Preliminary study of epidural nalbuphine treatment of post operative pain: A comparison with equipotent dose of epidural morphine

Epidural analgesia was used in 45 patients submitted to upper abdominal surgery. In 30 of them 0.15mg/kg nalbuphine (EN group) was injected and in the remained, an equipotent dose of 0.1mg/kg of preservative free morphine (EM group) was used. The patients were observed concerning the severity of pain before and after narcotic administration, duration of analgesia, occurrence and severity of side effects among them. The severity of pain was stated by the McGill pain score (from 0 to 5). Duration of analgesia was defined as the time interval from pain relief after narcotic administration untill requirement of an additional epidural narcotic injection. The adequacy of ventilation was estimated by sequential measurements of arterial P_{CO 2}.Pain relief was excellent in all patients after both narcotics administration. The analgesia time was significantly longer with epidural morphine than in the EN patients. Besides drowsiness, the other side effects incidence was lower with epidural nalbuphine than with epidural morphine. Two patients in the EM group presented clinical respiratory depression, showing a significant increase in arterial P_{CO 2}.We believe that the lack of respiratory depression seen in EN group is a consequence of the rostral diffusion of the drug, which reaches high concentrations at the respiratory centers level and a direct antagonist action upon them.Our results showed that epidurally administered nalbuphine provides a good analgesia, with minor side effects and favorably compairs with epidural morphine.(Weksler N, Ovadia L: Preliminary study of epidural nalbuphine in treatment of post operative pain: A comparison with equipotent dose of epidural morphine. J Anesth 3: 54–57, 1989)     

Non cardiogenic pulmonary edema as consequence of upper airway obstruction

Non cardiogenic pulmonary edema is a rare complication of upper airway obstruction. Its etiology is controversial, but probably can be explaired by the Starlings law, when the large negative intrathoracic pressure generated excedes the intravascular and interstitial pressures, shifting fluids from capillaries to interstitium and alveoli. In addition, alteration of capillary permeability potentiates fluid migration.We present herein, a case of non cardiogenic pulmonary edema following relief of upper airway obstruction in a 14 years old girl underwent surgical repair of cleft palate.Cardiogenic pulmonary edema could be excluded by a normal CVP, wedge pressure and four chamber echocardiography. The edema fluid: plasma protein ratio greater than 0.7 can indicate an increased capillary permeability. Mendelsons syndrome could be ruled out by the rapid improvement seen and the soft clinical course.(Weksler N, Ovadia L: Non cardiogenic pulmonary edema as consequence of upper airway obstruction J Anesth 3: 40–42, 1989)     

Influence of food restriction on lipid profile and spontaneous glucose levels in male rats subjected to paradoxical sleep deprivation

OBJECTIVES:

The purpose of this study was to determine the paired consequences of food restriction and paradoxical sleep deprivation on lipid profile and spontaneous glucose levels in male rats.

METHOD:

Food restriction began at weaning, with 6 g of food being provided per day, which was subsequently increased by 1 g per week until reaching 15 g per day by the eighth week. At adulthood, both rats subjected to food restriction and those fed ad libitum were exposed to paradoxical sleep deprivation for 96 h or were maintained in their home-cage groups.

RESULTS:

Animals subjected to food restriction exhibited a significant increase in high-density lipoprotein levels compared to animals that were given free access to food. After the paradoxical sleep deprivation period, the food-restricted animals demonstrated reduced concentrations of high-density lipoprotein relative to their respective controls, although the values for the food-restricted animals after sleep deprivation were still higher than those for the ad libitum group. The concentration of low-density lipoproteins was significantly increased in sleep-deprived animals fed the ad libitum diet. The levels of triglycerides, very low-density lipoproteins, and glucose in food-restricted animals were each decreased compared to both ad libitum groups.

CONCLUSION:

These results may help to illustrate the mechanisms underlying the relationship between sleep curtailment and metabolism and may suggest that, regardless of sleep deprivation, dietary restriction can minimize alterations in parameters related to cardiovascular risk.     

Intratesticular mucinous cystadenoma: immunohistochemical comparison with ovarian and colonic tissue

We report a case of a primary intratesticular mucinous cystadenoma in an asymptomatic 39-year-old man. The mass was found incidentally during a consultation for infertility. Pathologic examination of the orchiectomy specimen revealed a unilocular cyst lined with bland mucinous epithelium and mucinous extravasation, consistent with a diagnosis of mucinous cystadenoma. Foci of bone were also found in association with extensive chronic inflammation. Immunohistochemical stains performed showed immunoreactivity for cytokeratin 7, and nonreactivity for cytokeratin 20, CA125, chromogranin, and synaptophysin. The immunohistochemical staining patterns of the present case are compared with those of known mucinous cystadenomas of the ovary and nonneoplastic colonic mucosa. The histogenesis of this entity is discussed in light of the literature and the immunohistochemical findings in this rare case.     

The accuracy of sentinel node mapping according to T stage in patients with gastric cancer

Background  

Sentinel lymph node (SLN) mapping has been recently introduced to the field of gastric cancer. To the best of our knowledge, no study has dealt with the accuracy of SLN mapping according to the T stage of the primary tumor. The aim of the present study was to evaluate SLN status according to the T stage of the primary tumors.     

A high oleic sunflower oil fatty acid esters of plant sterols mixed with dietary diacylglycerol reduces plasma insulin and body fat accumulation in Psammomys obesus

Background  

Metabolic syndrome is associated with subsequent development of cardiovascular diseases and type 2 diabetes. It is characterized by reduced response to insulin, central obesity, and dyslipidemia. Intake of plant sterols (PS) has been shown to confer a healthier lipid profile and ameliorate cardiovascular disease risk factors in experimental animals and humans. In this study we used an animal model of type 2 diabetes to assess the effects of a preparation of PS esterified to high oleic sunflower oil fatty acids mixed with dietary diacylglycerol (PS-HOSO) on diabetic related metabolic parameters. Psammomys obesus (P. obesus) were fed high energy (HE) diet supplemented by either PS-HOSO or control oil. Following 4.5 weeks of intervention, animals were divided into fasting and non-fasting modes prior to outcome measurements. Glucose and insulin levels as well as blood lipid profile, body weight, and fat accumulation were evaluated in fasting and non-fasting modes.