Rehab Centers: Sulphur Containing Angiotensin Converting Enzyme Inhibitor- 3-Thienylalanine-Ornithyl-Proline Activates Endothelial Function and Expression of Genes Involved in Renin Angiotensin System.

Sulphur Containing Angiotensin Converting Enzyme Inhibitor- 3-Thienylalanine-Ornithyl-Proline Activates Endothelial Function and Expression of Genes Involved in Renin Angiotensin System.

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J Cardiovasc Pharmacol. 2012 Dec 7;
Chaudhary S, Seth MK, Vats ID, Kumar K, Biswas P, Karar J, Hussain ME, Pasha M, Pasha S

ABSTRACT: Experiments were performed to elucidate the mechanism of action of a 7-day oral administration of the sulfur-containing angiotensin-converting enzyme (ACE) inhibitor 3-thienyl-alanine-ornithyl-proline (TOP; 10 mg/kg/day) on endothelial dysfunction and oxidative stress compared with that of captopril (control; 40 mg/kg/day) in spontaneously hypertensive rats. The differential expression of mRNA by real-time reverse-transcriptase polymerase chain reaction and protein by Western blot analysis were assessed for the markers nicotinamide adenine dinucleotide phosphate oxidase, p22phox, endothelial nitric oxide synthase (eNOS), and AT1 receptor. Furthermore, TOP-induced vascular relaxation was also investigated using rat aortic rings in an organ bath. TOP significantly down-regulated both mRNA and protein expression of p22phox and AT1 receptor; the latter facilitates vasoconstriction through angiotensin II. In addition, TOP up-regulated eNOS, thus enhancing the production of nitric oxide. Vascular studies revealed that TOP caused endothelium-dependent vasorelaxation. In conclusion, unlike the free sulfur in captopril, the thiophene ring in TOP may act as a better scavenger of free radicals. Therefore, TOP exerted more significant antihypertensive effects than captopril, not only via ACE inhibition but also through more effective antioxidation, because the inherent thiophene moiety resulted in the enhanced production of nitric oxide.
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Intestinal Bowel Lengthening in Children with Short Bowel Syndrome: Systematic Review of the Bianchi and STEP Procedures.

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World J Surg. 2012 Dec 12;
King B, Carlson G, Khalil BA, Morabito A

BACKGROUND: It has been thirty years since Bianchi introduced the technique that made intestinal lengthening possible. The last three decades have seen lengthening procedures established as vital components of intestinal rehabilitation programs. The goal of the present study was to use a systematic literature review to determine patient outcomes for the two most commonly used lengthening procedures, the Bianchi procedure and the serial transverse enteroplasty procedure (STEP). METHODS: Pubmed and Embase were searched using the terms “intestinal lengthening” and “bowel lengthening.” Patient outcomes were extracted from each relevant journal article on the basis of a set proforma. The results were combined to create overall mean outcomes. Mean outcomes were also calculated separately for the Bianchi procedure and STEP. Significance was tested with the independent t-test. RESULTS: Overall survival for the last thirty years is 83 %. However, survival for the last fifteen years has been 89 %, with no significant difference between the two procedures. The Bianchi procedure has a higher rate of weaning patients who were static on parenteral nutrition with conservative measures: 55 % versus 48 %. In addition, the Bianchi procedure was associated with a higher rate of patients receiving transplants: 10 % versus 6 %. The STEP has a higher rate of complication. Length of follow-up is significantly longer for the Bianchi procedure: 76 versus 22 months. The impact that this differential could have had on our results must be considered. CONCLUSIONS: Outcomes for intestinal lengthening procedures are very good, and increasingly so. However, further analysis is required in order to fully understand the relative strengths and weaknesses of each procedure.
HubMed – rehab

 

Active rehabilitation during ECMO as a bridge to lung transplantation.

Filed under: Rehab Centers

Respir Care. 2012 Dec 4;
Rehder KJ, Turner DA, Hartwig MG, Williford WL, Bonadonna D, Walczak RJ, Davis RD, Zaas D, Cheifetz IM

BACKGROUND: Patients with end-stage lung disease often progress to critical illness, which dramatically reduces their chance of survival following lung transplantation. Pre-transplant deconditioning has a significant impact on outcomes for all lung transplant patients and is likely a major contributor to increased mortality in critically ill lung transplant recipients. The aim of this report is to describe a series of patients bridged to lung transplant with extracorporeal membrane oxygenation (ECMO) and examine the potential impact of active rehabilitation and ambulation during pre-transplant ECMO. METHODS: This retrospective case series reviews all patients bridged to lung transplantation with ECMO at a single tertiary care lung transplant center. Pre-transplant ECMO patients receiving active rehabilitation and ambulation were compared to those patients who were bridged with ECMO but did not receive pre-transplant rehabilitation. RESULTS: Nine consecutive patients between April 2007 and May 2012 were identified for inclusion. One year survival for all patients was 100%, with one patient alive at 4 months post-transplant. The five patients participating in pre-transplant rehabilitation had shorter mean post-transplant length of mechanical ventilation (4 days vs. 34 days, p = 0.01), ICU stay (11 days vs. 45 days, p = 0.01), and hospital stay (26 days vs. 80 days, p = 0.01). No patients who participated in active rehabilitation had post-transplant myopathy, compared to three of four patients who did not participate in pre-transplant rehabilitation on ECMO. CONCLUSIONS: Bridging selected critically ill patients to transplant with ECMO is a viable treatment option, and active participation in physical therapy, including ambulation, may provide a more rapid post-transplantation recovery. This innovative strategy requires further study to fully evaluate potential benefits and risks.
HubMed – rehab

 

The trend of hospital accreditation in the Kingdom of Saudi Arabia.

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Saudi Med J. 2012 Dec; 33(12): 1350-1
Qureshi AZ, Ullah S, Ullah R

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