scholarly journals Ambulatory phlebectomy under tumescent local anesthesia in a kidney-transplant patient

2013 ◽  
Vol 70 (4) ◽  
pp. 417-419
Author(s):  
Zoran Bjelanovic ◽  
Ivan Lekovic ◽  
Miroljub Draskovic ◽  
Aleksandar Tomic ◽  
Milic Veljovic ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Severe Infection ◽  
Tacrolimus Concentration ◽  
Blood Levels ◽  
Kidney Transplant Patient ◽  
Blood Concentrations ◽  
Organ Rejection ◽  
Tumescent Local Anesthesia ◽  
Transplanted Organs ◽  
Prilocaine Hydrochloride

Introduction. Tumescent local anesthesia (TLA) is widely used for ambulatory surgery. Patients with transplanted organs are on immunosuppressive therapy and with risk for organ rejection or severe infection. Case report. Saphenectomy with phlebectomy on the left leg under TLA was performed in a patient with kidney transplantation performed four years ago. A combination of 35 mg of 1% prilocaine-hydrochloride, 5 mL of 8.4% sodium bicarbonate and 500 ?g of epinephrine in 460 mL of normal saline was used for TLA. Overall 750 mL of the solution was used. The patient had satisfactory postoperative analgesia and was discharged home on the same day. Blood levels of urea, creatinine, estimated glomerular filtration rate (eGFR) and tacrolimus concentration, measured preoperatively and on the second postoperative day, were in a regular range. Prilocaine blood concentrations determined on the 4th, 10th and 16th postoperative hours, were below toxic levels. Conclusion. TLA in a kidney-transplanted patient performed for saphenectomy with phlebectomy proved to be a safe and reliable anesthesia method.

scholarly journals Blood Micronutrient and Thyroid Hormone Concentrations in the Oldest-Old

2000 ◽  
Vol 85 (6) ◽  
pp. 2260-2265 ◽  
Author(s):  
Giovanni Ravaglia ◽  
Paola Forti ◽  
Fabiola Maioli ◽  
Barbara Nesi ◽  
Loredana Pratelli ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Oldest Old ◽  
Serum Zinc ◽  
Blood Levels ◽  
Elderly Age ◽  
Blood Concentrations ◽  
Significant Difference ◽  
Plasma Retinol ◽  
Age Range

Several micronutrients are involved in thyroid hormone metabolism, but it is unclear whether their marginal deficits may contribute to the alterations in thyroid function observed in extreme aging. The relationships among blood concentrations of thyroid hormones and selenium, zinc, retinol, and α-tocopherol were studied in 44 healthy Northern Italian oldest-old subjects (age range, 90–107 yr), selected by the criteria of the SENIEUR protocol. Control groups included 44 healthy adult (age range, 20–65 yr) and 44 SENIEUR elderly (age range, 65–89 yr) subjects. Oldest-old subjects had higher TSH (P < 0.01) and lower free T3 (FT3)/freeT4 (FT4) ratio, zinc, and selenium serum values (P < 0.001) than adult and elderly control subjects. No significant difference was found for plasma retinol and α-tocopherol values. The associations between micronutrients and thyroid hormones were evaluated by multivariate analysis. In oldest-old subjects, plasma retinol was negatively associated with FT4 (P = 0.019) and TSH serum levels (P = 0.040), whereas serum zinc was positively associated with serum FT3 (P = 0.010) and FT3/FT4 ratio (P = 0.011). In younger subjects, no significant association was found among thyroid variables and micronutrients. In conclusion, blood levels of specific micronutrients are associated with serum iodothyronine levels in extreme aging.

Effect of Time Interval Between Tumescent Local Anesthesia Infiltration and Start of Surgery on Operative Field Visibility in Hand Surgery Without Tourniquet

2015 ◽  
Vol 40 (8) ◽  
pp. 1606-1609 ◽  
Author(s):  
Muhammad Mustehsan Bashir ◽  
Rehan Qayyum ◽  
Muhammad Hammad Saleem ◽  
Kashif Siddique ◽  
Farid Ahmad Khan
Keyword(s):  
Local Anesthesia ◽  
Hand Surgery ◽  
Time Interval ◽  
Operative Field ◽  
Tumescent Local Anesthesia ◽  
Without Tourniquet

Optimization of lidocaine application in tumescent local anesthesia

2009 ◽  
Vol 61 (4) ◽  
pp. 641-653 ◽  
Author(s):  
Krystyna Głowacka ◽  
Krystyna Orzechowska-Juzwenko ◽  
Andrzej Bieniek ◽  
Anna Wiela-Hojeńska ◽  
Magdalena Hurkacz
Keyword(s):  
Local Anesthesia ◽  
Tumescent Local Anesthesia

Studies on the carbohydrate metabolism of sheep. XVI. Partition of ketone bodies in blood, tissues, and urine

1962 ◽  
Vol 13 (2) ◽  
pp. 307 ◽  
Author(s):  
RL Reid
Keyword(s):  
Renal Clearance ◽  
Blood Level ◽  
Ketone Bodies ◽  
Urine Flow ◽  
Blood Levels ◽  
Renal Tubules ◽  
Hydroxybutyric Acid ◽  
Acetoacetic Acid ◽  
Tissue Concentrations ◽  
Blood Concentrations

Acetone comprised 0–40% (average 18%) of the acetoacetic acid plus acetone fraction in sheep blood, in which the level of this fraction was 0.6–5.2 mg % (as acetone). Acetoacetic acid was largely converted to acetone during storage of blood at –20°C, with intermittent thawing for analysis. Concentrations of acetoacetic acid in red cells were similar to those in plasma, but those of ß-hydroxybutyric acid were considerably lower. In contrast to acetoacetic acid, ß-hydroxybutyric acid was virtually absent from foetal blood and from brain tissue. Concentrations of both ketone fractions in liver and muscle tissue were about one-half the blood concentrations. The renal clearance of acetoacetic acid plus acetone in hyperketonaemic pregnant ewes was independent of blood level up to 20 mg % and was little affected by rate of urine flow. Clearance values were in the range of 4–9 ml per min, which indicates that most of the acetoacetic acid filtered at the glomeruli is absorbed by the renal tubules. Renal clearance of ß-hydroxybutyric acid was dependent on blood level and was more affected by rate of urine flow than that of acetoacetic acid. Very little ß-hydroxybutyric acid appeared in the urine when blood levels were below 15 mg %. Clearance increased as blood concentration rose above this level, and reached maximum values, mostly of 3–5 ml per min, at blood levels exceeding 30 mg %.

scholarly journals A Human Relevant Defined Mixture of Persistent Organic Pollutants (POPs) Affects In Vitro Secretion of Glucagon-Like Peptide 1 (GLP-1), but Does Not Affect Translocation of Its Receptor

2019 ◽  
Vol 172 (2) ◽  
pp. 359-367 ◽  
Author(s):  
Maeve Shannon ◽  
Yuling Xie ◽  
Steven Verhaegen ◽  
Jodie Wilson ◽  
Hanne F Berntsen ◽  
...  
Keyword(s):  
Organic Pollutants ◽  
Persistent Organic Pollutants ◽  
Complex Mixture ◽  
Blood Levels ◽  
Environmental Toxicants ◽  
Blood Concentrations ◽  
Total Mixture ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Abstract Environmental exposure to persistent organic pollutants (POPs) has been suggested as a contributing factor for the increased rate of type 2 diabetes and obesity. A complex mixture of 29 POPs (Total mixture), based on human blood concentrations, was used to expose a glucagon-like peptide 1 (GLP-1) secreting enteroendocrine cell line (pGIP/neo: STC-1) in vitro for 3 and 24 h. Significant increases of GLP-1 occurred when cells were exposed to the Total mixture at ×500 blood levels. Six sub-mixtures representing chlorinated (Cl), brominated (Br), and perfluorinated chemicals (PFAA), and their combinations (Cl + Br, Cl + PFAA, Br + PFAA) were also tested at ×500. Secretion levels seen for these remained lower than the Total mixture, and the Br mixture had no effect. After 24 h, increased secretion was seen with all mixtures at ×1 blood levels. Cytotoxicity was present for ×100 and ×500 blood levels. When tested in a GLP-1 receptor translocation assay (U2OS-GLP1R-EGFP), neither agonistic nor antagonist effects on receptor internalization were seen for any of the mixtures. We conclude individual classes of POPs, alone or in combination, can affect GLP-1 secretion and may contribute as a molecular mechanism linking environmental toxicants and diabetes.

Serum Levels of Melatonin in Cancer Patients and their Relation to Body Sizes

1988 ◽  
Vol 3 (3) ◽  
pp. 193-196 ◽  
Author(s):  
S. Barni ◽  
P. Lissoni ◽  
S. Crispino ◽  
F. Rovelli ◽  
G. Esposti ◽  
...  
Keyword(s):  
Body Weight ◽  
Body Size ◽  
Cancer Patients ◽  
Serum Levels ◽  
Blood Levels ◽  
Melatonin Secretion ◽  
Normal Range ◽  
Blood Concentrations ◽  
Patients With Cancer ◽  
Body Sizes

Melatonin secretion is often enhanced in patients with cancer. In the light of a reported correlation between melatonin levels and body size, we investigated blood levels of this pineal hormone in a group of 72 patients affected by cancer, 30 of whom had body weight within the normal range, 30 were obese and the last 12 cases had body weight below the normal range, in order to establish whether in fact melatonin blood concentrations were related to body size. Melatonin levels were high in 19/72 patients (26%). The mean levels of the pineal hormone were similar in patients with normal, low and high body weight. Finally, there was no significant correlation between melatonin values and body weight, height or surface. Melatonin secretion thus does not appear to be influenced by body size in cancer patients.

scholarly journals Influence of TGFB1 and CTLA4 polymorphisms on calcineurin inhibitors dose and risk of acute rejection in renal transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Bogacz ◽  
Marlena Wolek ◽  
Jerzy Sieńko ◽  
Bogusław Czerny ◽  
Bogusław Machaliński ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Immunosuppressive Treatment ◽  
Calcineurin Inhibitors ◽  
Immunosuppressive Drugs ◽  
Dose Ratio ◽  
Blood Concentrations ◽  
Organ Rejection ◽  
Transplant Patients ◽  
The Impact ◽  
Tgf Β1

AbstractOrgan transplant is often the treatment of choice as it extends and improves patient life. Immunosuppressive treatment, which prevents acute rejection of the organ, is used in transplant patients to prevent the loss of transplant. The aim of the study was to determine the impact of the CTLA4 (+49A>G, rs231775) and the TGF-β1 (−800G>A, rs1800468) polymorphisms on the therapeutic effect of immunosuppressive drugs (cyclosporine—CsA, tacrolimus—TAC) and the risk of acute rejection in renal transplant patients. The analysis of the CTLA4 +49A>G and the TGF-β1 −800G>A polymorphisms was carried out in 392 patients after kidney transplant using real-time PCR. The CTLA4 +49A>G polymorphism did not affect CsA or TAC dose, ratio of drug concentration to dose (C/D), and blood concentrations. As for the TGF-β1 -800G>A polymorphism, patients with the GA genotype required lower TAC doses compared to the GG genotype (TAC 12 h: 3.63 mg vs 5.3 mg, TAC 24 h: 2.38 mg vs 3.29 mg). Comparing the C/D ratio in both groups (TAC 12 h and TAC 24 h), higher C/D ratio was observed in patients with the GA genotype. These results indicate that patients with the A allele require slightly lower doses of TAC. The results suggest that the TGF-β1 −800 G>A polymorphism may influence the TAC dose, while the +49A>G polymorphism of the CTLA4 gene does not correlate with the dose of CsA or TAC. The analysis of the biochemical parameters of the renal profile showed no impact of the CTLA4 and the TGF-β1 polymorphisms on the risk of organ rejection.

scholarly journals Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Mukesh Kumar Prasad ◽  
Payal Jain ◽  
Rohit Kumar Varshney ◽  
Aditi Khare ◽  
Gurdeep Singh Jheetay
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Blood Loss ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Skin Graft ◽  
Tumescent Local Anesthesia ◽  
Graft Harvest ◽  
Contracture Release ◽  
Split Skin

Background: Anesthetic management of severe post burn neck contracture is difficult, demanding due to fixed flexion deformity of neck, incomplete oral occlusion and insufficient mouth opening leading to difficulty in intubation. Patients undergoing contracture release, skin graft harvest under general anesthesia (GA) were compared with patients undergoing the same surgery under tumescent local anesthesia (TLA) technique. Methodology: Twenty-one patients with post burn neck contracture undergoing contracture release with split skin grafting under GA were compared with twenty-one patients undergoing the same surgery under TLA. Post-operative pain and satisfaction were assessed using 10 cm VAS (Visual Analogue Scale).  Results: Demographic profile was comparable in both groups. Changes in intra-operative vital parameters remained insignificant. The average volume of tumescent solution used was 254.76 + 49.05ml. Blood loss was significantly decreased, postoperative pain relief was more than sixteen hours in thirteen patients and extended beyond twenty-four hours in six patients in the TLA group. Time for the first rescue analgesia was significantly lesser in the GA group and the average dose of injection tramadol used in the GA group was significantly higher within the first 24 h. Overall satisfaction in the TLA group was significantly higher than in the GA group. Conclusion: TLA can be used as sole technique for release of post burn neck contracture and harvest of split skin grafts with less blood loss and significantly better postoperative pain relief avoiding complications of general anesthesia. Key words: Tumescent local anesthesia; Post burn neck contracture; Skin graft harvest; General anesthesia Citation: Prasad MK, Jain P, Varshney RK, Khare A, Jheetay GS. Tumescent local anesthesia as an alternative to general anesthesia in the release of post-burn neck contracture and skin graft harvesting: A comparative study. Anaesth. Pain intensive care 2021;25(1):34–39. DOI: 10.35975/apic.v25i1.1434 Received: 18 February 2020, Reviewed: 16 March 2020, Accepted: 30 April 2020

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