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Gregory L Powell, Jonna M Leyrer-Jackson, Julianna Goenaga, Mark D Namba, Jose Piña, Sade Spencer, Neringa Stankeviciute, Danielle Schwartz, Nicholas P Allen, Armani P Del Franco, Erin A McClure, Michael Foster Olive, Cassandra D Gipson
N-acetylcysteine (NAC), a promising glutamatergic therapeutic agent, has shown some clinical efficacy in reducing nicotine use in humans and has been shown to reverse drug-induced changes in glutamatergic neurophysiology. In rats, nicotine-seeking behavior is associated with alterations in glutamatergic plasticity within the nucleus accumbens core (NAcore). Specifically, cue-induced nicotine-seeking is associated with rapid, transient synaptic plasticity (t-SP) in glutamatergic synapses on NAcore medium spiny neurons...
January 2019: Physiological Reports
Andrea L Gutman, Caitlin V Cosme, Maria F Noterman, Wensday R Worth, John A Wemmie, Ryan T LaLumiere
Acid-sensing ion channels (ASICs) are abundantly expressed in the nucleus accumbens core (NAcore), a region of the mesolimbocortical system that has an established role in regulating drug-seeking behavior. Previous work shows that a single dose of cocaine reduced the AMPA-to-NMDA ratio in Asic1a-/- mice, an effect observed after withdrawal in wild-type mice, whereas ASIC1A overexpression in the NAcore of rats decreases cocaine self-administration. However, whether ASIC1A overexpression in the NAcore alters measures of drug-seeking behavior after the self-administration period is unknown...
November 6, 2018: Addiction Biology
Victor G B Liem, Sanne E Hoeks, Felix van Lier, Jurgen C de Graaff
PURPOSE OF REVIEW: This narrative review will discuss what value Big Data has to offer anesthesiology and aims to highlight recently published articles of large databases exploring factors influencing perioperative outcome. Additionally, the future perspectives of Big Data and its major pitfalls will be discussed. RECENT FINDINGS: The potential of Big Data has given an incentive to create nationwide and anesthesia-initiated registries like the MPOG and NACOR. These large databases have contributed in elucidating some of the rare perioperative complications, such as declined cognition after exposure to general anesthesia and epidural hematomas in parturients...
December 2018: Current Opinion in Anaesthesiology
Douglas Roberts-Wolfe, Ana-Clara Bobadilla, Jasper A Heinsbroek, Daniela Neuhofer, Peter W Kalivas
Cocaine-associated cues and contexts can precipitate drug seeking in humans and in experimental animals. Glutamatergic synapses in the core subcompartment of the nucleus accumbens (NAcore) undergo transient potentiation in response to presenting drug-associated cues. The NAcore contains two populations of medium spiny neurons (MSNs) that differentially express D1 or D2 dopamine receptors. By recording the ratio of AMPA and NMDA glutamate receptor currents (AMPA/NMDA ratio) from MSNs in NAcore tissue slices, we endeavored to understand which subpopulation of MSNs was undergoing transient potentiation...
August 8, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Ana-Clara Bobadilla, Constanza Garcia-Keller, Victoria Chareunsouk, Jeffrey Hyde, Daniela Medina Camacho, Jasper A Heinsbroek, Peter W Kalivas
Brain-derived neurotrophic factor (BDNF) regulates a variety of physiological processes, and several studies have explored the role of BDNF in addiction-related brain regions like the nucleus accumbens core (NAcore). We sought to understand the rapid effects of endogenous BDNF on cocaine seeking. Rats were trained to self-administer cocaine and extinguished. We then microinjected two inhibitors of BDNF stimulation of tropomyosin receptor kinase B (TrkB), the non-competitive receptor antagonist ANA-12 and TrkB/Fc, a fusion protein that binds BDNF and prevents TrkB stimulation...
June 11, 2018: Addiction Biology
Sade Spencer, Daniela Neuhofer, Vivian C Chioma, Constanza Garcia-Keller, Danielle J Schwartz, Nicholas Allen, Michael D Scofield, Tara Ortiz-Ithier, Peter W Kalivas
BACKGROUND: Cannabis is the most widely used illicit drug, but knowledge of the neurological consequences of cannabis use is deficient. Two primary components of cannabis are Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD). We established a THC+CBD model of self-administration and reinstated drug seeking to determine if, similar to other addictive drugs, cannabis produces enduring synaptic changes in nucleus accumbens core (NAcore) thought to contribute vulnerability to drug reinstatement...
October 15, 2018: Biological Psychiatry
Alexander Nagrebetsky, Richard P Dutton, Jesse M Ehrenfeld, Richard D Urman
The rapidly increasing number of kidney transplantations warrants assessment of anesthesia care in this patient population. We explored the frequency of arterial catheter (AC), central venous catheter (CVC) and pulmonary artery catheter (PAC) placement during kidney transplantation in the USA using data from the National Anesthesia Clinical Outcomes Registry (NACOR) and assessed the between-facility variation in the frequency of catheter placement. We defined cases of kidney transplantation using Agency for Healthcare Research and Quality Clinical Classification Software...
March 2, 2018: Journal of Medical Systems
Michael H Andreae, Jonah S Gabry, Ben Goodrich, Robert S White, Charles Hall
BACKGROUND: US health care disparities persist despite repeated countermeasures. Research identified race, ethnicity, gender, and socioeconomic status as factors, mediated through individual provider and/or systemic biases; little research exists in anesthesiology. We investigated antiemetic prophylaxis as a surrogate marker for anesthesia quality by individual providers because antiemetics are universally available, indicated contingent on patient characteristics (gender, age, etc), but independent of comorbidities and not yet impacted by regulatory or financial constraints...
February 2018: Anesthesia and Analgesia
Aurelien Bernheim, Kah-Chung Leong, Carole Berini, Carmela M Reichel
Methamphetamine (meth) addiction is a prevalent health concern worldwide, yet remains without approved pharmacological treatments. Preclinical evidence suggests that oxytocin may decrease relapse, but the neuronal underpinnings driving this effect remain unknown. Here we investigate whether oxytocin's effect is dependent on presynaptic glutamatergic regulation in the nucleus accumbens core (NAcore) by blocking metabotropic glutamate receptors 2/3 (mGluR2/3). Male and female Sprague-Dawley rats self-administered meth or sucrose on an escalating fixed ratio, followed by extinction and cue-induced reinstatement sessions...
October 2017: Pharmacology, Biochemistry, and Behavior
Ana-Clara Bobadilla, Constanza Garcia-Keller, Jasper A Heinsbroek, Michael D Scofield, Victoria Chareunsouk, Cara Monforton, Peter W Kalivas
Many studies support a perspective that addictive drugs usurp brain circuits used by natural rewards, especially for the dopamine-dependent reinforcing qualities of both drugs and natural rewards. Reinstated drug seeking in animal models of relapse relies on glutamate spillover from cortical terminals synapsing in the nucleus accumbens core (NAcore) to stimulate metabotropic glutamate receptor5 (mGluR5) on neuronal nitric oxide synthase (nNOS) interneurons. Contrasting the release of dopamine that is shared by sucrose and drugs of abuse, reinstated sucrose seeking does not induce glutamate spillover...
November 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Maria C Schippers, Bastiaan Bruinsma, Mathijs Gaastra, Tanja I Mesman, Damiaan Denys, Taco J De Vries, Tommy Pattij
Deep brain stimulation (DBS) of the nucleus accumbens (NA) is explored as a treatment for refractory psychiatric disorders, such as obsessive-compulsive disorder (OCD), depressive disorder (MDD), and substance use disorder (SUD). A common feature of some of these disorders is pathological impulsivity. Here, the effects of NAcore DBS on impulsive choice and impulsive action, two distinct forms of impulsive behavior, were investigated in translational animal tasks, the delayed reward task (DRT) and five-choice serial reaction time task (5-CSRTT), respectively...
2017: Frontiers in Behavioral Neuroscience
Alexander C W Smith, Michael D Scofield, Jasper A Heinsbroek, Cassandra D Gipson, Daniela Neuhofer, Doug J Roberts-Wolfe, Sade Spencer, Constanza Garcia-Keller, Neringa M Stankeviciute, Rachel J Smith, Nicholas P Allen, Melissa R Lorang, William C Griffin, Heather A Boger, Peter W Kalivas
Relapse to drug use can be initiated by drug-associated cues. The intensity of cue-induced relapse is correlated with the induction of transient synaptic potentiation (t-SP) at glutamatergic synapses on medium spiny neurons (MSNs) in the nucleus accumbens core (NAcore) and requires spillover of glutamate from prefrontal cortical afferents. We used a rodent self-administration/reinstatement model of relapse to show that cue-induced t-SP and reinstated cocaine seeking result from glutamate spillover, initiating a metabotropic glutamate receptor 5 (mGluR5)-dependent increase in nitric oxide (NO) production...
January 25, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Alexander Nagrebetsky, Rodney A Gabriel, Richard P Dutton, Richard D Urman
BACKGROUND: Although previous publications suggest an increasing demand and volume of nonoperating room anesthesia (NORA) cases in the United States, there is little factual information on either volume or characteristics of NORA cases at a national level. Our goal was to assess the available data using the National Anesthesia Clinical Outcomes Registry (NACOR). METHODS: We performed a retrospective analysis of NORA volume and case characteristics using NACOR data for the period 2010-2014...
April 2017: Anesthesia and Analgesia
Franklin Dexter, Richard H Epstein, Richard P Dutton, Hubert Kordylewski, Johannes Ledolter, Henry Rosenberg, Bradley J Hindman
BACKGROUND: Anesthesiologists providing care during off hours (ie, weekends or holidays, or cases started during the evening or late afternoon) are more likely to care for patients at greater risk of sustaining major adverse events than when they work during regular hours (eg, Monday through Friday, from 7:00 AM to 2:59 PM). We consider the logical inconsistency of using subspecialty teams during regular hours but not during weekends or evenings. METHODS: We analyzed data from the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry (NACOR)...
December 2016: Anesthesia and Analgesia
Margaret N Tillquist, Rodney A Gabriel, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: Reintubations are associated with significantly increased morbidity and mortality, increased hospital length of stay, and increased cost. Our aim was to assess the national incidence and associated risk factors for unanticipated early postoperative reintubations. DESIGN: Using the National Anesthesia Clinical Outcomes Registry (NACOR) from 2010 to 2014, multivariate logistic regression was fitted to determine if various patient, surgical, intraoperative, or provider data were associated with unanticipated early postoperative reintubations...
June 2016: Journal of Clinical Anesthesia
Timothy D Quinn, Rodney A Gabriel, Richard P Dutton, Richard D Urman
PURPOSE: To investigate factors associated with unplanned postoperative admissions to the intensive care unit (ICU). METHODS: Data from the National Anesthesia Clinical Outcomes Registry (NACOR) were analyzed. We performed univariate and multivariate logistic regression to identify patient- and surgery-specific characteristics associated with unplanned postoperative ICU admission. We also recorded the prevalence of Current Procedural Terminology (CPT) and International Classification of Diseases, ninth revision ( ICD-9) billing codes and outcomes for unplanned postoperative ICU admissions...
August 2017: Journal of Intensive Care Medicine
Ethan Y Brovman, Rodney A Gabriel, Robert W Lekowski, Richard P Dutton, Richard D Urman
OBJECTIVES: To examine anesthesia-centered outcomes in a large cohort of patients undergoing coronary artery bypass grafting (CABG) or valvular heart surgery. DESIGN: A retrospective study with univariate and multivariate logistic regression to identify independent predictors for mortality. SETTING: Diverse setting including university, small, medium, and large community hospitals. PARTICIPANTS: All patients undergoing CABG or valve surgery in the National Anesthesia Clinical Outcomes Registry (NACOR) from the Anesthesia Quality Institute...
April 2016: Journal of Cardiothoracic and Vascular Anesthesia
Christopher R Abrecht, Rodney A Gabriel, Richard P Dutton, Alan D Kaye, Edward Michna, Richard D Urman
BACKGROUND: There is abundant literature on the long-term complications of intrathecal pumps (ITP), spinal cord stimulators (SCS), and peripheral nerve stimulators (PNS) used in the treatment of chronic pain. There is less information, however, on the perioperative complications of these procedures. OBJECTIVE: Exploration of the perioperative outcomes of implantable pain devices. STUDY DESIGN: Observational study. SETTING: University hospitals, community hospitals, specialty hospitals, attached surgery centers, and freestanding surgery centers METHODS: Data were obtained from the National Anesthesia Clinical Outcomes Registry (NACOR) of the Anesthesia Quality Institute (AQI)...
November 2015: Pain Physician
Adrian Liau, Jeana E Havidich, Tracy Onega, Richard P Dutton
The Anesthesia Quality Institute (AQI) was chartered in 2008 by the American Society of Anesthesiologists to develop the National Anesthesia Clinical Outcomes Registry (NACOR). In this Technical Communication, we will describe how data enter NACOR, how they are authenticated, and how they are analyzed and reported. NACOR accepts case-level administrative, clinical, and quality capture data from voluntarily participating anesthesia practices and health care facilities in the United States. All data are transmitted to the AQI in summary electronic files generated by billing, quality capture, and electronic health care record software, typically on a monthly basis...
December 2015: Anesthesia and Analgesia
Richard P Dutton
PURPOSE OF REVIEW: The purpose of this study is to review the current state of large database research in anaesthesiology and to describe the evolution of the National Anesthesia Clinical Outcomes Registry (NACOR) in the USA. RECENT FINDINGS: The Anesthesia Quality Institute of the American Society of Anesthesiologists was created to develop a national anaesthesia registry for the USA. NACOR and the companion Anesthesia Incident Reporting System are now 5 years old and in daily use by hundreds of US practices...
December 2015: Current Opinion in Anaesthesiology
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