As the novel coronavirus disease (COVID-19) pandemic spreads throughout United States, evidence is mounting that racial and ethnic minorities socioeconomically disadvantaged groups are bearing a disproportionate burden of illness death. We conducted retrospective cohort analysis COVID-19 patients at Sutter Health, large integrated health system in northern California, to measure potential disparities. used Sutter's electronic record identify adults with suspected confirmed COVID-19, we...

Pretreating rats 24 hr earlier with naloxonazine (10 mg/kg i.v.) virtually eliminates the analgesic response observed morphine at 3.5 (i.v.) and significantly reduces elevation in tail-flick latencies seen higher doses. Full dose-response curves show a 4-fold shift to right (P less than .001) following treatment. At (i.v.), depresses respiratory function, as determined by arterial blood gas (pO2, pCO2 pH) measurements. Unlike analgesia, prior treatment of does not alter depressant actions...

The low solubility of desflurane in blood and tissues suggests that the partial pressures this agent should approach inspired pressure more rapidly than would tissue other potent inhaled anesthetics. We tested prediction, comparing pharmacokinetics with those isoflurane, halothane, nitrous oxide eight volunteers. measured rate at which alveolar (endtidal) (FA) concentration increased towards an (FI) 65-70%, then concurrent increase FA mixed expired concentrations (FM) desflurane, halothane...

The low solubility of sevoflurane in blood suggests that this agent should enter and leave the body more rapidly than isoflurane. However, closeness isoflurane tissue/blood partition coefficients rates equilibration with elimination from tissues be similar. We tested both predictions, comparing nitrous oxide seven volunteers. measured rate at which alveolar (end-tidal) (FA) concentration increased toward an inspired (FI) 65%–70%, then concurrent rise FA mixed expired concentrations (FM)...

Desflurane (formerly I-653) is a new inhalaticnal anesthetic with promising pharmacokinetic profile that includes low solubility in blood and tissue, including fat. Since its lipid less than of other volatile agents, it may have lower potency. Low would be expected to increase the rate at which alveolar concentration approaches inspired during induction as well elimination desflurane from emergence. We determined minimum (MAC) 44 unpremedicated ASA physical status 1 or 2 patients undergoing...

The electroencephalographic (EEG) effects of a new inhaled anesthetic are interest because the potential such agents to produce excitatory (convulsant) activity and usefulness EEG as an indicator depth cerebral activity. Accordingly, we examined in 12 healthy, young male volunteers during desflurane anesthesia. Each subject had baseline recording then steady-state exposure 6, 9, 12% (0.83, 1.24, 1.66 MAC) O2 alone, 3, 9% with 60% N2O. sequence doses presence N2O were randomized. We used...

The cardiovascular actions of three concentrations desflurane (formerly I-653), a new inhalation anesthetic, were examined in 12 unmedicated normocapnic, normothermic male volunteers. We compared the effects 0.83, 1.24, and 1.66 MAC with measurements obtained while same men conscious. Desflurane caused dose-dependent increase right-heart filling pressure decrease systemic vascular resistance mean arterial blood pressure. As measured by echocardiography, left ventricular end-diastolic area...

Intravenous infusion of morphine sulfate in rats for 24 hours produced marked opioid dependence, manifested by a series well-documented signs appearing after injection the opiate antagonist naloxone. Treatment with naloxonazine significantly reduced analgesia associated infusions more than hours. Furthermore, 14 16 withdrawal observed naloxonazine-treated were virtually identical to those that received alone. These results raise possibility different receptor mechanisms mediate and many dependence.

Anesthetics can alter the dose of exogenously administered epinephrine that causes cardiac arrhythmias. The purpose this study was to test hypothesis in humans anesthetized with sevoflurane, arrhythmic response is not different from isoflurane.We determined arrhythmogenicity submucosally 40 ASA physical status 1 or 2 patients who were undergo transsphenoidal surgery. Patients assigned randomly be given 1.0-1.3 minimum alveolar concentration sevoflurane isoflurane. A surgeon, blinded...

We studied the ventilatory effects of desflurane (formerly I-653) with and without N2O in healthy male volunteers. After insertion venous arterial (radial pulmonary) catheters, baseline measurements tidal volume (VT), respiratory rate (RR), response to CO2, mixed blood gases were made. Subjects randomly assigned receive either O2 (n = 6) or 60% 6). Anesthesia was induced by inhalation followed tracheal intubation muscle relaxants. In each volunteer, at end-tidal concentrations totaling 0.83,...

We determined the cardiovascular effects of 0.91, 1.34, and 1.74 MAC desflurane/nitrous oxide anesthesia (60% inspired nitrous contributed 0.5 at each level) in 12 healthy, normocapnic male volunteers. Desflurane/nitrous decreased systemic blood pressures, cardiac index, stroke volume vascular resistance, left ventricular work increased pulmonary arterial pressures central venous pressure a dose-dependent fashion, while heart rate was 10%-12% mixed oxygen tension 2–4 mm Hg higher all levels...

The authors used in vivo 19F nuclear magnetic resonance spectroscopy to determine rates of cerebral uptake and elimination desflurane, isoflurane, halothane rabbits. After anesthetizing animals by intramuscular intravenous injection methohexital inhalation 70% nitrous oxide, intraarterial catheters were inserted a tracheostomy craniotomy performed. Ventilation was controlled maintain arterial carbon dioxide tension (PaCO2) from between 35 45 mmHg. A 2-2.5-cm diameter circle dura exposed,...

We examined the potential toxicity of desflurane in 13 young 25.0 ± 2.3 (mean SD) yr-old men, given 7.35 0.81 MAC-hours anesthesia. Hepatic and renal function tests, serum electrolytes, standard urine hematologic tests were performed before, during, after No was found. There no changes hepatocellular integrity (plasma alanine transferase activity), synthetic (serum albumin, prothrombin time, partial thromboplastin time), or creatinine concentration, blood urea nitrogen concentration)....

Purpose: The coronavirus pandemic has created the greatest public health crisis in a century, causing >500,000 deaths United States alone. Minoritized and socioeconomically disadvantaged groups have borne disproportionate burden of severe illness, hospitalization, death from COVID-19. Recently developed FDA-approved vaccines been shown to significantly reduce COVID-19–related outcomes. Vaccination campaigns potential advance equity by prioritizing allocation those at highest risk while...

We investigated the cardiovascular actions of desflurane (formerly I-653) during spontaneous ventilation. gave 0.8-0.9, 1.2-1.3, and 1.6-1.7 MAC in oxygen (n = 6) 60% nitrous oxide, balance to unmedicated healthy male volunteers. Both anesthetic regimens decreased ventilation, increased partial pressure arterial carbon dioxide, produced similar changes. In comparison with values obtained when volunteers were conscious, anesthesia ventilation systemic vascular resistance mean blood pressure....

Cotzias Laboratory of Neuro-Oncology and the Biostatistics Laboratory, Memorial Sloan-Kettering Cancer Center Departments Neurology Pharmacology, Cornell University Medical College, New York, York

We asked if desflurane with or without nitrous oxide at 0.83, 1.24, and 1.66 MAC prevented cardiovascular responses to stimulation. measured cardiac output, heart rate, systemic arterial blood pressure, central venous pulmonary vascular resistance in six healthy male volunteers before (control) 0, 1, 2, 4, 6 min after tetanic electrical stimulation (50, 100, 200 Hz) of the ulnar nerve. At 0.83 1.24 MAC, mean pressure increased. Peak changes averaged 13%-20% most frequently occurred 0–2 (P <...

We studied the percutaneous losses of new inhaled anesthetic, desflurane (I-653), and isoflurane halothane during anesthetic administration elimination in seven healthy male volunteers. Anesthesia was induced maintained with midazolam, thiopental, fentanyl. administered 70% N2O for 30 min, then 2% desflurane, 0.4% isoflurane, 0.2% concurrently 65% min. Inspired, end-tidal, mixed-expired gas samples were collected volatile agents 5-7 days elimination. The right arm hand each subject enclosed...

Objective: COVID-19 and associated morbidity mortality has disproportionately affected minoritized populations. The epidemiology of spread among pregnant women by race/ethnicity is not well described. Using data from a large healthcare system in California, we estimated prevalence during pregnancy recommend vaccination approach based on minimizing adverse outcomes. Methods: Patients delivering at Sutter Health are tested (molecular) for COVID-19. These results were combined with antibody...

We studied the percutaneous losses of sevoflurane and isoflurane during administration elimination in seven healthy male volunteers. Anesthesia was induced maintained with fentanyl, midazolam, and/or thiopental, nitrous oxide for 30 min, after which 1% 0.4% 65% were administered min. Inspired, end-tidal, mixed-expired gas samples collected 5-7 days elimination. To measure loss, each subject's arm enclosed a glass cylinder sealed at both ends two ports, one flushing nitrogen obtaining min...

Disparities in outcomes for preventive and primary health care services often result when vulnerable patients rely on episodic encounters emergency that do not meet their long-term needs. Understanding socially or economically disadvantaged subgroups is crucial to improving community health, it requires innovative analytics dynamic application of clinical population data. While common practice use proxy indicators, such as quality life mortality, discussing equity, these have shown limited...

Abstract To measure disparities in coronavirus disease 2019 (COVID-19) hospitalization and intensive care unit (ICU) transfer among racially/ethnically marginalized groups before after implementation of the California statewide shelter-in-place (SIP) policy, we conducted a retrospective cohort study within health-care system California. COVID-19 patients diagnosed from January 1, 2020, to August 31, were identified electronic health records. We examined hospitalizations ICU transfers by...