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Yrjälä T, Helenius I, Rissanen T, Ahonen M, Taittonen M, Helenius L. The Extension of Surgery Predicts Acute Postoperative Pain, While Persistent Postoperative Pain Is Related to the Spinal Pathology in Adolescents Undergoing Posterior Spinal Fusion. Children 2022; 9:children9111729. [PMID: 36360457 PMCID: PMC9688920 DOI: 10.3390/children9111729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022]
Abstract
Persistent pain after posterior spinal fusion affects 12 to 42% of patients with adolescent idiopathic scoliosis. The incidence of persistent pain among surgically treated children with Scheuermann kyphosis and spondylolisthesis is not known. The aim of our study was to determine the predictors and incidence of acute and chronic postoperative pain in adolescents undergoing posterior spinal fusion surgery. The study was a retrospective analysis of a prospectively collected pediatric spine register data. The study included 213 consecutive patients (158 AIS, 19 Scheuermann kyphosis, and 36 spondylolisthesis), aged 10–21 years undergoing posterior spinal fusion at a university hospital between March 2010 and March 2020. The mean (SD) daily postoperative opioid consumption per kilogram was significantly lower in the spondylolisthesis patients 0.36 mg/kg/day (0.17) compared to adolescent idiopathic scoliosis 0.51 mg/kg/day (0.25), and Scheuermann kyphosis 0.52 mg/kg/day (0.25) patients after surgery (p = 0.0004). Number of levels fused correlated with the daily opioid consumption (rs = 0.20, p = 0.0082). The SRS-24 pain domain scores showed a statistically significant improvement from preoperative levels to two-year follow-up in all three groups (p ≤ 0.03 for all comparisons). The spondylolisthesis patients had the lowest SRS pain domain scores (mean 4.04, SD 0.94), reporting more pain two years after surgery, in comparison to AIS (mean 4.31, SD 0.60) (p = 0.043) and SK (mean 4.43, SD 0.48) patients (p = 0.049). Persistent postoperative pain in adolescents undergoing posterior spinal fusion is related to disease pathology while higher acute postoperative pain is associated with a more extensive surgery. Spondylolisthesis patients report more chronic pain after surgery compared to AIS and SK patients.
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Affiliation(s)
- Tommi Yrjälä
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Ilkka Helenius
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
- Correspondence:
| | - Tiia Rissanen
- Department of Biostatistics, University of Turku, 20500 Turku, Finland
| | - Matti Ahonen
- Department of Pediatric Surgery, Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
| | - Markku Taittonen
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Linda Helenius
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, 20521 Turku, Finland
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Yrjälä T, Helenius L, Taittonen M, Oksanen H, Keskinen H, Kolari T, Helenius I. Predictors of postoperative urinary retention after posterior spinal fusion for adolescent idiopathic scoliosis. Eur Spine J 2021; 30:3557-3562. [PMID: 34611717 DOI: 10.1007/s00586-021-07016-7] [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] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/26/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine predictors for postoperative urinary retention in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. Postoperative urinary retention affects almost every third adolescent after spinal fusion for idiopathic scoliosis. There are limited data regarding the risk factors of postoperative urinary retention in this patient group. METHODS A retrospective study with prospectively collected urinary retention data from paediatric spine register with 159 consecutive patients (114 females, mean age 15.6 years, range 10-21 years) undergoing pedicle screw instrumentation for adolescent idiopathic scoliosis at a university hospital between May 2010 and April 2020. Postoperative urinary retention was defined as an inability to void after catheter removal and documented residual over 300 mL as confirmed using an ultrasound or by catheterization. RESULTS Postoperative urinary retention was diagnosed in 33% (53 of 159) of the patients during hospital stay. Opioid amount on the day of catheter removal (OR 6.74 [95% CI: 2.47, 18.36], p < 0.001), male gender (OR 2.26 [95% CI: 1.01, 5.05], p = 0.048), and increasing weight (OR 1.04 [95% CI: 1.01, 1.07], p = 0.014) were associated with postoperative urinary retention. Mean opioid consumption on the day of catheter removal was 0.81 mg/kg (95% CI: 0.66, 0.96) in the retention group vs 0.57 mg/kg (95% CI: 0.51, 0.64) in the non-retention group, p < 0.001. CONCLUSIONS Higher total opioid consumption, opioid amount on the day of catheter removal, higher weight, and male gender increases the risk of postoperative urinary retention in adolescents with idiopathic scoliosis undergoing posterior spinal fusion.
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Affiliation(s)
- Tommi Yrjälä
- Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Linda Helenius
- Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Markku Taittonen
- Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Hanna Oksanen
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Heli Keskinen
- Department of Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland
| | - Terhi Kolari
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Ilkka Helenius
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Helenius L, Yrjälä T, Oksanen H, Pajulo O, Löyttyniemi E, Taittonen M, Helenius I. Pregabalin and Persistent Postoperative Pain Following Posterior Spinal Fusion in Children and Adolescents: A Randomized Clinical Trial. J Bone Joint Surg Am 2021; 103:00004623-990000000-00319. [PMID: 34424869 DOI: 10.2106/jbjs.21.00153] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Surgical correction of spinal deformity requires major surgical intervention with extensive manipulation of the spine and neural elements. Persistent postoperative pain affects patient quality of life and can also cause financial burden for patient families and for society. We aimed to investigate the effect of perioperative pregabalin on the incidence of persistent pain following instrumented spinal fusion. METHODS We conducted a randomized, double-blinded, and placebo-controlled single-center clinical trial. Adolescents and children 10 to 21 years old with a spinal deformity who were scheduled for pedicle screw instrumentation and fusion were randomized into either the pregabalin or placebo group. Patients received 2 mg/kg of pregabalin or a placebo twice daily preoperatively and for 5 days postoperatively. The duration of follow-up was 2 years. The primary outcomes were cumulative opioid consumption during the first 48 hours postoperatively and the incidence of persistent postoperative pain over the course of the 2-year follow-up. RESULTS Sixty-four of 77 eligible patients were enrolled in the study, with all patients completing the 2-year follow-up. Thirty-three patients were randomized into the pregabalin group and 31 into the placebo group. There was no significant difference in cumulative 48-hour opioid consumption between the study groups. The Scoliosis Research Society 24-Item Questionnaire pain domain score improved significantly, from a mean value of 3.8 in both groups to 4.3 in the pregabalin and 4.0 in the placebo group at 2 years postoperatively, with no differences between the study groups at any time point (p = 0.317). The Scoliosis Research Society total scores of the study groups were similar (p = 0.678). Back pain, as measured with use of a visual analogue scale, improved significantly (p = 0.001) with no significant differences at any time point (preoperatively and 6 months, 1 year, and 2 years postoperatively). CONCLUSIONS Perioperative pregabalin does not reduce postoperative opioid consumption or the incidence of persistent postoperative pain following instrumented posterior spinal fusion for spinal deformities in an adolescent population. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Linda Helenius
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland
| | - Tommi Yrjälä
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland
| | - Hanna Oksanen
- Department of Pediatric Orthopedic Surgery, University of Turku and Turku University Hospital, Turku, Finland
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Olli Pajulo
- Department of Pediatric Orthopedic Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Markku Taittonen
- Department of Anesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka Helenius
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Laurila S, Sun L, Lahesmaa M, Schnabl K, Laitinen K, Klén R, Li Y, Balaz M, Wolfrum C, Steiger K, Niemi T, Taittonen M, U-Din M, Välikangas T, Elo LL, Eskola O, Kirjavainen AK, Nummenmaa L, Virtanen KA, Klingenspor M, Nuutila P. Secretin activates brown fat and induces satiation. Nat Metab 2021; 3:798-809. [PMID: 34158656 DOI: 10.1038/s42255-021-00409-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/07/2021] [Indexed: 02/06/2023]
Abstract
Brown adipose tissue (BAT) thermogenesis is activated by feeding. Recently, we revealed a secretin-mediated gut-BAT-brain axis, which stimulates satiation in mice, but the purpose of meal-induced BAT activation in humans has been unclear. In this placebo-controlled, randomized crossover study, we investigated the effects of intravenous secretin on BAT metabolism (measured with [18F]FDG and [15O]H2O positron emission tomography) and appetite (measured with functional magnetic resonance imaging) in healthy, normal weight men (GUTBAT trial no. NCT03290846). Participants were blinded to the intervention. Secretin increased BAT glucose uptake (primary endpoint) compared to placebo by 57% (median (interquartile range, IQR), 0.82 (0.77) versus 0.59 (0.53) μmol per 100 g per min, 95% confidence interval (CI) (0.09, 0.89), P = 0.002, effect size r = 0.570), while BAT perfusion remained unchanged (mean (s.d.) 4.73 (1.82) versus 6.14 (3.05) ml per 100 g per min, 95%CI (-2.91, 0.07), P = 0.063, effect size d = -0.549) (n = 15). Whole body energy expenditure increased by 2% (P = 0.011) (n = 15). Secretin attenuated blood-oxygen level-dependent activity (primary endpoint) in brain reward circuits during food cue tasks (significance level false discovery rate corrected at P = 0.05) (n = 14). Caloric intake did not significantly change, but motivation to refeed after a meal was delayed by 39 min (P = 0.039) (n = 14). No adverse effects were detected. Here we show in humans that secretin activates BAT, reduces central responses to appetizing food and delays the motivation to refeed after a meal. This suggests that meal-induced, secretin-mediated BAT activation is relevant in the control of food intake in humans. As obesity is increasing worldwide, this appetite regulating axis offers new possibilities for clinical research in treating obesity.
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Affiliation(s)
- Sanna Laurila
- Turku PET Centre, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, Turku, Finland
- Satakunta Central Hospital, Pori, Finland
| | - Lihua Sun
- Turku PET Centre, University of Turku, Turku, Finland
| | - Minna Lahesmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Internal Medicine, Jorvi Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Katharina Schnabl
- Chair for Molecular Nutritional Medicine, Technical University of Munich, TUM School of Life Sciences, Freising, Germany
- EKFZ - Else Kröner Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
- ZIEL - Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Kirsi Laitinen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Riku Klén
- Turku PET Centre, University of Turku, Turku, Finland
| | - Yongguo Li
- Chair for Molecular Nutritional Medicine, Technical University of Munich, TUM School of Life Sciences, Freising, Germany
- EKFZ - Else Kröner Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
- ZIEL - Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Miroslav Balaz
- Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland
| | - Christian Wolfrum
- Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland
| | - Katja Steiger
- Institue of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tarja Niemi
- Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
| | - Markku Taittonen
- Department of Anesthesiology, Turku University Hospital, Turku, Finland
| | - Mueez U-Din
- Turku PET Centre, University of Turku, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | | | - Laura L Elo
- Institute of Biomedicine, University of Turku, Turku, Finland
- Turku Bioscience Centre, University of Turku, Turku, Finland
- Turku Bioscience Centre, Åbo Akademi University, Turku, Finland
| | - Olli Eskola
- Turku PET Centre, University of Turku, Turku, Finland
| | | | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Kirsi A Virtanen
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Institute of Public Health and Clinical Nutrition - University of Eastern Finland (UEF), Kuopio, Finland
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Martin Klingenspor
- Chair for Molecular Nutritional Medicine, Technical University of Munich, TUM School of Life Sciences, Freising, Germany
- EKFZ - Else Kröner Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
- ZIEL - Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland.
- Turku PET Centre, Turku University Hospital, Turku, Finland.
- Department of Endocrinology, Turku University Hospital, Turku, Finland.
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5
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Saari TJ, Raiko J, U-Din M, Niemi T, Taittonen M, Laine J, Savisto N, Haaparanta-Solin M, Nuutila P, Virtanen KA. Basal and cold-induced fatty acid uptake of human brown adipose tissue is impaired in obesity. Sci Rep 2020; 10:14373. [PMID: 32873825 PMCID: PMC7463032 DOI: 10.1038/s41598-020-71197-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/20/2020] [Indexed: 11/17/2022] Open
Abstract
Fatty acids (FA) are important substrates for brown adipose tissue (BAT) metabolism, however, it remains unclear whether there exists a difference in FA metabolism of BAT between lean and obese healthy humans. In this study we evaluated supraclavicular BAT fatty acid uptake (FAU) along with blood perfusion in lean and obese subjects during cold exposure and at room temperature using positron emission tomography (PET)/computed tomography (CT). Additionally, tissue samples were taken from supraclavicular region (typical BAT region) from a subset of subjects to evaluate histological presence of BAT. Non-shivering cold stress elevated FAU and perfusion of BAT in lean, but not in obese subjects. Lean subjects had greater FAU in BAT compared to obese subjects during cold exposure and interestingly also at room temperature. The higher BAT FAU was related to younger age and several indicators of superior systemic metabolic health. The subjects who manifested BAT histologically had several folds higher BAT FAU compared to subjects with no such histological manifestation. Together, obese subjects have less active tissue in supraclavicular region both in basal and cold-activated state and the FA metabolism of BAT is blunted in obesity.
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Affiliation(s)
- T J Saari
- Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.,Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - J Raiko
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - M U-Din
- Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.,Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - T Niemi
- Department of Surgery, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - M Taittonen
- Department of Anesthesiology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - J Laine
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - N Savisto
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - M Haaparanta-Solin
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland.,MediCity Research Laboratories, University of Turku, Tykistökatu 6A, 20520, Turku, Finland
| | - P Nuutila
- Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.,Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - K A Virtanen
- Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland. .,Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland. .,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PL 1627, 70211, Kuopio, Finland.
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6
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Gnad T, Navarro G, Lahesmaa M, Reverte-Salisa L, Copperi F, Cordomi A, Naumann J, Hochhäuser A, Haufs-Brusberg S, Wenzel D, Suhr F, Jespersen NZ, Scheele C, Tsvilovskyy V, Brinkmann C, Rittweger J, Dani C, Kranz M, Deuther-Conrad W, Eltzschig HK, Niemi T, Taittonen M, Brust P, Nuutila P, Pardo L, Fleischmann BK, Blüher M, Franco R, Bloch W, Virtanen KA, Pfeifer A. Adenosine/A2B Receptor Signaling Ameliorates the Effects of Aging and Counteracts Obesity. Cell Metab 2020; 32:56-70.e7. [PMID: 32589947 PMCID: PMC7437516 DOI: 10.1016/j.cmet.2020.06.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/15/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022]
Abstract
The combination of aging populations with the obesity pandemic results in an alarming rise in non-communicable diseases. Here, we show that the enigmatic adenosine A2B receptor (A2B) is abundantly expressed in skeletal muscle (SKM) as well as brown adipose tissue (BAT) and might be targeted to counteract age-related muscle atrophy (sarcopenia) as well as obesity. Mice with SKM-specific deletion of A2B exhibited sarcopenia, diminished muscle strength, and reduced energy expenditure (EE), whereas pharmacological A2B activation counteracted these processes. Adipose tissue-specific ablation of A2B exacerbated age-related processes and reduced BAT EE, whereas A2B stimulation ameliorated obesity. In humans, A2B expression correlated with EE in SKM, BAT activity, and abundance of thermogenic adipocytes in white fat. Moreover, A2B agonist treatment increased EE from human adipocytes, myocytes, and muscle explants. Mechanistically, A2B forms heterodimers required for adenosine signaling. Overall, adenosine/A2B signaling links muscle and BAT and has both anti-aging and anti-obesity potential.
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Affiliation(s)
- Thorsten Gnad
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Gemma Navarro
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain; Centro de Investigación en Red, Enfermedades Neurodegenerativas (CiberNed), Instituto de Salud Carlos III, Madrid, Spain
| | - Minna Lahesmaa
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Laia Reverte-Salisa
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Francesca Copperi
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Arnau Cordomi
- Laboratory of Computational Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jennifer Naumann
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Aileen Hochhäuser
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Saskia Haufs-Brusberg
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - Daniela Wenzel
- Institute of Physiology I, Life&Brain Center, Medical Faculty, University of Bonn, 53105 Bonn, Germany; Department of Systems Physiology, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Frank Suhr
- Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany; Exercise Physiology Research Group, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
| | - Naja Zenius Jespersen
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Scheele
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Christian Brinkmann
- Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Joern Rittweger
- Department of Muscle and Bone Metabolism, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Christian Dani
- Université Côte d'Azur, CNRS, Inserm, iBV, Faculté de Médecine, 06107 Nice Cedex 2, France
| | - Mathias Kranz
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiopharmaceutical Cancer Research, Research Site Leipzig, Leipzig, Germany
| | - Winnie Deuther-Conrad
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiopharmaceutical Cancer Research, Research Site Leipzig, Leipzig, Germany
| | - Holger K Eltzschig
- Department of Anesthesiology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Tarja Niemi
- Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
| | - Markku Taittonen
- Department of Anesthesiology, Turku University Hospital, Turku, Finland
| | - Peter Brust
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiopharmaceutical Cancer Research, Research Site Leipzig, Leipzig, Germany
| | - Pirjo Nuutila
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Leonardo Pardo
- Laboratory of Computational Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Bernd K Fleischmann
- Institute of Physiology I, Life&Brain Center, Medical Faculty, University of Bonn, 53105 Bonn, Germany
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Rafael Franco
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain; Centro de Investigación en Red, Enfermedades Neurodegenerativas (CiberNed), Instituto de Salud Carlos III, Madrid, Spain
| | - Wilhelm Bloch
- Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Kirsi A Virtanen
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland (UEF), Kuopio, Finland
| | - Alexander Pfeifer
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany.
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7
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Lahesmaa M, Eriksson O, Gnad T, Oikonen V, Bucci M, Hirvonen J, Koskensalo K, Teuho J, Niemi T, Taittonen M, Lahdenpohja S, U Din M, Haaparanta-Solin M, Pfeifer A, Virtanen KA, Nuutila P. Cannabinoid Type 1 Receptors Are Upregulated During Acute Activation of Brown Adipose Tissue. Diabetes 2018; 67:1226-1236. [PMID: 29650773 DOI: 10.2337/db17-1366] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/02/2018] [Indexed: 11/13/2022]
Abstract
Activating brown adipose tissue (BAT) could provide a potential approach for the treatment of obesity and metabolic disease in humans. Obesity is associated with upregulation of the endocannabinoid system, and blocking the cannabinoid type 1 receptor (CB1R) has been shown to cause weight loss and to decrease cardiometabolic risk factors. These effects may be mediated partly via increased BAT metabolism, since there is evidence that CB1R antagonism activates BAT in rodents. To investigate the significance of CB1R in BAT function, we quantified the density of CB1R in human and rodent BAT using the positron emission tomography radioligand [18F]FMPEP-d2 and measured BAT activation in parallel with the glucose analog [18F]fluorodeoxyglucose. Activation by cold exposure markedly increased CB1R density and glucose uptake in the BAT of lean men. Similarly, β3-receptor agonism increased CB1R density in the BAT of rats. In contrast, overweight men with reduced BAT activity exhibited decreased CB1R in BAT, reflecting impaired endocannabinoid regulation. Image-guided biopsies confirmed CB1R mRNA expression in human BAT. Furthermore, CB1R blockade increased glucose uptake and lipolysis of brown adipocytes. Our results highlight that CB1Rs are significant for human BAT activity, and the CB1Rs provide a novel therapeutic target for BAT activation in humans.
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Affiliation(s)
- Minna Lahesmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Olof Eriksson
- Turku PET Centre, Åbo Akademi, Turku, Finland
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Thorsten Gnad
- Institute of Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Vesa Oikonen
- Turku PET Centre, University of Turku, Turku, Finland
| | - Marco Bucci
- Turku PET Centre, University of Turku, Turku, Finland
| | - Jussi Hirvonen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Kalle Koskensalo
- Turku PET Centre, University of Turku, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Jarmo Teuho
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Tarja Niemi
- Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
| | - Markku Taittonen
- Department of Anesthesiology, Turku University Hospital, Turku, Finland
| | | | - Mueez U Din
- Turku PET Centre, University of Turku, Turku, Finland
| | - Merja Haaparanta-Solin
- Turku PET Centre, University of Turku, Turku, Finland
- MediCity Research Laboratories, University of Turku, Turku, Finland
| | - Alexander Pfeifer
- Institute of Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Kirsi A Virtanen
- Turku PET Centre, University of Turku, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
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8
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Giroud M, Pisani DF, Karbiener M, Barquissau V, Ghandour RA, Tews D, Fischer-Posovszky P, Chambard JC, Knippschild U, Niemi T, Taittonen M, Nuutila P, Wabitsch M, Herzig S, Virtanen KA, Langin D, Scheideler M, Amri EZ. miR-125b affects mitochondrial biogenesis and impairs brite adipocyte formation and function. Mol Metab 2016; 5:615-625. [PMID: 27656399 PMCID: PMC5021678 DOI: 10.1016/j.molmet.2016.06.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 12/17/2022] Open
Abstract
Objective In rodents and humans, besides brown adipose tissue (BAT), islands of thermogenic adipocytes, termed “brite” (brown-in-white) or beige adipocytes, emerge within white adipose tissue (WAT) after cold exposure or β3-adrenoceptor stimulation, which may protect from obesity and associated diseases. microRNAs are novel modulators of adipose tissue development and function. The purpose of this work was to characterize the role of microRNAs in the control of brite adipocyte formation. Methods/Results Using human multipotent adipose derived stem cells, we identified miR-125b-5p as downregulated upon brite adipocyte formation. In humans and rodents, miR-125b-5p expression was lower in BAT than in WAT. In vitro, overexpression and knockdown of miR-125b-5p decreased and increased mitochondrial biogenesis, respectively. In vivo, miR-125b-5p levels were downregulated in subcutaneous WAT and interscapular BAT upon β3-adrenergic receptor stimulation. Injections of an miR-125b-5p mimic and LNA inhibitor directly into WAT inhibited and increased β3-adrenoceptor-mediated induction of UCP1, respectively, and mitochondrial brite adipocyte marker expression and mitochondriogenesis. Conclusion Collectively, our results demonstrate that miR-125b-5p plays an important role in the repression of brite adipocyte function by modulating oxygen consumption and mitochondrial gene expression. miR-125b-5p levels negatively correlate with UCP1 expression in rodent and human. miR125b levels in white adipose tissue are positively correlated with BMI. miR-125b-5p modulates oxygen consumption. Mitochondriogenesis is controlled by miR-125b-5p. In vivo modulation of miR-125b-5p controls brown and brite adipocyte formation.
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Affiliation(s)
- Maude Giroud
- Univ. Nice Sophia Antipolis, CNRS, Inserm, iBV, 06100 Nice, France
| | - Didier F Pisani
- Univ. Nice Sophia Antipolis, CNRS, Inserm, iBV, 06100 Nice, France
| | - Michael Karbiener
- Department of Phoniatrics, ENT University Hospital, Medical University Graz, Graz, Austria
| | - Valentin Barquissau
- Inserm, UMR1048, Obesity Research Laboratory, Institute of Metabolic and Cardiovascular Diseases, Toulouse, France; University of Toulouse, UMR1048, Paul Sabatier University, Toulouse, France
| | | | - Daniel Tews
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, D-89075 Ulm, Germany
| | - Pamela Fischer-Posovszky
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, D-89075 Ulm, Germany
| | | | - Uwe Knippschild
- Department of General and Visceral Surgery, Ulm University Surgery Center, D-89075 Ulm, Germany
| | - Tarja Niemi
- Department of Endocrinology, Turku University Hospital, Turku, 20521, Finland
| | - Markku Taittonen
- Department of Endocrinology, Turku University Hospital, Turku, 20521, Finland
| | - Pirjo Nuutila
- Department of Endocrinology, Turku University Hospital, Turku, 20521, Finland; Turku University Hospital, Turku, Finland
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, D-89075 Ulm, Germany
| | - Stephan Herzig
- Institute for Diabetes and Cancer (IDC), Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, Heidelberg, Germany; Molecular Metabolic Control, Medical Faculty, Technical University Munich, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Kirsi A Virtanen
- Department of Endocrinology, Turku University Hospital, Turku, 20521, Finland; Turku PET Centre, University of Turku, Turku, Finland
| | - Dominique Langin
- Inserm, UMR1048, Obesity Research Laboratory, Institute of Metabolic and Cardiovascular Diseases, Toulouse, France; University of Toulouse, UMR1048, Paul Sabatier University, Toulouse, France; Toulouse University Hospitals, Department of Clinical Biochemistry, Toulouse, France
| | - Marcel Scheideler
- Institute for Diabetes and Cancer (IDC), Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, Heidelberg, Germany; Molecular Metabolic Control, Medical Faculty, Technical University Munich, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Ez-Zoubir Amri
- Univ. Nice Sophia Antipolis, CNRS, Inserm, iBV, 06100 Nice, France.
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9
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Pisani DF, Dumortier O, Beranger GE, Casamento V, Ghandour RA, Giroud M, Gautier N, Balaguer T, Chambard JC, Virtanen KA, Nuutila P, Niemi T, Taittonen M, Van Obberghen E, Hinault C, Amri EZ. Visfatin expression analysis in association with recruitment and activation of human and rodent brown and brite adipocytes. Adipocyte 2016; 5:186-95. [PMID: 27386154 DOI: 10.1080/21623945.2015.1122854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/06/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022] Open
Abstract
Human brown adipocytes are able to burn fat and glucose and are now considered as a potential strategy to treat obesity, type 2 diabetes and metabolic disorders. Besides their thermogenic function, brown adipocytes are able to secrete adipokines. One of these is visfatin, a nicotinamide phosphoribosyltransferase involved in nicotinamide dinucleotide synthesis, which is known to participate in the synthesis of insulin by pancreatic β cells. In a therapeutic context, it is of interest to establish whether a potential correlation exists between brown adipocyte activation and/or brite adipocyte recruitment, and adipokine expression. We analyzed visfatin expression, as a pre-requisite to its secretion, in rodent and human biopsies and cell models of brown/brite adipocytes. We found that visfatin was preferentially expressed in mature adipocytes and that this expression was higher in brown adipose tissue of rodents compared to other fat depots. However, using various rodent models we were unable to find any correlation between visfatin expression and brown or brite adipocyte activation or recruitment. Interestingly, the situation is different in humans where visfatin expression was found to be equivalent between white and brown or brite adipocytes in vivo and in vitro. In conclusion, visfatin can be considered only as a rodent brown adipocyte biomarker, independently of tissue activation.
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Affiliation(s)
- Didier F. Pisani
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
| | - Olivier Dumortier
- Univ. of Nice-Sophia Antipolis, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- INSERM, IRCAN, U1081, Nice, France
- CNRS, IRCAN, UMR7284, Nice, France
| | - Guillaume E. Beranger
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
| | - Virginie Casamento
- Univ. of Nice-Sophia Antipolis, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- INSERM, IRCAN, U1081, Nice, France
- CNRS, IRCAN, UMR7284, Nice, France
| | - Rayane A. Ghandour
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
| | - Maude Giroud
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
| | - Nadine Gautier
- Univ. of Nice-Sophia Antipolis, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- INSERM, IRCAN, U1081, Nice, France
- CNRS, IRCAN, UMR7284, Nice, France
| | - Thierry Balaguer
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
- Centre Hospitalo-Universitaire Nice, Department of Plastic, Reconstructive and Hand Surgery, St-Roch Hospital, Nice, France
| | - Jean-Claude Chambard
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
| | - Kirsi A. Virtanen
- Turku PET Center, University of Turku, Turku, Finland
- Turku PET Center, Turku University Hospital, Turku, Finland
| | - Pirjo Nuutila
- Turku PET Center, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Tarja Niemi
- Department of Surgery, Turku University Hospital, Turku, Finland
| | - Markku Taittonen
- Department of Anesthesiology, Turku University Hospital, Turku, Finland
| | - Emmanuel Van Obberghen
- Univ. of Nice-Sophia Antipolis, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- INSERM, IRCAN, U1081, Nice, France
- CNRS, IRCAN, UMR7284, Nice, France
- Centre Hospitalo-Universitaire Nice, Biochemistry Laboratory, Pasteur Hospital, Nice, France
| | - Charlotte Hinault
- Univ. of Nice-Sophia Antipolis, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- INSERM, IRCAN, U1081, Nice, France
- CNRS, IRCAN, UMR7284, Nice, France
- Centre Hospitalo-Universitaire Nice, Biochemistry Laboratory, Pasteur Hospital, Nice, France
| | - Ez-Zoubir Amri
- Univ. Nice-Sophia Antipolis, UFR Medecine, Nice, France
- CNRS, iBV, UMR, 7277, Nice, France
- INSERM, iBV, U1091, Nice, France
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Raiko J, Holstila M, Virtanen KA, Orava J, Saunavaara V, Niemi T, Laine J, Taittonen M, Borra RJH, Nuutila P, Parkkola R. Brown adipose tissue triglyceride content is associated with decreased insulin sensitivity, independently of age and obesity. Diabetes Obes Metab 2015; 17:516-9. [PMID: 25586670 DOI: 10.1111/dom.12433] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/16/2014] [Accepted: 12/31/2014] [Indexed: 02/03/2023]
Abstract
The aim of the present study was to determine whether single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) can non-invasively assess triglyceride content in both supraclavicular fat depots and subcutaneous white adipose tissue (WAT) to determine whether these measurements correlate to metabolic variables. A total of 25 healthy volunteers were studied using (18)F-fluorodeoxyglucose positron emission tomography (PET) and (15)O-H2O PET perfusion during cold exposure, and (1)H-MRS at ambient temperature. Image-guided biopsies were collected from nine volunteers. The supraclavicular triglyceride content determined by (1)H-MRS varied between 60 and 91% [mean ± standard deviation (s.d.) 77 ± 10%]. It correlated positively with body mass index, waist circumference, subcutaneous and visceral fat masses and 8-year diabetes risk based on the Framingham risk score and inversely with HDL cholesterol and insulin sensitivity (M-value; euglycaemic-hyperinsulinaemic clamp). Subcutaneous WAT had a significantly higher triglyceride content, 76-95% (mean ± s.d. 87 ± 5%; p = 0.0002). In conclusion, the triglyceride content in supraclavicular fat deposits measured by (1)H-MRS may be an independent marker of whole-body insulin sensitivity, independent of brown adipose tissue metabolic activation.
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Affiliation(s)
- J Raiko
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
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Saraste A, Ukkonen H, Varis A, Vasankari T, Tunturi S, Taittonen M, Rautakorpi P, Luotolahti M, Airaksinen KEJ, Knuuti J. Effect of spinal cord stimulation on myocardial perfusion reserve in patients with refractory angina pectoris. Eur Heart J Cardiovasc Imaging 2014; 16:449-55. [DOI: 10.1093/ehjci/jeu276] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Garcia Martin A, Fernandez Golfin C, Salido Tahoces L, Fernandez Santos S, Jimenez Nacher J, Moya Mur J, Velasco Valdazo E, Hernandez Antolin R, Zamorano Gomez J, Veronesi F, Corsi C, Caiani E, Lamberti C, Tsang W, Holmgren C, Guo X, Bateman M, Iaizzo P, Vannier M, Lang R, Patel A, Adamayn K, Tumasyan LR, Chilingaryan A, Nasr G, Eleraki A, Farouk N, Axelsson A, Langhoff L, Jensen M, Vejlstrup N, Iversen K, Bundgaard H, Watanabe T, Iwai-Takano M, Attenhofer Jost CH, Pfyffer M, Seifert B, Scharf C, Candinas R, Medeiros-Domingo A, Chin JY, Yoon H, Vollbon W, Singbal Y, Rhodes K, Wahi S, Katova TM, Simova II, Hristova K, Kostova V, Pauncheva B, Bircan A, Sade L, Eroglu S, Pirat B, Okyay K, Bal U, Muderrisoglu H, Heggemann F, Buggisch H, Welzel G, Doesch C, Hansmann J, Schoenberg S, Borggrefe M, Wenz F, Papavassiliu T, Lohr F, Roussin I, Drakopoulou M, Rosen S, Sharma R, Prasad S, Lyon A, Carpenter J, Senior R, Breithardt OA, Razavi H, Arya A, Nabutovsky Y, Ryu K, Gaspar T, Kosiuk J, Eitel C, Hindricks G, Piorkowski C, Pires S, Nunes A, Cortez-Dias N, Belo A, Zimbarra Cabrita I, Sousa C, Pinto F, Baron T, Johansson K, Flachskampf F, Christersson C, Pires S, Cortez-Dias N, Nunes A, Belo A, Zimbarra Cabrita I, Sousa C, Pinto F, Santoro A, Federico Alvino F, Giovanni Antonelli G, Raffaella De Vito R, Roberta Molle R, Sergio Mondillo S, Gustafsson M, Alehagen U, Johansson P, Tsukishiro Y, Onishi T, Chimura M, Yamada S, Taniguchi Y, Yasaka Y, Kawai H, Souza JRM, Zacharias LGT, Pithon KR, Ozahata TM, Cliquet AJ, Blotta MH, Nadruz WJ, Fabiani I, Conte L, Cuono C, Liga R, Giannini C, Barletta V, Nardi C, Delle Donne M, Palagi C, Di Bello V, Glaveckaite S, Valeviciene N, Palionis D, Laucevicius A, Hristova K, Bogdanova V, Ferferieva V, Shiue I, Castellon X, Boles U, Rakhit R, Shiu MF, Gilbert T, Papachristidis A, Henein MY, Westholm C, Johnson J, Jernberg T, Winter R, Ghosh Dastidar A, Augustine D, Cengarle M, Mcalindon E, Bucciarelli-Ducci C, Nightingale A, Onishi T, Watanabe T, Fujita M, Mizukami Y, Sakata Y, Nakatani S, Nanto S, Uematsu M, Saraste A, Luotolahti M, Varis A, Vasankari T, Tunturi S, Taittonen M, Rautakorpi P, Airaksinen J, Ukkonen H, Knuuti J, Boshchenko A, Vrublevsky A, Karpov R, Yoshikawa H, Suzuki M, Hashimoto G, Kusunose Y, Otsuka T, Nakamura M, Sugi K, Rosner S, Orban M, Lesevic H, Karl M, Hadamitzky M, Sonne C, Panaro A, Martinez F, Huguet M, Moral S, Palet J, Oller G, Cuso I, Jornet A, Rodriguez Palomares J, Evangelista A, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Gilmanov D, Baroni M, Cerone E, Galli E, Berti S, Glauber M, Soesanto A, Yuniadi Y, Mansyur M, Kusmana D, Venkateshvaran A, Dash PK, Sola S, Govind SC, Shahgaldi K, Winter R, Brodin LA, Manouras A, Dokainish H, Sadreddini M, Nieuwlaat R, Lonn E, Healey J, Nguyen V, Cimadevilla C, Dreyfus J, Codogno I, Vahanian A, Messika-Zeitoun D, Lim YJ, Kawamura A, Kawano S, Polte C, Gao S, Lagerstrand K, Cederbom U, Bech-Hanssen O, Baum J, Beeres F, Van Hall S, Boering Y, Zeus T, Kehmeier E, Kelm M, Balzer J, Della Mattia A, Pinamonti B, Abate E, Nicolosi G, Proclemer A, Bassetti M, Luzzati R, Sinagra G, Hlubocka Z, Jiratova K, Dostalova G, Hlubocky J, Dohnalova A, Linhart A, Palecek T, Sonne C, Lesevic H, Karl M, Rosner S, Hadamitzky M, Ott I, Malev E, Reeva S, Zemtsovsky E, Igual Munoz B, Alonso Fernandez Pau P, Miro Palau Vicente V, Maceira Gonzalez Alicia A, Estornell Erill J, Andres La Huerta A, Donate Bertolin L, Valera Martinez F, Salvador Sanz Antonio A, Montero Argudo Anastasio A, Nemes A, Kalapos A, Domsik P, Chadaide S, Sepp R, Forster T, Onaindia J, Arana X, Cacicedo A, Velasco S, Rodriguez I, Capelastegui A, Sadaba M, Gonzalez J, Salcedo A, Laraudogoitia E, Archontakis S, Gatzoulis K, Vlasseros I, Arsenos P, Tsiachris D, Vouliotis A, Sideris S, Karistinos G, Kalikazaros I, Stefanadis C, Ancona R, Comenale Pinto S, Caso P, Coppola M, Arenga F, Cavallaro C, Vecchione F, D'onofrio A, Calabro R, Correia CE, Moreira D, Cabral C, Santos J, Cardoso J, Igual Munoz B, Maceira Gonzalez A, Estornell Erill Jordi J, Jimenez Carreno R, Arnau Vives M, Monmeneu Menadas J, Domingo-Valero D, Sanchez Fernandez E, Montero Argudo Anastasio A, Zorio Grima E, Cincin A, Tigen K, Karaahmet T, Dundar C, Sunbul M, Guler A, Bulut M, Basaran Y, Mordi I, Carrick D, Berry C, Tzemos N, Cruz I, Ferreira A, Rocha Lopes L, Joao I, Almeida A, Fazendas P, Cotrim C, Pereira H, Ochoa JP, Fernandez A, Filipuzzi J, Casabe J, Salmo J, Vaisbuj F, Ganum G, Di Nunzio H, Veron L, Guevara E, Salemi V, Nerbass F, Portilho N, Ferreira Filho J, Pedrosa R, Arteaga-Fernandez E, Mady C, Drager L, Lorenzi-Filho G, Marques J, Almeida AMG, Menezes M, Silva G, Placido R, Amaro C, Brito D, Diogo A, Lourenco MR, Azevedo O, Moutinho J, Nogueira I, Machado I, Portugues J, Quelhas I, Lourenco A, Calore C, Muraru D, Melacini P, Badano L, Mihaila S, Puma L, Peluso D, Casablanca S, Ortile A, Iliceto S, Kang MK, Yu S, Park J, Kim S, Park T, Mun HS, C S, Cho SR, Han S, Lee N, Khalifa EA, Hamodraka E, Kallistratos M, Zacharopoulou I, Kouremenos N, Mavropoulos D, Tsoukas A, Kontogiannis N, Papanikolaou N, Tsoukanas K, Manolis A, Villagraz Tecedor L, Jimenez Lopez Guarch C, Alonso Chaterina S, Blazquez Arrollo L, Lopez Melgar B, Veitia Sarmiento A, Mayordomo Gomez S, Escribano Subias M, Lichodziejewska B, Kurnicka K, Goliszek S, Dzikowska Diduch O, Kostrubiec M, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Sakata K, Ishiguro M, Kimura G, Uesugo Y, Takemoto K, Minamishima T, Futuya M, Matsue S, Satoh T, Yoshino H, Signorello M, Gianturco L, Colombo C, Stella D, Atzeni F, Boccassini L, Sarzi-Puttini P, Turiel M, Kinova E, Deliiska B, Krivoshiev S, Goudev A, De Stefano F, Santoro C, Buonauro A, Schiano-Lomoriello V, Muscariello R, De Palma D, Galderisi M, Ranganadha Babu B, Chidambaram S, Sangareddi V, Dhandapani V, Ravi M, Meenakshi K, Muthukumar D, Swaminathan N, Ravishankar G, Bruno RM, Giardini G, Catizzo B, Brustia R, Malacrida S, Armenia S, Cauchy E, Pratali L, Cesana F, Alloni M, Vallerio P, De Chiara B, Musca F, Belli O, Ricotta R, Siena S, Moreo A, Giannattasio C, Magnino C, Omede' P, Avenatti E, Presutti D, Sabia L, Moretti C, Bucca C, Gaita F, Veglio F, Milan A, Eichhorn J, Springer W, Helling A, Alarajab A, Loukanov T, Ikeda M, Kijima Y, Akagi T, Toh N, Oe H, Nakagawa K, Tanabe Y, Watanabe N, Ito H, Hascoet S, Hadeed K, Marchal P, Bennadji A, Peyre M, Dulac Y, Heitz F, Alacoque X, Chausseray G, Acar P, Kong W, Ling L, Yip J, Poh K, Vassiliou V, Rekhraj S, Hoole S, Watkinson O, Kydd A, Boyd J, Mcnab D, Densem C, Shapiro L, Rana B, Potpara T, Djikic D, Polovina M, Marcetic Z, Peric V, Lip G, Gaudron P, Niemann M, Herrmann S, Hu K, Strotmann J, Beer M, Bijnens B, Liu D, Ertl G, Weidemann F, Peric V, Jovanovic A, Djikic D, Otasevic P, Kochanowski J, Piatkowski R, Scislo P, Grabowski M, Marchel M, Opolski G, Bandera F, Guazzi M, Arena R, Corra U, Ghio S, Forfia P, Rossi A, Dini F, Cahalin L, Temporelli L, Rallidis L, Tsangaris I, Makavos G, Anthi A, Pappas A, Orfanos S, Lekakis J, Anastasiou-Nana M, Kuznetsov VA, Krinochkin DV, Yaroslavskaya EI, Zaharova EH, Pushkarev GS, Mizia-Stec K, Wita K, Mizia M, Loboz-Grudzien K, Szwed H, Kowalik I, Kukulski T, Gosciniak P, Kasprzak J, Plonska-Gosciniak E, Cimino S, Pedrizzetti G, Tonti G, Cicogna F, Petronilli V, De Luca L, Iacoboni C, Agati L, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Galrinho A, Moura Branco L, Fiarresga A, Cacela D, Ramos R, Cruz Ferreira R, Van Den Oord S, Akkus Z, Bosch J, Renaud G, Sijbrands E, Verhagen H, Van Der Lugt A, Van Der Steen A, Schinkel A, Mordi I, Tzemos N, Stanton T, Delgado D, Yu E, Drakopoulou M, Gonzalez-Gonzalez A, Karonis T, Roussin I, Babu-Narayan S, Swan L, Senior R, Li W, Parisi V, Pagano G, Pellegrino T, Femminella G, De Lucia C, Formisano R, Cuocolo A, Perrone Filardi P, Leosco D, Rengo G, Unlu S, Farsalinos K, Amelot K, Daraban A, Ciarka A, Delcroix M, Voigt J, Miskovic A, Poerner T, Goebel B, Stiller C, Moritz A, Sakata K, Uesugo Y, Kimura G, Ishiguro M, Takemoto K, Minamishima T, Futuya M, Satoh T, Yoshino H, Miyoshi T, Tanaka H, Kaneko A, Matsumoto K, Imanishi J, Motoji Y, Mochizuki Y, Minami H, Kawai H, Hirata K, Wutthimanop A, See O, Vathesathokit P, Yamwong S, Sritara P, Rosner A, Kildal A, Stenberg T, Myrmel T, How O, Capriolo M, Frea S, Giustetto C, Scrocco C, Benedetto S, Grosso Marra W, Morello M, Gaita F, Garcia-Gonzalez P, Cozar-Santiago P, Chacon-Hernandez N, Ferrando-Beltran M, Fabregat-Andres O, De La Espriella-Juan R, Fontane-Martinez C, Jurado-Sanchez R, Morell-Cabedo S, Ridocci-Soriano F, Mihaila S, Piasentini E, Muraru D, Peluso D, Casablanca S, Puma L, Naso P, Iliceto S, Vinereanu D, Badano L, Tarzia P, Villano A, Figliozzi S, Russo G, Parrinello R, Lamendola P, Sestito A, Lanza G, Crea F, Sulemane S, Panoulas V, Bratsas A, Frankel A, Nihoyannopoulos P, Dores H, Andrade M, Almeida M, Goncalves P, Branco P, Gaspar A, Gomes A, Horta E, Carvalho M, Mendes M, Yue W, Li X, Chen Y, Luo Y, Gu P, Yiu K, Siu C, Tse H, Cho E, Lee S, Hwang B, Kim D, Jang S, Jeon H, Youn H, Kim J. Poster session Thursday 12 December - PM: 12/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bucci M, Borra R, Någren K, Pärkkä JP, Del Ry S, Maggio R, Tuunanen H, Viljanen T, Cabiati M, Rigazio S, Taittonen M, Pagotto U, Parkkola R, Opie LH, Nuutila P, Knuuti J, Iozzo P. Trimetazidine reduces endogenous free fatty acid oxidation and improves myocardial efficiency in obese humans. Cardiovasc Ther 2011; 30:333-41. [PMID: 21884010 DOI: 10.1111/j.1755-5922.2011.00275.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The metabolic modulator trimetazidine (TMZ) has been suggested to induce a metabolic shift from myocardial fatty acid oxidation (FAO) to glucose utilization, but this mechanism remains unproven in humans. The oxidation of plasma derived FA is commonly measured in humans, whereas the contribution of FA from triglycerides stored in the myocardium has been poorly characterized. AIMS To verify the hypothesis that TMZ induces a metabolic shift, we combined positron emission tomography (PET) and magnetic resonance spectroscopy ((1)H-MRS) to measure myocardial FAO from plasma and intracellular lipids, and myocardial glucose metabolism. Nine obese subjects were studied before and after 1 month of TMZ treatment. Myocardial glucose and FA metabolism were assessed by PET with (18)F-fluorodeoxyglucose and (11)C-palmitate. (1)H-MRS was used to measure myocardial lipids, the latter being integrated into the PET data analysis to quantify myocardial triglyceride turnover. RESULTS Myocardial FAO derived from intracellular lipids was at least equal to that of plasma FAs (P = NS). BMI and cardiac work were positively associated with the oxidation of plasma derived FA (P ≤ 0.01). TMZ halved total and triglyceride-derived myocardial FAO (32.7 ± 8.0 to 19.6 ± 4.0 μmol/min and 23.7 ± 7.5 to 10.3 ± 2.7 μmol/min, respectively; P ≤ 0.05). These changes were accompanied by increased cardiac efficiency since unchanged LV work (1.6 ± 0.2 to 1.6 ± 0.1 Watt/g × 10(2), NS) was associated with decreased work energy from the intramyocardial triglyceride oxidation (1.6 ± 0.5 to 0.4 ± 0.1 Watt/g × 10(2), P = 0.036). CONCLUSIONS In obese subjects, we demonstrate that myocardial intracellular triglyceride oxidation significantly provides FA-derived energy for mechanical work. TMZ reduced the oxidation of triglyceride-derived myocardial FAs improving myocardial efficiency.
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Affiliation(s)
- Marco Bucci
- Turku PET Centre, University of Turku, Turku, Finland
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Bucci M, Borra R, Någren K, Maggio R, Tuunanen H, Oikonen V, Del Ry S, Viljanen T, Taittonen M, Rigazio S, Giannessi D, Parkkola R, Knuuti J, Nuutila P, Iozzo P. Human obesity is characterized by defective fat storage and enhanced muscle fatty acid oxidation, and trimetazidine gradually counteracts these abnormalities. Am J Physiol Endocrinol Metab 2011; 301:E105-12. [PMID: 21505146 DOI: 10.1152/ajpendo.00680.2010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An impaired ability to store fatty acids (FA) in subcutaneous adipose tissue (SAT) may be implicated in the pathogenesis of obesity-related diseases via overexposure of lean tissues and production of free radicals from FA oxidation (FAO). We studied regional FA metabolism in skeletal muscle and adipose tissue in humans and investigated the long-term effects of the FAO inhibitor trimetazidine on glucose and FA metabolism. Positron emission tomography (PET) and [(11)C]palmitate were used to compare FA metabolism in SAT and skeletal muscle between eight obese and eight nonobese subjects (BMI ≥/< 30 kg/m(2)). A subgroup of nine subjects underwent a 1-mo trimetazidine administration. PET with [(11)C]palmitate and [(18)F]fluorodeoxyglucose, indirect calorimetry, and MRI before and after this period were performed to characterize glucose and FA metabolism, fat masses, skeletal muscle triglyceride, and creatine contents. Obesity was characterized by a 100% elevation in FAO and a defect in the FA esterification rate constant (P < 0.05) in skeletal muscle. FA esterification was reduced by ~70% in SAT (P < 0.001) in obese vs. control subjects. The degrees of obesity and insulin resistance were both negatively associated with esterification-related parameters and positively with FAO (P < 0.05). Trimetazidine increased skeletal muscle FA esterification (P < 0.01) and mildly upregulated glucose phosphorylation (P = 0.066). Our data suggest that human obesity is characterized by a defect in tissue FA storage capability, which is accompanied by a (potentially compensatory) elevation in skeletal muscle FAO; trimetazidine diverted FA from oxidative to nonoxidative pathways and provoked an initial activation of glucose metabolism in skeletal muscle.
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Affiliation(s)
- Marco Bucci
- Turku PET Centre, University of Turku, Turku, Finland
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Schrey A, Kinnunen I, Vahlberg T, Minn H, Grénman R, Taittonen M, Aitasalo K. Blood pressure and free flap oxygenation in head and neck cancer patients. Acta Otolaryngol 2011; 131:757-63. [PMID: 21413842 DOI: 10.3109/00016489.2011.554438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION This study suggests that although oxygen partial pressure in tissue (p(ti)O(2)) measurement is a feasible method for continuous postoperative monitoring of free flaps, low correlation between blood pressure (BP) and p(ti)O(2) might predict compromised overall outcome. Thus, it is of utmost importance to keep the BP optimal for adequate perfusion of re-anastomosed tissue transfers. OBJECTIVE Optimal BP is an important factor in assuring adequate blood flow in a free flap. Tissue oxygenation in free flaps as a postoperative monitoring target is in routine clinical use in some clinics. Correlation between p(ti)O(2) and systemic BP was investigated. METHODS Ten consecutive patients underwent resection of head and neck squamous cell carcinoma followed by microvascular reconstruction with a free microvascular flap. P(ti)O(2) of each flap was continuously monitored for 3 postoperative days with a polarographic measurement system. BP was measured invasively and continuously during the operation and during the first postoperative day at the intensive care unit. The correlation coefficient between p(ti)O(2) and BP was analysed. RESULTS The correlation coefficient between p(ti)O(2) and BP was relatively high in all patients with uneventful flap survival (r (mean) = 0.63, n = 5). In flaps with haemodynamic problems or compromised flap vitality the correlation appeared low (r(mean) = -0.02, n = 5).
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Affiliation(s)
- Aleksi Schrey
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Finland.
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Virtanen KA, Lidell ME, Orava J, Heglind M, Westergren R, Niemi T, Taittonen M, Laine J, Savisto NJ, Enerbäck S, Nuutila P. Functional brown adipose tissue in healthy adults. N Engl J Med 2009; 360:1518-25. [PMID: 19357407 DOI: 10.1056/nejmoa0808949] [Citation(s) in RCA: 2269] [Impact Index Per Article: 151.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Using positron-emission tomography (PET), we found that cold-induced glucose uptake was increased by a factor of 15 in paracervical and supraclavicular adipose tissue in five healthy subjects. We obtained biopsy specimens of this tissue from the first three consecutive subjects and documented messenger RNA (mRNA) and protein levels of the brown-adipocyte marker, uncoupling protein 1 (UCP1). Together with morphologic assessment, which showed numerous multilocular, intracellular lipid droplets, and with the results of biochemical analysis, these findings document the presence of substantial amounts of metabolically active brown adipose tissue in healthy adult humans.
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Abstract
AIM This paper reports a study to assess the usability and use of different pain assessment tools and to compare patients' and nurses' pain assessments in the recovery room after prostatectomy. BACKGROUND Pain assessment is the first step towards providing adequate pain relief but poses problems because of the subjective nature of the pain experience and the lack of quantifiable measurements. Pain tools have been tested in several clinical settings, but not in the recovery room. METHODS Data were collected in the recovery room from 45 consecutive patients who had undergone prostatectomy by asking them to evaluate their pain intensity using visual analogue scale, numeric rating scale and verbal expressions. One of two research nurses measured patients' pain at regular intervals and at the same time as the patients. Physiological parameters were also evaluated. Data were analysed as frequencies and percentages. Sum variables were formed and results were analysed using Spearman's rank correlation, Pearson's correlation and with multiple regression analysis. RESULTS Patients varied in their ability to assess the intensity of their pain using different tools, but assessments were correlated with each other and with nurses' estimations. Nurses and patients obtained similar assessments, but nurses both underestimated and overestimated patients' pain. Patients' verbal assessments varied widely. Patients' and nurses' pain assessments showed no association with patients' pulse or mean arterial blood pressure. CONCLUSIONS According to our results, it is not totally clear whether pain tools are usable in the recovery room. This issue calls for further research.
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Affiliation(s)
- Katja Heikkinen
- Turku Polytechnic and Department of Nursing, University of Turku, Turku, Finland.
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Abstract
A case of a child who presented with severe and rapid shock after receiving a common adder (vipera berus berus) bite in sea water is presented. Although most poisonous snakebites in Europe tend to be relatively minor and uncomplicated, the present case highlights the need to regard all viper bites as life-threatening accidents, before proved otherwise by a medical professional.
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Affiliation(s)
- M Märtson
- Department of Paediatric Surgery, Turku University Central Hospital and University of Turku, Turku, Finland.
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Abstract
This study evaluated if adding low-dose ketamine to fentanyl could offer a haemodynamically stable drug combination with little respiratory side-effects. Eight healthy, consenting male volunteers received in a random, cross-over and double-blind fashion both fentanyl 2 micrograms.kg-1 + ketamine 0.25 mg.kg-1 and fentanyl 2 micrograms.kg-1 + placebo. The fentanyl and placebo reduced minute ventilation, alveolar ventilation and oxygen consumption (p < 0.05), with little effect on haemodynamics. After fentanyl and ketamine, the decrease in minute ventilation and alveolar ventilation was attenuated compared to the placebo-containing combination (p < 0.05), but with a simultaneous increase in oxygen consumption (p < 0.05) and stimulation of haemodynamics (p < 0.05). Both treatments decreased oxygen saturation and arterial oxygen pressure similarly. Ketamine thus attenuated the fentanyl-induced reduction in ventilation without preventing the decrease in blood oxygenation. In conclusion, combining low-dose ketamine to fentanyl offers no benefits in terms of preventing respiratory depression.
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Affiliation(s)
- L Mildh
- Department of Anaesthesiology, Helsinki University Hospital, Töölö Hospital, Finland
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Abstract
In this double-blind placebo controlled study the preoperative cardiovascular and metabolic effects of intramuscular (i.m.) clonidine and midazolam are assessed. Forty-five ASA Grade I patients (n = 15 per group) undergoing plastic surgical procedures were randomly allocated to receive either placebo, clonidine 4 micrograms kg-1 or midazolam 70 micrograms kg-1. Drugs were administered into the deltoid muscle approximately 90 min prior to the scheduled induction of anaesthesia. The metabolic measurements were performed using an indirect calorimetry device. Heart rate and blood pressure were measured noninvasively. Pre-operative subjective anxiety, dryness of mouth and tiredness were assessed using visual analogue scales (VAS). Clonidine increased subjective tiredness significantly more than placebo. Clonidine also induced moderate decreases in blood pressure and heart rate. Oxygen consumption (VO2), CO2 production and energy expenditure (EE) decreased significantly after clonidine and midazolam. The decrease in VO2 and EE was maximally 11-14% on average from the base-lines after clonidine and midazolam. These effects were of longer duration after clonidine and lasted until the end of the 90 min study period. In conclusion, both clonidine and midazolam are effective as a means of decreasing pre-operative VO2 and EE.
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Affiliation(s)
- M Taittonen
- Department of Anesthesiology, University of Turku, Finland
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Abstract
This pilot study compared the metabolic effects of placebo and 6 mg and 12 mg of oral tizanidine in random double-blind cross-over fashion in five healthy volunteers. The metabolic measurements were made with a portable metabolic chart (Deltatrac, Datex/Instrumentarium, Helsinki, Finland). Heart rate (HR), systolic (BPS), mean (BPM) and diastolic (BPD) blood pressure were measured noninvasively. Subjective assessment of tiredness and dryness of mouth were measured by using visual analogue scales (VAS). There were no statistically significant differences in tiredness or dryness of mouth between the groups. BPD decreased significantly after both doses of tizanidine when compared to placebo (by an average of 12% after 6 mg of tizanidine and 15% after 12 mg of tizanidine from the baseline). Oxygen consumption and energy expenditure decreased significantly after 6 and 12 mg of tizanidine when compared to placebo. The average decrease in oxygen consumption was 3% after 6 mg of tizanidine and 8% after 12 mg of tizanidine, when compared to the baseline. Energy expenditure decreased by an average of 5% after 6 mg of tizanidine and 9% after 12 mg of tizanidine, when compared to the baseline. There were no other statistically significant differences between the groups. This study indicates that 6 and 12 mg of oral tizanidine can be useful for reducing energy expenditure and oxygen consumption without prominent cardiovascular effects.
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Affiliation(s)
- M Taittonen
- Department of Anaesthesiology, Turku University Hospital, Finland
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