Intralipid-A Magic Bullet? *Corresponding author: Joseph Eldor Theoretical Medicine Institute, Jerusalem, Israel Email: Published By: MedCrave Group LLC September 15, 2017 Table of Contents Chapter 1: Intralipid-Iodine for Hysterosalpingography in Infertile Women 1 1. Abstract 2 2. Introduction 3 3. Conclusion 5 4. References 6 Chapter 2: Intralipid Treatment for Post Operative Delirium 7 1. Abstract 8 2. Keywords 8 3. Post Operative Delirium 9 4. Conclusion 12 5. References 13 Chapter 3: Can Intralipid Infusion Open A Coronary Occlusion Causing Acute Myocardial Infarction? 14 1. Abstract 15 2. Keywords 15 3. Introduction 16 4. Conclusion 20 5. References 21 Chapter 4: Intralipid Treatment for Alzheimer Disease 22 1. Abstract 23 2. Keywords 23 3. Dr. Aloysius "Alois" Alzheimer 24 4. Blood-Brain Barrier 30 5. Conclusion 33 6. References 34 Chapter 5: Intralipid Treatment for Newborns with Meconium Stained Amniotic Fluid (MSAF) 36 1. Abstract 37 2. Keywords 37 3. MAS and MSAF 38 4. Endotracheal Suction 38 5. Conclusion 42 6. References 43 Chapter 6: Warburg Effect and Intralipid Effect on the Mitochondria of Cancer Cells 44 1. Abstract 45 2. Keywords 45 3. Dr. Otto heinrich Warburg 46 4. Mitochondria In Cancer Cells 46 5. Intralipid 48 6. Conclusion 52 7. References 53 Chapter 7: Combined Intralipid - Urotherapy for Patients with Cancer (Part 1, Part 2, Part 3) 57 Part 1 57 1. Abstract 58 2. Keywords 58 3. The Philosophy of Cancer 59 4. Immunotherapy 60 5. Preconclusion 61 6. Conclusion No.1 62 7. References 62 Part 2 65 1. Cancer Antigens 65 2. Cancer Vaccines 67 3. Cancer Immunotherapy 69 4. Cancer Antibodies 74 5. Conclusion No. 2 76 6. References 77 Part 3 79 1. Intralipid Effects on the Immune System 79 2. Conclusion No. 3 81 3. References 82 Chapter 8: Combined Spinal Epidural Catheters for Epidural Cooling, Cerebrospinal Fluid Aspiration and Spinal 83 Intralipid Infusion for Treatment of Spinal and Brain Injuries, Diseases and Protection 1. Abstract 84 2. Keywords 84 3. Introduction 85 4. CSF Role in Ischemic Injury 85 5. Traumatic Injury to the Central Nervous System 85 6. Inadvertent Intralipid Spinal-Epidural Injection 86 7. Epidural Saline Infusion 87 8. Paraplegia-A Serious Complication of Descending and Thoraco-Abdominal Aortic Operations 87 9. Hypothermia for Prevention of Paraplegia Associated with Thoracic Aortic Surgery 88 10. Epidural Cooling Catheter to Protect the Spinal Cord from Ischemia during Aortic Surgery 88 11. The Effect of Intrathecal Tetracaine on the Neurological Sequelae of Spinal Cord Ischemia and 90 Reperfusion with Aortic Occlusion 12. The Use of Prophylactic Hypothermia for Traumatic Brain Injury 90 13. Lipid Neuroprotection 91 14. Lipid Resuscitation Therapy 92 15. Pretreatment or Resuscitation with a Lipid Infusion 93 16. Intralipid Reversing other Drugs Toxicity 93 17. The Lipid Sink Effect 94 18. Guidelines for the Management of Local Anaesthetic Toxicity 95 19. Lipid Emulsion Overdose 95 20. Intralipid Rescue: 1966-2009 95 21. Intralipid Prevents and Rescues Fatal Pulmonary Arterial Hypertension and Right Ventricular Failure 96 and Enhances the Inflammatory Response to Endotoxin 22. Is Intralipid Approved by the FDA for Local Anesthesia-Induced Cardiovascular Collapse or 96 Resuscitation? 23. Conclusions 97 24. References 98 Chapter 9: Intralipid Treatment: Is It Only The Tip Of An Iceberg? A New Suggestion: Bone Cement Implantation 100 Syndrome (BCIS) 1. Abstract 101 2. Keywords 101 3. Pretreatment or Resuscitation with a Lipid Infusion 102 4. Intralipid rescue: 1966-2009 104 5. Bone Cement Implantation Syndrome (BCIS) 105 6. Conclusion 107 7. References 107 Chapter 10: Intralipid for Amniotic Fluid Embolism (AFE)? 108 1. Abstract 109 2. Introduction 110 3. Material and Method 110 4. Statistical Analysis 110 5. Results 112 6. Discussion 112 7. Conclusion 113 8. References 113 Chapter 11: Intralipid-Iodine for Imaging 115 1. Field of the Invention 116 2. Summary of the Invention 116 3. Detailed Description of the Invention 116 4. Conclusion 119 5. References 119 Chapter 12: Intralipid use in Trauma 120 1. Abstract 121 2. Keywords 121 3. Introduction 122 4. Intralipid Use In Rapid Blood Loss 122 5. Conclusion 125 6. References 125 Intralipid-A Magic Bullet? Chapter I Intralipid-Iodine for Hysterosalpingography in Infertile Women 1 Intralipid-A Magic Bullet? Abstract Tubal disease is the cause of female infertility in approximately 30% of women and 10-25% of these are due to proximal tubal obstruction. Selective salpingography represent an approach in the diagnosis and treatment of proximal tubal abnormalities. Intralipid (IL) is a synthetic product composed of 10 % soybean oil, 1,2 % egg yolk phospholipids, 2.25 % glycerin, and water. When indicated, IL is infused 7–10 days prior to embryo transfer (ET), Rates of ongoing pregnancy and live births were higher among women who underwent hysterosalpingography with oil contrast than among women who underwent this procedure with water contrast. It is the first time that intralipid-iodine is suggested to be used for hysterosalpingography in infertile women. Keywords: Intralipid- Iodine; Hysterosalpingography; Infertility 2 Intralipid-A Magic Bullet? Tubal disease is the cause of female infertility in approximately tubes [6]. To determine whether hysterosalpingography 30% of women [1] and 10-25% of these are due to proximal (HSG) increases the conception rate and to compare the tubal obstruction [2]. Selective salpingography represent therapeutic effectiveness of oil and water soluble contrast an approach in the diagnosis and treatment of proximal media, the histories of 744 women who attended the Yale tubal abnormalities. The common indications for selective Infertility salpingography are to differentiate spasm from true Clinic in 1965-69 were reviewed. Exclusion of women obstruction [3]. In addition to that it allows clarifying findings who had been infertile less than 1 year before coming to from an equivocal hysterosalpingogram. Isthmic as well as the clinic, in whom a HSG was done outside the clinic, intramural blockages were included. The tubal obstruction and in whom there was no follow-up resulted in a study may due to amorphous materials occluding the tubal lumen, population of 460. The pregnancy rate for the study group inflammatory changes and adhesions [4]. The use of (49%) was identical to that for the larger population. The selective salpingography and fallopian tube recanalization study group was divided into women who became pregnant has revolutionized the diagnosis and treatment of infertility during their clinic attendance or within 1 year of terminating [3]. Diagnostic procedure has been used since 1980 [3]. clinic care and women who did not become pregnant in It consists on opacification of the fallopian tube directly this period. These 2 categories were then subdivided through a catheter placed in the tubal ostium. The objective according to whether a HSG was done. To determine the is to differentiate spasm from true obstruction and to clear relative effectiveness of different media, the conception it with a catheter and guide wire system. Pregnancy rates rate following HSG in the Yale Clinic, where the iodized among infertile women have been reported to increase after oil Ethiodol was used, was compared with that among 63 hysterosalpingography, but it is unclear whether the type of women who had HSG done by a private practitioner with contrast medium used (oil-based or water-soluble contrast) the water soluble dye Salpix. 221 women were in the influences this potential therapeutic effect. Ethiodol HSG group, 121 (55%) of whom conceived. Of the Dreyer et al. [5] performed a multicenter, randomized 239 Yale Clinic patients who did not have HSG, 103 (43%) trial in 27 hospitals in the Netherlands in which infertile became pregnant. Exclusion of couples with organic factors women who were undergoing hysterosalpingography were that could account for infertility resulted in a pregnancy rate randomly assigned to undergo this procedure with the use of 58% for the HSG group and 47% for the non-HSG group. of oil-based or water-based contrast. Subsequently, couples 25 (40%) of the 63 women in the Salpix group conceived, received expectant management or the women underwent but exclusion of couples with organic factors lowered the intrauterine insemination. The primary outcome was pregnancy rate to 38% in this group. The average length ongoing pregnancy within 6 months after randomization. of infertility was 0.5 years longer in the non-HSG group Outcomes were analyzed according to the intention-to-treat than in the Ethiodol HSG group, but shorter in the Salpix principle. A total of 1119 women were randomly assigned HSG group compared to the Ethiodol group. These results to hysterosalpingography with oil contrast (557 women) or suggest that Ethiodol HSG may enhance fertility. Although water contrast (562 women). A total of 220 of 554 women the oil media has been criticized on the basis that it may in the oil group (39.7%) and 161 of 554 women in the water cause granuloma formation or embolization, documented group (29.1%) had an ongoing pregnancy (rate ratio, 1.37; complications in the Yale series were rare. In contrast to 95% confidence interval [CI], 1.16 to 1.61; P<0.001), and earlier studies, unilateral nonpatency on x-ray was not 214 of 552 women in the oil group (38.8%) and 155 of 552 found to affect eventual conception (58% pregnancy rate women in the water group (28.1%) had live births (rate ratio, among women in the Ethiodol HSG group with normal tubes 1.38; 95% CI, 1.17 to 1.64; P<0.001). Rates of adverse compared with 50% in those with filling of only 1 tube) [7]. events were low and similar in the two groups. Previous studies have suggested increased fertility rates Rates of ongoing pregnancy and live births were higher following hysterosalpingography (HSG) using oil as among women who underwent hysterosalpingography compared with aqueous contrast medium.