Chronic pain is common and undesirable after surgery. Progression from acute to chronic involves altered processing. The authors studied relationships between presence of versus preoperative descending control (diffuse noxious inhibitory controls; DNICs) postoperative persistence spread skin deep tissue hyperalgesia (change in electric/pressure tolerance thresholds; ePTT/pPTT) up 6 months postoperatively. In 20 patients undergoing elective major abdominal surgery under standardized...

Danger-associated molecular patterns (DAMPs) released of trauma could contribute to an immune suppressed state that renders patients vulnerable towards nosocomial infections. We investigated DAMP release in patients, starting the prehospital phase, and assessed its relationship with suppression Blood was obtained from 166 adult at scene, emergency room (ER), serially afterwards. Circulating levels DAMPs cytokines were determined. Immune by determination HLA-DRA gene expression ex vivo...

Background: Plasma levels of the danger-associated molecular patterns (DAMPs) nuclear DNA (nDNA) and mitochondrial (mtDNA) have been shown to be related sepsis mortality. However, intermediate factors and/or mechanisms contributing this relation are largely unknown. Our aim was determine whether plasma nDNA mtDNA markers inflammation, severity shock, organ damage in septic shock patients. Moreover, we investigated relationship between nDNA/mtDNA inflammatory cytokines during experimental...

<h3>Background and Objectives:</h3> This study was performed to determine the minimum effective volume of ropivacaine 0.75% required produce shoulder analgesia for an ultrasound (US)-guided block at C7 root level with assessment pulmonary function. <h3>Methods:</h3> Using Dixon Massey up-and-down method design, 20 patients scheduled elective open surgery under combined general anesthesia continuous interscalene brachial plexus were included. Initial 6 mL; success or failure determined a 1-mL...

Thoracic paravertebral block (TPVB) can be used for unilateral surgical procedures. Modifications of the classic approach have been proposed to minimize risk pleural puncture. In this study, we evaluated feasibility and success rate a transverse in-plane ultrasound (US)-guided TPVB with radiologic confirmation catheter position.A total 36 patients scheduled surgery were included in prospective study. Ultrasonographically, process thoracic vertebra rib identified at appropriate level. The...

Mechanical ventilation (MV) can induce ventilator-induced lung injury. A role for proinflammatory pathways has been proposed. The current studies analyzed the roles of Toll-like receptor (TLR) 4 and TLR2 involvement in inflammatory response after MV healthy lung.Wild-type (WT) C57BL6, TLR4 knockout (KO), KO mice were mechanically ventilated h. Bronchoalveolar lavage fluid was presence endogenous ligands. Lung homogenates used to investigate changes expression. Cytokines measured homogenate...

BackgroundHyperalgesia is a well recognized hallmark of disease. Pro-inflammatory cytokines have been suggested to be mainly responsible, but human data are scarce. Changes in pain threshold during systemic inflammation evoked by endotoxemia, were evaluated with three quantitative sensory testing methods. Methods and ResultsPressure thresholds, electrical thresholds tolerance the cold pressor test measured before 2 hours after intravenous administration ng/kg purified E. coli endotoxin 27...

Despite the large amount of human and experimental studies no effective (prophylactic) treatment exists for chemotherapy induced peripheral neuropathy (CIPN), a disabling side effect many cancer treatments. One underlying reasons this could be that often preclinical animal models used are not best representation clinical situation. We therefore present systematic summary comparison all currently described in literature CIPN focusing on stimulus evoked pain-like behaviour neurophysiological...

Abstract Introduction The aim of the study was to assess influence annual volume and factors related intensive care unit (ICU) organization on in-hospital mortality among patients admitted ICU with severe sepsis. Methods A retrospective cohort conducted using database Dutch National Intensive Care Evaluation (NICE) registry. Analyses were based consecutive between 1 January 2003 30 June 2005 who fulfilled criteria for sepsis within first 24 hours admission. 13-item questionnaire sent all 32...

The direct visualisation of nerves and adjacent anatomical structures may make ultrasonography the preferred method for nerve localisation. In this prospective randomised study, we investigated whether, distal sciatic block in popliteal fossa, an ultrasound guided technique would result use less local anaesthetic without changing characteristics quality. Using electrical stimulation or guidance, nevre was identified two groups 20 patients scheduled lower limb surgery. Hereafter lignocaine...

In what way volume, concentration and dose affect block duration is controversial. The purpose of the present study to investigate effect dose, volume mepivacaine on sensory motor blockade in ultrasound-guided single shot axillary brachial plexus blockade. this parallel group randomized trial conducted Sint Maartenskliniek Nijmegen, 45 adult patients undergoing minor orthopaedic forearm, wrist or hand surgery were 3 groups. Group A: 20 mL 1.5 %, B: 30 1 % C: %. Randomization was...

Both the initial trauma and subsequent hemodynamic instability may contribute to intestinal damage, which is of great importance in (immunological) posttrauma complications. This study assesses damage using biomarker Fatty Acid Binding Protein (iFABP) patients during first days their hospital admission risk factors involved. Plasma iFABP levels were measured blood samples obtained from adult multiple (n = 93) at scene by Helicopter Emergency Medical Services, arrival emergency department...

Introduction Danger-associated molecular patterns (DAMPs) can elicit immune responses and may subsequently induce an immune-suppressed state. Previous work showed that increased plasma levels of DAMPs are associated with suppression susceptibility towards infections in trauma patients. Like trauma, major surgical procedures such as cytoreductive surgery (CRS) combined hyperthermic intraperitoneal chemotherapy (HIPEC), also thought to cause profound DAMP release. Furthermore, the incidence...

Background: The sciatic nerve block by the posterior approaches represents one of more difficult ultrasound‐guided blocks. Our clinical experiences with these blocks indicated a point slightly distal to subgluteal fold as an advantageous position allow good ultrasonic visibility. In this study, we systematically scanned from popliteal crease, determine optimal for ultrasonographic visualization. Methods: After institutional approval and written informed consent, recruited 15 volunteers...

To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter (HEMS) for vitally compromised children. Incidence success rate of several were studied, with distinction made between restricted to HEMS-physician which HEMS is more experienced than EMS.Prospective study consecutive group children examined treated eastern region Netherlands. Data regarding type emergency, physiological parameters, NACA scores, treatment, 24-hour survival...