Two expired immediately after diagnosis, and the other two could have potentially been treated with improvements in transfer and diagnosis times. Age, individual injuries, Silmitasertib datasheet and measures of injury severity were similar between patients undergoing open surgical or endovascular repair. Patients who underwent endovascular repair experienced a significantly lower intraoperative (0% vs 18%; P < .05) and overall hospital mortality (12% vs 37%; P < .05). Additionally, endovascular repair was associated with reductions in operative time, estimated blood loss, and intraoperative blood transfusions. Five endovascular patients required secondary interventions to treat endograft-related complications,
including malapposition to the aortic arch (n = 3), midendograft stenosis (n = 1), and left upper extremity ischemia (n = 1).
Conclusions: Blunt thoracic aortic injury to the descending thoracic aorta is associated with a high overall hospital mortality. Thoracic
endovascular aortic repair is associated with significantly lower operative times, procedural blood loss, intraoperative find more blood transfusion, as well as intraoperative and overall hospital mortality compared with conventional open surgical repair. Consideration of this form of therapy as the initial form of treatment is warranted in anatomically acceptable candidates. (J Vasc Surg 2012;56:1274-80.)”
“Postoperative cognitive dysfunction (POCD) is characterized by the progressive deterioration of intellectual/cognitive function following surgery. It has been suggested that the senile brain, which characteristically expresses higher levels of central proinflammatory
cytokines, interleukin (IL)-6, IL-1 beta, and tumor necrosis factor (TNF)-alpha, is more susceptible to additional insult following surgery. The authors of this study investigated the expression of central cytokines IL-6 and TNF-alpha. and hippocampal glial cell activation selleck products in aged and adult rats following partial hepatectomy.
Cognitive function was assessed in a reversal-learning version of the Morris water maze (MWM) before and after surgery. Hippocampal pro-inflammatory cytokines IL-6 and TNF-alpha and glial cell activation markers glial fibrillary acidic protein (GFAP) and SWOP were measured at each time point; CD200 and CD200R were also measured to explore potential mechanisms of glial cell activation.
Surgical trauma resulted in impairments in distance and latency only on postoperative day 1 (p<0.001, respectively) in adult rats. Aged rats exhibited impairments on day 1 (p<0.001) that persisted until postoperative day 3 (p = 0.002 and p = 0.001, respectively). All significant impairments paralleled upregulated cytokine IL-1 beta, and IL-6 expression. Immunohistochemistry assay further showed more hippocampal glial cell activation in aged rats compared to that in adults.
Overall, these findings suggest that surgical trauma, rather than anesthesia, resulted in cognitive function impairment potentiated by aging.