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Tewfik G, Grech D, Laham L, Chaudhry F, Naftalovich R. The Risks and Benefits of Physician Practice Acquisition and Consolidation: A Narrative Review of Peer-Reviewed Publications Between 2009 and 2022 in the United States. J Multidiscip Healthc 2024; 17:2271-2279. [PMID: 38765617 PMCID: PMC11102090 DOI: 10.2147/jmdh.s463618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
The objective of this narrative review was to assess current literature regarding acquisition and consolidation of physician practices in the United States (US). The acquisition and consolidation of physician practices is a trend affecting patient care, quality of services, healthcare economics and the daily practice of physicians. As practices are acquired by fellow physician groups, private equity investors and entities such as hospitals or large healthcare systems, it is important to better understand the underlying forces driving these transactions and their effects. This is a narrative review of peer-reviewed publications to determine what current literature has covered regarding the acquisition and consolidation of physician practices in the US regarding risks and benefits of this trend. Sources included the SCOPUS, Medline- PUBMED and Web of Science databases. Peer reviewed publications from 2009 to 2022 were included for initial review and curation for relevance using the search terms "physician" and "practice" with either "acquisition" or "consolidation". Synthesis conducted after narrowing down of relevant articles did not use quantitative measurements, but instead examined overall trends, as well as risk and benefits of ongoing acquisition and consolidation in a narrative format. Journal articles focused on physician consolidation in the US often reported increases in physician numbers with decreases in numbers of individual practices. Private equity quantitative analyses reported rapidly accelerating acquisitions driven by these investors, and vertical integration scholarly work reported frequent geographic consolidation of nearby practitioners. Risks associated with these transactions included such items as decreased physician autonomy and higher cost of care. Benefits included practice stability, improved negotiation with insurers and improved access to resources.
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Affiliation(s)
- George Tewfik
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Dennis Grech
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Linda Laham
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Faraz Chaudhry
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Rotem Naftalovich
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
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Pai SL, Grech D, Gayer S, Rodriguez L, Joshi GP, Rajan N. Should rocuronium and sugammadex replace succinylcholine for airway emergencies in class B ambulatory anesthesia settings? Minerva Anestesiol 2023; 89:197-205. [PMID: 36326774 DOI: 10.23736/s0375-9393.22.16852-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION In class B surgical facilities, where only oral or intravenous (IV) sedation is employed without the administration of volatile anesthetics, laryngospasm is among the most common airway complications. However, these facilities generally do not stock succinylcholine to avoid the cost of storing dantrolene for the treatment of malignant hyperthermia (MH). High dose IV rocuronium with sugammadex reversal has been suggested as an alternative to succinylcholine for airway emergencies. The aim of this paper was to evaluate the clinical utility, patient safety, and financial implications of replacing succinylcholine with rocuronium and sugammadex in lieu of stocking dantrolene in class B facilities. EVIDENCE ACQUISITION A systematic review of the literature concerning neuromuscular blockade for airway emergencies in class B settings in adult patients was conducted. The MEDLINE and EMBASE databases were searched for published studies from January 1, 1990, to October 1, 2021. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the certainty of evidence. EVIDENCE SYNTHESIS The search strategy yielded 1124 articles. After review, 107 articles were included, with 49 graded as "strong" evidence to provide recommendations for the posed questions. CONCLUSIONS The use of succinylcholine in isolation without volatile agents has a low incidence of triggering MH. Laryngospasm is a common airway emergency that requires immediate treatment to avoid morbidity and mortality. Both succinylcholine and rocuronium-sugammadex provide adequate treatment of airway emergencies and rapid return of spontaneous ventilation, but succinylcholine has a superior economic and clinical profile.
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Affiliation(s)
- Sher-Lu Pai
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA -
| | - Dennis Grech
- New Jersey Medical School, Department of Anesthesiology, Rutgers, Newark, NJ, USA
| | - Steven Gayer
- Miller School of Medicine, Department of Anesthesiology, University of Miami, Miami, FL, USA
| | - Leopoldo Rodriguez
- Anesthesiology and Perioperative Medicine, Boulder Valley Anesthesiology PLLC, Boulder, CO, USA
| | - Girish P Joshi
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA
| | - Niraja Rajan
- Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, PA, USA
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Thepmankorn P, Sufian MA, Singer O, Gupta S, Grech D, Ballesteros T, Shah SP. Anesthetic Implications of Previously Undiagnosed Temporomandibular Joint Ankylosis: A Case Report. A A Pract 2023; 17:e01640. [PMID: 36706159 DOI: 10.1213/xaa.0000000000001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Temporomandibular joint (TMJ) ankylosis is characterized by bony fusion that limits TMJ mobility. We present the case of an elderly woman who was brought to the operating room for dental rehabilitation under general anesthesia. The patient had an undiagnosed TMJ ankylosis, which was discovered only after induction of anesthesia due to her nonverbal status and advanced dementia. The surgical team canceled the case due to limited access to the surgical field. We discuss the factors that suggest TMJ ankylosis and propose the perioperative management when TMJ ankylosis is suspected but unconfirmed.
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Affiliation(s)
- Parisorn Thepmankorn
- From the Department of Anesthesia, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Mahir A Sufian
- From the Department of Anesthesia, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Omar Singer
- From the Department of Anesthesia, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Somdatta Gupta
- Department of Anesthesia, Hackensack University Medical Center, Hackensack, New Jersey
| | - Dennis Grech
- From the Department of Anesthesia, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Tomas Ballesteros
- Department of General Dentistry, Rutgers School of Dentistry, Newark, New Jersey
| | - Shridevi Pandya Shah
- From the Department of Anesthesia, Rutgers New Jersey Medical School, Newark, New Jersey
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Piazzi L, Cinti MF, Guala I, Grech D, La Manna G, Pansini A, Pinna F, Stipcich P, Ceccherelli G. Variations in coralligenous assemblages from local to biogeographic spatial scale. Mar Environ Res 2021; 169:105375. [PMID: 34111774 DOI: 10.1016/j.marenvres.2021.105375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/17/2021] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
The present study aims at contributing to the knowledge of the spatial variability of coralligenous reefs through the evaluation of patterns ranging from local to biogeographic scale around the island of Sardinia. The coralligenous reef assemblages of six areas were studied through a hierarchical sampling design: three sites per area were selected, in each site three plots were sampled and in each plot ten photographic samples were collected. The structure of coralligenous reefs across closed biogeographic regions is described, highlighting that nearly pristine assemblages, although characterized by similar high diversity, can be either dominated by animals, such as gorgonians and bryozoans, or macroalgae. The observed variations seem largely related to biogeographic patterns rather than spatial distance, supporting the need to identify specific reference conditions to assess the ecological quality of this habitat depending on the biogeographic area to be monitored.
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Affiliation(s)
- L Piazzi
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy.
| | - M F Cinti
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - I Guala
- IMC - International Marine Centre, Loc. Sa Mardini, Torregrande, 09170, Oristano, Italy
| | - D Grech
- IMC - International Marine Centre, Loc. Sa Mardini, Torregrande, 09170, Oristano, Italy
| | - G La Manna
- MareTerra Onlus - Environmental Research and Conservation, Regione Sa Londra 9, 07041, Alghero (SS), Italy
| | - A Pansini
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - F Pinna
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - P Stipcich
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - G Ceccherelli
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
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Mansoor A, Ellwood S, Hoffman G, Scholer A, Gore A, Grech D, Patrick B, Sifri Z. The Efficacy and Safety of Transversus Abdominis Plane Blocks After Open Cholecystectomy in Low- and Middle-Income Countries. J Surg Res 2020; 256:136-142. [PMID: 32693331 DOI: 10.1016/j.jss.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/08/2020] [Accepted: 06/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Postoperative pain management is challenging in low- and middle-income countries (LMICs). This study assesses the safety and efficacy of transversus abdominis plane (TAP) blocks as an adjunct for postoperative pain control after an open cholecystectomy in LMICs during short-term surgical missions (STSMs). TAP block is a regional anesthesia technique that has been shown to be effective in providing supplementary analgesia to the anterolateral wall post abdominal surgery. METHODS A retrospective chart review of patients undergoing open cholecystectomy during STSMs was performed. STSMs took place in Guatemala, the Philippines, and Peru from 2009 to 2019. Measured outcomes including pain scores, presence of postoperative nausea or vomiting, and opioid consumption were compared between TAP block and non-TAP block groups. RESULTS Of the 48 patients analyzed, 28 underwent TAP block (58%). Non-TAP block patients received, on average, 8 mg of oral morphine equivalents more than the TAP patients (P = 0.035). No significant difference was noted in pain scores, which were taken immediately after surgery, 2 h after surgery, and at multiple times between these time points to calculate an average. Of the patients who received a TAP block, 11% reported nausea or vomiting compared with 45% in the standard group (P < 0.01). There were no reported procedure-related complications. CONCLUSIONS TAP blocks are safe and effective adjuncts for postoperative pain management on STSMs to LMICs. Additional studies are needed to investigate the potential advantages and disadvantages of more widespread use of TAP blocks in LMICs.
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Affiliation(s)
- Amtul Mansoor
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey
| | - Stephen Ellwood
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey
| | - Gary Hoffman
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey.
| | - Anthony Scholer
- John Wayne Cancer Institute at Providence St. John's Health Center, Santa Monica, California; Department of Surgical Oncology, Prisma Health Greenville Memorial Medical Campus, Greenville, South Carolina
| | - Amy Gore
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey
| | - Dennis Grech
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey
| | - Bradley Patrick
- International Surgical Health Initiative, Jersey City, New Jersey
| | - Ziad Sifri
- Department of Surgery, New Jersey Medical School, Newark, New Jersey; International Surgical Health Initiative, Jersey City, New Jersey
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Xiong M, Zheng ZX, Hu ZR, He J, Madubuko U, Grech D, Zhang XA, Xu B. Propofol-sparing effect of different concentrations of dexmedetomidine : Comparison of gender differences. Anaesthesist 2018; 68:15-21. [PMID: 30406275 PMCID: PMC6342900 DOI: 10.1007/s00101-018-0506-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
Background The pharmacodynamics of propofol are closely linked to gender. Dexmedetomidine can decrease propofol needs during propofol anesthesia. The aim of this study was to compare the gender differences on the calculated effect site median effective concentration (EC50) of propofol for loss of consciousness (LOC) after pretreatment with different concentrations of dexmedetomidine. Methods In this study 60 male and 60 female patients were randomly allocated to receive dexmedetomidine at target plasma concentrations of 0.0 ng/ml (0.0 group), 0.4 ng/ml (0.4 group), 0.6 ng/ml (0.6 group) and 0.8 ng/ml (0.8 group). Propofol was administered after dexmedetomidine had been intravenously infused for 15 min. The propofol infusion was targeted to provide an initial effect-site concentration of 1.0 μg/ml, followed by increments by 0.2 μg/ml when the effect-site concentration and target concentration of propofol were in equilibrium until LOC was established, where LOC was defined by the observer’s assessment of alertness/sedation scale (OAA/S) score < 2. Results The calculated effect-site EC50 of propofol LOC was higher in males than in females in the 0.0, 0.4, 0.6, and 0.8 groups (2.43 vs. 2.17, 1.99 vs. 1.82, 1.72 vs. 1.56 and 1.50 vs. 1.32 μg/ml, respectively, all p < 0.05). The hypnotic interaction between dexmedetomidine and propofol could be described with an additive model of pharmacodynamic interaction. Conclusion Gender significantly influenced the calculated effect-site EC50 of propofol for LOC after pretreatment with different concentrations of intravenous dexmedetomidine. It was concluded that an additive interaction could describe the results seen. Thus, gender has to be considered when these drugs are co-administered.
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Affiliation(s)
- Ming Xiong
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China.,Department of Anesthesiology & Peri-Operative Medicine, New Jersey Medical School, Rutgers, NJ, USA
| | - Zhao -Xin Zheng
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China.,Department of Anesthesiology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Zu-Rong Hu
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China.,Department of Anesthesiology, Guangdong Province Hospital for Women and Children Health Care, Guangzhou, China
| | - Jing He
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China
| | - Uchenna Madubuko
- Department of Anesthesiology & Peri-Operative Medicine, New Jersey Medical School, Rutgers, NJ, USA
| | - Dennis Grech
- Department of Anesthesiology & Peri-Operative Medicine, New Jersey Medical School, Rutgers, NJ, USA
| | - Xing-An Zhang
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China
| | - Bo Xu
- Department of Anesthesiology, General Hospital of Southern Theatre Command of PLA, 510010, Guangzhou, China.
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Micaroni V, Strano F, Di Franco D, Crocetta F, Grech D, Piraino S, Boero F. Project “Biodiversity MARE Tricase”: a biodiversity inventory of the coastal area of Tricase (Ionian Sea, Italy) – Mollusca: Heterobranchia. The European Zoological Journal 2018. [DOI: 10.1080/24750263.2018.1462413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- V. Micaroni
- Lungomare Cristoforo Colombo s.n.c, Avamposto MARE, Tricase, Italy
| | - F. Strano
- Lungomare Cristoforo Colombo s.n.c, Avamposto MARE, Tricase, Italy
- Dipartimento di Scienze della Vita (D.S.V.), Università degli Studi di Trieste, Trieste, Italy
- Dipartimento di Biologia ed Evoluzione Organismi Marini (B.E.O.M.), Stazione Zoologica Anton Dohrn, Napoli, Italy
| | - D. Di Franco
- Dipartimento di Scienze della Vita e dell’Ambiente (Di.S.V.A.), Università Politecnica delle Marche, Ancona, Italy
| | - F. Crocetta
- Stazione Zoologica Anton Dohrn, Benthos Ecology Center, Napoli, Italy
| | - D. Grech
- Maremmana Ecologia S.r.l., Reparto Ambientale, Grosseto, Italy
| | - S. Piraino
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali (Di.S.Te.B.A.), Università del Salento, Lecce, Italy
- Consorzio Nazionale Interuniversitario per le Scienze del Mare (Co.N.I.S.Ma.), Roma, Italy
| | - F. Boero
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali (Di.S.Te.B.A.), Università del Salento, Lecce, Italy
- Consorzio Nazionale Interuniversitario per le Scienze del Mare (Co.N.I.S.Ma.), Roma, Italy
- Istituto di Scienze Marine del Consiglio Nazionale delle Ricerche (CNR-ISMAR), UO Genova, Genova, Italy
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Chen P, Li J, Han X, Grech D, Xiong M, Bekker A, Ye JH. Acupuncture for alcohol use disorder. Int J Physiol Pathophysiol Pharmacol 2018; 10:60-69. [PMID: 29593851 PMCID: PMC5871630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
Alcohol use disorder (AUD) is a common medical and social problem, affecting about 240 million people in the world. To address this major health concern, the currently available treatments for AUD need to be improved. Acupuncture, a popular form of complementary and alternative therapy, is emerging as an effective treatment for AUD. This review summarizes how preclinical and clinical studies are related to the application of acupuncture for AUD. These studies suggest that if used correctly, acupuncture may effectively reduce alcohol intake, attenuate alcohol withdrawal syndrome, and rebalance AUD-induced maladaptation in neurotransmitters and hormones in related brain areas. The progress of research in this field is at an early stage. Future investigations with rigorous design and carefully constructed protocols are still needed.
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Affiliation(s)
- Pei Chen
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
- Department of Neurology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine5 Haiyuncang, Dongcheng District, Beijing, China
| | - Jing Li
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
| | - Xiao Han
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
- Department of Neurology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine5 Haiyuncang, Dongcheng District, Beijing, China
| | - Dennis Grech
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
| | - Ming Xiong
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
| | - Alex Bekker
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
| | - Jiang-Hong Ye
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School185 South Orange Avenue, Newark, New Jersey 07103, USA
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Grech D, Li Z, Morcillo P, Kalyoussef E, Kim DD, Bekker A, Ulloa L. Intraoperative Low-frequency Electroacupuncture under General Anesthesia Improves Postoperative Recovery in a Randomized Trial. J Acupunct Meridian Stud 2016; 9:234-241. [PMID: 27776761 PMCID: PMC6289585 DOI: 10.1016/j.jams.2016.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 11/15/2022] Open
Abstract
Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery. Patients with electroacupuncture required 60% less postoperative analgesic, even they had pain scores similar to those in the control patients. Electroacupuncture prevented postoperative hyperglycemia and attenuated serum adrenocorticotropic hormone in the older and heavier group of patients. From an immunological perspective, electroacupuncture did not affect the protective immune responses to surgical trauma, including the induction of interleukin-6 and interleukin-10. The most significant immunological effect of electroacupuncture was enhancing transforming growth factor-β1 production during surgery in the older and lighter group of patients. These results suggest that intraoperative electroacupuncture on anesthetized patients can reduce postoperative use of analgesics and improve immune and stress responses to surgery.
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Affiliation(s)
- Dennis Grech
- Department of Anesthesiology, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Zhifeng Li
- Laboratory of Surgical Immunology, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Patrick Morcillo
- Laboratory of Surgical Immunology, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Evelyne Kalyoussef
- Department of Otolaryngology, Head and Neck Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - David D Kim
- Department of Anesthesiology, New Jersey Medical School, Rutgers University, Newark, NJ, USA; Departments of Pharmacology and Physiology, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Alex Bekker
- Department of Anesthesiology, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Luis Ulloa
- Laboratory of Surgical Immunology, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
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Fu R, Zuo W, Gregor D, Li J, Grech D, Ye JH. Pharmacological Manipulation of the Rostromedial Tegmental Nucleus Changes Voluntary and Operant Ethanol Self-Administration in Rats. Alcohol Clin Exp Res 2016; 40:572-82. [PMID: 26876382 PMCID: PMC4775316 DOI: 10.1111/acer.12974] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/23/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND The aversive properties of ethanol (EtOH) that limit its intake are poorly understood. There is an increasing interest in the role of the rostromedial tegmental nucleus (RMTg), because it encodes aversion signals and inhibits motivated behaviors. It is also a major source of inhibitory GABAergic inputs to the midbrain dopamine neurons. Up to this time, the role of the RMTg in EtOH-drinking behaviors has not been well explored. METHODS Male Long-Evans rats were trained either to drink EtOH under the intermittent 2-bottle-choice protocol or to self-administer EtOH in operant chambers under fixed-ratio-3 schedules. Changes in drinking behaviors induced by the bilateral infusion into the RMTg of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), an agonist of AMPA-type glutamate receptors, or muscimol, an agonist of GABAA receptors, were measured. RESULTS Consumption and preference for EtOH, numbers of active lever pressing, and head entrance to the EtOH port were all significantly decreased upon activation of the RMTg by the infusion of AMPA, but were increased upon inhibition of the RMTg by the infusion of muscimol. By contrast, intra-RMTg infusion of these agents did not change sucrose consumption. CONCLUSIONS These data show for the first time that EtOH-drinking and EtOH-seeking behaviors of rats changed inversely with RMTg function, supporting the idea that the RMTg plays a crucial role in EtOH-drinking behaviors.
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Affiliation(s)
- Rao Fu
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - Wanhong Zuo
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - Danielle Gregor
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - Jing Li
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - Dennis Grech
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - Jiang-Hong Ye
- Department of Anesthesiology, Pharmacology and Physiology, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
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Sharma SK, Rohatgi A, Bajaj M, Sprung CL, Morales RC, Kasdan H, Reiter A, Volker T, Meissonnier J, Beloborodova N, Moroz V, Bedova A, Sarshor Y, Osipov A, Chernevskaya K, Fedotcheva N, Chernevskaya E, Beloborodova N, Imahase H, Yamada KC, Sakamoto Y, Ohta M, Sakurai R, Yahata M, Umeka M, Miike T, Koami H, Nagashima F, Iwamura T, Inoue S, Li Z, Grech D, Morcillo P, Bekker A, Ulloa L, Mukhopadhyay S, Pandey AD, Bhattacharjee S, Mohapatra SK, Wilson JK, Jadhav S, Misra RN, Gandham N, Angadi K, Vywahare C, Gupta N, Desai D, Bakochi A, Mohanty T, Linder A, Malmström J, Anand D, Bhargava S, Srivastava LM, Ray S, Fisher J, Bentzer P, Linder A, da Costa LHA, dos Santos Júnior NN, Catalão CHR, da Rocha MJA, Focà A, Peronace C, Matera G, Giancotti A, Barreca GS, Quirino A, Loria MT, Settembre P, Liberto MC, Amantea B, Hartog C, Moeller C, Fleischmann C, Thomas-Rueddel D, Vlasakov V, Rochwerg B, Theurer P, Reinhart K, Smith AE, Taylor SD, Da Costa C, Radford A, Lee T, Singer J, Boyd J, Fineberg D, Williams M, Russell JA. Sepsis 2016 Agra, India. Crit Care 2016; 20 Suppl 1:45. [PMID: 26996981 PMCID: PMC4895252 DOI: 10.1186/s13054-016-1204-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
P1 D-Dimer in adult patients with presumed sepsis and their clinical outcomes Surinder Kumar Sharma, Anurag Rohatgi, Mansi Bajaj P2 Diagnosis of infection utilizing Acellix CD64 Charles L. Sprung, Ricardo Calderon Morales, Harvey Kasdan, Allon Reiter, Tobias Volker, Julien Meissonnier P3 High levels of phenylcarboxylic acids reflect the severity in ICU patients and affect phagocytic activity of neutrophils Natalia Beloborodova, Viktor Moroz, Aleksandra Bedova, Yulia Sarshor, Artem Osipov, Katerina Chernevskaya P4 The role of bacterial phenolic metabolites in mitochondrial dysfunction Nadezhda Fedotcheva, Ekaterina Chernevskaya, Natalia Beloborodova P5 The early diagnosis of severe sepsis and judgment of rapid transport to critical care center: better prognostic factor Hisashi Imahase, Kosuke C Yamada, Yuichiro Sakamoto, Miho Ohta, Ryota Sakurai, Mayuko Yahata, Mitsuru Umeka, Toru Miike, Hiroyuki Koami, Futoshi Nagashima, Takashi Iwamura, Satoshi Inoue P6 Translational neuromodulation of the immune system Zhifeng Li, Dennis Grech, Patrick Morcillo, Alex Bekker, Luis Ulloa P7 Pathway-level meta-analysis reveals transcriptional signature of septic shock Samanwoy Mukhopadhyay, Abhay D Pandey, Samsiddhi Bhattacharjee, Saroj K Mohapatra P8 Antibiotic dosing in septic patients on the critical care unit - a literature review Julie K Wilson P9 Pandemic of Escherichia coli clone O25: H4-ST131 producing CTX-M-15 extended spectrum- β- lactamase- as serious cause of multidrug resistance extraintestinal pathogenic E. coli infections in India Savita Jadhav, Rabindra Nath Misra, Nageswari Gandham, Kalpana Angadi, Chanda Vywahare, Neetu Gupta, Deepali Desai P10 Detection and characterization of meningitis using a DDA-based mass spectrometry approach Anahita Bakochi, Tirthankar Mohanty, Adam Linder, Johan Malmström P11 Diagnostic usefulness of lipid profile and procalcitonin in sepsis and trauma patients Dimple Anand, Seema Bhargava, Lalit Mohan Srivastava, Sumit Ray P12 Heparin – a novel therapeutic in sepsis? Jane Fisher, Peter Bentzer, Adam Linder P13 Hypothalamic impairment is associated with vasopressin deficiency during sepsis Luis Henrique Angenendt da Costa, Nilton Nascimentos dos Santos Júnior Carlos Henrique Rocha Catalão, Maria José Alves da Rocha P14 Presepsin (soluble CD14 subtype) is a dependable prognostic marker in critical septic patients Alfredo Focà, Cinzia Peronace, Giovanni Matera, Aida Giancotti, Giorgio Settimo Barreca, Angela Quirino, Maria Teresa Loria, Pio Settembre, Maria Carla Liberto, Bruno Amantea P15 Safety and efficacy of gelatin-containing solutions versus crystalloids and albumin - a systematic review with quantitative and qualitative summaries Christiane Hartog, Christiane Hartog, Claudia Moeller, Carolin Fleischmann, Daniel Thomas-Rueddel, Vlasislav Vlasakov, Bram Rochwerg, Philip Theurer, Konrad Reinhart P16 Immunomodulatory properties of peripheral blood mesenchymal stem cells following endotoxin stimulation in an equine model Anna E. Smith, Sandra D. Taylor P17 Frequency and outcome of early sepsis-associated coagulopathy Christopher Da Costa, Amanda Radford, Terry Lee, Joel Singer, John Boyd, David Fineberg, Mark Williams, James A Russell
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