Serum lactate as a prognostic factor in coronary artery bypass graft operation by on pump method

Background: Lactic acidosis in cardiac surgical patients is a manifestation of systemic inflammation and excess pro-inflammatory cytokine production. This investigation was designed to integrate basic concepts about lactate acidosis with a clinically used of serum lactate in patients under coronary artery bypass surgery (CABG) by on pump method. Methods: From August to September 2012, 15 patients scheduled for routine cardiac surgery entered to our sample and followed up two weeks. Lactate concentration in arterial blood sample was studied. Method of surgery duration of cardiopulmonary bypass, aorta cross clamp timing, hemodynamic parameters, inotrope dosage and patient outcome were documented. The data were collected and analyzed. Results: The mean age of the patients was 62±14 years. The patients with a poor outcome had significantly higher lactate levels in ABG samples (p0.05). The PH of ABG samples did not generally correlate with the ABG lactate concentration (r=0.116, p=0.68). Increased lactate concentration was reliably associated with patient hemodynamic parameters, inotrope dosage, duration of on pump time and aorta cross clamp time. Conclusion: This study demonstrates a correlation between serum lactate levels and patient prognosis after CABG surgery by on pump method

Pyrrolizidine alkaloids from Heliotropium transoxanum Bunge

Background and objectives: The plants belonging to the genus Heliotropium L. (Boraginaceae) are the main sources of toxic pyrrolizidine alkaloids (PAs). In the present study, we have investigated the PAs of the aerial parts of Heliotropium transoxanum Bunge, a perennial species native to Iran. Methods: Silica gel column chromatography and silica gel PTLC were applied for the isolation of PAs present in the total methanol extract of H. transoxanum. The structures of the isolated compounds were identified using 1H-NMR, 13C-NMR and EIMS spectral analyses. Results: Three PAs, heliotrine (1), lasiocarpine (2) and heliotrine N-oxide (3),with known mutagenic and genotoxic properties, were isolated from the aerial parts of H. transoxanum. Conclusion: The results of this study on the presence of toxic PAs in H. transoxanum introduce this herb as a poisonous species and also suggest it as an appropriate source for the isolation of heliotrine and lasiocarpine for further toxicological and pharmacological studies

Comparing the Effects of Propofol Infusion and Inhalation Isoflurane on Hemodynamic Variations and Depth of Anesthesia in Cataract Surgery Patients

BACKGROUND AND OBJECTIVE: In cataract surgery, given that most patients are older people, surgery with general anesthesia requires better hemodynamic control along with maintaining the depth of anesthesia. The present study was conducted to compare the effects of propofol and isoflurane on hemodynamic variations and depth of anesthesia in cataract surgery patients. METHODS: The present clinical trial was conducted among 60 patients who were cataract surgery candidates. The patients were randomly assigned to propofol group (n = 30) and isoflurane group (n = 30). One µg/kg fentanyl and one mg/kg intravenous lidocaine were administered in both groups and anesthesia was induced using 1.5 – 2.5 mg/kg propofol. In order to maintain anesthesia, 50 – 75 µg/kg/min propofol was administered in the first group and 1% isoflurane was administered in the second group. Depth of anesthesia, hemodynamic variations, recovery time, wake-up time, nausea and vomiting were recorded and compared in the two groups. FINDINGS: Depth of anesthesia was similarly below 60 in both groups at different times. Hemodynamic variations were not significantly different in the two groups. Mean recovery time in propofol and isoflurane groups was 20.56 and 15.4 minutes, respectively (p<0.001), and wake-up time in the two groups was 8.83 and 7.16 minutes, respectively (p= 0.004). CONCLUSION: The results showed that there was no difference between the effects of these two drugs on hemodynamics and depth of anesthesia, but recovery time and wake-up time in propofol group were significantly higher than isoflurane group

Increased serum heat shock protein 27 antibody titers and prooxidant-antioxidant balance in patients with beta-thalassemia major

Objective: Determination of the serum heat shock protein 27 (Hsp27) antibody titers and prooxidant-antioxidant balance (PAB) in patients with thalassemia as markers of cell and oxidative stress, respectively. Methods: Serum PAB and anti-Hsp27 antibody titers were measured in 140 patients with thalassemia major and 140 sex- and age-matched healthy volunteers. Results: A significantly higher serum PAB value was observed in patients in comparison to controls. In the patient group, anti-Hsp27 antibody titers were significantly higher than for the control group (p < 0.001). We found a weak negative correlation between anti-Hsp27 antibody concentrations and the PAB (p = 0.03), but these values were not correlated with serum superoxide dismutase activity in the thalassemic patients. Conclusions: Increased levels of serum PAB and Hsp27 antibodies may be involved in the pathological consequences of β-thalassemia major and may contribute to the development of endothelial injury

The effects of intravenous lidocaine before propofol induction in premedicated dogs

OBJECTIVE: The effects of lidocaine, administered before induction of anaesthesia with propofol, on arterial blood pressure, heart rate, respiratory rate, cough reflex, ease of intubation, extrapyramidal signs and required dose of propofol in healthy premedicated dogs were evaluated. METHODS: Twenty-four client-owned dogs were premedicated intramuscularly with 1 mu g/kg dexmedetomidine and 0 center dot 2 mg/kg methadone, and randomly allocated to receive 2 mg/kg lidocaine (group L) or saline (group P) 120 seconds before induction of anaesthesia with propofol. Heart rate, non-invasive arterial blood pressure and respiratory rate were assessed at pre-established intervals. Quality of intubation, cough reflex and the occurrence of adverse effects were scored according to predefined scales. The total amount of propofol administered was also recorded. RESULTS: Cardiovascular and respiratory variables changed over time but were not significantly different between treatments. No significant differences between groups were found for the incidence of coughing, quality of intubation, adverse effects and propofol intubation dose. CLINICAL SIGNIFICANCE: Intravenous administration of lidocaine 2 mg/kg before propofol induction was not associated with significant cardiovascular and respiratory benefits compared to standard induction and did not result in a propofol dose-sparing effect or improvement of the quality of intubation in dogs premedicated with dexmedetomidine and methadone