arrhythmias causing collapse in the community were found to have as the predisposing substrate high baseline cardiac sympathetic activity, from previously unrecognized mild heart failure; it was surprising at the time that we did not find critical coronary artery stenosis as the substrate. In some the arrhythmia event had a behavioural trigger. In Takotsubo cardiomyopathy ("Broken Heart Syndrome") the myocardial stunning appears to represent a catecholamine cardiomyopathy, from astronomically high plasma adrenaline concentrations, rather than be caused by activation of the cardiac sympathetic nerves. Some diseases (essential hypertension, heart failure, panic disorder) have forms of sympathetic neural enhancement which contribute to cardiovascular risk: reuptake of noradrenaline by sympathetic nerves after release is faulty and single sympathetic fibres fire in multiple salvos within a single cardiac cycle. Paradoxically, obesity-hypertension does not share in this sympathetic neural augmentation, which is present only in normal-weight hypertensive patients, providing the possible basis for an observed "Obesity Paradox" (longer survival in obesity-hypertension than in normal weight hypertension). Community-wide specific prevention of cardiovascular triggering is not currently possible, due to there being no available simple screening tests which could be applied to the community at-large for the commonest substrates, silent coronary artery disease and mild heart failure. Standard medical preventive measures for coronary atherosclerosis will of course be helpful. Targeted prevention of triggering can be done in those with a detected predisposing substrate, such as genetic Long QT Syndrome, and in survivors of a serious triggered event, who need detailed, appropriate testing.

Systemic absorption of epinephrine compared between the intranasal and intramuscular routes of administration in healthy adults.

Epinephrine 5 mg administered via the intranasal (IN) route was shown to be bioequivalent to epinephrine 0.3 mg administered via the intramuscular (IM) route in our preliminary study. To investigate the pharmacokinetics and pharmacodynamics of IN and IM epinephrine absorption in a larger group of healthy adults (n = 12). Each subject was administered IN saline, IN epinephrine (5 mg), and IM epinephrine (0.3 mg) on 3 separate days. Plasma epinephrine levels were determined using liquid chromatography-tandem mass spectrometry. IN epinephrine administration showed significant systemic absorption compared to IN saline control with the areas under the curve (AUC0-180 min) of 4.4 (4.9) ± 4.0 and 0.2 (0.5) ± 0.3 ng.min/mL, respectively; the values are mean (median) ± standard deviation. IN epinephrine absorption was about 0.5-fold that of IM epinephrine (AUC0-180 min 10.0 (9.2) ± 8.6 ng.min/mL), but the difference was not statistically significant (p = 0.16). The mean peak epinephrine concentration and the time to reach it were also not significantly different between the IN and IM routes. The corresponding values were 120 pg/mL and 41 min for IN, and 209 pg/mL and 41 min for IM, respectively. The systemic absorption of IN epinephrine 5 mg was significantly different from the control IN saline and about 0.5-fold that of IM epinephrine 0.3 mg. Although epinephrine administration via the less invasive IN route is safe and feasible, further investigations are necessary to achieve an adequate and consistent systemic absorption comparable to that of the conventional IM injection.

Risk factors, hematological and biochemical profile associated with colic in Delman horses in Gresik, Indonesia

Background: Horses are herd animals that have been domesticated in the last century. In several countries, an overview of risk factors and clinical evaluation in horses with colic has not been well‐described. This study aimed to evaluate risk factors and hematological profiles in horses associated with colic in Gresik, East Java, Indonesia. Methods: A cross-sectional study was performed during April - October 2019. A total of 115 horses were diagnosed based on physical examination, clinical symptoms, and rectal examination. A questionnaire was asked to the horse-owners to analyze the risk factors while the clinical examination was performed and blood samples were collected for pre-treatment and 14 days post-treatment. Hematological profile was evaluated from a whole blood sample. Serum cortisol, plasma epinephrine, and norepinephrine concentrations were also evaluated after separating the aliquots. Results: Of the 115 horses, 96 were diagnosed with colic. The horses with colic showed a significant association between cases with gender (p<0.021), breed (p<0.000), wheat bran feeding (p<0.015), concentrate feeding (p<0.003), anthelmintics administration (p<0.000), gastrointestinal parasites (p<0.000), dental diseases (p<0.024), previous exposure to colic (p<0.000), body condition score (p<0.000), and access to water per day (p<0.000). Based on whole blood and serum evaluation, there were ameliorated significantly on the hematological profile (p<0.01), serum cortisol (p<0.05), and plasma epinephrine (p<0.01) at 14 days post-treatment. Conclusion: This study has identified factors associated with colic in Delman horses. The study provides crucial information to investigate cases of colic and to contribute the development of healthcare strategies during treatment and clinical evaluation.

Bone Regeneration in Rat using Polycaprolactone/Gelatin/Epinephrine Scaffold

Solid supports like the extracellular matrix network are necessary for bone cell attachment and start healing in the damaged bone. Scaffolds which are made of different materials are widely used as a supportive structure in bone tissue engineering. In the current study, a 3-D Polycaprolactone/Gelatin bone scaffold was developed by blending electrospinning and freeze-drying techniques for bone tissue engineering. To improve the efficiency of the scaffold, different concentrations of epinephrine due to its effect on bone healing were loaded. Fabricated scaffolds were characterized by different tests such as surface morphology, FTIR, porosity, compressive strength, water contact angle, degradation rate. The interaction between prepared scaffolds and blood and cells was evaluated by hemolysis, and MTT test, respectively, and bone healing was evaluated by a rat calvaria defect model. Based on the results, the porosity of scaffolds was about 75% and by adding epinephrine, mechanical strength decreased while due to the hydrophilic properties of it, degradation rate increased. In vivo and in vitro studies showed the best cell proliferation and bone healing were in PCL/Gelatin/Epinephrine1%-treated group. These results showed the positive effect of fabricated scaffold on osteogenesis and bone healing and the possibility of using it in clinical trials.

Pharmacokinetics of adrenaline autoinjectors.

Anaphylaxis is a medical emergency with adrenaline acknowledged as the first-line therapy. It is therefore important that patients have access to self-injectable adrenaline in the community. Manufacturers have been requested by European Medicine Regulators to generate pharmacokinetic data for these autoinjector devices. For the first time, these data provide an insight into how individual devices work in different populations, and how they compare. We undertook a thorough literature search and also accessed grey literature, using searches of medicine regulators' websites and freedom of information requests. The data demonstrate that it takes at least 5-10min to achieve early peak plasma concentration for most devices. The specific autoinjector device seems to be the most important determinant of pharmacokinetics, with different devices giving rise to different plasma adrenaline profiles. Needle length does not seem to be the most important factor; rather, the force and speed of injection (which varies from one device to another) is likely to be of greater importance. In general, peak plasma adrenaline concentration is lower and time-to-peak concentration longer with increased skin-to-muscle depth. However, it is difficult to draw conclusions with the current available data, due to a lack of head-to-head comparisons, small numbers of study participants and the failure to acknowledge the biphasic nature of intramuscular adrenaline absorption for analysis purposes.

Stress hormones kinetics in ventricular fibrillation cardiac arrest and resuscitation: Translational and therapeutic implications.

Knowing the kinetics of endogenous stress hormones during cardiac arrest and cardiopulmonary resuscitation (CRP) will help to optimize personalized physiology-guided treatment. The aim of this study was to examine the dynamic changes in stress hormones in a swine model of ventricular fibrillation (VF) cardiac arrest. Ventricular fibrillation was induced in 10 healthy Landrace/Large White piglets, which were subsequently left untreated for 8 min. All animals were resuscitated according to the 2015 European Resuscitation Council guidelines. The concentration of adrenalin, noradrenalin, and cortisol was measured at baseline and at the 4th and 8th minute of VF-cardiac arrest, as well as at 30-min, 60-min, 24 h and 48 h post-ROSC. By the end of the 4th min of VF, the animals of the ROSC group exhibited significantly higher adrenaline levels compared to those of the no-ROSC group (7264 pg/ml vs. 1648 pg/ml, p = 0.03). Noradrenaline was higher in the ROSC group at the 4th min of VF (3021 pg/ml vs. 1626 pg/ml, p = 0.02). Cortisol levels in the ROSC group were significantly lower by the end of the 8th min of VF [16.25 ng/ml vs. 92.82 ng/ml, p = 0.03]. With a cut-off point of 5970 pg/ml, adrenaline at the 4th min of VF exhibited 100% sensitivity and 80% specificity for predicting ROSC. Higher endogenous adrenaline and lower endogenous cortisol levels were associated with ROSC.

Effects of different sedatives/analgesics on stress responses in patients undergoing craniotomy and bone flap decompression.

ObjectiveTo explore the effects of sedation and analgesia with dexmedetomidine and other drugs on the stress response in patients with cerebral hemorrhage after craniotomy hematoma removal and bone flap decompression and insertion of an indwelling endotracheal catheter.MethodsA total of 180 patients with cerebral hemorrhage with consciousness disturbance who underwent emergency surgery were included in this study. They were divided into six groups treated with propofol, dexmedetomidine, lidocaine, sufentanil, dezocine, and remifentanil, respectively. Intravenous medication was given after recovery of spontaneous respiration, and stress responses were compared among the group.ResultsSerum concentrations of norepinephrine, epinephrine, and cortisol and systolic blood pressure were significantly correlated with drug treatment. Serum norepinephrine concentrations differed significantly among the groups, except between the sufentanil and propofol groups. There were significant differences in serum epinephrine concentrations among all groups, and significant differences in serum cortisol concentrations among all groups, except the propofol, dexmedetomidine, and lidocaine groups.ConclusionDexmedetomidine can reduce the stress response in patients with intracerebral hemorrhage undergoing emergency craniotomy and bone flap decompression, and can reduce adverse events from an indwelling endotracheal catheter 3 hours post-operation.

Micelle silymarin supplementation to sows' diet from day 109 of gestation to entire lactation period enhances reproductive performance and affects serum hormones and metabolites.

The aim of the present study was to explore the influences of varying doses of micelle silymarin (0%, 0.05%, 0.1%, and 0.2%) supplementation on sows' feed intake, milk yields, serum hormones, and litter growth using 40 multiparous sows (Landrace × Yorkshire, parity from 3 to 5) from the 109th prenatal day to the 21st postnatal day. Each treatment included 10 sows and each sow was used as an experimental unit. On weaning day, litter weight and litter weight gain were linearly improved (P < 0.01, both), corresponding to the increasing dose of silymarin micelle in the diet. Also, litter weight, litter weight gain, and average daily gain (ADG) of piglets born to treated sows exceeded (P < 0.05) those of offspring from the control sows (0% micelle silymarin). Feed intake in week 1, week 2, and the entire lactation period was increased (linear, P < 0.01) as micelle silymarin dose increased. Body weight (BW) loss of sows during lactation was linearly reduced (P = 0.003) with the increasing amounts of micelle silymarin. Average daily milk yields during lactation were also linearly increased (P = 0.002) in treated sows, exceeding (P = 0.046) that of control sows. Also, uniform increases were observed (P = 0.037) in fat content in milk produced by treated sows on day 14 of lactation. Epinephrine concentrations and aspartate aminotransferase (AST) activity in sow serum on day 21 postpartum were linearly declined (P = 0.010) as micelle silymarin dose increased, and were both declined (P < 0.05) in treated sows compared with the control. In addition, treated sows' serum had higher activity of superoxide dismutase (SOD) at parturition and glutathione peroxidase (GSH-Px), lower oxidized glutathione (GSSG) concentrations, and GSSG/GSH (glutathione) ratio (all, P < 0.01) on day 21 of lactation. Moreover, offspring from micelle silymarin-treated sows tended to (0.05 < P <0.1) have higher serum catalase (CAT) activity and total antioxidant capacity (T-AOC) concentrations. Taken together, the results showed that sows fed increasing levels of micelle silymarin from the 109th prenatal day to the 21st postnatal day had an incremental dose-dependent effect on higher feed intake, diminished BW loss, greater milk yields, and greater litter weight at weaning, and 0.2% of micelle silymarin could be optimal to achieve the better effect.