Background The immune system can produce various inflammatory mediators to protect the body from stress and surgical trauma. However, this excessive inflammatory response will interfere with the body's immune system, causing systemic inflammatory response syndrome and multi-organ failure if allowed to continue. Lidocaine as an anti-inflammatory is used to treat surgical pain and pain arising from the disease process and treat ventricular arrhythmias. This study aims to prove the efficacy of systemic lidocaine injection as an anti-inflammatory drug in BALB/c mice with sterile musculoskeletal injuries. Methods This study used a prospective experimental laboratory study on experimental animals of BALB/c mice using a simple randomized design. Sixteen adult white BALB/c mice (male, healthy, 10–12 weeks old, 35–40 g body weight, and no disability) were selected and randomly divided into two groups: the group given lidocaine (2 mg/kg body weight) and a group that was given sterile distilled water. NF-kβ and TNF-α protein levels were detected by ELISA, while mRNA expression of NF-kβ was analyzed and determined by quantitative real-time PCR. Results Musculoskeletal injury significantly increased the expression of both mRNA and protein levels of NF-kβ and TNF-α protein level. In addition, the NF-kβ (protein and mRNA) and TNF-α (protein) levels in rats experiencing inflammation due to musculoskeletal injury were significantly decreased in the lidocaine group ( p < 0.001). Conclusions The administration of systemic lidocaine injection was able to inhibit the expression of mRNA NF-kβ, the protein levels of NF-kβ, and protein levels of TNF-α in mice with musculoskeletal injuries.
Latar Belakang: Badai sitokin menyebabkan perburukan pasien COVID-19. Terapi efektif dibutuhkan untuk mengatasi hiperinflamasi. Tocilizumab adalah terapi imunomodulator yang menunjukkan efektivitas terhadap badai sitokin yang berat pada penelitian sebelumnya. Tujuan: Membandingkan skor SOFA, CRP, Prokalsitonin, dan Ferritin sebelum dan setelah pemberian Tocilizumab pada pasien kritis COVID-19. Metode: Penelitian ini adalah penelitian Observasional analitik dengan desain cross sectional yang dilaksanakan di RSUP Wahidin Sudirohusodo periode pasien Maret 2020 - November 2021. Pemilihan sampel dengan total sampling yang memenuhi kriteria inklusi. Semua sampel akan diambil data rekam medis berupa skor SOFA, CRP, Prokalsitonin, dan Ferritin sebelum dan setelah pemberian Tocilizumab sampai hari ke-7 pemberian. Hasil: Terdapat perbedaan bermakna skor SOFA sebelum dan setelah pemberian Tocilizumab sampai hari ke-7 (p<0.001) pada 23 sampel yang diuji dengan Friedman. Terdapat perbedaan bermakna kadar CRP sebelum dan setelah pemberian Tocilizumab mulai hari ke-2 (p<0.001) pada 42 sampel yang diuji Wilcoxon. Ditemukan perbedaan bermakna kadar CRP sebelum dan setelah pemberian hari ke 2,4, hingga hari ke-7 (p<0.001) pada 28 sampel yang diuji dengan Friedman. Ada perbedaan bermakna kadar prokalsitonin sebelum dan setelah pemberian Tocilizumab mulai hari ke-2 (p<0.001) pada 42 sampel yang diuji Wilcoxon. Selanjutnya ditemukan perbedaan bermakna kadar prokalsitonin sebelum dan setelah pemberian pada hari ke 2,4, hingga hari ke-7 (p<0,001) pada 20 sampel yang diuji dengan Friedman. Ditemukan perbedaan bermakna kadar ferritin sebelum sebelum dan setelah pemberian Tocilizumab mulai hari ke-2 (p<0,001) pada 42 sampel yang diuji Wilcoxon. Terdapat perbedaan bermakna kadar ferritin sebelum dan setelah pemberian pada hari ke 2,4, hingga hari ke-7 (p<0,001) pada 20 sampel yang diuji dengan Friedman. Simpulan: Tocilizumab menghasilkan penurunan skor SOFA, kadar CRP, Prokalsitonin, dan Ferritin pada pasien kritis COVID-19.
Corona Virus Disease 2019 (COVID-19) is an infectious disease that has been designated as a worldwide pandemic. Symptoms of Covid-19 are not only respiratory symptoms but also extrapulmonary symptoms, including the discovery of impaired liver function in the form of increased transaminase enzymes. Therefore, this study was conducted to see the correlation of transaminase enzymes with the prognosis of COVID-19 patients treated in the Intensive Care Unit (ICU) Dr. Wahidin Sudirohusodo Hospital. The study was conducted on June to August 2021. The cross-sectional analytical research method used retrospective medical record data for the period from July to December 2020 with a sample of 137 patients with COVID-19 confirmed. From the results of the Pearson test, patients with increased SGOT were associated with a mortality prognosis (p=0.000, p<0.05) with a correlation coefficient (r) of -0.383 and an increase in SGPT were associated with a mortality prognosis (p=0.013, p<0.05) with a correlation coefficient (r) of -0.211. From the results of the Kruskal Wallis test, there were differences in prognosis in patients with increased SGOT and SGPT grades 1,2,3, and 4 (p = 0.000 and p = 0.028). There is a correlation between the increased transaminase enzymes with the prognosis of the patient's mortality. Patients with severe elevated SGOT and SGPT enzymes had a greater prognosis of mortality than those with mild enzyme elevations. Extrapulmonary symptoms of stroke were associated with increased SGOT and myocardial infarction symptoms, and nephropathy was associated with increased SGOT and SGPT. Comorbid coronary artery disease and hepatitis were associated with increased SGOT and SGPT.
Latar Belakang: Berbagai cara telah digunakan untuk mengurangi gejolak hemodinamik saat laringoskopi dan intubasi. salah satunya dengan menggunakan fentanil. Pengadaan fentanil memiliki masalah karena digolongkan sebagai obat narkotika sehingga ketersediaannya terbatas. Alternatif lainnya yaitu dexmedetomidine. Penelitian ini menggunakan bispectral index untuk mengontrol kedalaman hipnotif sedatif. Monitoring BIS bertujuan untuk memastikan peningkatan hemodinamik yang terjadi bukan karena proses pulih sadar akibat dangkalnya hipnotif sedatif, sehingga peningkatan hemodinamik yang terjadi merupakan akibat dari respon nyeri. Penelitian ini bertujuan untuk membandingkan efektifitas pemberian dexmedetomidine 0,5 mcg/kgBB dengan fentanil 2 mcg/kgBB dalam menekan respon kardiovaskular pada tindakan laringoskopi dan intubasi. Metode: Penelitian ini menggunakan metode randomized clinical trial secara tersamar tunggal yang dilakukan di instalasi kamar operasi pusat RSUP Dr. Wahidin Sudirohusodo Makassar pada periode Februari - Maret 2022. Pasien dibagi kedalam dua kelompok: kelompok D (mendapatkan dexmedetomidine) dan kelompok F (mendapatkan fentanil). Karakteristik pasien dan indikator hemodinamik pasien sebelum dan beberapa menit setelah intubasi dicatat dan dianalisis untuk melihat perbandingan antar kelompok Hasil: Total terdapat 40 pasien yang dialokasikan ke tiap kelompok secara acak. Terdapat perbedaan perubahan tekanan darah sistolik (TDS), tekanan darah diastolik (TDD), tekanan arteri rerata (TAR), dan laju jantung (LJ) yang bermakna (p < 0,05) antar kelompok pada selisih waktu tertentu. Dexmedetomidine 0,5 mcg/kgBB pada penelitian ini efektif untuk menjaga hemodinamik selama tindakan laringoskopi dan intubasi dengan peningkatan TDS 16%, TDD 14%, TAR 15 % dan LJ 17 %. Kesimpulan: Dexmedetomidin lebih efektif menekan respon kardiovaskuler pada laringoskopi dan intubasi dibandingkan dengan fentanil. Dengan demikian, dexmedetomidin dapat digunakan menggantikan fentanil untuk laringoskopi dan intubasi
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