[Registry of perioperative cardiac arrests in a clinical hospital in the period 2006-2017]. / Registro de paro cardiorrespiratorio perioperatorio en un hospital universitario en el período 2006-2017.

BACKGROUND: Perioperative cardiac arrest (PCA) is a rare but important event in the operating room. AIM: To describe PCA events at a Clinical Hospital in Santiago, Chile. MATERIAL AND METHODS: Registry of PCA that occurred in the operating room (OR) and during procedures not carried out in the OR between September 2006 and November 2017. Precipitating events, type of anesthesia and results of resuscitation maneuvers were described. RESULTS: Eighty events (five outside of the OR) during 170,431 surgical procedures were recorded, resulting in an incidence of 4.4 events per 10,000 interventions. Hypotension/hypoperfusion was the most frequently found preexisting condition (42.5%). The main cause was the presence of preoperative complications (57.5%). Nineteen cases (23.8%) were attributable to anesthesia, with an incidence of 1.11 per 10,000 anesthetic procedures. Survival rate at hospital discharge was 52.5%. The figure for PCA caused by anesthesia was 84.2%. CONCLUSIONS: The incidence of PCA and its survival is similar to that reported abroad. In general, PCA has a better prognosis than other types of cardiac arrest, especially if it has an anesthetic cause.

Registro de paro cardiorrespiratorio perioperatorio en un hospital universitario en el período 2006-2017 / Registry of perioperative cardiac arrests in a clinical hospital in the period 2006-2017

Background: Perioperative cardiac arrest (PCA) is a rare but important event in the operating room. Aim: To describe PCA events at a Clinical Hospital in Santiago, Chile. Material and Methods: Registry of PCA that occurred in the operating room (OR) and during procedures not carried out in the OR between September 2006 and November 2017. Precipitating events, type of anesthesia and results of resuscitation maneuvers were described. Results: Eighty events (five outside of the OR) during 170,431 surgical procedures were recorded, resulting in an incidence of 4.4 events per 10,000 interventions. Hypotension/hypoperfusion was the most frequently found preexisting condition (42.5%). The main cause was the presence of preoperative complications (57.5%). Nineteen cases (23.8%) were attributable to anesthesia, with an incidence of 1.11 per 10,000 anesthetic procedures. Survival rate at hospital discharge was 52.5%. The figure for PCA caused by anesthesia was 84.2%. Conclusions: The incidence of PCA and its survival is similar to that reported abroad. In general, PCA has a better prognosis than other types of cardiac arrest, especially if it has an anesthetic cause.

Disfunción cognitiva postoperatoria / Postoperative cognitive dysfunction

Cognitive function may decline after surgical procedures. Cognitive postoperative dysfunction (CPOD) is subtle and requires neuropsychological test for diagnosis. Multifactorial in origin, its cause is unknown but associated with different risk factors, which especially affects origin people submitted to extense surgery. CPOD is transient, but in some cases is prolonged and is associated with an increase in mortality and permanente disability. The aging population and the increase of elderly patients requiring surgery a cause of concern. Clinical studies are required to recognize preventive and therapeutic measures to reduce CPOD in the future. (AU)

Role of angiotensin II and oxidative stress in renal inflammation by hypernatremia: benefits of atrial natriuretic peptide, losartan, and tempol.

The body regulates plasma sodium levels within a small physiologic range, despite large variations in daily sodium and water intake. It is known that sodium transport in the kidneys plays an important role in hypoxia, being the major determinant of renal oxygen consumption. Tubular epithelial cell hypoxia is an important contributor to the development of renal inflammation, and the damage may progress to structural injury, ending in acute renal failure. In this review, we will summarize the renal inflammatory effects of high acute plasma sodium (acute hypernatremia), and the molecular mechanisms involved. We will also discuss recent findings related to the role of oxidative stress and angiotensin II (Ang II) in the pathogenesis of renal injury. We will comment on the effects of agents used to prevent or attenuate the inflammatory response, such as the atrial natriuretic peptide, the superoxide dismutase mimetic - tempol, and losartan.

Signaling pathways involved in renal oxidative injury: role of the vasoactive peptides and the renal dopaminergic system.

The physiological hydroelectrolytic balance and the redox steady state in the kidney are accomplished by an intricate interaction between signals from extrarenal and intrarenal sources and between antinatriuretic and natriuretic factors. Angiotensin II, atrial natriuretic peptide and intrarenal dopamine play a pivotal role in this interactive network. The balance between endogenous antioxidant agents like the renal dopaminergic system and atrial natriuretic peptide, by one side, and the prooxidant effect of the renin angiotensin system, by the other side, contributes to ensuring the normal function of the kidney. Different pathological scenarios, as nephrotic syndrome and hypertension, where renal sodium excretion is altered, are associated with an impaired interaction between two natriuretic systems as the renal dopaminergic system and atrial natriuretic peptide that may be involved in the pathogenesis of renal diseases. The aim of this review is to update and comment the most recent evidences about the intracellular pathways involved in the relationship between endogenous antioxidant agents like the renal dopaminergic system and atrial natriuretic peptide and the prooxidant effect of the renin angiotensin system in the pathogenesis of renal inflammation.

Effect of hydroalcoholic extract of Zingiber officinalis rhizomes on LPS-induced rat airway hyperreactivity and lung inflammation.

Ginger, the rhizome of Zingiber officinalis Roscoe (Zingiberaceae), is a common constituent of diets around the world and its extracts have been reported to exhibit several pharmacological activities. We investigated the effect of crude hydroalcoholic extract of ginger on the rat trachea hyperreactivity (RTHR) and lung inflammation induced by lipopolysaccharide (LPS). Our results demonstrate that ginger extract and celecoxib attenuated RTHR 90 min and 48 h after LPS. Ginger and celecoxib reduced the serum level of prostaglandin (PGE2) and thromboxane (TXA2) 90 min after LPS. Celecoxib and ginger also reduced myeloperoxidase activity and the number of cells in rat bronchoalveolar lavage 48 h post-LPS. On lung parenchyma, ginger and celecoxib reduced the release of PGE2 and TXA2 48 h post-LPS. These results suggest that ginger exerts an anti-inflammatory effect on lung attenuating RTHR and COX metabolites seem to be involved in these processes.

Anti-inflammatory effect of the hydralcoholic extract of Zingiber officinale rhizomes on rat paw and skin edema.

Plant extracts have been used for centuries as a popular mode of treatment for several health disorders. Over the last ten years, the study of those extracts has attracted attention in different fields of the biological sciences. Ginger, the rhizome of Zingiber officinale Roscoe (Zingiberaceae), is a commom constituent of diet worldwide and it has been reported that its extracts present some pharmacological activities. Here we investigate the effects of the crude hydralcoholic extract of ginger rhizomes on the classical models of rat paw and skin edema. The carrageenan-, compound 48/80- or serotonin-induced rat paw edema were inhibited significantly by the intraperitoneal administration of alcoholic ginger extract. Ginger extract was also effective in inhibiting 48/80-induced rat skin edema at doses of 0.6 and 1.8 mg/site. Rat skin edema induced by substance P or bradikinin was not affected by treatment with Z. officinalle extract. The intraperitoneal administration of ginger extract (186 mg/kg(-1) body wt.) 1 h prior to serotonin injections, reduced significantly the serotonin-induced rat skin edema. Our results demonstrated that crude extract of Zingiber officinale was able to reduce rat paw and skin edema induced by carrageenan, 48/80 compound and serotonin. The antiedematogenic activity seems to be related, at least partially, to an antagonism of the serotonin receptor.

The anti-inflammatory and analgesic effects of a crude extract of Petiveria alliacea L. (Phytolaccaceae).

Petiveria alliacea L (Phytolaccaceae) is a perennial bush plant that grows widely in Brazil. The roots and leaves of P. alliacea have been used in folk medicine for their antispasmodic, sedative, diuretic and antihelminthic actions. We recently described the anti-inflammatory properties of P. alliacea administered topically and orally in different animal models. In the present study, we investigated the anti-inflammatory activity of a crude lyophilized extract of P. alliacea roots administered to rats with pleurisy. The oral administration of P. alliacea root extract did not significantly reduce the total number of leukocytes at the doses tested. By contrast, the highest dose of extract tested (43.9 mg/kg body wt.) significantly reduced the number of migrating neutrophils, mononuclear cells and eosinophils; the dose of 31.4 mg/kg body wt. also reduced mononuclear cell migration. The P. alliacea root extract also showed a significant analgesic effect in the experimental model used. The results of this study provide a basis for the use of P. alliacea extracts in popular folk medicine, but further studies are necessary to elucidate the mechanism of its anti-inflammatory and analgesic actions.

[Activities of the Brazilian Senate in the area of public health, 1995 and 1996]. / Atividades do Senado Federal brasileiro na área de saúde pública, 1995 e 1996.

The objective of this study was to identify and describe the actions of Brazilian senators in the field of public health in 1995 and 1996. We also sought to determine if profession, regional background, or political party influenced the senators' actions. The actions were divided into three types: legislative (proposal and review of bills and petitions); supervisory (information requests to the executive branch and the establishment of inquiry committees and other special committees); and parliamentary (speeches). The data were collected from two databases maintained by the Senate, namely MATE and DISC. Of the 89 senators who were in office during the study period, 76 were involved with public health issues. Of the total of 667 actions studied, there was a predominance of speeches (43% of all actions), most of them responding to news reported by regional or national media. Supervisory activities were limited (5% of all actions were information requests). The subjects dealt with most frequently were health policies (30%), drugs (9%), regulation of health professions (8%), disease control (7%), and worker health (6%). Concerning the professions of the senators, the most frequent categories were physicians, teachers, and journalists. The senators representing the North and Northeast regions performed 62% of the actions and were involved with almost all the health subjects. Although 43% of the actions were carried out by liberal and right-wing senators, the senators from socialist and labor parties had a stronger proportional participation (both in terms of senators involved and actions performed). It is interesting to note that socialist and labor senators showed minimal involvement in the issue of worker health. The predominance of speeches as a prevalent type of action, the limited and disjointed scope of legislative actions, and, especially, the poor monitoring and control show the need for deep changes in the work process of the Senate's technical committees and, therefore, of the Senate's technical support unit.

The study of steady magnetic fields associated with primary and secondary ST shift in ischaemic rabbit hearts.

The study of injury potentials associated with DC currents that generate the primary or secondary ST shifts during cardiac ischaemia is possible only through the invasive technique of the DC electrogram. Clinical surface ECG recordings are AC coupled and cannot be used. This paper reports the use of non-invasive and unshielded magnetocardiographic measurements to evaluate the DC injury currents associated with ST shifts during coronary artery occlusions in the isolated rabbit heart. The effect on the magnetic ST shift is studied under different ischaemic conditions including regional ischaemia, global ischaemia, global ischaemia following long periods of regional ischaemia, regional ischaemia after repeated episodes of reversible global ischaemia, and bilateral regional ischaemia. Recording of DC magnetic fields allows the characterization of primary and secondary ST displacement for each induced ischaemic condition. Our measurements show that the ST shift starts earlier when inducing ischaemia in hearts previously subjected to ischaemic episodes than in hearts where the ischaemia was produced for the first time.

Pharmacological assay of Cordia verbenacea. III: Oral and topical antiinflammatory activity and gastrotoxicity of a crude leaf extract.

The antiinflammatory effects and gastrotoxicity of a lyophilized 70% ethanol extract of the leaves of Cordia verbenacea were investigated through experimental models in rats and mice. The oral administration of 1.24 mg/kg of the extract significantly inhibited nystatin-induced oedema. Topical application of the extract at a dose of 0.09 mg/ear in mice was clearly more effective than 1.0 mg/ear of naproxen in the reduction of the ear oedema induced by corton oil. At antiinflammatory doses, the extract showed an important protective effect on the gastric mucosa, reducing significantly the number of gastric lesions.