Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
Más filtros












Base de datos
Intervalo de año de publicación
1.
Br J Anaesth ; 126(1): 245-255, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32859366

RESUMEN

BACKGROUND: The mechanisms underlying the role of T-type calcium channels (T-channels) in thalamocortical excitability and oscillations in vivo during neurosteroid-induced hypnosis are largely unknown. METHODS: We used patch-clamp electrophysiological recordings from acute brain slices ex vivo, recordings of local field potentials (LFPs) from the central medial thalamic nucleus in vivo, and wild-type (WT) and Cav3.1 knock-out mice to investigate the molecular mechanisms of hypnosis induced by the neurosteroid analogue (3ß,5ß,17ß)-3-hydroxyandrostane-17-carbonitrile (3ß-OH). RESULTS: Patch-clamp recordings showed that 3ß-OH inhibited isolated T-currents but had no effect on phasic or tonic γ-aminobutyric acid A currents. Also in acute brain slices, 3ß-OH inhibited the spike firing mode more profoundly in WT than in Cav3.1 knockout mice. Furthermore, 3ß-OH significantly hyperpolarised neurones, reduced the amplitudes of low threshold spikes, and diminished rebound burst firing only in WT mice. We found that 80 mg kg-1 i.p. injections of 3ß-OH induced hypnosis in >60% of WT mice but failed to induce hypnosis in the majority of mutant mice. A subhypnotic dose of 3ß-OH (20 mg kg-1 i.p.) accelerated induction of hypnosis by isoflurane only in WT mice, but had similar effects on the maintenance of isoflurane-induced hypnosis in both WT and Cav3.1 knockout mice. In vivo recordings of LFPs showed that a hypnotic dose of 3ß-OH increased δ, θ, α, and ß oscillations in WT mice in comparison with Cav3.1 knock-out mice. CONCLUSIONS: The Cav3.1 T-channel isoform is critical for diminished thalamocortical excitability and oscillations that underlie neurosteroid-induced hypnosis.


Asunto(s)
Androstanoles/farmacología , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Canales de Calcio Tipo T/metabolismo , Hipnóticos y Sedantes/farmacología , Nitrilos/farmacología , Androstanoles/metabolismo , Animales , Fenómenos Electrofisiológicos , Hipnóticos y Sedantes/metabolismo , Masculino , Ratones , Ratones Noqueados , Modelos Animales , Neuroesteroides/metabolismo , Neuroesteroides/farmacología , Nitrilos/metabolismo
3.
AMA J Ethics ; 22(4): E298-304, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32345422

RESUMEN

Many procedures performed today involve a team of specialists with their own training histories and backgrounds. Some errors are inevitable in the course of clinical careers. Because errors tend to lead to complications, they often also lead to assignations of blame. When this happens, too often clinicians are at odds with each other about how to respond to a patient or a patient's loved ones after that patient suffers harm. This commentary on a case of a surgical complication examines how transparency in communication, cooperative disclosure, and working collaboratively to restore an injured patient's health support clinicians' common purpose, long-standing work relationships, and collegiality.


Asunto(s)
Comunicación , Revelación , Humanos
4.
AMA J Ethics ; 22(4): E319-324, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32345425

RESUMEN

Enhanced recovery after surgery (ERAS®) protocols vary by surgery type. This article examines benefits of ERAS pathways, compares ERAS pathways to traditional protocols from clinical and ethical standpoints, and discusses formal recommendations of the American College of Surgeons, the American Society of Anesthesiologists, and other groups.


Asunto(s)
Anestesiólogos , Cirujanos , Humanos , Tiempo de Internación , Dolor , Atención Perioperativa
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...