Infusione continua di detomidina durante chirurgia laparoscopica nel cavallo

RIASSUNTO L’anestesia in stazione quadrupedale è una pratica che permette l’esecuzione di diverse manualità mediche e chirurgiche nel cavallo, senza dover sottoporre il soggetto ai maggiori pericoli di un’anestesia generale. Questa tecnica anestesiologica prevede l’impiego di sedativi in associazione con una tecnica analgesica (somministrazione sistemica, anestesia loco-regionale) qualora la manualità da eseguire comporti l’insorgenza di uno stimolo dolorifico. La laparoscopia prevede l’inserimento intraddominale dei trocar e dello strumentario necessario per eseguire la tecnica. Per evitare danni agli organi da parte dello strumentario in addome, il soggetto deve mantenere una posizione adeguata e non deve effettuare movimenti bruschi. Nello studio è stato formulato un protocollo che ha previsto la sedazione del soggetto mediante la somministrazione di detomidina in associazione con buprenorfina per via endovenosa ed anestesia loco-regionale della porzione interessata dalla chirurgia mediante lidocaina. Per il mantenimento è stata attuata l’infusione endovenosa continua di detomidina con lo scopo di ottenere un livello di sedazione costante nel tempo ed adeguato alla manualità. Infatti la somministrazione di un farmaco per via endovenosa continua permette di variare più rapidamente il livello ematico di questo e, conseguentemente, di poterne modulare gli effetti. La detomidina è un farmaco che produce un accumulo nell’organismo, per cui è stato adottato un protocollo che prevede il dimezzamento il dosaggio dell’infusione ogni quindici minuti. L’impiego di questo protocollo anestesiologico ha permesso di effettuare la procedura laparoscopica senza difficoltà da parte del chirurgo. Il piano analgesico ottenuto è risultato efficace ed adeguato per lo svolgimento della manualità chirurgica. A fine intervento tutti i soggetti hanno ripreso la capacità di deambulare in breve tempo, non presentando complicazioni. SUMMARY Standing horse anesthesia is a practice that allows the execution of medical and surgical techniques, without applying to general anesthesia that is a very stressful and more dangerous event for a horse. In this kind of anesthesia, sedatives are employed in association with an analgesic technique (sistemic analgesia or loco-regional anesthesia) when the practice is supposed to be painful. The abdominal introduction of trocars and of laparoscopic tools is necessary in order to perfom a laparoscopic surgery; for this reason the patient is expected to stand motionless and it is important that it does not make roguh movements during the procedure. The wording of the anesthesia protocol for this study implied the use of detomidine for sedation in association with intravenous buprenorphine as analgesic and loco-regional anesthesia with lidocaine of the surgical area. For the maintenance, detomidine by intravenous continuous infusion was employed with the purpose to obtain a constat sedation level and adequate to the procedure. In fact the constant infusion of drugs permits to change blood concentration more rapidly and consequently it is possible to easily modulate the effects of drugs. Detomidine is a sedative that can accumulate in the organism, so the anesthestic protocol foresaw to halve the dosage every fifteen minutes. This anesthetic protocol provided a good sedation and the laparoscopic technique was performed without problems. The obtained analgesic plan resulted efficacious and adequate for the course of the surgery. At the end of the procedure all the subjects were able rapidly to walk and did not present complications

Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Background: genetics plays an important role in the susceptibility to sporadic colorectal cancer (CRC). In the last 10 years genome-wide association studies (GWAS) have identified over 40 independent low penetrance polymorphic variants. However, these loci only explain around 1‑4% of CRC heritability, highlighting the dire need of identifying novel risk loci. In this study, we focused our attention on the genetic variability of the TAS2R16 gene, encoding for one of the bitter taste receptors that selectively binds to salicin, a natural antipyretic that resembles aspirin. Given the importance of inflammation in CRC, we tested whether polymorphic variants in this gene could affect the risk of developing this neoplasia hypothesizing a role of TAS2R16 in modulating chronic inflammation within the gut. Methods: we performed an association study using 6 tagging SNPs, (rs860170, rs978739, rs1357949, rs1525489, rs6466849, rs10268496) that cover all TAS2R16 genetic variability. The study was carried out on 1902 CRC cases and 1532 control individuals from four European countries. Results: we did not find any statistically significant association between risk of developing CRC and selected SNPs. However, after stratification by histology (colon vs. rectum) we found that rs1525489 was associated with increased risk of rectal cancer with a (Ptrend of = 0.0071). Conclusions: our data suggest that polymorphisms within TAS2R16 gene do not have a strong influence on colon cancer susceptibility, but a possible role in rectal cancer should be further evaluated in larger cohorts

mRNA PGC-1α levels in blood samples reliably correlates with its myocardial expression: study in patients undergoing cardiac surgery

et al.[Objective]: Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) is a transcriptional coactivator that has been proposed to play a protective role in mouse models of cardiac ischemia and heart failure, suggesting that PGC-1α could be relevant as a prognostic marker. Our previous studies showed that the estimation of peripheral mRNA PGC-1α expression was feasible and that its induction correlated with the extent of myocardial necrosis and left ventricular remodeling in patients with myocardial infarction. In this study, we sought to determine if the myocardial and peripheral expressions of PGC-1α are well correlated and to analyze the variability of PGC-1α expression depending on the prevalence of some metabolic disorders. [Methods]: This was a cohort of 35 consecutive stable heart failure patients with severe aortic stenosis who underwent an elective aortic valve replacement surgery. mRNA PGC-1α expression was simultaneously determined from myocardial biopsy specimens and blood samples obtained during surgery by quantitative PCR, and a correlation between samples was made using the Kappa index. Patients were divided into two groups according to the detection of baseline expression levels of PGC-1α in blood samples, and comparisons between both groups were made by chi-square test or unpaired Student’s t-test as appropriate. [Results]: Based on myocardial biopsies, we found that mRNA PGC-1α expression in blood samples showed a statistically significant correlation with myocardial expression (Kappa index 0.66, p<0.001). The presence of higher systemic PGC-1α expression was associated with a greater expression of some target genes such as silent information regulator 2 homolog-1 (x-fold expression in blood samples: 4.43±5.22 vs. 1.09±0.14, p=0.044) and better antioxidant status in these patients (concentration of Trolox: 0.40±0.05 vs. 0.34±0.65, p=0.006). [Conclusions]: Most patients with higher peripheral expression also had increased myocardial expression, so we conclude that the non-invasive estimation of mRNA PGC-1α expression from blood samples provides a good approach of the constitutive status of the mitochondrial protection system regulated by PGC-1α and that this could be used as prognostic indicator in cardiovascular disease.Grant from Sociedad Valenciana de Cardiología, 2013 to Óscar Fabregat-Andrés.Peer Reviewe

How we fix free flaps to the bone in oral and oropharyngeal reconstructions

Purpose: The use of suture anchors has been described in orthopedic, hand, oculoplastic, temporomandibular joint and in aesthetic surgery, but no study reports the use of the Mitek\uae anchors (Depuy Mitek Surgical Products, Inc. Raynham, Massachusetts) for fixing the free flaps used in oncologic oral and oropharyngeal reconstruction. Materials and Methods: In this prospective non-randomized study, 9 patients underwent surgical resection of oral or oropharyngeal cancer followed by a free flap reconstruction; mini anchors were used to fix the flap directly to the bone. We collected data regarding the patients, the tumor stage, the surgical procedure, the radiotherapy and the number of anchors used. Results: The average follow-up was 28 months (range 24\u201338).We observed no complications with trans-oral, sub-mandibular and trans-mandibular approach in both oral and oropharyngeal reconstructions. All anchors became osteo-integrated and no complications occurred after radiotherapy. Conclusions: In our opinion this device favors free flap adhesion to the bone. We registered no postoperative complications related to the use of the device which looks suitable for use in irradiated tissues. The radiotherapy did not cause any long-term complications related to the use of Mitek\uae mini bone anchors

Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Abstract Background Genetics plays an important role in the susceptibility to sporadic colorectal cancer (CRC). In the last 10 years genome-wide association studies (GWAS) have identified over 40 independent low penetrance polymorphic variants. However, these loci only explain around 1‑4% of CRC heritability, highlighting the dire need of identifying novel risk loci. In this study, we focused our attention on the genetic variability of the TAS2R16 gene, encoding for one of the bitter taste receptors that selectively binds to salicin, a natural antipyretic that resembles aspirin. Given the importance of inflammation in CRC, we tested whether polymorphic variants in this gene could affect the risk of developing this neoplasia hypothesizing a role of TAS2R16 in modulating chronic inflammation within the gut. Methods We performed an association study using 6 tagging SNPs, (rs860170, rs978739, rs1357949, rs1525489, rs6466849, rs10268496) that cover all TAS2R16 genetic variability. The study was carried out on 1902 CRC cases and 1532 control individuals from four European countries. Results We did not find any statistically significant association between risk of developing CRC and selected SNPs. However, after stratification by histology (colon vs. rectum) we found that rs1525489 was associated with increased risk of rectal cancer with a (Ptrend of = 0.0071). Conclusions Our data suggest that polymorphisms within TAS2R16 gene do not have a strong influence on colon cancer susceptibility, but a possible role in rectal cancer should be further evaluated in larger cohorts

Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Background: genetics plays an important role in the susceptibility to sporadic colorectal cancer (CRC). In the last 10 years genome-wide association studies (GWAS) have identified over 40 independent low penetrance polymorphic variants. However, these loci only explain around 1‑4% of CRC heritability, highlighting the dire need of identifying novel risk loci. In this study, we focused our attention on the genetic variability of the TAS2R16 gene, encoding for one of the bitter taste receptors that selectively binds to salicin, a natural antipyretic that resembles aspirin. Given the importance of inflammation in CRC, we tested whether polymorphic variants in this gene could affect the risk of developing this neoplasia hypothesizing a role of TAS2R16 in modulating chronic inflammation within the gut. Methods: we performed an association study using 6 tagging SNPs, (rs860170, rs978739, rs1357949, rs1525489, rs6466849, rs10268496) that cover all TAS2R16 genetic variability. The study was carried out on 1902 CRC cases and 1532 control individuals from four European countries. Results: we did not find any statistically significant association between risk of developing CRC and selected SNPs. However, after stratification by histology (colon vs. rectum) we found that rs1525489 was associated with increased risk of rectal cancer with a (Ptrend of = 0.0071). Conclusions: our data suggest that polymorphisms within TAS2R16 gene do not have a strong influence on colon cancer susceptibility, but a possible role in rectal cancer should be further evaluated in larger cohorts

Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Background: genetics plays an important role in the susceptibility to sporadic colorectal cancer (CRC). In the last 10 years genome-wide association studies (GWAS) have identified over 40 independent low penetrance polymorphic variants. However, these loci only explain around 1‑4% of CRC heritability, highlighting the dire need of identifying novel risk loci. In this study, we focused our attention on the genetic variability of the TAS2R16 gene, encoding for one of the bitter taste receptors that selectively binds to salicin, a natural antipyretic that resembles aspirin. Given the importance of inflammation in CRC, we tested whether polymorphic variants in this gene could affect the risk of developing this neoplasia hypothesizing a role of TAS2R16 in modulating chronic inflammation within the gut. Methods: we performed an association study using 6 tagging SNPs, (rs860170, rs978739, rs1357949, rs1525489, rs6466849, rs10268496) that cover all TAS2R16 genetic variability. The study was carried out on 1902 CRC cases and 1532 control individuals from four European countries. Results: we did not find any statistically significant association between risk of developing CRC and selected SNPs. However, after stratification by histology (colon vs. rectum) we found that rs1525489 was associated with increased risk of rectal cancer with a (Ptrend of = 0.0071). Conclusions: our data suggest that polymorphisms within TAS2R16 gene do not have a strong influence on colon cancer susceptibility, but a possible role in rectal cancer should be further evaluated in larger cohorts

Additional file 4: Table S4. of Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Description of data Association between colon/rectalcancer risk and SNPs in the TAS2R16 region considering only Italy. (DOCX 17 kb

Additional file 2: Table S2. of Association between polymorphisms of TAS2R16 and susceptibility to colorectal cancer

Description of data Association between colon/rectal cancer risk and SNPs in the TAS2R16 region considering only the Czech Republic. (DOCX 17 kb

Exploring the Neandertal legacy of pancreatic ductal adenocarcinoma risk in Eurasians

Abstract Background The genomes of present-day non-Africans are composed of 1–3% of Neandertal-derived DNA as a consequence of admixture events between Neandertals and anatomically modern humans about 50–60 thousand years ago. Neandertal-introgressed single nucleotide polymorphisms (aSNPs) have been associated with modern human disease-related traits, which are risk factors for pancreatic ductal adenocarcinoma (PDAC), such as obesity, type 2 diabetes, and inflammation. In this study, we aimed at investigating the role of aSNPs in PDAC in three Eurasian populations. Results The high-coverage Vindija Neandertal genome was used to select aSNPs in non-African populations from 1000 Genomes project phase 3 data. Then, the association between aSNPs and PDAC risk was tested independently in Europeans and East Asians, using existing GWAS data on more than 200 000 individuals. We did not find any significant associations between aSNPs and PDAC in samples of European descent, whereas, in East Asians, we observed that the Chr10p12.1-rs117585753-T allele (MAF = 10%) increased the risk to develop PDAC (OR = 1.35, 95%CI 1.19–1.54, P = 3.59 × 10–6), with a P-value close to a threshold that takes into account multiple testing. Conclusions Our results show only a minimal contribution of Neandertal SNPs to PDAC risk