Effects of infliximab against carbon tetrachloride-induced intestinal injury via lipid peroxidation and apoptosis.

Carbon tetrachloride (CCL4) is often employed in the production of chlorofluorocarbons, petroleum refining, oil and rubber processing, and laboratory applications. Oral, subcutaneous, and inhalation exposure to CCL4 in animal studies have been shown to be capable of leading to various types of cancer (benign and malignant, liver, breast, and adrenal gland tumors). The present study also evaluated the protective role of infliximab (INF) against the deleterious effects of CCL4 on the intestinal system. Twenty-four male Sprague-Dawley rats were randomly assigned into three groups, control (n = 8), CCL4 (n = 8), and CCL4 + INF (n = 8). The control group received 1 mL isotonic saline solution only via intraperitoneal (i.p.) injection. The CCL4 group received a single i.p. dose of 2 mL/kg CCL4. The CCL4 + INF group received a single i.p. dose of 7 mg/kg INF followed 24 h later by a single dose of 2 mL/kg CCL4. All rats were euthanized 2 days following drug administration. CCL4 group samples also exhibited diffuse loss of enterocytes, vascular congestion, neutrophil infiltration, an extension of the subepithelial space and significant epithelial lifting along the length of the villi with a few denuded villous tips. In addition, CCL4 treatment increased intestinal malondialdehyde (MDA) level and caspase-3 positivity. On the other hand, INF decreased MDA levels, caspase-3 positivity, and loss of villous. Our findings suggest that CCL4 appears to exert a highly deleterious effect on the intestinal mucosa. On the other hand, INF is effective in preventing this CCL4-induced intestinal injury by reducing oxidative stress and apoptosis.

Reversal of neuromuscular blockade with sugammadex or neostigmine/atropine: Effect on postoperative gastrointestinal motility.

STUDY OBJECTIVE: To compare sugammadex with conventional reversal of neuromuscular block in terms of postoperative gastrointestinal motility. DESIGN: Double blinded, randomized, controlled clinical trial. SETTING: Operating room, postoperative recovery area. PATIENTS: Seventy-two patients with ASA physical status I or II, scheduled for total thyroid surgery were studied. INTERVENTIONS: When 4 twitches were observed on train-of-four stimulation, neuromuscular block was reversed conversatively in the control group, and with sugammadex in the study group. MEASUREMENTS: Time to first flatus and feces, incidence of postoperative nausea, vomiting, diarrhea and constipation were collected. MAIN RESULTS: Median time of first flatus was 24 hours (18-32 [10-36]) in the neostigmine group, and 24 (18-28 [12-48]) in the sugammadex group (P > .05). Median (IQR) time of first feces was 24 hours (18-36 [10-48]) in neostigmine group, 32 hours (28-36 [12-72]) in sugammadex group (P > .05). There were no occurrences of nausea, vomiting, diarrhea, or constipation. CONCLUSIONS: Sugammadex may be safely used in cases where postoperative ileus is expected.

The protective effect of infliximab on cisplatin-induced intestinal tissue toxicity.

OBJECTIVE: Cisplatin (CP) is a popular chemotherapeutic agent. However, high doses of CP may lead to severe side effects to the gastrointestinal system. The aim of this study was to investigate the protective effects of infliximab on small intestine injury induced by high doses of CP. MATERIALS AND METHODS: The A total of 30 rats were equally divided into three groups, including sham (C), cisplatin (CP), and cisplatin + infliximab (CPI). The CP group was treated with 7 mg/kg intraperitoneal cisplatin, and a laparotomy was performed 5 days later. The CPI group received 7 mg/kg infliximab intraperitoneally, were administered 7 mg/kg cisplatin 4 days later, and a laparotomy was performed 5 days after receiving cisplatin. Histopathological and immunohistochemical analysis of small intestine tissue sections were performed, and superoxide dismutase, malondialdehyde, and TNF-α levels were measured. RESULTS: Histopathological evaluation revealed that the CP group had damage in the epithelium and connective tissue, but this damage was significantly improved in the CPI group (p < 0.05). In addition, these histopathological findings were confirmed by biochemical analyses. CONCLUSIONS: These results suggest that infliximab is protective against the adverse effects of CP.

A safety-based comparison of pure LigaSure use and LigaSure-tie technique in total thyroidectomy.

BACKGROUND AND AIM: Sutureless total thyroidectomy by using vessel sealing devices has been shown to be safe in some recent clinical studies. However, some surgeons are still concerned about the use of these energy devices in the vicinity of there current laryngeal nerve and parathyroid glands. The objective of this study was to investigate the effects of the use of pure LigaSure on postoperative complications and to discuss the pertinent literature. METHODS: A total of 456 patients having undergone a total thyroidectomy operation between June 2009 and March 2011 were included in the study. Data were prospectively collected and retrospectively evaluated. Patients were separated into 2 groups. Group L comprised of 182 patients where onlyLigaSure was used, and group LT consisted of 274 patients where ligation was used in the vicinity of the recurrent laryngeal nerve and parathyroid glands, and LigaSure was used in all other parts of the surgery. Patient's blood calcium values were checked preoperatively and at postoperative 24, 48, and 72 hours. Groups were assessed in terms of demographic properties, thyroid pathology, duration of operation, and postoperative complications. RESULTS: Groups were similar in respect of demographic properties, operation duration, thyroid gland pathology. No mortality rate was recorded. Laboratory hypocalcemia rate was higher in group L (P 0.003), but no significant difference was identified between groups in terms of symptomatic hypocalcemia.No permanent hypocalcemia or recurrent laryngeal nerve injury developed in any of the patients in the two groups. CONCLUSIONS: Pure LigaSure for total thyroidectomy may increase laboratory hypocalcemia rate, but not symptomatic hypocalcemia. Hemorrhage related complications were similar and low in the two groups. Ligations in the places close to delicate anatomic structures did not cause longer operative times and may be a safer option in total thyroidectomy.