Flow Cytometric Analysis of Lymphocyte Subsets in Migraine Patients During and Outside of an Acute Headache Attack

We have conducted flow cytometric studies of two subsets of lymphocyte markers in groups of migraineurs during ( n = 12; group B) and outside ( n = 10; group C) of a migraine without aura attack (total n = 22; group A), including a group of patients tested in both of these phases ( n = 5; group D), and compared these results with those obtained from a population of age-comparable, sex- and race-matched healthy volunteers ( n = 12; group E). Comparison of the first set of lymphocytes (CD3+CD16+56+, CD3-CD16+56+, CD3-CD19+, CD3+CD19+, and CD3+HLA-DR+) between the patients in group A and the controls (group E) showed differences, reflecting greater group A percentages of CD3+CD16+CD56+ and CD3-CD19+ lymphocytes. Furthermore, these differences reached statistical significance only for the CD3+CD16+CD56+ lymphocytes, and then solely for the patients in group C (Scheffe's test, p< 0.05). Paired analysis of the above lymphocyte markers for subjects in group D failed to show significant differences between patients when they were having and not having a migraine attack, raising the possibility that results from a larger study could show meaningful increases in percentages of CD3+CD16+CD56+ lymphocytes as one of the immune parameters useful for differentiating migraineurs from controls. Comparison of a second set of lymphocyte markers (CD19+CD5+, CD20+CD72-, CD20-CD72+, CD20+CD72+) among either the different groups of patients or between the patients and controls failed, however, to show statistically significant differences, emphasizing the apparent specificity of the findings described above for CD3+CD16+CD56+ lymphocytes. Our results, albeit of a preliminary nature, suggest the occurrence of significant, differential changes in lymphocyte subset immunophenotyping between groups of pain-free migraineurs and patients during an acute migraine episode or controls. Corroboration of these findings may prove useful in clinical laboratory practice to identify changes in immunological parameters specifically associated with migraineurs, and help towards a better understanding of the etiology and pathophysiology of this condition.

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Concurrent Treatment with Denileukin Diftitox (DD) To Deplete T-Regulatory Cells Enhances Rebound Lymphocytosis and Eosinophilia in Patients Treated with High-Dose IL-2 (HDIL-2) for Metastatic Renal Cell Cancer (MRCC).

Blood ◽

10.1182/blood.v108.11.1729.1729 ◽

2006 ◽

Vol 108 (11) ◽

pp. 1729-1729

Author(s):

Adi Gidron ◽

John Eklund ◽

Brenda Martone ◽

Alfred W. Rademaker ◽

Charles Goolsby ◽

...

Keyword(s):

Flow Cytometry ◽

Immune Response ◽

Statistical Significance ◽

Cell Cancer ◽

Peak Level ◽

High Dose ◽

Maximal Increase ◽

Group A ◽

Group B ◽

Group D

Abstract Background: CD4+CD25+hi T cells (Treg) play a suppressive role in immune regulation. DD is an IL-2 receptor specific cytotoxin. We postulated depletion of Treg with DD may enhance immune effector cell populations after HDIL-2 treatment, including rebound lymphocytosis and also eosinophilia which has been reported to be involved in immune response to neoplasm (Mattes J Exp Med 197: 387, 2003). Methods: In this pilot study, 12 pts (8 male, median age 58 yrs) with MRCC were tx with HDIL-2 and DD in different schedules to determine safety and effect on immune response as manifested by changes in Treg, peak lymphocyte, and eosinophil counts. Pts were treated with IL-2 600,000 IU/kg Q8H on days (d) 1–5 and 15–19. Three (group A) and 4 (group B) pts were given 6 and 9ug/kg daily on d8–10 respectively, while 5 (group C) pts received 9ug/kg of DD on d −4 to −2. Nine (group D) pts with metastatic melanoma who received HDIL-2 as above but without DD were included as controls. Flow cytometry was done on days −4, 1,8,10,15,22 for group C and on days 1,8,10,15,22 for groups B, and D. CBC was obtained concurrent or within 24 hours of flow cytometry. Group A pts were evaluated for safety only and were excluded from analysis. Results: Prior to enrollment, all pts had undergone nephrectomy and four patients received interferon-alpha. One pt from group B withdrew from study and was not included in analysis. Administration of DD resulted in a median decline of 25% in Treg number (not significant). DD given before HDIL-2 was associated with a greater increase in Treg post HDIL-2. In Group C there was an increase of rebound median Treg count of 0.88k/ul compared with 0.060k/ul in group B (p=0.025). Absolute lymphocytosis was higher in the combined group getting DD compared to control (median maximal increase of 7.6 vs 4.7 k/ul, respectively) although the difference did not reach statistical significance. However, group C pts had a greater increase in absolute lymphocytosis than did group B pts in which absolute lymphocytosis actually decreased (median increase 10.6 vs. median decrease 0.4 k/ul, p=0.025). A higher peak level of eosinophilia was noted in groups B and C compared with group D (mean increase of 10.5 vs. 4.0 k/ul p=0.2). Group C had a greater peak eosinophilia than group B (11.2 vs 2.2 k/ul p=0.053) Toxicity was manageable and consistent with those seen with HDIL-2. Median HDIL-2 dose given was 21 (range, 14–28). No clinical responses were observed. Of 11 pts included in the analysis 1 pt from group A expired 68 weeks after enrollment. All remaining patients are alive. Survival from enrollment ranges from 11 to 93 weeks. Conclusion: Overall, the combination of DD and HDIL-2 results in a stimulatory effect as manifested by increased rebound lymphocytosis and eosinophilia compared to HDIL-2 alone. Administration of DD in conjunction with HDIL-2 was associated with a rebound in Treg that may be schedule and dose dependent. The results suggest an enhanced immune stimulatory effect as manifested by lymphocytosis and peak eosinophilia in group C. However, this stimulatory effect also extends to Treg that may prove detrimental clinically. Further exploration of these effects in immunotherapy naïve patients would be beneficial.

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Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

European Journal of Dentistry ◽

10.1055/s-0041-1735910 ◽

2021 ◽

Author(s):

Edith Umasi Ramos ◽

Luan Pier Benetti ◽

Júlio César Silva Oliveira ◽

Ana Paula Farnezi Bassi

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Wilcoxon Test ◽

Total N ◽

Study Results ◽

Significant Difference ◽

Group A ◽

Facial Edema ◽

Anti Inflammatory ◽

Group B

Abstract Objective We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone. Materials and Methods The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura. Statistical Analysis For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05. Results The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B. Conclusion As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

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Effect of combined application of Zylexis and a vaccine against FHV-1 and FCV on selected immune response parameters in cats

Medycyna Weterynaryjna ◽

10.21521/mw.6443 ◽

2020 ◽

Vol 76 (08) ◽

pp. 6443-2020

Author(s):

OLIWIER TEODOROWSKI ◽

BARBARA MAJER-DZIEDZIC ◽

MARCIN KALINOWSKI ◽

STANISŁAW WINIARCZYK ◽

ŁUKASZ ADASZEK

Keyword(s):

Immune Response ◽

Cellular Response ◽

Immunological Parameters ◽

Combined Application ◽

Combined Administration ◽

Group A ◽

Haptoglobin Level ◽

Group B ◽

Almost All ◽

Group D

The aim of the study was to evaluate the immune response in cats after the administration of Zylexis (group A), a vaccine against FHV-1 and FCV infections (group B), and a combination of the vaccine and Zylexis (group D). The evaluated parameters included the total number of leukocytes and lymphocytes in peripheral blood, the number of CD4 and CD8 lymphocytes, the ratio of CD4 to CD8 (CD4/CD8) and the concentration of antiFCV and anti-FHV-1 antibodies in the serum of the subjects, as well as the bacteriolytic activity of lysozyme and the haptoglobin level. Significantly higher values of almost all these parameters were recorded in cats receiving a combination of the immunostimulator and the vaccine during the whole study period compared to cats receiving only the immunostimulator or only the vaccine. Additionally, the increase in immunological parameters in animals from this group was positively correlated with the concentration of anti-FHV-1 and anti-FCV antibodies. This may indicate a stimulated humoral as well as cellular response. Neither Zylexis nor the vaccine alone induced as strong an immune response as the combined administration of the vaccine with the immunostimulator. This indicates that it may be advisable to combine vaccines against FHV-1 and FCV with immunostimulators to increase immunity against FHV-1 and FCV. Further studies of the influence of combined administration of vaccines and different immunomodulating preparations on the parameters of specific and non-specific immune responses in cats are necessary.

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Effect of Acupoint Catgut Embedding on Intestinal Flora in Rats with Ovariectomized Osteoporosis

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16281724938230 ◽

2021 ◽

Vol 46 (4) ◽

pp. 307-318

Author(s):

Na Shi ◽

Chu-Qiong Zhang ◽

Long Han ◽

Gang Ouyang

Keyword(s):

Pathogenic Bacteria ◽

Statistical Significance ◽

Intestinal Flora ◽

Valeric Acid ◽

Mineral Density ◽

Treatment Of Osteoporosis ◽

Prevention And Treatment ◽

Group A ◽

Group B ◽

Group D

Objectives: By observing the effect of acupoint catgut embedding on the intestinal flora of ovariectomized osteoporotic rats, the correlation between the regulation of intestinal flora and the prevention and treatment of osteoporosis was discussed preliminarily. Methods: By observing the effect of acupoint catgut embedding on the intestinal flora of ovariectomized osteoporotic rats, the correlation between the regulation of intestinal flora and the prevention and treatment of osteoporosis was discussed preliminarily. Result: Compared with Group A and Group B, bone mineral density (BMD) of femur and tibia in Group C decreased significantly (p<0.05), indicating successful modeling. Compared with Group C, BMD of femur and tibia in Group D was significantly increased (p<0.05). Compared with Group A and Group B, content of serum estrogens, calcium, and PTHrP in Group C were significantly decreased (p<0.05 or p<0.01). Content of serum estrogen, calcium, and PTHrP in Group D were significantly higher than those in Group C (p<0.05 or p<0.01). Compared with Group A and Group B, the abundance of mollicutes, actinobacteria, acidobacteria, chloroflexi and fusobacteria in group C was significantly increased. The abundance of probiotics in Group D such as lactobacillales, (lactobacillaceae, lactobacillus), bacillales, and streptococcus was significantly higher than that in Group C (p<0.05). The content of SCFAs such as acetic acid, butyric acid, iso-valeric acid, valeric acid and caproic acid in Group D were significantly higher than those in Group C, with statistical significance (p<0.05). Conclusions: Acupoint catgut embedding can effectively improve BMD, increase content of estrogen, calcium, PTHrP and SCFAs. Furthermore, embedding can also improve the abundance of probiotics and reduce the abundance of pathogenic bacteria. The changes of intestinal flora were correlated with the changes of estrogen and calcium, which may be one of the mechanisms of acupoint catgut embedding in the prevention and treatment of osteoporosis.

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The potential role of mobile phones in the spread of bacterial infections

The Journal of Infection in Developing Countries ◽

10.3855/jidc.556 ◽

2009 ◽

Vol 3 (08) ◽

pp. 628-632 ◽

Cited By ~ 52

Author(s):

Kabir O. Akinyemi ◽

Audu D. Atapu ◽

Olabisi O. Adetona ◽

Akitoye O. Coker

Keyword(s):

Mobile Phones ◽

Potential Role ◽

Statistical Significance ◽

Coagulase Negative Staphylococcus ◽

Strict Adherence ◽

Bacterial Agent ◽

Group A ◽

Group B ◽

Group D

BACKGROUND: Mobile phones are indispensable accessories both professionally and socially but they are frequently used in environments of high bacteria presence. This study determined the potential role of mobile phones in the dissemination of diseases. METHODOLOGY: Specifically, 400 swab samples from mobile phones were collected and divided into groups categorized by the owners of the phones as follows: Group A was comprised of 100 food vendors; Group B, 104 lecturers/students; Group C, 106 public servants; and Group D, 90 health workers. Samples were cultured and the resulting isolates were identified and subjected to antimicrobial susceptibility tests by standard procedures. RESULTS: The results revealed a high percentage (62.0%) of bacterial contamination. Mobile phones in Group A had the highest rate of contamination (92; 37%), followed by Group B (76; 30.6%), Group C (42; 16.9%), and Group D (38; 15.3%). Coagulase negative Staphylococcus (CNS) was the most prevalent bacterial agent from mobile phones in Group A (50.1%) and least from phones in Group D (26.3), followed by S. aureus. Other bacterial agents identified were Enterococcus feacalis, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella spp. There was no statistical significance difference (P < 0.05) in the occurrence of S. aureus, the most frequently identified pathogenic bacterial agent isolated from the mobile phones in the study groups. Fluoroquinolones and third-generation cephalosporin were found to be effective against most isolates. CONCLUSION: Mobile phones may serve as vehicles of transmission of both hospital and community-acquired bacterial diseases. Strict adherence to infection control, such as hand washing, is advocated.

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Remineralizing Potential of Clinpro® and Tooth Mousse Plus® on Artificial Carious Lesions

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-43.2.6 ◽

2019 ◽

Vol 43 (2) ◽

pp. 103-108

Author(s):

Sakshi Buckshey ◽

Robert P Anthonappa ◽

Nigel M. King ◽

Anut Itthagarun

Keyword(s):

Mineral Content ◽

Statistical Significance ◽

Similar Efficacy ◽

Surface Zone ◽

Carious Lesions ◽

Group A ◽

Ph Cycling ◽

Group B ◽

Tooth Mousse ◽

Group D

Background: Calcium phosphate and fluoride (F) delivery systems claim to facilitate enamel remineralization. Aim: To evaluate and compare (i) the remineralizing potential of Clinpro® Tooth Crème(CTC) and Tooth Mousse Plus®(TMP) on artificial carious lesions, and (ii) the benefit of 1000ppm F dentifrice prior to the application of CTC and TMP. Study design: Carious lesions, 200–300μm deep were produced by placing molars in demineralizing solution for 96h, sections 100–150μm thick were then randomly assigned to six groups(n=150). Specimens were treated thrice daily with a non-fluoridated(Group A), or fluoridated dentifrice[1000ppm, (Group B)], or CTC(Group C), TMP(Group D), fluoridated dentifrice followed by CTC(Group E), or a fluoridated dentifrice followed by TMP(Group F), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography. Results: Posttreatment maximum mineral content at the surface zone(Vmax) was significantly increased in Groups B, C, and D compared to the other groups. The lesion depth(LD) decreased in Group D>Group C>Group E, and the net mineral content gain(ΔZ) in Group C>Group D, which did not reach statistical significance. Conclusions: CTC and TMP exhibited similar efficacy in remineralizing artificial carious lesions. Nevertheless, the net mineral gain or lesion consolidation following CTC use was higher than TMP.

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Survival of classic swine fever virus in hams made from the meat of pigs vaccinated with the PAV-250 strain and unvaccinated pigs

Revista Mexicana de Ciencias Pecuarias ◽

10.22319/rmcp.v10i3.4528 ◽

2019 ◽

Vol 10 (3) ◽

pp. 536-551

Author(s):

Heidi Amezcua Hempel ◽

María Salud Rubio Lozano ◽

Eliseo Manuel Hernández Baumgarten ◽

Pablo Correa Girón † ◽

Oscar Torres Ángeles ◽

...

Keyword(s):

Reference Strain ◽

Clinical Signs ◽

Classical Swine Fever ◽

Fever Virus ◽

Direct Immunofluorescence ◽

Biometric Analysis ◽

Treatment Groups ◽

Group A ◽

Group B ◽

Group D

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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AB0422 LEFT VENTRICULAR ABNORMALITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS FOLLOWED BY SEQUENTIAL ECHOCARDIOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1941 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1510.1-1511

Author(s):

T. Kuga ◽

M. Matsushita ◽

K. Tada ◽

K. Yamaji ◽

N. Tamura

Keyword(s):

Lupus Erythematosus ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Monocyte Count ◽

Lv Dysfunction ◽

Group A ◽

Group B ◽

Lv Diastolic Dysfunction ◽

Group D

Background:Cardiovascular disease (CVD) is detected in up to 50% of systemic lupus erythematosus (SLE) patients1and major cause of death2. Even clinically silent SLE patients can develop left ventricular (LV) diastolic dysfunction3. Proper echocardiographic follow up of SLE patients is required.Objectives:To clarify how the prevalence of LV abnormalities changes over follow-up period and identify the associated clinical factors, useful in suspecting LV abnormalities.Methods:29 SLE patients (24 females and 5 men, mean age 52.8±16.3 years, mean disease duration 17.6±14.5 years) were enrolled. All of them underwent echocardiography as the baseline examination and reexamined over more than a year of follow-up period(mean 1075±480 days) from Jan 2014 to Sep 2019. Patients complicated with pulmonary artery hypertension, deep venous thrombosis or pulmonary embolism and underwent cardiac surgery during the follow-up period were excluded. Left ventricular(LV) systolic dysfunction was defined as ejection fraction (EF) < 50%. LV diastolic dysfunction was defined according to ASE/EACVI guideline4. LV dysfunction (LVD) includes one or both of LV systolic dysfunction and LV diastolic function. Monocyte to HDL ratio (MHR) was calculated by dividing monocyte count with HDL-C level.Prevalence of left ventricular abnormalities was analysed at baseline and follow-up examination. Clinical characteristics and laboratory data were compared among patient groups as follows; patients with LV dysfunction (Group A) and without LV dysfunction (Group B) at the follow-up echocardiography, patients with LV asynergy at any point of examination (Group C) and patients free of LV abnormalities during the follow-up period (Group D).Results:At the baseline examination, LV dysfunction (5/29 cases, 13.8%), LV asynergy (6/29 cases, 21.7%) were detected. Pericarditis was detected in 7 patients (24.1%, LVD in 3 patients, LV asynergy in 2 patients) and 2 of them with subacute onset had progressive LV dysfunction, while 5 patients were normal in echocardiography after remission induction therapy for SLE. At the follow-up examination, LV dysfunction (9/29 cases, 31.0%, 5 new-onset and 1 improved case), LV asynergy (6/29 cases, 21.7%, 2 new-onset and 2 improved cases) were detected. Though any significant differences were observed between Group A and Group B at the baseline, platelet count (156.0 vs 207.0, p=0.049) were significantly lower in LV dysfunction group (Group A) at the follow-up examination. Group C patients had significantly higher uric acid (p=0.004), monocyte count (p=0.009), and MHR (p=0.003) than Group D(results in table).Conclusion:LV dysfunction is progressive in most of patients and requires regular follow-up once they developed. Uric acid, monocyte count and MHR are elevated in SLE patients with LV asynergy. Since MHR elevation was reported as useful marker of endothelial dysfunction5, our future goal is to analyse involvement of monocyte activation and endothelial dysfunction in LV asynergy of SLE patients.References:[1]Doria A et al. Lupus. 2005;14(9):683-6.[2]Manger K et al. Ann Rheum Dis. 2002 Dec;61(12):1065-70.[3]Leone P et al. Clin Exp Med. 2019 Dec 17.[4]Nagueh SF et al. J Am Soc Echocardiogr. 2016 Apr;29(4):277-314.[5]Acikgoz N et al. Angiology. 2018 Jan;69(1):65-70.Numbers are median (interquartile range), Mann-Whitney u test were performed, p value less than 0.05 was considered statistically significant.Disclosure of Interests: :None declared

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Prophylactic temporary abdominal aortic balloon occlusion for patients with pernicious placenta previa: a retrospective study

BMC Anesthesiology ◽

10.1186/s12871-021-01354-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Huo ◽

Hansheng Liang ◽

Yi Feng

Keyword(s):

Placenta Previa ◽

Balloon Occlusion ◽

Artery Embolism ◽

Abdominal Aortic ◽

Significant Difference ◽

Group A ◽

Group B ◽

Clinical Records ◽

Group D ◽

Central Placenta Previa

Abstract Background Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa. Methods This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D). Results Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept. Conclusions PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.

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