The Effect of Anaesthesia of the Airway in Dog and Man: A Study of Respiratory Reflexes, Sensations and Lung Mechanics

1976 ◽  
Vol 50 (6) ◽  
pp. 439-454 ◽  
Author(s):  
Brenda A. Cross ◽  
A. Guz ◽  
S. K. Jain ◽  
Sietske Archer ◽  
J. Stevens ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Lung Mechanics ◽  
Afferent Pathway ◽  
Toxic Level ◽  
Co2 Response ◽  
Cough Reflex ◽  
Bupivacaine Hydrochloride ◽  
Systematic Effects ◽  
Respiratory Reflexes

1. The effect of breathing an anaesthetic aerosol of 5% bupivacaine hydrochloride has been assessed in dog and man. 2. In the dog, the cough reflex was abolished and the Hering—Breuer inflation reflex severely impaired or abolished; breathing became slower and deeper; no pathological changes were found in the lungs of these dogs. 3. In man, no untoward effects resulted from a 10 min period of aerosol inhalation; there were no systematic effects on airway resistance or lung volumes and the cough reflex in response to either tactile or chemical (citric acid aerosol) stimulation was invariably abolished. The Hering—Breuer inflation reflex was impaired, but this was not associated with any change in resting ventilation. The V̇E/CO2 response was enhanced after aerosol anaesthesia; subjects felt an exaggerated dyspnoea. The aerosol anaesthesia abolished the afferent pathway of a reflexly elicited bronchoconstriction in one subject. There was no effect on the ability to hold the breath, or on the quality of the associated sensation. 4. Control aerosols of sodium chloride solution or phosphate buffer produced no effects. Control experiments with intravenous infusions of bupivacaine proved that none of the effects could have been produced by systemic effects of the absorbed anaesthetic. 5. Plasma concentrations of bupivacaine in man did not exceed a recognized toxic level. The experiments demonstrate a safe reversible anaesthesia of the airways in man lasting for a period of 10–20 min.

The Effect of Local Anaesthesia of the Airway on Respiratory Reflexes in the Rabbit

1973 ◽  
Vol 44 (6) ◽  
pp. 519-538 ◽  
Author(s):  
S. K. Jain ◽  
Diana Trenchard ◽  
Felicity Reynolds ◽  
M. I. M. Noble ◽  
A. Guz
Keyword(s):  
Ventilatory Response ◽  
Plasma Concentrations ◽  
Systemic Effects ◽  
Pathological Changes ◽  
Vagus Nerves ◽  
Cough Reflex ◽  
Alveolar Level ◽  
Toxic Concentrations ◽  
Respiratory Reflexes ◽  
Stimulation Of

1. The effect of breathing anaesthetic aerosols (lignocaine 20% and bupivacaine 5%) on respiratory reflexes was studied in rabbits. 2. The cough reflex was blocked in every experiment. 3. The inflation reflex was abolished in eleven out of twenty-six rabbits given lignocaine aerosol and in fourteen out of fifteen rabbits given bupivacaine aerosol. 4. The deflation reflex was blocked pari passu with the inflation reflex. 5. The ventilatory response to histamine was sometimes blocked; more commonly it was partially preserved. 6. The ventilatory response to phenyldiguanide was never impaired and often enhanced. 7. Bronchoconstriction produced by electrical stimulation of the peripheral cut ends of the cervical vagus nerves was unaffected. 8. Block of the above respiratory reflexes was associated with slower, deeper breathing. 9. Bupivacaine has produced more consistent and reliable results than lignocaine; the effects were reversible in both cases usually within 30 min. 10. Plasma concentrations of both anaesthetics were usually below the generally accepted toxic concentrations in man. 11. Control experiments using intravenous infusions of the anaesthetics proved that none of the effects could have been produced by systemic effects of the absorbed anaesthetic. 12. No pathological changes were found in the airways on both macroscopic and microscopic examination. 13. The experiments show that it is possible to block respiratory reflexes whose afferents arise from the airways, and to preserve a reflex arising at alveolar level.

Inhibition of respiratory reflexes by local anesthetic aerosols in dogs and rabbits

1975 ◽  
Vol 38 (6) ◽  
pp. 1045-1050 ◽  
Author(s):  
D. S. Dain ◽  
H. A. Boushey ◽  
W. M. Gold
Keyword(s):  
Electrical Stimulation ◽  
Local Anesthetic ◽  
Nervous Activity ◽  
Smooth Muscles ◽  
Vagus Nerves ◽  
Cough Reflex ◽  
Bupivacaine Hydrochloride ◽  
Anesthetized Dogs ◽  
Respiratory Reflexes ◽  
Stimulation Of

The effects of inhalation of 100 breaths of bupivacaine hydrochloride (5 percent solution in saline) on the cough reflex, the Breuer-Hering inflation, reflex, and the duration of apnea and bronchoconstriction produced by histamine aerosol were studied in nine anesthetized dogs. Cough was abolished in every animal; the duration of the inflation reflex was shortened from 47 +/- 4.6 s (mean plus or minus SE) to 16 +/- 3.4 s. The duration apnea produced by histamine was abolished or shortened and the rise in resistance was diminished from 170 plus or minus 22 per cent (control) to 49 +/- 6 per cent (after bupivacaine). These reflexes returned toward control values within 45 min. Bupivacaine inhibited the bronchoconstriction produced by electrical stimulation of the distal ends of cut vagus nerves both in dogs and in rabbits, but it did not alter the rise in resistance produced by histamine aerosol in vagotomized dogs. We conclude that administration of bupivacaine aerosol produces a reversible blockage of both afferent and efferent nervous activity in airways without abolishing the ability of smooth muscles to contract.

Management of Oral Anti-Coagulation in Patients with Heart Failure—Insights from the ThrombEVAL Study

2018 ◽  
Vol 118 (11) ◽  
pp. 1930-1939
Author(s):  
Sebastian Göbel ◽  
Jürgen Prochaska ◽  
Lisa Eggebrecht ◽  
Ronja Schmitz ◽  
Claus Jünger ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Vitamin K Antagonists ◽  
Plasma Concentrations ◽  
Regular Care ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
Specialized Care ◽  
The Impact

AbstractPatients with heart failure (HF) are frequently anti-coagulated with vitamin K-antagonists (VKAs). The use of long-acting VKA may be preferable for HF patients due to higher stability of plasma concentrations. However, evidence on phenprocoumon-based oral anti-coagulation (OAC) therapy in HF is scarce. The aim of this study was to assess the impact of the presence of HF on quality of phenprocoumon-based OAC and the subsequent clinical outcome. Quality of OAC therapy and the incidence of adverse events were analysed in a cohort of regular care (n = 2,011) from the multi-centre thrombEVAL study program (NCT01809015) stratified by the presence of HF. To assess the modifiability of outcome, results were compared with data from individuals receiving specialized care for anti-coagulation (n = 760). Overall, the sample comprised of 813 individuals with HF and 1,160 subjects without HF in the regular care cohort. Quality of OAC assessed by time in therapeutic range (TTR) was 66.1% (47.8%/82.8%) for patients with HF and 70.6% (52.1%/85.9%) for those without HF (p = 0.0046). Stratification for New York Heart Classification (NYHA)-class demonstrated a lower TTR with higher NYHA classes: TTRNYHA-I 69.6% (49.4%/85.6%), TTRNYHA-II 66.5% (50.1%/82.9%) and TTRNYHA-≥III 61.8% (43.1%/79.9%). This translated into a worse net clinical benefit outcome for HF (hazard ratio [HR] 1.63 [1.31/2.02]; p < 0.0001) and an increased risk of bleeding (HR 1.40 [1.04/1.89]; p = 0.028). Management in a specialized coagulation service resulted in an improvement of all, TTR (∆+12.5% points), anti-coagulation-specific and non-specific outcome of HF individuals. In conclusion, HF is an independent risk factor for low quality of OAC therapy translating into an increased risk for adverse events, which can be mitigated by specialized care.

scholarly journals Plasma glutathione status as indicator of pre-analytical centrifugation delay

2020 ◽  
Author(s):  
Tomin Tamara ◽  
Natalie Bordag ◽  
Elmar Zuegner ◽  
Abdullah Al-Baghdadi ◽  
Maximilian Schinagl ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Time Dependent ◽  
Dependent Manner ◽  
Prolonged Incubation ◽  
Glutathione Status ◽  
Potential Marker ◽  
Analytical Centrifugation ◽  
Plasma Glutathione ◽  
Downstream Analysis

Prolonged incubation of blood prior to plasma preparation can significantly influence the quality of the resulting data. Different markers for this pre-clinical variability have been proposed over the years but with limited success. In this study we explored the usefulness of glutathione (GSH) status, namely ratio of reduced to oxidized glutathione (GSH/GSSG), as potential marker of plasma preparation delay. For that purpose, blood from 20 healthy volunteers was collected into tubes with a cysteine quencher (N-ethylmaleimide; NEM) for GSH stabilization. Plasma preparation was delayed at room temperature for up to 3 hours and every hour, a plasma sample was prepared and the GSH/GSSG ratio measured. We report that over the course of the investigation, plasma concentrations of both GSH and GSSG increased linearly (R2 = 0.99 and 0.98, respectively). Since GSH increased at a much faster rate compared to GSSG, the GSH/GSSG ratio also increased linearly in a time dependent manner (R2 = 0.99). As GSH is an intracellular antioxidant, we speculated that this might stem from ongoing blood hemolysis, which was confirmed by the time dependent rise in lactate dehydrogenase (LDH) activity in the plasma samples. Moreover, we demonstrate that the addition of the thiol alkylating reagent NEM directly to the blood tubes does not seem to influence downstream analysis of clinical parameters. In conclusion we propose that the glutathione status could be used as an indicator of the centrifugation delay prior to plasma preparation.

scholarly journals Effect of Short-Term Exposure to High Particulate Levels on Cough Reflex Sensitivity in Healthy Tourists: A Pilot Study

2016 ◽  
Vol 10 (1) ◽  
pp. 96-104 ◽  
Author(s):  
Ryuhei Sato ◽  
Peijun Gui ◽  
Kumiko Ito ◽  
Masahiro Kohzuki ◽  
Satoru Ebihara
Keyword(s):  
Quality Of Life ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Airborne Particulate Matter ◽  
Forced Expiratory Volume ◽  
Short Term ◽  
Cough Reflex ◽  
Short Term Exposure ◽  
Related Quality

Background: Previous studies have reported a relationship between particulate air pollution and respiratory symptoms or decline in lung function, but information about acute effects of short-term exposure to airborne particulate matter (PM) on cough and pulmonary function is scarce. Objective: To investigate the effect of short-term exposure to high concentrations of PM on the cough reflex threshold, urge-to-cough, pulmonary function, and cough-related quality of life in a group of healthy non-resident volunteers visiting Beijing, China. Methods: Seventeen healthy residents of Sendai, Japan, who planned to attend a meeting in Beijing, were recruited. We checked local air quality and measured cough reflex thresholds, urge-to-cough, pulmonary function, and Leicester Cough Questionnaire-acute (LCQ-acute) scores in the volunteers before, during, and after their trip to Beijing. Results: The PM2.5 and PM10 concentrations in Beijing were significantly higher than those in Japan on the measurement days. Cough reflex thresholds, expressed as nebulized citric acid concentrations required to induce ≥ 2 and ≥ 5 coughs, were significantly lower during the stay in Beijing than before or after the visit. Vital capacity, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC were significantly lower during the stay in Beijing than before the trip. Similarly, the urge-to-cough threshold was significantly lower during the stay in Beijing than after the trip, as was the total LCQ-acute score. Conclusion: We tentatively concluded that short-term exposure to high PM concentrations may have adverse effects on cough reflex and urge-to-cough thresholds, pulmonary function, and cough-related quality of life.

scholarly journals Extraction of geoid heights from shipborne GNSS measurements along the Weser River in northern Germany

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
D. Lavrov ◽  
G. Even-Tzur ◽  
J. Reinking
Keyword(s):  
Measurement Data ◽  
Geoid Height ◽  
Theoretical Background ◽  
Geoid Model ◽  
Measuring Techniques ◽  
Systematic Effects ◽  
Gnss Measurements ◽  
Accuracy Assessments

AbstractIn-land geoid models rely on several measuring techniques. The quality of those models is directly related to the spatial resolution of the measurement data. Occasionally, a local geoid model does not cover the coastal area at all and a local marine geoid simply does not exist. ShipborneGNSS measurementsmay provide away of overcoming this problem in coastal areas. However, several corrections to the raw measurements must be applied in order to account for systematic effects induced by ship dynamics and other static and dynamic impacts from tides, atmospheric pressure or wind stress. This paper presents the theoretical background for the method and the results of a case study in the estuary of the Weser River in Germany. A series of GNSS measurements were carried out aboard a ship and the approximate geoid height along the river was derived. For accuracy assessments of this method, the resultswere compared to the German Combined QuasiGeoid 2011 (GCG2011). The results are very promising and indicate the ability to extract geoid heights from shipborne GNSS measurements.

scholarly journals Management of Cough

2020 ◽  
Vol 6 (3) ◽  
pp. 85
Author(s):  
Arief Bakhtiar ◽  
Putri Mega Juwita
Keyword(s):  
Quality Of Life ◽  
Respiratory Tract ◽  
Defense Mechanism ◽  
Healthy Individuals ◽  
Afferent Pathway ◽  
Symptomatic Management ◽  
Proven Efficacy ◽  
Reflex Arc ◽  
Foreign Materials

Cough is the most frequent symptom for which patients consult with their health care provider throughout the world. This symptom could be happened not only in sick individuals but also healthy individuals. At some stage, it is distressing, inhibits normal social activities, and reduces quality of life. Besides these detrimental effects, cough is the most effective defense mechanism to eliminate foreign materials, including various pathogens, from the respiratory tract. It begins with a series of breathing maneuvers which triggers sudden expulsion of air which is divided into three phases, i.e. inspiration, compression, and expiration phase. Cough occurs due to activation of mechanical or chemical sensory receptors in the larynx and lower respiratory tract which stimulates reflex arc complex. This stimulus is then transmitted to the afferent pathway to the cough center in the medulla through the vagus nerve to trigger expiration muscles to produce cough. It is important to know the cause of cough because cough is an indicator for patients and doctors for early diagnosis and therapy of disease. Therefore, cough is classified into acute, subacute, and chronic according to its duration. Available medications for symptomatic management of cough are inadequate due to lack of proven efficacy and/or their undesirable or intolerable side effects. This article aims to provide information on cough management to improve therapeutic effectiveness and patient quality of life.

Herb-Drug interactions between Aidi injection and doxorubicin in rats with diethylnitrosamine-induced hepatocellular carcinoma

2020 ◽  
Author(s):  
Yuan Lu ◽  
Jie Pan ◽  
Shuai Zhang ◽  
Liu Chunhua ◽  
Jia Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Drug Interactions ◽  
Plasma Concentrations ◽  
Ultra Performance Liquid Chromatography ◽  
Limited Information ◽  
Anti Cancer ◽  
Liquid Chromatography Tandem Mass ◽  
Aidi Injection ◽  
Reduced Toxicity

Abstract Background Aidi Injection (ADI), a Chinese herbal preparation with anti-cancer activity, is used for the treatment of hepatocellular carcinoma (HCC). Several clinical studies have shown that co-administration of ADI with doxorubicin (DOX) is associated with reduced toxicity of chemotherapy, enhanced clinical efficacy and improved quality of life for patients. However, limited information is available about the herb-drug interactions between ADI and DOX. The study aimed to investigate the pharmacokinetic mechanism of herb-drug interactions between ADI and DOX in a rat model of HCC. Methods Experimental HCC was induced in rats by oral administration of diethylnitrosamine. The HCC rats were pretreated with ADI (10 mL/kg, intraperitoneal injection) for 14 consecutive days prior to administration of DOX (7 mg/kg, intravenous injection) to investigate pharmacokinetic interactions. Plasma concentrations of DOX and its major metabolite, doxorubicinol (DOXol), were determined using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Results Preadministration of ADI significantly altered the pharmacokinetics of DOX in HCC rats, leading to increased plasma concentrations of both DOX and DOXol. The plasma drug concentration-time curves (AUCs) of DOX and DOXol in rats pretreated with ADI were 3.79-fold and 2.92-fold higher, respectively, than those in control rats that did not receive ADI. Conclusions Increased levels of DOX were found in the plasma of HCC rats pretreated with ADI, which may lead to enhanced efficacy but also potential toxicity.

Analysis of differential residuals of SLR observations to GNSS: Methodology and results from analyzing 25 years of data

2021 ◽  
Author(s):  
Dimitrios Ampatzidis ◽  
Daniela Thaller ◽  
Lin Wang
Keyword(s):  
Reference Frames ◽  
Systematic Errors ◽  
Satellite Orbits ◽  
Terrestrial Reference Frames ◽  
Station Coordinates ◽  
Systematic Effects ◽  
The Absolute ◽  
Alternative Scenarios ◽  
Gnss Observations

&lt;p&gt;The SLR observations to GNSS play a significant role as space tie, and allow investigations of many quantities related to the global Terrestrial Reference Frames (TRF), e.g., satellite orbits, scale, station coordinates, local ties. The differences between the observed ranges (via SLR observations) minus the computed spatial distances (via GNSS orbits based on GNSS observations) form the so-called &amp;#8220;SLR residuals&amp;#8221;. The analysis of these SLR residuals offers the opportunity to investigate the biases of the SLR measurements, the quality of the GNSS orbits and the quality and consistency of station coordinates. However, the absolute residuals contain a various number of inconsistencies and systematics which are not straightforward to be identified and separated, and, therefore to be further investigated. The present study focuses on the derivation of three alternative scenarios/cases through the usage of differential residuals between epochs, satellites and stations. These differential SLR residuals are derived from the processing of 25 years of SLR observations to GNSS (using GPS and GLONASS). The advantage of using the differential residuals is the elimination of one or more sources of systematic errors, according to each scenario. The comparison between the absolute and the differential residuals, respectively, is proven to stand as a useful diagnostic tool for the assessment of the systematic effects.&lt;/p&gt;

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