Subcutaneous Injection Of Epinephrine Research Articles

Effectiveness of Scalp Nerves Block in Reducing the Immediate Postoperative Pain in Patients Undergoing Craniotomy in Elective Neurosurgical Procedures

Objective: To determine the usefulness of regional scalp block in controlling pain after craniotomy. Methodology: This prospective, randomized, double-blind, placebo-controlled study was conducted at the Pakistan Institute of Health Sciences, Islamabad from November 2021 to April 2022. Adult patients aged 18 to 65 years, scheduled for elective craniotomy for neurosurgical procedures with an American Society of Anesthesiologists (ASA) physical status of I or II, of either gender, were included. Patients underwent craniotomy for their respective lesions. Patients were randomized into two groups: one receiving a regional scalp nerve block of 0.5% bupivacaine with 1:100,000 epinephrine after general anesthesia, and the other undergoing general anesthesia as a placebo. Pain intensity was assessed using the Visual Analog Scale (VAS) pain score at baseline (preoperatively), at 1 hour postoperatively, and at 6 hours postoperatively. Results: The mean age of patients in the treatment group was 43.14 years, while in the control group, it was 42.55 years. The treatment group had 26 males (54.2%) and 22 females (45.8%), while the control group had 25 males (52.1%) and 23 females (47.9%). There was no significant difference in the VAS score preoperatively (p > 0.05). Patients undergoing surgeries lasting less than 3 hours showed that the treatment group had a significantly lower mean VAS score of 3.08 at 1 hour compared to the control group's score of 5.11 (p = 0.027), while at the 6-hour post-surgery it was insignificant (p = 0.844). For surgeries lasting more than 3 hours, the treatment group had a significantly lower mean VAS score at 1 hour and at 6 hours post-surgery compared to the control group (p < 0.05). There were no overall complications associated with the subcutaneous injection of epinephrine and bupivacaine in blocking the scalp nerves. Conclusion: The administration of scalp nerve blocks using bupivacaine and epinephrine prior to surgical incisions has demonstrated notable advantages in terms of postoperative pain management. Such nerve blocks can offer superior postoperative analgesia compared to the control group.

Use of Subcutaneous Injection of Epinephrine and Triamcinolone with Tranexamic Acid Reduces Blood Loss, Transfusion Rates, and Length of Stay in Open Sagittal Craniosynostosis Repair.

In 2017, we adopted the use of triamcinolone/epinephrine (TAC/Epi) scalp injection and later added tranexamic acid (TXA) in open sagittal synostosis surgery. We believe that this reduced blood loss and transfusion rates. A total of 107 consecutive patients operated for sagittal synostosis aged <4 months from 2007 to 2019 were retrospectively reviewed. We collected demographics [age, sex, weight at surgery, and length of stay (LOS)], intraoperative information [estimated blood loss (EBL)], administration of packed red blood cell, transfusion of plasmalyte/albumen, operating time, baseline hemoglobin (Hb) and hematocrit (Hct), type of local anesthetic (1/4% bupivacaine vs. TAC/Epi), and use/volume of TXA. Hb, Hct, coagulation studies, and platelets at 2 hours postoperatively and postoperative day (POD) 1 were recorded. There were 3 groups: 1/4% bupivacaine/epinephrine (N=64), TAC/Epi (N=13), and TAC/Epi with TXA bolus/infusion intraoperatively (N=30). Groups receiving TAC/Epi or TAC/Epi with TXA had lower mean EBL ( P <0.0001), lower rate/amount of packed red blood cell transfusion ( P <0.0001), lower prothrombin time/international normalized ratio on POD 1 ( P <0.0001), higher platelets ( P <0.001), and shorter operative time ( P <0.0001). LOS was shortest for TAC/Epi with TXA ( P <0.0001). No significant differences between groups were noted on POD 1 Hb, Hct, or partial prothrombin time. Post hoc testing revealed an advantage of TAC/Epi with TXA over TAC/Epi alone for 2-hour postoperative international normalized ratio ( P =0.0249), Operating Room time ( P =0.0179), and LOS ( P =0.0049). Use of TAC/Epi alone reduced EBL, LOS, Operating Room time, and improved laboratory values postoperatively in open sagittal synostosis surgery. Addition of TXA further improved operative time and LOS. It is likely that lower rates of transfusion could be tolerated.

Effect of Metformin Pretreatment on Serum Adropin Level in Rats with Adrenalin-Induced Acute Myocardial Infarction

AbstractBackground: Beside adropin's role in energy homeostasis and insulin sensitivity, it is also incriminated in myocardial ischemia. Level of adropin during myocardial infarction (MI) and the effect of metformin pretreatment on serum adropin level in rat models of MI is underinvestigated.Aim of Study: This study investigated the level of adropin in MI and the possible involvement of adropin and endothelial nitric oxide synthase enzyme activity (eNOS) in the cardio-protective effect of metformin during acute myocardial ischemia.Material and Methods: A total of forty adult male albino rats weighing 185-220g were divided equally into four groups Group I: Normal control group. Group II: MI group, which was induced by subcutaneous injection of adrenalin (2mg/kg) in two doses 24 hours apart. Group III: Normal rats which were treated with oral metformin via a feeding tube in a dose of 300mg/kg for 2 weeks. Group IV: Rats with adrenalin-induced MI and pretreated with oral metformin in the same dose and duration before induction of MI on the 13th and 14th days of the study. Serum adropin and eNOS were measured, in addition to cardiac troponin I, Creatine Kinase isoenzyme (CK-MB), and C-reactive protein (CRP). Sections from the heart was stained with Masson's trichrome stain and examined to quantify the degree of ischemic injury at the tissue level.Results: In MI group, both serum adropin level and the eNOS were significantly increased with significant positive correlation between adropin and troponin I, CK-MB, and eNOS in the same group (r= 0.857, 0.97 & 0.845, respectively, p<0.05). However, Metformin pretreatment in group IV, produced significant reduction in the level of adropin accom-panied by significant increase in levels of eNOS enzyme activity in comparison to rats with untreated MI. Additionally histological examination, showed reduction of the inflamma-tory cell infiltration, myocardial fibrosis and necrosis. More-over, there was a positive correlation between adropin and eNOS in the same group (r=0.682, p<0.05).Conclusion: Adropin and eNOS enzyme play a vital role in the pathophysiology of acute myocardial infarction. In addition, the cardioprotective effect of metformin pretreatment in this condition depends on enhancing the activity of eNOS enzyme independent on adropin level.

Stres Dapat Mengganggu Proses Spermatogenesis pada Mencit

Introduction: This study aimed to determine the effect of stress on the process of spermatogenesis and testosterone levels of mice (Mus musculus) male.Method: This was an experimental study using a completely randomized design. The variables examined were the number of spermatogenic cells (spermatogonia, spermatocytes, and spermatids oval) and testoseron levels. Data analysis using oneway analysis of variance (ANOVA), test a small real difference (LSD) 5%, and the kruskal wallis test. This study used 36 mice (Mus musculus) male age 2 months with 20–40 gram body weight divided into 4 groups. The control group (subcutaneous injection of 0.1 ml physiological saline), subcutaneous epinephrine injection group 0.001 mg/20 g BW, subcutaneous epinephrine injection group 0.005 mg/20 g BW, the subcutaneous injection of epinephrine 0.01 mg/20 BB gr.Result: The results show that the analysis of spermatogenic cells (spermatogonia, spermatocytes, and spermatids oval), that repeated exposure to epinephrine with different doses showed that there was a significant decrease. The average decline in a row in the treated group (P1, P2, P3) compared with the control group (K0) for spermatogonia was 28.8%, 42.4%, 45.5%, to spermatocytes was 13.7%, 37.4%, 38.9% and for oval spermatids was 33.3%, 44.2%, 50.4% Having followed by LSD 5% found that there were significant differences for almost all groups except the pair P2–P3 groups for the number of spermatogonia, spermatocytes, and partner groups P1–P2 and P2–P3. As for the blood serum levels of testosterone hormone mice showed no significant decrease.Discussion: Administration of high doses of epinephrine (as stressor) can lead to bottlenecks in the process of spermatogenesis as indicated by decreased number of spermatogenic cells but not cause a decrease in testosterone levels.

Comparatively evaluating effect contribution of promoting blood circulation of herb pairs containing Angelicae Sinensis Radix on Xin-Sheng-Hua granule by withdrawal analysis

Xin-Sheng-Hua granule (XSHG) is a popular remedy commonly used in clinic for the treatment of lochiostasis after delivery. To comparatively investigate the roles of herb pairs containing Angelicae Sinensis Radix (Danggui) upon the formula by evaluating the blood coagulation and hemorheology function in acute blood stasis rats, acute blood stasis rat model was established by ice water bath and subcutaneous injection of adrenaline. And the blood stasis mice were administrated intragastrically with different samples of the formula minus herb pairs containing Danggui and the whole formula (XSHG, SHD, DY, DC, DT, DH, DJ and DZ). The whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR) and haematocrit (HCT) were applied to evaluate the effects of the formula minus herb pairs containing Danggui on hemorheology of blood stasis rats. The thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), and plasma fibrinogen (FIB) were used to observe the effects of the formula minus herb pairs containing Danggui on blood coagulation function of blood stasis rats. Additionally, the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of different samples on platelet aggregation index of blood stasis rats.Afterwards, multi-attribute comprehensive index methods and principal component analysis were both applied to comprehensively assess the total effects of the formula minus herb pairs containing Danggui on promoting blood circulation and dissipating blood stasis. Compared with normal group, the hemorheological parameters and coagulation indexes of model group had statistical differences (P<0.01). Compared with model group, different samples (XSHG, SHD, DY, DC, DT, DH, DJ and DZ) could improve the blood hemorheology indexes, coagulation parameters and platelet aggregation in acute blood stasis rats. According to multi-attribute comprehensive index methods and the principal component analysis, the effects of promoting blood circulation by removing blood stasis became poor when excluding herb pairs containing Danggui from the formula, the sample DY and DC had the weakest effect of activating blood circulation and dissipating blood stasis, and the effect of sample DY was slightly poorer than DC. The orders of contribution of herb pairs containing Danggui on the formula were Danggui-Yimucao>Danggui-Chuanxiong>Danggui-Honghua>Danggui-Zhigancao>Danggui-Taoren>Danggui-Jiangtan. In conclusion, various herb pairs containing Danggui played different roles on the effects of improving the abnormality of hemorheology and coagulation function. And the herb pairs Danggui-Yimucao were particularly important for the formula, which was consistent with the characteristics of XSHG and the traditional effect of Yimucao. Moreover, it could lay foundation to further reveal the compatibility mechanism of XSHG.

Anaphylaxis to Celebrex during an oral challenge

We report a case of a 65-year-old female with an anaphylactic type reaction during a graded oral celecoxib challenge. She was previously using NSAIDS and Celebrex (celecoxib) for analgesia in 2005. However, due to the side effect profile of COX2 inhibitors, Celebrex was discontinued. The patient’s primary analgesic was ibuprofen. Upon reintroduction of Celebrex, the patient developed urticaria after the second dose and urticaria with angioedema after the third dose. When the patient presented to the allergy clinic, it was felt that the urticaria and angioedema were secondary to ibuprofen. Because she had a negative crude prick skin test to Celebrex, an oral challenge to Celebrex was done. One hour after the 200 mg cumulative challenge, the patient was asymptomatic and an additional 200 mg was given. Twenty minutes later the patient developed facial flushing, angioedema, respiratory distress and hypotension, with her blood pressure dropping to 78/53 mmHg from a baseline of 120/80 mmHg. The patient was treated with epinephrine 0.1 mg subcutaneously, without recovery. After 5 and 15 minutes additional 0.2 mg subcutaneous epinephrine injections were administered. She was also treated with Reactine 20mg and prednisone 50mg. The patient was stabilized within thirty minutes. The patient was able to tolerate ibuprofen and sulfonamide antibiotics without any side effects. She was also taking hydrochlorothiazide on a daily basis for hypertension. She does not have any previously documented allergies or adverse reactions to medications. Discussion

Coronary vasospasm caused by local infiltration of epinephrine after spinal anesthesia.

Coronary vasospasm caused by local infiltration of epinephrine after spinal anesthesia.

Evaluate activating blood circulation and dissipating blood stasis effect mechanism of Foshousan on acute blood stasis rats on basis of metabolomic approach

Ice water bath and subcutaneous injection of adrenaline were used to establish the acute blood stasis model of rats. Ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was used to study the urine metabolic changes of acute blood stasis rats. Potential biomarkers were selected by variable importance projection, and identified on basis of MS information and databases. The metabolic pathways were predicted via MetPA database. To study the effect of Foshousan on endogenous metabolites of acute blood stasis model rats, find potential biomarkers, and explore the effect mechanism of Foshousan on activating blood circulation and dissipating blood stasis. Eleven potential biomarkers were identified with multivariate statistical analysis of urine metabolite profiles, and which also were used to explain the phenylalanine metabolism, tryptophan metabolism and sphingolipid metabolism. Those disturbed metabolic pathways in acute blood stasis rats could be regulated closely to normal state after Foshousan administration. Metabolomics has a bright prospect in the efficacy evaluation and effect mechanism elucidation of the traditional Chinese medicines.

Diagnosis of hypersplenism with the epinephrine stimulation test - 23 years of experience at a tertiary care hospital.

Hypersplenism can be defined by thrombocytopenia and/or neutropenia resulting from blood cell sequestration in an enlarged spleen. In multimorbid patients the differential diagnosis of cytopenia is challenging and currently there is no established test for diagnosing hypersplenism. The epinephrine stimulation test (EST) measures changes in platelets, neutrophil counts and spleen size following a subcutaneous epinephrine injection. We retrospectively analysed the results of EST in 228 patients. Increases in neutrophils and platelets after epinephrine injection were significantly greater in patients with enlarged than in patients with normal size spleens. Using cutoffs of low, intermediate and high confidence EST was positive in 69.8% vs. 41.3% (low confidence), 49.6% vs. 17.4% (intermediate confidence) and 38.8% vs. 10.9% (high confidence) in patients with enlarged vs. normal size spleens. Changes in platelet and neutrophil counts correlated with each other and with changes in spleen size, confirming cell release from the spleen during EST. When stratified according to the underlying diagnosis, patients with liver disease had the strongest response to EST, patients with malignant haematological diseases the weakest. In addition the response to EST was significantly related to changes in platelet and neutrophil counts after splenectomy, confirming the validity of our test. No serious side effects occurred during EST. When used in a large patient cohort, EST is a safe and simple diagnostic test. In this exploratory study EST is of value in evaluating patients with cytopenia and a positive EST argues strongly for hypersplenism. Future studies should prospectively evaluate EST for the management of patients with splenomegaly.

Diagnosis of hypersplenism with the epinephrine stimulation test - 23 years of experience at a tertiary care hospital.

Hypersplenism can be defined by thrombocytopenia and/or neutropenia resulting from blood cell sequestration in an enlarged spleen. In multimorbid patients the differential diagnosis of cytopenia is challenging and currently there is no established test for diagnosing hypersplenism. The epinephrine stimulation test (EST) measures changes in platelets, neutrophil counts and spleen size following a subcutaneous epinephrine injection. We retrospectively analysed the results of EST in 228 patients. Increases in neutrophils and platelets after epinephrine injection were significantly greater in patients with enlarged than in patients with normal size spleens. Using cutoffs of low, intermediate and high confidence EST was positive in 69.8% vs. 41.3% (low confidence), 49.6% vs. 17.4% (intermediate confidence) and 38.8% vs. 10.9% (high confidence) in patients with enlarged vs. normal size spleens. Changes in platelet and neutrophil counts correlated with each other and with changes in spleen size, confirming cell release from the spleen during EST. When stratified according to the underlying diagnosis, patients with liver disease had the strongest response to EST, patients with malignant haematological diseases the weakest. In addition the response to EST was significantly related to changes in platelet and neutrophil counts after splenectomy, confirming the validity of our test. No serious side effects occurred during EST. When used in a large patient cohort, EST is a safe and simple diagnostic test. In this exploratory study EST is of value in evaluating patients with cytopenia and a positive EST argues strongly for hypersplenism. Future studies should prospectively evaluate EST for the management of patients with splenomegaly.

Diagnosis of hypersplenism with the epinephrine stimulation test - 23 years of experience at a tertiary care hospital.

Hypersplenism can be defined by thrombocytopenia and/or neutropenia resulting from blood cell sequestration in an enlarged spleen. In multimorbid patients the differential diagnosis of cytopenia is challenging and currently there is no established test for diagnosing hypersplenism. The epinephrine stimulation test (EST) measures changes in platelets, neutrophil counts and spleen size following a subcutaneous epinephrine injection. We retrospectively analysed the results of EST in 228 patients. Increases in neutrophils and platelets after epinephrine injection were significantly greater in patients with enlarged than in patients with normal size spleens. Using cutoffs of low, intermediate and high confidence EST was positive in 69.8% vs. 41.3% (low confidence), 49.6% vs. 17.4% (intermediate confidence) and 38.8% vs. 10.9% (high confidence) in patients with enlarged vs. normal size spleens. Changes in platelet and neutrophil counts correlated with each other and with changes in spleen size, confirming cell release from the spleen during EST. When stratified according to the underlying diagnosis, patients with liver disease had the strongest response to EST, patients with malignant haematological diseases the weakest. In addition the response to EST was significantly related to changes in platelet and neutrophil counts after splenectomy, confirming the validity of our test. No serious side effects occurred during EST. When used in a large patient cohort, EST is a safe and simple diagnostic test. In this exploratory study EST is of value in evaluating patients with cytopenia and a positive EST argues strongly for hypersplenism. Future studies should prospectively evaluate EST for the management of patients with splenomegaly.

Local Antinociception Induced by Endothelin-1 in the Hairy Skin of the Rat's Back

Subcutaneous injection of endothelin-1 (ET-1) into the glabrous skin of the rat's hind paw is known to produce impulses in nociceptors and acute nocifensive behavioral responses, such as hind paw flinching, and to sensitize the skin to mechanical and thermal stimulation. In this report, we show that in contrast to the responses in glabrous skin, ET-1 injected subcutaneously into rat hairy skin causes transient antinociception. Concentrations of 1 to 50 microM ET-1 (in 0.05 mL) depress the local nocifensive response to noxious tactile probing at the injection site with von Frey filaments for 30 to 180 minutes; distant injections have no effect at this site, showing that the response is local. Selective inhibition of ET(A) but not of ET(B) receptors inhibits this antinociception, as does coinjection with nimodipine (40 muM), a blocker of L-type Ca(2+) channels. Local subcutaneous injection of epinephrine (45 microM) also causes antinociception through alpha-1 adrenoreceptors, but such receptors are not involved in the ET-1-induced effect. Both epinephrine and ET-1, at antinociceptive concentrations, reduce blood flow in the skin; the effect from ET-1 is largely prevented by subcutaneous nimodipine. These data suggest that ET-1-induced antinociception in the hairy skin of the rat involves cutaneous vasoconstriction, presumably through neural ischemia, resulting in conduction block. The pain-inducing effects of ET-1 have been well documented in glabrous skin of the rat, a frequently used test site. The opposite behavioral effect, antinociception, occurs from ET-1 in hairy skin and is correlated with a reduction in blood flow. Vasoactive effects are important in assessing mechanisms of peripherally acting agents.

Effects of Maslinic Acid as a Novel Glycogen Phosphorylase Inhibitor on Blood Glucose and Hepatic Glycogen in Mice

AIM: To determine the effects of maslinic acid, a novel glycogen phosphorylase inhibitor, on blood glucose and hepatic glycogen in normal and hyperglycemia mice and investigate its mechanism. METHODS: Mice were given intragastrically either vehicle or maslinic acid for 7 days. The model of hyperglycemia in mice was set up by subcutaneous injection of adrenaline or intragastric administration of glucose respectively; the fasting plasma glucose and hepatic glycogen of both normal and hyperglycemia mice were measured. RESULTS: The elevation of blood glucose level caused by adrenaline or glucose was antagonized by maslinic acid significantly. Maslinic acid also increased the hepatic glycogen content in both adrenaline and glucose-induced hyperglycemia mice. Maslinic acid showed no significant effect on fasting plasma glucose level while increased the hepatic glycogen content of normal mice. CONCLUSION: Maslinic acid presents anti-diabetic effect, the mechanism is probably concerned with inhibiting excessive hepatic glycogen degradation.

Glucose concentration in the blood of intact and alloxan-treated mice after pretreatment with commercial preparations of Stevia rebaudiana (Bertoni).

The study was concerned with the effect of mice pretreatment with two commercial products of Stevia rebaudiana Bertoni on the blood glucose concentration. One group of mice was pretreated four days with 200 mg/kg of Stevita (Stevita Co, INC, Arlington Texas) (stevia) and the other with 20 mg/kg of Clear Steviosides liquid (Stevita Co, INC, Herbal supplement, Brazil) (stevioside), whereas the animals of control group received at the same time physiological solution. Blood glucose concentration was measured before pretreatment and four days after that. The changes in glucose level were provoked by glucose-tolerance test (500 mg/kg, p.o.) and subcutaneous injection of adrenaline (0.2 mg/kg). The same procedure of measuring blood glucose was applied on the mice with alloxan-induced diabetes mellitus (two doses of 100 mg/kg with a 24-hour interval). Blood glucose levels in mice pretreated with stevia and stevioside were lower compared with control (7.82:6.82:8.01). Also, a smaller increase in this parameter compared to control was registered with pretreated mice in the glucose-tolerance test, pretreatment with stevioside being again more effective (8.68:6.36:5.82). Pretreatment with stevioside caused no significant increase in blood glucose concentration after administering adrenaline, which was not the case with the animals pretreated with stevia and control. Pretreatment with stevia, and to a greater extent with stevioside, protected test animals from the toxic action of alloxan compared with controls.

Cutaneous anthrax associated with facial palsy: case report and literature review

BACKGROUND: Anthrax is primarily an animal disease. Bacillus anthracis , the causal agent in anthrax, is a Gram-positive rod. Humans can acquire anthrax by industrial exposure to infected animals or animal products. METHODS: Reported here is the case of a 48-year-old male farm worker from Iran with a history of direct contact with herds. He presented after 6 days of fever with toxicity and a crusted ulcer on the face that was later confirmed bacteriologically to be cutaneous anthrax. He was treated with large doses of intravenous penicillin and corticosteroids along with multiple subcutaneous epinephrine injections that were used to control the infection and massive facial edema. RESULTS: After 14 days, he partially recovered; however, ipsilateral facial nerve palsy developed and persisted despite therapeutic efforts. CONCLUSION: It is not possible to conclude whether early diagnosis and treatment of anthrax results in a lower risk of complications. Facial palsy can be added to the list of variable complications of the cutaneous effects of anthrax.

Epinephrine absorption in adults: Intramuscular versus subcutaneous injection

We report a prospective, randomized, blinded, placebo-controlled, 6-way crossover study of intramuscular versus subcutaneous injection of epinephrine in young men. Peak plasma epinephrine concentrations were significantly higher (P < .01) after epinephrine was injected intramuscularly into the thigh than after epinephrine was injected intramuscularly or subcutaneously into the upper arm. We recommend intramuscular injection of epinephrine into the thigh as the preferred route and site of injection of this life-saving medication in the initial treatment of anaphylaxis. (J Allergy Clin Immunol 2001;108:871-3.)

Reduced blood loss during burn surgery.

The purpose of this study was to investigate the use of subcutaneous injection of burn wounds and skin graft donor sites with an adrenaline-saline solution to reduce blood loss during burn surgery. This retrospective study reviewed the requirements of blood products in 30 randomly selected adult patients with more than 10% body area burned, who had at least one burn operation at a university regional burn center, between January 1991 and June 1997. Patients were matched by age and percent body area burned and stratified according to the surgical technique in two groups. In Group 1, 15 patients received the modified tumescent surgical technique: subcutaneous injection of adrenaline (1 part/million in warm saline solution) into the subcutaneous tissue of the donor sites for autologous skin graft and areas of burn eschar to be excised, combined with pneumatic tourniquets in extremities and saline-adrenaline soaked nonadherent pads. In Group 2, 15 patients received the traditional surgical technique: soaked gauze compresses with an adrenaline-thrombin solution (1 ml of 1:1,000 adrenaline, thrombin 10,000 units, and 1 L of normal saline). Outcome measures, transfusion of blood products, operating time and complications between the two patient groups were analyzed using the Wilcoxon 2-sample test. The two patient groups were not different by age (40.4 +/- 19.4 vs 38.9 +/- 17.9), percent total body area burned (27.6 +/- 15.4 vs 32.8 +/- 13.4), or percent full thickness burn (7.0 +/- 8.5 vs 11.5 +/- 8.5). The modified tumescent surgical technique significantly reduced mean total blood units transfused per patient (7.9 +/- 11.5 vs 15.7 +/- 12.9 units; P = .031), and the mean blood units transfused intraoperatively per patient (4.7 +/- 7.8 vs 8.9 +/- 8.0 units; P = .026). The modified tumescent surgical technique significantly reduced the intraoperative and total blood transfusion requirements in our thermally injured patients.

Lec choc anaphylactique chez l'enfant

Le choc anaphylactique est en fait la forme extrême de la réaction allergique. L'adrénaline est la drogue de choix pour agir sur la vasodilatation périphérique et la dépression myocardique à l'origine du collapsus. Tout choc anaphylactique devra secondairement faire l'objet d'un bilan afin de préciser dans la mesure du possible le ou les allergènes en cause. Ce bilan response avant tout sur le bilan cutané allergologique guidé par le contexte de survenue et l'interrogatoire policier.

Le choc anaphylactique chez l’enfant

Anaphylactic shock in children. T. Bourrier Anaphylactic shock is a life-threatening allergic reaction with cardiovascular collapse. The cardiovascular collapse may occur suddenly without warning signs or may be preceded by symptoms such as pruritus, wheezing, dyspnea, urticaria, pallor, digestive symptoms, and weakness. Food allergens, injected drugs and hymenoptera stings are the main etiologies. Anaphylactic shock requires an emergency treatment with immediate intramuscular or subcutaneous epinephrine injection. Subsequent avoidance of the inciting allergens is mandatory together with the availability of a first aid kit including ready-to-use epinephrine syringes. Besides its absolute necessity in any doctor’s office, such first aid kits should be available in any children's group.

The relative effect of dietary energy density on repleted and resting muscle glycogen concentrations

The aim of this study was to assess the effect of dietary energy density on the glycogen concentration of bovine gluteus medius (GM) and longissimus thoracis et lumborum (LTL) muscles in castrated and intact males. Cattle received diet C (90% whole corn and supplement: 10% alfalfa haylage) or diet AH (100% alfalfa haylage) in three experiments involving a 2×2 factorial cross-over design. Cattle fed an AH diet for 70 days prior to the first experiment had high glycogen concentrations in the GM (129±9.9 mmol/kg) and LTL (108±7.6 mmol/kg) at the first biopsy session. These concentrations are similar to GM (133±6.2 mmol/kg) and LTL (105±5.8 mmol/kg) glycogen concentrations when these cattle subsequently received diet C for 30 or 37 days. Diet C increased muscle glycogen concentration, but the consistency of the increase in glycogen was dependent on the initial concentration. When the initial glycogen concentration was depleted to 50 μmol/g with one subcutaneous injection of adrenaline, repleted glycogen concentration was higher for diet C than AH ( P<0.01) in all comparisons involving GM and LTL muscles of both steers and bulls. For resting muscle glycogen, the GM of bulls was more sensitive to the effect of diet C than the bull LTL or either muscle in steers. Diet was not a major determinant of resting muscle glycogen concentration. The ultimate pHs of GM, LTL and semimembranosus (SM) were not affected by diet and residual glycogen was lower in LTL of bulls fed either diet than for LTL of steers fed AH. Diet and male status did not affect residual glycogen in GM or SM.