Comparison of the Conox (qCON) and Sedline (PSI) depth of anaesthesia indices to predict the hypnotic effect during desflurane general anaesthesia with ketamine

Journal of Clinical Monitoring and Computing - Comparison of two depth of anesthesia indices, qCON (Conox) and PSI (Sedline), during desflurane sedation and their sensitivity to random ketamine...     

Generalizability of nociception level as a measure of intraoperative nociceptive stimulation: A retrospective analysis

Background

Nociception-guided intraoperative opioid administration might help reduce postoperative pain. A commonly used and validated nociception monitor system is nociception level (NOL), which provides the nociception index, ranging from 0 to 100, with 0 representing no nociception and 100 representing extreme nociception. We tested the hypothesis that NOL responses are similar in men and women given remifentanil and fentanyl, across various types of anesthesia, as a function of American Society of Anesthesiologists physical status designations, and over a range of ages and body morphologies.

Methods

We conducted a retrospective cohort analysis of trial data from eight prospective NOL validation studies. Among 522 noncardiac surgical patients enrolled in these studies, 447 were included in our analysis. We assessed NOL responses to various noxious and non-noxious stimuli.

Results

The average NOL in response to 315 noxious stimuli was 47 ± 15 (95% CI = 45–49). The average NOL in response to 361 non-noxious stimuli was 10 ± 12 (95% CI = 9–11). NOL responses were similar in men and women, in patients given remifentanil and fentanyl, across various types of anesthesia, as a function of American Society of Anesthesiologists physical status designations, and over a range of ages and body morphologies.

Conclusion

Nociception level appears to provide accurate estimates of intraoperative nociception over a broad range of patients and anesthetic conditions.     

The role of the NOP receptor in regulating food intake, meal pattern, and the excitability of proopiomelanocortin neurons

We evaluated the role of the nociceptin/orphanin FQ (NOP) receptor in regulating food intake, meal pattern and the activity of hypothalamic arcuate (ARC) neurons. The microstructural analysis of food intake and meal pattern was performed under both food-deprived and ad libitum conditions. Whole-cell patch clamp recordings were obtained using the in vitro hypothalamic slice preparation and biocytin-filled electrodes. NOP receptor knockout mice exhibited significantly reduced body weight. Fasting-induced hyperphagia was diminished for the first 2 h of a 6-h re-feeding period, and was associated with decreased meal duration and size, as well as a biphasic effect on meal frequency. The genotype effect observed under ad libitum conditions was comparatively unremarkable. Orphanin FQ/nociceptin (OFQ/N) was able to decrease evoked excitatory postsynaptic current amplitude, increase the S₂:S₁ ratio via the paired-pulse paradigm, and decrease miniature excitatory postsynaptic current frequency in ARC neurons from wild type animals but not NOP receptor knockouts. In addition OFQ/N activated a reversible outward current that was antagonized by the G-protein activated, inwardly-rectifying K⁺ (GIRK) channel blocker tertiapin in wild type but not NOP knockout animals. Both the presynaptic and postsynaptic actions of OFQ/N were observed in ARC neurons subsequently determined to be immunopositive for characteristic phenotypic markers of anorexigenic proopiomelanocortin (POMC) neurons. Taken together, these results demonstrate the contribution of the NOP receptor in controlling food intake and meal pattern, as well as glutamate release and GIRK1 channel activity at POMC synapses.     

Acute adverse reactions associated with angiotensin-converting enzyme inhibitors: genetic factors and therapeutic implications

Angiotensin-converting enzyme inhibitors (ACEIs) have been used in the treatment of various cardiovascular diseases. Despite the therapeutic benefits of ACEIs, there are several reported side effects, including chronic cough, angioedema and anaphylactoid reactions. These adverse events cannot be explained by the vasodilatory effects of this group of medications. Preliminary studies have shown that patients with a history of developing these side effects have a lower activity of an enzyme called aminopeptidase-P. This enzyme has an important role in degrading bradykinin. This defect in enzymatic activity can be partially explained by genetic variation. Using genome-wide screening strategies, the locus (loci), gene(s) and untimely polymorphisms that explain the low enzymatic activity and side effects can be identified.     

Green synthesis of silver nanoparticles using onion extract and their application for the preparation of a modified electrode for determination of ascorbic acid

A high-quality method for one-pot biosynthesis of silver nanoparticles (AgNPs) using onion extracts as reductant and stabilizer is reported. The synthesized AgNPs were characterized by ultraviolet-visible spectroscopy (UV-Vis), X-ray powder diffraction (XRD), and transmission electron microscopy (TEM). UV-Vis spectroscopy results showed that the AgNP absorption band was located at a peak of 397 nm in aqueous solution. Both XRD and TEM results confirmed that the AgNPs were mainly spherical with average diameters of 6.0 nm by TEM and about 5.3–10.2 nm calculated using XRD data. The ability of AgNPs to reduce charge transfer resistance was also investigated using electrochemical impedance spectroscopy. Finally, the effect of synthesized NPs on ascorbic acid signal was investigated by square wave voltammetry. The peak current of square wave voltammograms of ascorbic acid increased linearly with its concentration in the range of 0.4–450.0μM. The detection limit for ascorbic acid was 0.1μM.