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| 1 | 在 esophagogastroduodenoscopy 使用 lidocaine 的实用性与 propofol 表现在镇静下面显示文摘 AIM:To determine whether topical lidocaine benefits esophagogastroduoduenoscopy(EGD) by decreasing propofol dose necessary for sedation or procedurerelated complications.METHODS:The study was designed as a prospective,single centre,double blind,randomised clinical trial and was conducted in 2012 between January and May(NCT01489891).Consecutive patients undergoing EGD were randomly assigned to receive supplemental topical lidocaine(L;50 mg in an excipient solution which was applied as a spray to the oropharynx) or placebo(P;taste excipients solution without active substance,similarly delivered) prior to the standard propofol sedation procedure.The propofol was administered as a bolus intravenous(iv) dose,with patients in the L and P groups receiving initial doses based on the patient’s American Society of Anaesthesiologists(ASA) classification(ASAⅠ-Ⅱ:0.50-0.60 mg/kg;ASA Ⅲ-Ⅳ:0.25-0.35 mg/kg),followed by 10-20 mg iv dose every 30-60 s at the anaesthetist’s discretion.Vital signs,anthropometric measurements,amount of propofol administered,sedation level reached,examination time,and the subjective assessments of the endoscopist’s and anaesthetist’s satisfaction(based upon a four point Likert scale) were recorded.All statistical tests were performed by the Stata statistical software suite(Release 11,2009;StataCorp,LP,College Station,TX,United States).RESULTS:No significant differences were found between the groups treated with lidocaine or placebo in terms of total propofol dose(310.7 ± 139.2 mg/kg per minute vs 280.1 ± 87.7 mg/kg per minute,P = 0.15) or intraprocedural propofol dose(135.3 ± 151.7 mg/kg per minute vs 122.7 ± 96.5 mg/kg per minute,P = 0.58).Only when the L and P groups were analysed with the particular subgroups of female,< 65-year-old,and lower anaesthetic risk level(ASA Ⅰ-Ⅱ) was a statistically significant difference found(L:336.5 ± 141.2 mg/kg per minute vs P:284.6 ± 91.2 mg/kg per minute,P = 0.03) for greater total propofol requirements).The total incidence of complications was also similar between the two groups,with the L group showing a complication rate of 32.2%(95%CI:21.6-45.0) and the P group showing a complication rate of 26.7%(95%CI:17.0-39.0).In addition,the use of lidocaine had no effect on the anaesthetist’s or endoscopist’s satisfaction with the procedure.Thus,the endoscopist’s satisfaction Likert assessments were equally distributed among the L and P groups:unsatisfactory,[L:6.8%(95%CI:2.2-15.5) vs P:0%(95%CI:0-4.8);neutral,L:10.1%(95%CI:4.2-19.9) vs P:15%(95%CI:7.6-25.7)];satisfactory,[L:25.4%(95%CI:10-29.6) vs P:18.3%(95%CI:15.5-37.6);and very satisfactory,L:57.6%(95%CI:54-77.7) vs P:66.6%(95%CI:44.8-69.7)].Likewise,the anaesthetist’s satisfaction Likert assessments regarding the ease of maintaining a patient at an optimum sedation level without agitation or modification of the projected sedation protocol were not affected by the application of lidocaine,as evidenced by the lack of significant differences between the scores for the placebo group:unsatisfactory,L:5.8%(95%CI:1.3-13.2) vs P:0%(95%CI:0-4.8);neutral,L:16.9%(95%CI:8.9-28.4) vs P:16.7%(95%CI:8.8-27.7);satisfactory,L:15.2%(95%CI:7.7-26.1) vs P:20.3%(95%CI:11.3-31.6);and very satisfactory,L:62.7%(95%CI:49.9-74.3) vs P:63.3%(95%CI:50.6-74.7).CONCLUSION:Topical pharyngeal anaesthesia is safe in EGD but does not reduce the necessary dose of propofol or improve the anaesthetist’s or endoscopist’s satisfaction with the procedure. | Felipe de la Morena Cecilio Santander Carlos Esteban Beatriz de Cuenca Juan Antonio García Javier Sánchez Ricardo Moreno | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，5： | 3 |
| 2 | Simulating microwave-heated open systems: Tuning competitive sorption in zeofites显示文摘 | Santander J E Gomez S Malinger K A | 2009 | Journal of Physical Chemistry B2009，113，13： | 1 |
| 3 | Maternal and congenitalsyphilis in Bolivia, 1996:prevalence and risk factors 显示文摘 | Southwick KL Blanco S Santander A | 2001 | Bull WorldHealth Organ2001，79，1： | 1 |
| 4 | Maternal and con- genital syphilis in Bolivia 1996 prevalence and risk factores显示文摘 | Southwick K L Blaneo S Santander A | 2007 | Bull World Health Organ2007，79，1： | 1 |
| 5 | Monocyte-derived dendritic cells from chagasic patients vs healthy donors secrete differential levels of IL-10 and IL-12 when stimulated with a protein fragment of Trypanosoma cruzi heat-shock protein-70显示文摘 | CUELLAR A SANTANDER S P THOMAS M C | 2008 | Immunol Cell Biol2008，86，3： | 1 |
| 6 | Monocyte- derived dendritic cells from chagasic patients vs healthy donors se- crete differential levels of IL-10 and IL-12 when stimulated with a protein fragment of Trypanosoma cruzi heat-shock protein-70 显示文摘 | Cuellar A Santander S P del Carmen Thomas M | 2008 | Immunology and cell biology2008，86，3： | 1 |
| 7 | HPV- 16 E6 and E7 oncogene expression is downregulated as a result of Mdm2 knockdown 显示文摘 | DIAZ D SANTANDER M A CHAVEZ J A | 2012 | Int J Oncol2012，41，1： | 1 |
| 8 | Phehotype,viru- lance and immunogenicity of Edwardsiella ictaluri cyclic ade- nosine 3r,5r-monophosphate receptor protein(Crp) mutants in catfish host显示文摘 | SANTANDER J MITRA A CURTISS Ill R | 2011 | Fish Shellfish Immunol2011，31，6： | 1 |
| 9 | Influence of the vertical dimension in treatment of myofascial pain-dysfunction syndrome显示文摘 | Miralles R Santander H | 1983 | J Prosthet Dent1983，50，： | 1 |
| 10 | First report ofEdwarsiella tarda from tilapia in Venezuela 显示文摘 | Chavijo A M Conary G Santander J | 2002 | Bulletin ofthe European Association of Fish Pathologists2002，22，： | 1 |
| 11 | Action principles of cosolvent additives in ethanol-diesel blends: stability studies 显示文摘 | Reyes Y Aranda D A G Santander L A M | 2009 | Energy and Fuels2009，23，5： | 1 |
| 12 | Monocytederived dendritic ceils from chagasic patients vs healthy donors secrete differential levels of IL-10 and IL-12 when stimulated with a protein fragment of Trypanosoma cruzi heat- shock protein-70 显示文摘 | Cuellar A Santander SP Thomas Mdel C | 2008 | Immunol Cell Biol2008，86，3： | 1 |
| 13 | Realization of the medium and high vacuum primary standard in CENAM, Mexico 显示文摘 | Guzman J C T Santander L A and Jousten K | 2005 | Metrologic2005，42，6： | 1 |
| 14 | Optimized technology for the application of piezoresistive pressure sensors显示文摘 | MERLOS A SANTANDER J ALVAREZ M D | 2000 | Journal of Micromechanics and Microengineering2000，10，： | 1 |
| 15 | Insecticidal properties of heliotropium stenophyllum essential oil on the house fly,Muscadomestica L显示文摘 | URZUA A MODAK B SANTANDER R | 2013 | Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas2013，12，2： | 1 |
| 16 | Monocyte-derived dendritic cells from chagasic patients vshealthy donors secrete differential levels of IL-10and IL-12when stimulated with a protein fragment of Trypanosoma cru-zi heat shock protein-70显示文摘 | CUELLAR A SANTANDER S P THOMAS MDEL C | 2008 | Immunol Cell Biol2008，86，3： | 1 |
| 17 | Indomethacin but not a selective cyclooxygenase-2 inhibitor inhibits esophageal adenocarcinogenesis in rats显示文摘AIM:To evaluate the effects of indomethacin [dual cyclooxygenase(COX)-1/COX-2 inhibitor] and 3-(3,4-difluorophenyl)-4-(4-(methylsulfonyl) phenyl)2-(5H)-furanone(MF-tricyclic)(COX-2 selective inhibitor) in a rat experimental model of Barrett's esophagus and esophageal adenocarcinoma.METHODS:A total of 112 surviving post-surgery rats were randomly divided into three groups:the control group(n = 48),which did not receive any treatment;the indomethacin group(n = 32),which were given 2 mg/kg per day of the COX-1/COX-2 inhibitor;and the MF-tricyclic group(n = 32),which received 10 mg/kg per day of the selective COX-2 inhibitor.Randomly selected rats were killed either 8 wk or 16 wk after surgery.The timing of the deaths was in accordance with a previous study performed in our group.Only rats that were killed at the times designated by the protocol were included in the study.We then assessed the histology and prostaglandin E2(PGE2) expression levels in the rat esophagi.An additional group of eight animals that did not undergo esophagojejunostomy were included in order to obtain normal esophageal tissue as a control.RESULTS:Compared to a control group with no treatment(vehicle-treated rats),indomethacin treatment was associated with decreases in ulcerated esophageal mucosa(16% vs 35% and 14% vs 17%,2 mo and 4 mo after surgery,respectively;P = 0.021),length of intestinal metaplasia in continuity with anastomosis(2 ± 1.17 mm vs 2.29 ± 0.75 mm and 1.25 ± 0.42 mm vs 3.5 ± 1.54 mm,2 mo and 4 mo after surgery,respectively;P = 0.007),presence of intestinal metaplasia beyond anastomosis(20% vs 71.4% and 0% vs 60%,2 mo and 4 mo after surgery,respectively;P = 0.009),severity of dysplasia(0% vs 71.4% and 20% vs 85.7% high-grade dysplasia,2 mo and 4 mo after surgery,respectively;P = 0.002),and adenocarcinoma incidence(0% vs 57.1% and 0% vs 60%,2 mo and 4 mo after surgery,respectively;P < 0.0001).Treatment with the selective COX-2 inhibitor,MF-tricyclic,did not prevent development of intestinal metaplasia or adenocarcinoma.In parallel,we observed a significant decrease in PGE2 levels in indomethacin-treated rats,but not in those treated with MF-tricyclic,at both 2 mo and 4 mo.Compared to control rats that did not undergo surgery(68 ± 8 ng/g,P = 0.0022 Kruskal-Wallis test) there was a significant increase in PGE2 levels in the esophageal tissue of the rats that underwent surgery either 2 mo(1332 ± 656 ng/g) or 4 mo(1121 ± 1015 ng/g) after esophagojejunostomy.However,no differences were found when esophageal PGE2 levels were compared 2 mo vs 4 mo post-esophagojejunostomy.At both the 2-and 4-mo timepoints,we observed a significant decrease in PGE2 levels in indomethacin-treated rat esophagi compared to those in either the control or MF-tricyclic groups(P = 0.049 and P = 0.017,respectively).No differences in PGE2 levels were found when we compared levels in rats treated with MF-tricyclic to not-treated rats.CONCLUSION:In this rat model of gastrointestinal reflux,indomethacin was associated with a decrease in the severity of esophagitis and reduced development of esophageal intestinal metaplasia and adenocarcinoma. | Paula Esquivias Antonio Morandeira Alfredo Escartín Carmelo Cebrián Sonia Santander Francisco Esteva María Asunción García-González Javier Ortego Angel Lanas Elena Piazuelo | 2012 | World Journal of Gastroenterology2012，18，35： | 0 |
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