Texas Medical Center

About: Texas Medical Center is a healthcare organization based out in Houston, Texas, United States. It is known for research contribution in the topics: Population & Cancer. The organization has 2845 authors who have published 2394 publications receiving 79426 citations.

The safety of emergency neuromuscular blockade and orotracheal intubation in the acutely injured trauma patient.

Abstract: Background This study was done to determine the safety and success of orotracheal intubation with planned neuromuscular blockade in patients who are severely injured. The study was performed at Carle Foundation Hospital, designated Level I trauma center located in east central Illinois. Study design A retrospective review of the trauma registry and medical records of all patients requiring emergency airway control from September 1, 1987 to September 30, 1991 was performed. Two hundred twenty-nine patients who were critically injured were reviewed, the mean injury severity score was 29 (range of 3 to 75), the mean revised trauma score was 9 (range of 3 to 12), the mean Glasgow Coma Scale was 9 (range of 3 to 15), and the mean age was 31 years (range of one to 94 years). Results Indications for intubation included hemodynamic instability or altered level of consciousness (66.4 percent), or both, combative or uncooperative behavior (33.2 percent), and need to secure airway for transport (0.4 percent). Two hundred twenty-three (97.4 percent) patients were successfully intubated. Six (2.6 percent) patients required cricothyroidotomy and one (0.4 percent) patient was aspirated during intubation. Eight (3.5 percent) patients had cervical spine injuries but had no complications from orotracheal intubation. In the combative group, 32 (42 percent) patients had significant head injuries and 17 (22 percent) had other potentially life-threatening injuries. Conclusions Orotracheal intubation with planned neuromuscular blockade and in-line cervical traction is a safe, effective method for airway control in patients who are severely injured. This technique is also indicated to expedite therapy in combative, uncooperative patients because of the high incidence of significant life-threatening injuries to the brain and other organs.

Compartmentalization role of A-kinase anchoring proteins (AKAPs) in mediating protein kinase A (PKA) signaling and cardiomyocyte hypertrophy.

Abstract: The Beta-adrenergic receptors (β-ARs) stimulation enhances contractility through protein kinase-A (PKA) substrate phosphorylation. This PKA signaling is conferred in part by PKA binding to A-kinase anchoring proteins (AKAPs). AKAPs coordinate multi-protein signaling networks that are targeted to specific intracellular locations, resulting in the localization of enzyme activity and transmitting intracellular actions of neurotransmitters and hormones to its target substrates. In particular, mAKAP (muscle-selective AKAP) has been shown to be present on the nuclear envelope of cardiomyocytes with various proteins including: PKA-regulatory subunit (RIIα), phosphodiesterase-4D3, protein phosphatase-2A, and ryanodine receptor (RyR2). Therefore, through the coordination of spatial-temporal signaling of proteins and enzymes, mAKAP controls cyclic-adenosine monophosphate (cAMP) levels very tightly and functions as a regulator of PKA-mediated substrate phosphorylation leading to changes in calcium availability and myofilament calcium sensitivity. The goal of this review is to elucidate the critical compartmentalization role of mAKAP in mediating PKA signaling and regulating cardiomyocyte hypertrophy by acting as a scaffolding protein. Based on our literature search and studying the structure–function relationship between AKAP scaffolding protein and its binding partners, we propose possible explanations for the mechanism by which mAKAP promotes cardiac hypertrophy.

Effects of dipyridamole on heart muscle mitochondria.

Abstract: Previously reported beneficial effects of dipyridamole on "damaged" mitochondria have not been confirmed in these experiments. Dipyridamole, in fact, has specific stimulatory or inhibitory effects on mitochondrial respiration depending on which segment of the electron transport chain is predominant. It is postulated that dipyridamole inhibits respiration by accepting electrons from NADH, thus competing with the main electron transport pathway for electrons. The drug is also capable of interacting with a highenergy intermediate when succinate is the substrate, resulting in an "uncoupling-like" action.

Cardiovascular Complications of Energy Drinks

Abstract: Energy drinks (EDs) are gaining popularity every year with a broad consumer base including athletes, amateur competitors, and even those experiencing work-related fatigue. Evidence indicates that a significant number of individuals who consume EDs experience resultant morbidity and/or mortality, with a preponderance of cases involving teenagers and young adults. Adverse effects of ED consumption may occur in healthy persons, however certain individuals may be particularly susceptible to complications. At-risk populations include those of young age, the caffeine-naive, or caffeine-sensitive, pregnant women, competitive athletes, and those with underlying cardiovascular disease. This paper summarizes the cardiovascular complications associated with ED use and provides suggestions on consumption of these drinks in various populations.