For the
maternal separation paradigm, ACTH and cortisol levels were determined at baseline as well as peak levels during each of 4 consecutive separation episodes. For the acute ethanol administration paradigm, hormone levels were determined at baseline and again at 5 min, 10 min, and 60 min following the ethanol infusion. For postpartum sampling, hormone levels were determined at postpartum days 7, 14, 21, 30, 60, 90, 120, and 150. Infants carrying the 77G allele exhibited lower levels of cortisol across all 4 separation episodes. Furthermore, adolescents carrying the 77G allele exhibited lower cortisol levels at 5 and 10 min following acute ethanol administration.
Adult females with prior reproductive experience and who carry the 77G allele exhibited lower cortisol levels across the postpartum Raf inhibitor period. Pifithrin-�� manufacturer No significant genotype effects were found for ACTH, although there were some trends for lower ACTH levels in 77G allele carriers. These data are consistent with human studies that have demonstrated attenuated cortisol responses to stress among carriers of the OPRM1 118G allele, lending further support to the argument that the rhesus and human allelic variants are functionally similar. Our results also suggest that OPRM1 variation may influence coping style, as well as alcohol-induced and postpartum levels of HPA axis activity and, as such, may modify LGX818 vulnerability
to alcohol use disorders and postpartum depression. Published by Elsevier Ltd.”
“Background: Management of limb and other malperfusion syndromes is controversial in acute type A aortic dissection. We assessed our hypothesis that urgent proximal aortic repair resolves most cases of limb ischemia without additional peripheral revascularization.
Methods: We retrospectively reviewed operative cases of acute type A aortic dissection from 1999 to 2011. Our standard technique involved urgent replacement of the ascending aorta and hemiarch. Persistent limb ischemia after aortic repair was treated by bypass surgery. Comparisons between groups both with and without limb ischemia were made.
Results: We repaired 335 cases during the study period. Sixty-one patients had limb ischemia (18.2%), of whom 51 were classified with lower limb ischemia (15.2%). All patients with upper limb ischemia survived to discharge without limb loss or death. Only 11 of the 51 patients with lower limb ischemia (21.6%) required peripheral revascularization after aortic repair. There was one case of lower limb loss resulting from delayed recognition of persistent ischemia. Renal dysfunction occurred in 21% of patients with isolated lower limb ischemia and in 31% of patients with uncomplicated dissection (P = .29).