RESUMO
Although the most important primary local inflammatory response factor to intubation is not yet clear, it is known that it may be directly attributed to the presence of trauma during intubation or the response of oral bacterial flora present in the trachea. It is known that prolonged intubation is associated with worse outcomes, but other underlying systemic issues, such as sepsis and trauma, are also associated with this result. Likewise, patients who require advanced airway management and excessive manipulation are more likely to experience complications. There are various inflammatory mediators that are generated during orotracheal intubation, many of which can be considered targets for therapies to help reduce inflammation caused by intubation. However, there is little evidence on the management of the inflammatory response induced by orotracheal intubation in pediatric patients. Therefore, the aim of this narrative review is to highlight the intubation associated complications that can arise from poorly controlled inflammation in intubated pediatric patients, review the proposed pathophysiology behind this, and discuss the current treatments that exist. Finally, taking into account the discussion on pathophysiology, we describe the current therapies being developed and future directions that can be taken in order to create more treatment options within this patient population.
Assuntos
Intubação Intratraqueal , Traqueia , Humanos , Criança , Estudos Retrospectivos , Intubação Intratraqueal/efeitos adversos , InflamaçãoRESUMO
BACKGROUND: Cardiovascular effects for drugs such as hyoscine butylbromide are poorly documented in the literature, unlike atropine, which is considered the antimuscarinic of choice in the presence of intraoperative bradycardia. AIM: The aim of the study was to describe the dose-related cardiovascular effect of hyoscine butylbromide in patients between 18 and 65 years of age, with low perioperative risk undergoing elective surgery under general anaesthesia on an outpatient basis or hospitalised at our institution between 1 January and 31 May 2019. METHODS: Descriptive, cross-sectional, retrospective study; 28 patients with low perioperative risk who underwent general anaesthesia were selected. Changes in heart rate and blood pressure were analysed during the first 6 minutes after the administration of hyoscine butylbromide. The data obtained was recorded in a Microsoft Excel database and analysed using the Excel analysis tool and IBM SPSS. RESULTS: The average dose of 0.15mg/kg of hyoscine butylbromide achieved an increase in heart rate and mean arterial pressure in 96% and 92.8%, respectively, in the first 6 minutes after the administration. Significant changes in heart rate and blood pressure were obtained during the first 6 minutes at doses between 0.05mg/kg and 0.15mg/kg. CONCLUSION: Hyoscine butylbromide generates positive effects on the heart rate and blood pressure of patients under general anaesthesia, representing a possible alternative in the management of intraoperative bradycardia.
Assuntos
Bradicardia , Escopolamina , Humanos , Bradicardia/induzido quimicamente , Estudos Retrospectivos , Estudos Transversais , Brometo de Butilescopolamônio/efeitos adversos , Anestesia GeralRESUMO
Understanding of the mechanisms implicated in the protective role of probiotic bacteria is of the utmost scientific interest. This study provides original insight into the genetic and molecular basis of the responses of Lactobacillus reuteri PL503 against hydrogen peroxide (H2O2)-induced oxidative stress. Six experimental groups were considered depending on the addition and concentration of H2O2 and resveratrol: 1. CONTROL (L. reuteri in MRS broth); 2. H2O2 (L. reuteri in MRS broth + 0.5 mM H2O2); 3. LRES (L. reuteri in MRS broth + 20 µM resveratrol); 4. HRES (L. reuteri in MRS broth + 100 µM resveratrol); 5. H2O2-LRES (L. reuteri in MRS broth + 0.5 mM H2O2 + 20 µM resveratrol); 6. H2O2-HRES (L. reuteri in MRS broth + 0.5 mM H2O2 + 100 µM resveratrol). Three replicates were incubated at 37 °C for 24 h in microaerophilic conditions sampled at 12, 16, 20 and 24 h. The NADH-dependent-oxidoreductase encoded by the dhaT gene is a plausible candidate to be strongly implicated in the antioxidant response of L. reuteri. Resveratrol (100⯵M) is found to protect L. reuteri against protein carbonylation plausibly through various mechanisms including direct scavenging of reactive oxygen species (ROS), upregulation of the dhaT gene and promoting the synthesis of sulfur containing compounds. The hypothesis formulated on the ability of L. reuteri to detoxify H2O2 and its underlying mechanism needs to be clarified. Furthermore, the consequences of protein carbonylation as a reflection of oxidative damage to bacteria and its role in the responses of bacteria to oxidative stress need to be further investigated.
Assuntos
Antioxidantes/farmacologia , Limosilactobacillus reuteri/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Resveratrol/farmacologia , Peróxido de Hidrogênio/toxicidade , Limosilactobacillus reuteri/metabolismo , Oxirredução/efeitos dos fármacos , Carbonilação Proteica/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Enxofre/metabolismo , Ativação Transcricional/efeitos dos fármacosRESUMO
The Neotropical lizard Mabuya agmosticha Rodrigues, 2000 is a habitat-specialist of thorny bromeliads in rocky outcrops of northeastern Brazil. Its distribution in the Caatinga Domain is most likely relictual. In recent years, new surveys conducted in northeastern Brazil have revealed new records of the species in the Caatinga and also in the Atlantic Forest Domain. In this study, we add four new records for M. agmosticha, extending its known geographic range in the states of Rio Grande do Norte and Paraíba. In addition, we investigated the potential geographical distribution of the species using ecological niche modeling (ENM), which combines the available occurrence records with environmental variables. Our model revealed a continuous range of areas with suitable climatic conditions for the species, from the state of Rio Grande do Norte to the northeast portion of the state of Bahia, plus some relictual distribution spots, mainly in the states of Bahia, Pernambuco, Ceará and western Rio Grande do Norte. Based on the model, we suggest that the distribution of M. agmosticha is continuous on a large geographic scale. On a smaller spatial scale, however, it is clear that its distribution is clumped, reflecting its specialist habits associated with rupicolous bromeliads.(AU)
Assuntos
Animais , Lagartos , Distribuição Animal , Ecossistema , BrasilRESUMO
The Neotropical lizard Mabuya agmosticha Rodrigues, 2000 is a habitat-specialist of thorny bromeliads in rocky outcrops of northeastern Brazil. Its distribution in the Caatinga Domain is most likely relictual. In recent years, new surveys conducted in northeastern Brazil have revealed new records of the species in the Caatinga and also in the Atlantic Forest Domain. In this study, we add four new records for M. agmosticha, extending its known geographic range in the states of Rio Grande do Norte and Paraíba. In addition, we investigated the potential geographical distribution of the species using ecological niche modeling (ENM), which combines the available occurrence records with environmental variables. Our model revealed a continuous range of areas with suitable climatic conditions for the species, from the state of Rio Grande do Norte to the northeast portion of the state of Bahia, plus some relictual distribution spots, mainly in the states of Bahia, Pernambuco, Ceará and western Rio Grande do Norte. Based on the model, we suggest that the distribution of M. agmosticha is continuous on a large geographic scale. On a smaller spatial scale, however, it is clear that its distribution is clumped, reflecting its specialist habits associated with rupicolous bromeliads.