187 research outputs found
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OBJECTIVE: It has previously been shown that a combination of inhaled nitric oxide (iNO) and intravenous (IV) steroid attenuates endotoxin-induced organ damage in a 6-hour porcine endotoxemia model. We aimed to further explore these effects in a 30-hour model with attention to clinically important variables. DESIGN: Randomized controlled trial. SETTING: University animal laboratory. SUBJECTS: Domestic piglets (nâ=â30). INTERVENTIONS: Animals were randomized into 5 groups (nâ=â6 each): 1) Controls, 2) LPS-only (endotoxin/lipopolysaccharide (LPS) infusion), 3) LPS + iNO, 4) LPS + IV steroid, 5) LPS + iNO + IV steroid. MEASUREMENTS AND MAIN RESULTS: Exposure to LPS temporarily increased pulmonary artery mean pressure and impeded renal function with elevated serum creatinine and acidosis compared to a control group over the 30-hour study period. Double treatment with both iNO and IV steroid tended to blunt the deterioration in renal function, although the only significant effect was on Base Excess (pâ=â0.045). None of the LPS + iNO + IV steroid treated animals died during the study period, whereas one animal died in each of the other LPS-infused groups. CONCLUSIONS: This study suggests that combined early therapy with iNO and IV steroid is associated with partial protection of kidney function after 30 hours of experimental LPS infusion
Calcitonin gene-related peptide stimulates proliferation of alveolar epithelial cells
<p>Abstract</p> <p>Background</p> <p>Alveolar epithelial cells are known as progenitor cells for the restoration from the damage in the lung. Calcitonin gene-related peptide (CGRP) has been reported to play an important role in the proliferation of various types of epithelial and endothelial cells. We investigated the effects of CGRP on the proliferation of alveolar epithelial cells <it>in vitro </it>and <it>in vivo</it>.</p> <p>Methods</p> <p>A549 cells were cultured in Dulbecco Modified Eagle Medium with 5% fatal bovin serum for 24 hours, then CGRP was added <it>in vitro</it>. The proliferation of DNA synthesis was measured using 5-bromo-2-deoxyuridine, an analog of thymidine, by enzyme-linked immunosorbent assay.</p> <p>As one intracellular response to CGRP, we examined activation of p44/42- extracellular signal-regulated kinase (ERK) pathway by adding CGRP, using western blotting method.</p> <p>Recombinant adenovirus encoding nuclear-targeted-human ÎČ-CGRP (rhCGRP) was administered into Male Wister rat (n = 5, 10 weeks old) lungs by intratracheal instillation <it>in vivo</it>. 7 days after the administration of CGRP, rat lungs were harvested and histological findings and immunohistochemical staining of proliferating cell nuclear antigen (PCNA) were evaluated to examine cell proliferation.</p> <p>Results</p> <p><it>In vitro </it>study, CGRP increased the proliferation of A549 cells in a dose and time dependent manner. CGRP8-37 (inhibitor of CGRP receptor) decreased CGRP induced proliferation of DNA synthesis. Phosphorylation of ERK pathway was observed within 15 minutes and peaked in one hour. U0126 (inhibitor of ERK pathway) decreased CGRP induced proliferation of DNA synthesis.<it>In vivo </it>study, histological examination of the lung indicated proliferation of alveolar epithelial cells in the rhCGRP-treated group and the nuclei of alveolar epithelial cells were positive for PCNA immunostaining.</p> <p>Conclusion</p> <p>In this study, we conclude that CGRP stimulates proliferation of human alveolar epithelial cells <it>in vivo </it>and <it>in vitro</it>.</p
Role of Calcitonin Gene-Related Peptide in Bone Repair after Cyclic Fatigue Loading
Calcitonin gene related peptide (CGRP) is a neuropeptide that is abundant in the sensory neurons which innervate bone. The effects of CGRP on isolated bone cells have been widely studied, and CGRP is currently considered to be an osteoanabolic peptide that has effects on both osteoclasts and osteoblasts. However, relatively little is known about the physiological role of CGRP in-vivo in the skeletal responses to bone loading, particularly fatigue loading.We used the rat ulna end-loading model to induce fatigue damage in the ulna unilaterally during cyclic loading. We postulated that CGRP would influence skeletal responses to cyclic fatigue loading. Rats were fatigue loaded and groups of rats were infused systemically with 0.9% saline, CGRP, or the receptor antagonist, CGRP(8-37), for a 10 day study period. Ten days after fatigue loading, bone and serum CGRP concentrations, serum tartrate-resistant acid phosphatase 5b (TRAP5b) concentrations, and fatigue-induced skeletal responses were quantified. We found that cyclic fatigue loading led to increased CGRP concentrations in both loaded and contralateral ulnae. Administration of CGRP(8-37) was associated with increased targeted remodeling in the fatigue-loaded ulna. Administration of CGRP or CGRP(8-37) both increased reparative bone formation over the study period. Plasma concentration of TRAP5b was not significantly influenced by either CGRP or CGRP(8-37) administration.CGRP signaling modulates targeted remodeling of microdamage and reparative new bone formation after bone fatigue, and may be part of a neuronal signaling pathway which has regulatory effects on load-induced repair responses within the skeleton
The Adult Human Brain Harbors Multipotent Perivascular Mesenchymal Stem Cells
Blood vessels and adjacent cells form perivascular stem cell niches in adult tissues. In this perivascular niche, a stem cell with mesenchymal characteristics was recently identified in some adult somatic tissues. These cells are pericytes that line the microvasculature, express mesenchymal markers and differentiate into mesodermal lineages but might even have the capacity to generate tissue-specific cell types. Here, we isolated, purified and characterized a previously unrecognized progenitor population from two different regions in the adult human brain, the ventricular wall and the neocortex. We show that these cells co-express markers for mesenchymal stem cells and pericytes in vivo and in vitro, but do not express glial, neuronal progenitor, hematopoietic, endothelial or microglial markers in their native state. Furthermore, we demonstrate at a clonal level that these progenitors have true multilineage potential towards both, the mesodermal and neuroectodermal phenotype. They can be epigenetically induced in vitro into adipocytes, chondroblasts and osteoblasts but also into glial cells and immature neurons. This progenitor population exhibits long-term proliferation, karyotype stability and retention of phenotype and multipotency following extensive propagation. Thus, we provide evidence that the vascular niche in the adult human brain harbors a novel progenitor with multilineage capacity that appears to represent mesenchymal stem cells and is different from any previously described human neural stem cell. Future studies will elucidate whether these cells may play a role for disease or may represent a reservoir that can be exploited in efforts to repair the diseased human brain
Somatostatin Inhibits Cell Migration and Reduces Cell Counts of Human Keratinocytes and Delays Epidermal Wound Healing in an Ex Vivo Wound Model
The peptide hormone somatostatin (SST) and its five G protein-coupled receptors
(SSTR1-5) were described to be present in the skin, but their cutaneous
function(s) and skin-specific signalling mechanisms are widely unknown. By using
receptor specific agonists we show here that the SSTRs expressed in
keratinocytes are functionally coupled to the inhibition of adenylate cyclase.
In addition, treatment with SSTR4 and SSTR5/1 specific agonists significantly
influences the MAP kinase signalling pathway. As epidermal hormone receptors in
general are known to regulate re-epithelialization following skin injury, we
investigated the effect of SST on cell counts and migration of human
keratinocytes. Our results demonstrate a significant inhibition of cell
migration and reduction of cell counts by SST. We do not observe an effect on
apoptosis and necrosis. Analysis of signalling pathways showed that somatostatin
inhibits cell migration independent of its effect on cAMP. Migrating
keratinocytes treated with SST show altered cytoskeleton dynamics with delayed
lamellipodia formation. Furthermore, the activity of the small GTPase Rac1 is
diminished, providing evidence for the control of the actin cytoskeleton by
somatostatin receptors in keratinocytes. While activation of all receptors leads
to redundant effects on cell migration, only treatment with a SSTR5/1 specific
agonist resulted in decreased cell counts. In accordance with reduced cell
counts and impaired migration we observe delayed re-epithelialization in an
ex vivo wound healing model. Consequently, our experiments
suggest SST as a negative regulator of epidermal wound healing
Den attraktiva arbetsplatsen : Möter platskontoren de anstÀlldas behov?
Previous research have shown a possible relationship between the indoor work environmentand the impact it has on the employeesâ performance. Different factors can affect theperformance; physical parameters, such as ventilation and air quality, noise levels, thermalclimate, lighting and access to daylight, as well as the level of flexibility of the work, furnitureetc. Therefore, this study aims to investigate the quality of the indoor work environment at siteoffices within Company AB in Sweden. Further, how the physical and the psychologicalenvironment play an important role regarding the attractiveness of the workspace. The studywill only focus on four physical parameters affecting the physical functionality of an office; airquality, noise, temperature and lighting. The following research questions were asked: 1) Whatdifferent types of site offices can be identified in Sweden and what are the commonly usedoffice layouts? 2) How well does the actual indoor work environment at site offices align withthe restrictions by the Swedish Work Environment Authority? 3) How is the indoorenvironment of the site offices perceived by the people utilizing the workspace? 4) Which arethe most important parts to look at to improve the attractiveness of the site offices at CompanyAB? The study is both qualitative and quantitative including measurements, interviews,meetings, and a questionnaire as the main sources of information used to answer the researchquestions.According to the results, the two most commonly used site offices are construction trailers andrented premises. The visited offices had varied layouts since they are designed to fit the needsof the specific project organizations. Out of the four parameters, noise was the only one thatentirely fulfilled the requirements in the six site offices visited.The employees perceived the physical parameters in the site offices differently. The air qualitywas generally perceived to be sufficient in the office spaces but quite bad in the meeting rooms.Multiple employees thought noise was one of the most problematic parameters and it wasshown to possibly depend on work role or task. Employees expressed the need of a versatileoffice layout, with both open office areas and smaller secluded rooms combined, which couldincrease their concentration level and decrease disturbance. Another problematic parameterwas the temperature and generally, the need was to stabilize it throughout the year. Regardingthe lighting, many expressed the desire to be able to adjust it on their own.People perceive things differently which is why a more varied and flexible office might fulfillmore peopleâs needs. If these needs are fulfilled, it could improve not only the physical workenvironment but also the psychological work environment and therefore increase theattractiveness and job satisfaction of the employees.Tidigare forskning har visat en möjlig koppling mellan inomhusklimat och dess pĂ„verkan pĂ„den anstĂ€lldas prestation. Olika faktorer kan pĂ„verka prestationen; fysiska parametrar; sĂ„somventilation och luftkvalitet, ljudnivĂ„, termiskt klimat, ljus och tillgĂ„ng till dagsljus samt nivĂ„nav flexibilitet pĂ„ jobbet, möbler och andra faktorer. DĂ€rför syftar denna studie till att undersökakvalitĂ©n av arbetsmiljön inomhus pĂ„ platskontor hos Company AB i Sverige. Vidare, hur denfysiska och psykiska miljön spelar en stor roll gĂ€llande hur attraktiv en arbetsplats Ă€r. Dennastudie kommer bara fokusera pĂ„ fyra fysiska parametrar som pĂ„verkar den fysiskafunktionaliteten av ett kontor; luftkvalitet, ljud, temperatur och ljus. Följande forskningsfrĂ„gorhar stĂ€llts: 1) Vilka olika typer av platskontor kan identifieras i Sverige och vilka olikautformningar anvĂ€nds vanligast? 2) Hur vĂ€l uppfyller den faktiska inomhusmiljön pĂ„platskontoren kraven frĂ„n Arbetsmiljöverket? 3) Hur upplevs inomhusmiljön pĂ„ platskontorenav mĂ€nniskorna som jobbar i dem? 4) Vilka Ă€r de viktigaste aspekterna för att ökaattraktiviteten av platskontoren pĂ„ Company AB? Studien Ă€r bĂ„de kvalitativ och kvantitativoch inkluderar bĂ„de mĂ€tningar, intervjuer, möten och en enkĂ€t som de frĂ€mstainformationskĂ€llorna för att svara pĂ„ forskningsfrĂ„gorna.Resultaten visar pĂ„ att de vanligaste platskontoren Ă€r byggbodar och inhyrda lokaler. Debesökta kontoren hade olika uppbyggnad eftersom de var utformade för att passa de specifikaprojektorganisationerna. Utav de fyra parametrarna var ljudet det enda som uppfyllde kraven ide sex besökta platskontoren.De anstĂ€llda upplevde de fysiska parametrarna pĂ„ olika sĂ€tt. Luftkvaliteten upplevdes generelltsom tillrĂ€cklig bland kontorsplatserna men ganska dĂ„lig i mötesrummen. Flera anstĂ€llda tyckteatt ljudet var en av de mest problematiska parametrarna och det visade sig möjligtvis bero pĂ„arbetsroll eller uppgift. De anstĂ€llda uttryckte ett behov av en varierad utformning av kontorenmed en kombination av bĂ„de öppna kontorslandskap och mindre avskilda rum vilket skullekunna öka koncentrationsförmĂ„gan och minska störande ljud. En annan problematiskparameter var temperaturen och generellt var behovet att fĂ„ en mer stabil temperatur över Ă„ret.Vad gĂ€ller ljussĂ€ttningen sĂ„ uttryckte mĂ„nga att de ville kunna reglera den sjĂ€lva.MĂ€nniskor upplever saker olika vilket gör att ett mer varierat och flexibelt kontor kan uppfyllafler mĂ€nniskors behov. Om dessa behov uppfylls kan detta förbĂ€ttra inte bara den fysiskaarbetsmiljön utan ocksĂ„ den psykiska arbetsmiljön och kan dĂ€rigenom öka attraktiviteten samtarbetsnöjdheten hos de anstĂ€llda
Den attraktiva arbetsplatsen : Möter platskontoren de anstÀlldas behov?
Previous research have shown a possible relationship between the indoor work environmentand the impact it has on the employeesâ performance. Different factors can affect theperformance; physical parameters, such as ventilation and air quality, noise levels, thermalclimate, lighting and access to daylight, as well as the level of flexibility of the work, furnitureetc. Therefore, this study aims to investigate the quality of the indoor work environment at siteoffices within Company AB in Sweden. Further, how the physical and the psychologicalenvironment play an important role regarding the attractiveness of the workspace. The studywill only focus on four physical parameters affecting the physical functionality of an office; airquality, noise, temperature and lighting. The following research questions were asked: 1) Whatdifferent types of site offices can be identified in Sweden and what are the commonly usedoffice layouts? 2) How well does the actual indoor work environment at site offices align withthe restrictions by the Swedish Work Environment Authority? 3) How is the indoorenvironment of the site offices perceived by the people utilizing the workspace? 4) Which arethe most important parts to look at to improve the attractiveness of the site offices at CompanyAB? The study is both qualitative and quantitative including measurements, interviews,meetings, and a questionnaire as the main sources of information used to answer the researchquestions.According to the results, the two most commonly used site offices are construction trailers andrented premises. The visited offices had varied layouts since they are designed to fit the needsof the specific project organizations. Out of the four parameters, noise was the only one thatentirely fulfilled the requirements in the six site offices visited.The employees perceived the physical parameters in the site offices differently. The air qualitywas generally perceived to be sufficient in the office spaces but quite bad in the meeting rooms.Multiple employees thought noise was one of the most problematic parameters and it wasshown to possibly depend on work role or task. Employees expressed the need of a versatileoffice layout, with both open office areas and smaller secluded rooms combined, which couldincrease their concentration level and decrease disturbance. Another problematic parameterwas the temperature and generally, the need was to stabilize it throughout the year. Regardingthe lighting, many expressed the desire to be able to adjust it on their own.People perceive things differently which is why a more varied and flexible office might fulfillmore peopleâs needs. If these needs are fulfilled, it could improve not only the physical workenvironment but also the psychological work environment and therefore increase theattractiveness and job satisfaction of the employees.Tidigare forskning har visat en möjlig koppling mellan inomhusklimat och dess pĂ„verkan pĂ„den anstĂ€lldas prestation. Olika faktorer kan pĂ„verka prestationen; fysiska parametrar; sĂ„somventilation och luftkvalitet, ljudnivĂ„, termiskt klimat, ljus och tillgĂ„ng till dagsljus samt nivĂ„nav flexibilitet pĂ„ jobbet, möbler och andra faktorer. DĂ€rför syftar denna studie till att undersökakvalitĂ©n av arbetsmiljön inomhus pĂ„ platskontor hos Company AB i Sverige. Vidare, hur denfysiska och psykiska miljön spelar en stor roll gĂ€llande hur attraktiv en arbetsplats Ă€r. Dennastudie kommer bara fokusera pĂ„ fyra fysiska parametrar som pĂ„verkar den fysiskafunktionaliteten av ett kontor; luftkvalitet, ljud, temperatur och ljus. Följande forskningsfrĂ„gorhar stĂ€llts: 1) Vilka olika typer av platskontor kan identifieras i Sverige och vilka olikautformningar anvĂ€nds vanligast? 2) Hur vĂ€l uppfyller den faktiska inomhusmiljön pĂ„platskontoren kraven frĂ„n Arbetsmiljöverket? 3) Hur upplevs inomhusmiljön pĂ„ platskontorenav mĂ€nniskorna som jobbar i dem? 4) Vilka Ă€r de viktigaste aspekterna för att ökaattraktiviteten av platskontoren pĂ„ Company AB? Studien Ă€r bĂ„de kvalitativ och kvantitativoch inkluderar bĂ„de mĂ€tningar, intervjuer, möten och en enkĂ€t som de frĂ€mstainformationskĂ€llorna för att svara pĂ„ forskningsfrĂ„gorna.Resultaten visar pĂ„ att de vanligaste platskontoren Ă€r byggbodar och inhyrda lokaler. Debesökta kontoren hade olika uppbyggnad eftersom de var utformade för att passa de specifikaprojektorganisationerna. Utav de fyra parametrarna var ljudet det enda som uppfyllde kraven ide sex besökta platskontoren.De anstĂ€llda upplevde de fysiska parametrarna pĂ„ olika sĂ€tt. Luftkvaliteten upplevdes generelltsom tillrĂ€cklig bland kontorsplatserna men ganska dĂ„lig i mötesrummen. Flera anstĂ€llda tyckteatt ljudet var en av de mest problematiska parametrarna och det visade sig möjligtvis bero pĂ„arbetsroll eller uppgift. De anstĂ€llda uttryckte ett behov av en varierad utformning av kontorenmed en kombination av bĂ„de öppna kontorslandskap och mindre avskilda rum vilket skullekunna öka koncentrationsförmĂ„gan och minska störande ljud. En annan problematiskparameter var temperaturen och generellt var behovet att fĂ„ en mer stabil temperatur över Ă„ret.Vad gĂ€ller ljussĂ€ttningen sĂ„ uttryckte mĂ„nga att de ville kunna reglera den sjĂ€lva.MĂ€nniskor upplever saker olika vilket gör att ett mer varierat och flexibelt kontor kan uppfyllafler mĂ€nniskors behov. Om dessa behov uppfylls kan detta förbĂ€ttra inte bara den fysiskaarbetsmiljön utan ocksĂ„ den psykiska arbetsmiljön och kan dĂ€rigenom öka attraktiviteten samtarbetsnöjdheten hos de anstĂ€llda
Den attraktiva arbetsplatsen : Möter platskontoren de anstÀlldas behov?
Previous research have shown a possible relationship between the indoor work environmentand the impact it has on the employeesâ performance. Different factors can affect theperformance; physical parameters, such as ventilation and air quality, noise levels, thermalclimate, lighting and access to daylight, as well as the level of flexibility of the work, furnitureetc. Therefore, this study aims to investigate the quality of the indoor work environment at siteoffices within Company AB in Sweden. Further, how the physical and the psychologicalenvironment play an important role regarding the attractiveness of the workspace. The studywill only focus on four physical parameters affecting the physical functionality of an office; airquality, noise, temperature and lighting. The following research questions were asked: 1) Whatdifferent types of site offices can be identified in Sweden and what are the commonly usedoffice layouts? 2) How well does the actual indoor work environment at site offices align withthe restrictions by the Swedish Work Environment Authority? 3) How is the indoorenvironment of the site offices perceived by the people utilizing the workspace? 4) Which arethe most important parts to look at to improve the attractiveness of the site offices at CompanyAB? The study is both qualitative and quantitative including measurements, interviews,meetings, and a questionnaire as the main sources of information used to answer the researchquestions.According to the results, the two most commonly used site offices are construction trailers andrented premises. The visited offices had varied layouts since they are designed to fit the needsof the specific project organizations. Out of the four parameters, noise was the only one thatentirely fulfilled the requirements in the six site offices visited.The employees perceived the physical parameters in the site offices differently. The air qualitywas generally perceived to be sufficient in the office spaces but quite bad in the meeting rooms.Multiple employees thought noise was one of the most problematic parameters and it wasshown to possibly depend on work role or task. Employees expressed the need of a versatileoffice layout, with both open office areas and smaller secluded rooms combined, which couldincrease their concentration level and decrease disturbance. Another problematic parameterwas the temperature and generally, the need was to stabilize it throughout the year. Regardingthe lighting, many expressed the desire to be able to adjust it on their own.People perceive things differently which is why a more varied and flexible office might fulfillmore peopleâs needs. If these needs are fulfilled, it could improve not only the physical workenvironment but also the psychological work environment and therefore increase theattractiveness and job satisfaction of the employees.Tidigare forskning har visat en möjlig koppling mellan inomhusklimat och dess pĂ„verkan pĂ„den anstĂ€lldas prestation. Olika faktorer kan pĂ„verka prestationen; fysiska parametrar; sĂ„somventilation och luftkvalitet, ljudnivĂ„, termiskt klimat, ljus och tillgĂ„ng till dagsljus samt nivĂ„nav flexibilitet pĂ„ jobbet, möbler och andra faktorer. DĂ€rför syftar denna studie till att undersökakvalitĂ©n av arbetsmiljön inomhus pĂ„ platskontor hos Company AB i Sverige. Vidare, hur denfysiska och psykiska miljön spelar en stor roll gĂ€llande hur attraktiv en arbetsplats Ă€r. Dennastudie kommer bara fokusera pĂ„ fyra fysiska parametrar som pĂ„verkar den fysiskafunktionaliteten av ett kontor; luftkvalitet, ljud, temperatur och ljus. Följande forskningsfrĂ„gorhar stĂ€llts: 1) Vilka olika typer av platskontor kan identifieras i Sverige och vilka olikautformningar anvĂ€nds vanligast? 2) Hur vĂ€l uppfyller den faktiska inomhusmiljön pĂ„platskontoren kraven frĂ„n Arbetsmiljöverket? 3) Hur upplevs inomhusmiljön pĂ„ platskontorenav mĂ€nniskorna som jobbar i dem? 4) Vilka Ă€r de viktigaste aspekterna för att ökaattraktiviteten av platskontoren pĂ„ Company AB? Studien Ă€r bĂ„de kvalitativ och kvantitativoch inkluderar bĂ„de mĂ€tningar, intervjuer, möten och en enkĂ€t som de frĂ€mstainformationskĂ€llorna för att svara pĂ„ forskningsfrĂ„gorna.Resultaten visar pĂ„ att de vanligaste platskontoren Ă€r byggbodar och inhyrda lokaler. Debesökta kontoren hade olika uppbyggnad eftersom de var utformade för att passa de specifikaprojektorganisationerna. Utav de fyra parametrarna var ljudet det enda som uppfyllde kraven ide sex besökta platskontoren.De anstĂ€llda upplevde de fysiska parametrarna pĂ„ olika sĂ€tt. Luftkvaliteten upplevdes generelltsom tillrĂ€cklig bland kontorsplatserna men ganska dĂ„lig i mötesrummen. Flera anstĂ€llda tyckteatt ljudet var en av de mest problematiska parametrarna och det visade sig möjligtvis bero pĂ„arbetsroll eller uppgift. De anstĂ€llda uttryckte ett behov av en varierad utformning av kontorenmed en kombination av bĂ„de öppna kontorslandskap och mindre avskilda rum vilket skullekunna öka koncentrationsförmĂ„gan och minska störande ljud. En annan problematiskparameter var temperaturen och generellt var behovet att fĂ„ en mer stabil temperatur över Ă„ret.Vad gĂ€ller ljussĂ€ttningen sĂ„ uttryckte mĂ„nga att de ville kunna reglera den sjĂ€lva.MĂ€nniskor upplever saker olika vilket gör att ett mer varierat och flexibelt kontor kan uppfyllafler mĂ€nniskors behov. Om dessa behov uppfylls kan detta förbĂ€ttra inte bara den fysiskaarbetsmiljön utan ocksĂ„ den psykiska arbetsmiljön och kan dĂ€rigenom öka attraktiviteten samtarbetsnöjdheten hos de anstĂ€llda
Neuraxial opioids as analgesia in labour, caesarean section and hysterectomy: A questionnaire survey in Sweden [version 2; referees: 2 approved]
Background: Neuraxial opioids improve labour analgesia and analgesia after caesarean section (CS) and hysterectomy. Undesirable side effects and difficulties in arranging postoperative monitoring might influence the use of these opioids. The aim of the present survey was to assess the use of intrathecal and epidural morphine in gynaecology and obstetrics in Sweden. Methods: A questionnaire was sent to all anaesthetic obstetric units in Sweden concerning the use and postoperative monitoring of morphine, sufentanil and fentanyl in spinal/epidural anaesthesia. Results: A total of 32 of 47 (68%) units responded representing 83% of annual CS in Sweden. In CS spinal anaesthesia, 20/32 units use intrathecal morphine, the most common dose of which was 100 ÎŒg (17/21). Intrathecal fentanyl (10-20 ÎŒg) was used by 21 units and sufentanil (2.5 -10 ÎŒg) by 9/32 of the responding units. In CS epidural anaesthesia, epidural fentanyl (50-100 ÎŒg) or sufentanil (5-25 ÎŒg) were commonly used (25/32), and 12/32 clinics used epidural morphine, the majority of units used a 2 mg dose. Intrathecal morphine for hysterectomy was used by 20/30 units, with 200 ÎŒg as the most common dose (9/32). Postoperative monitoring was organized in adherence to the National Guidelines; the patient is monitored postoperative care or an obstetrical ward over 2-6 hours and up-to 12 hours in an ordinary surgical ward. Risk of respiratory depression/difficult to monitor was a reason for not using intrathecal opioids. Conclusions: Neuraxial morphine is used widely in Sweden in CS and hysterectomy, but is still restricted in some units because of the concern for respiratory depression and difficulties in monitoring
Effects of in vitro hyperthermia on proliferative responses and lymphocyte activity
Fever is induced by both exogenous products like endotoxin, and endogenous cytokines, most notably IL-1 and IL-6, and tumour necrosis factor (TNF). These mediators are believed to interact with the hypothalamus, to induce enhanced body temperature. However, little is known about the biological effects of fever on the function of the immune system. We here report that a 90-min pulse of mild hyperthermia (40°C) induces enhanced proliferation of peripheral blood mononuclear cells (PBMC). This proliferative response was completely inhibited by antibodies to MHC class II, which had no effect on mitogen-induced proliferation of PBMC. The enzyme-linked immunospot (ELISPOT) assay is a sensitive method for detection of single cells secreting antibodies or cytokines. A 90-min pulse of mild hyperthermia (40°C) induced a significantly enhanced immunoglobulin production in PBMC, as determined by ELISPOT, indicating B cell activation. The T cell cytokine pattern both with and without stimulation with hyperthermia differed between individuals. Enhanced interferon-gamma (IFN-Îł) secretion was noted at 39â41°C. This IFN-Îł response was inhibited by antibodies to MHC class II and thus was MHC class II-restricted and dependent on antigen-presenting cells. None of the individuals tested showed IL-4 response after stimulation with hyperthermia. These findings favour the notion that fever may play an important role in immune responses, and it is possible that fever may act as a physiological adjuvant, with effects on the immune system both in infection and inflammation of other origins
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