Acute respiratory acidosis: large-dose furosemide and cerebrospinal fluid ions

1994 ◽  
Vol 76 (6) ◽  
pp. 2651-2655 ◽  
Author(s):  
S. Javaheri ◽  
W. Corbett ◽  
J. M. Adams ◽  
P. J. Davis ◽  
P. S. Gartside
Keyword(s):  
Cerebrospinal Fluid ◽  
Large Dose ◽  
Ionic Composition ◽  
Respiratory Acidosis ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Group I ◽  
Serial Serum ◽  
Group Ii ◽  
Nacl Cotransport

NaCl cotransport carrier is known to be involved in transepithelial fluid absorption and secretion in various tissues. Recent studies indicate that Na-K-2Cl cotransport carrier also exists in the choroid plexus cells and that inhibition of the carrier decreases cerebrospinal fluid (CSF) production. In this study, we used large-dose intravenous furosemide, an inhibitor of Na-K-2Cl carrier, to determine the effects on cisternal CSF ionic composition in acute respiratory acidosis. In pentobarbital-anesthetized mechanically ventilated dogs, renal pedicles were ligated to prevent furosemide-induced diuresis. The experimental group (group II, n = 7) received 400 mg/kg of furosemide intravenously, and group I (control group, n = 7) received the vehicle. In group II, serial serum and CSF furosemide concentrations were approximately 10(-3) and 10(-5) mol/l, respectively. During 5 h of acute respiratory acidosis in both groups, the mean arterial PCO2 increased approximately 25 Torr, with comparable changes in CSF PCO2. In both groups, CSF [HCO3-] and [H+] rose approximately 3 meq/l and 20 neq/l, respectively. Changes in CSF [Na+], [K+], [Cl-], and [Na(+)-Cl-] were also similar and were not significantly different from each other when the two groups were compared. These data show that furosemide at the dose that inhibits NaCl cotransport carrier does not significantly alter ionic composition of cisternal CSF.

Furosemide and cerebrospinal fluid ions during acute respiratory acidosis

1989 ◽  
Vol 67 (2) ◽  
pp. 563-569 ◽  
Author(s):  
S. Javaheri ◽  
J. F. Freidel ◽  
P. J. Davis
Keyword(s):  
Cerebrospinal Fluid ◽  
Ionic Composition ◽  
Respiratory Acidosis ◽  
Base Line ◽  
Acid Base Balance ◽  
Acid Base ◽  
Mechanically Ventilated ◽  
Group I ◽  
Base Balance ◽  
Group Ii

The purpose of this study was to investigate the effects of furosemide, an inhibitor of NaCl cotransport, on cisternal cerebrospinal fluid (CSF) acid-base balance during acute respiratory acidosis (ARA). We measured blood and CSF acid-base variables in two groups (n = 7 in each) of anesthetized, paralyzed, and mechanically ventilated dogs with bilateral ligation of renal pedicles (to eliminate saluresis). After base-line samples were obtained (-1 h), furosemide (50 mg/kg) was administered intravenously within 15 min (group II); group I received an equal volume of half-normal saline. ARA was induced 1 h later (0 h) and arterial CO2 tension was maintained between 55 and 60 Torr for 5 h. Mean cisternal CSF PCO2 was 42.8 +/- 2.6 and 39.5 +/- 1.7 Torr, respectively in groups I and II and rose approximately 20 Torr during ARA. In group I, CSF [HCO3-] was 22.0 +/- 1.0, 24.8 +/- 0.6, and 25.4 +/- 1.6 meq/l, respectively at 0, 2.5, and 5 h. Respective values for group II were 22.2 +/- 1.3, 24.3 +/- 1.8, and 24.6 +/- 1.0 meq/l. These values were not significantly different from each other. In each group, CSF [Na+-Cl-] increased significantly during ARA, but the changes were not significantly different when the two groups were compared. We conclude that furosemide at the dose used in the present study does not change ionic composition and acid-base balance of cisternal CSF compared with control. Because changes in CSF [Na+-Cl-] during ARA were similar in both groups, any inhibition of Cl- influx into CSF by furosemide should have been proportional to that of Na+.

Effects of acetazolamide on cerebrospinal fluid ions in metabolic alkalosis in dogs

1987 ◽  
Vol 62 (4) ◽  
pp. 1582-1588 ◽  
Author(s):  
S. Javaheri
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Carbonic Anhydrase ◽  
Metabolic Alkalosis ◽  
Renal Effects ◽  
Mechanically Ventilated ◽  
Group I ◽  
The Central Nervous System ◽  
Group Ii

We hypothesized that inhibition of carbonic anhydrase in the central nervous system by acetazolamide should limit the rise in cisternal cerebrospinal fluid (CSF) [HCO3-] observed in metabolic alkalosis. To test this hypothesis, isosmotic isonatremic metabolic alkalosis was produced in two groups of anesthetized, paralyzed, and mechanically ventilated dogs (8 in each group). Group II animals received 50 mg/kg of acetazolamide intravenously 1 h before induction of metabolic alkalosis of 5-h duration. Renal effects of acetazolamide were eliminated by ligation of renal pedicles. In both groups cisternal CSF [Na+] remained relatively constant during metabolic alkalosis. In group I CSF [Cl-] decreased 3.6 and 8.2 meq/l, respectively, 2.5 and 5 h after induction of metabolic alkalosis. Respective increments in CSF [HCO3-] were 3.4 and 6.0 meq/l. In acetazolamide-treated dogs, during metabolic alkalosis, increments in CSF [HCO3-] (4.8 and 7.2 meq/l, respectively, at 2.5 and 5 h) and decrements in CSF [Cl-] (9.1 and 13.3 meq/l) were greater than those observed in group I. We conclude that, in dogs with metabolic alkalosis and bilateral ligation of renal pedicles, acetazolamide impairs CSF regulation of HCO3- and Cl- ions; acetazolamide not only failed to impede HCO3- rise but actually appeared to increase it. The mechanisms for these observations are discussed.

Assessment of aerosolized Colistin and Gentamicin in mechanically ventilated patient

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aya Mohamed Mohamed Abdel Dayem ◽  
Haitham Salah Eldin ◽  
Karim Mohamed Elhamy
Keyword(s):  
Mechanical Ventilation ◽  
Antibiotic Use ◽  
Control Group ◽  
Local Concentration ◽  
Mechanically Ventilated ◽  
Survival Status ◽  
Group I ◽  
Group Ii ◽  
And Control ◽  
Systemic Antibiotics

Abstract Background and Objectives ineffective parental antibiotic use in treatment of Ventilator associated pneumonia (VAP) open the window for using inhaled antibiotic formula to achieve higher local concentration of antibiotics and subsequently good recovery response, the aim of that work was evaluation of aerosolized antibiotics (Colistin and Gentamicin) efficacy in improving the mechanically ventilated patient as adjunctive to intravenous systemic antibiotics Methods 30 mechanically ventilated patients classified equally in to 3 groups; Group I 10 patients received aerosolized Colistin along with systematic antibiotics (SA). Group II: 10 patients received aerosolized Gentamicin along with systematic antibiotics (SA) and Group III (Control): 10 patients received only systematic antibiotics (SA). All patients were followed up for clinical response by bacteriological culture (after 5 days of aerosolized antibiotics), development of VAP, days of mechanical ventilation, length of stay in the ICU, and mortality. Results The incidence of VAP was 10%; in group I no cases had VAP, while in group II and control group, just (20%) and (10%) of cases had VAP respectively, with insignificant association of VAP with particular group, (P = 0.3). Clinically; only group I showed significant lower degree of temperature in comparison with control group, (P = 0.01). The mean days of MV and ICU in each groups were (6.8±2.15; 8.9±3.11, 5.9±2.23; 7.2±2.7, 5.1±1.1; 6.1±1.85) respectively, with insignificant statistical difference between the treatment groups, (P = 0.2 and 0.07) respectively. Finally, the survival rate in group I was 90%, and was slightly lower in group II and control group; 60% and 50% respectively, with insignificant association of survival status in particular group, (P = 0.1) Conclusion the empirical treatment by AA (Colistin) was effective as an adjuvant to systemic antibiotics for protection of VAP than aerosolized Gentamicin, it had rapid resolution of respiratory infection signs, and subsequently the mechanical ventilation days, ICU stay days, and probably the cost of ICU admission, but did not affect mortality.

Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  
Keyword(s):  
Reproductive Age ◽  
Cervix Uteri ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Group Iii ◽  
Aggressive Form ◽  
Group I ◽  
Group Ii ◽  
Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

scholarly journals Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

2021 ◽  
Author(s):  
Pankaj Arora ◽  
Kanica Rawat ◽  
Rajiv Azad ◽  
Kehkashan Chouhan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Phase Contrast ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Group I ◽  
Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

scholarly journals Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

2016 ◽  
Vol 94 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Fatma H. Rizk ◽  
Samah A. Elshweikh ◽  
Amira Y. Abd El-Naby
Keyword(s):  
Metabolic Syndrome ◽  
Liver Enzymes ◽  
Resistance Index ◽  
Control Group ◽  
Model Assessment ◽  
Group Iii ◽  
Group I ◽  
Elevated Liver Enzymes ◽  
Liver Functions ◽  
Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

Comparison of the parameters of retinal sensitivity after vitrectomy due to rhegmatogenous retinal detachment

2021 ◽  
pp. 349-354
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
O.A. Pavlovsky ◽  
E.D. Bosov ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Light Sensitivity ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Gas Tamponade ◽  
Group I ◽  
Silicone Oil Tamponade ◽  
Group Ii

Purpose. To compare the parameters of a light sensitivity (LS) of the central zone of a retina after vitrectomy due to reghmatogenous retinal detachment (RRD) with a silicone oil tamponade (SOT) and gas tamponade (GT). Material and methods. The study included 20 eyes after pars plana vitrectomy due to macula-off rhegmatogenous retinal detachment (RRD) by 25G. All patients were divided in 2 groups depending on the choice of the tamponade. The group I (10 eyes) included cases with the silicone oil tamponade (SOT) (1300 cSt), in the group II (10 eyes) – the gas tamponade (GT) (C2F6). The control group included contralateral eyes without ophthalmic pathology. All patients underwent standard ophthalmological examination and fundus- microperimetry (FMP) on the 30th day after removal of the SOT for the group I, or on the 30th day after the C2F6 tamponade for the group II. Results. According to FMP data, the parameter of average light sensitivity (LS) in the group I was significantly reduced, both in comparison with the group II (p=0.007) and the control group (p=0.003). Differentiation by zones in the group I revealed a decrease in each analyzed parameter in comparison with the control group (p<0.05) and a decrease in the 2nd zone (p=0.031) and the 4th zone (p=0.038) in comparison with the group II. In the 1st zone of the group I the formation of a relative scotoma was revealed in 4 cases out of 10 (40%). The parameters of light sensitivity (LS) in comparison with the control in the group II were significantly reduced when analyzed in each zone (p<0.05). A strong positive correlation was found between the Best Corrected Visual Acuity (BCVA) and the average LS in the group II (r=0.87). Conclusion. There is a decrease in the functional parameters of the retina with SOT compared with GT in the form of a decrease in the LS parameter in the 10° zone according to FMP data. Key words: retinal detachment, photosensitivity, microperimetry, silicone tamponade.

To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Controlled Study ◽  
Control Group ◽  
Chi Square ◽  
Group I ◽  
Chi Square Test ◽  
Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

scholarly journals Effect of Fiber Rich Product on Childhood Obesity and Lipid Profile Aged 10-12 Years

2021 ◽  
Vol 9 (3) ◽  
pp. 87-90
Author(s):  
A. Jyoth ◽  
Keyword(s):  
Exercise Group ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
Diet Survey ◽  
Group Ii ◽  
And Control ◽  
Experimental Group ◽  
Positive Results ◽  
Green Peas

The effect of fiber rich product on child hood obesity studied with 60 sample which were collected randomly among 10-12 years and categorized into 2 groups i.e, experimental group and control group. Experimental group further categorized into three groups i.e, supplementation with exercise (n=15), only supplementation group (n=15), only exercise group (n=15) and control group consists of (n=15).Anthropometric, and diet survey conducted as parameters. A fiber rich product was prepared and supplemented for 2 months to the selected subjects and it consists of whole Bengal gram, whole green gram, green peas, barley and jaggery. Positive results were obtained in three experimental groups. Significant decrease observed inweight, and BMI, Total cholesterol, Triglycerides, LDL, VLDL significant increase observed in HDL in group I II and III. The results were (51.60-48.26kg, 24.7-23.1, 195.2-152.3 mg/dl, 168.2-145.0 mg/dl, 52.2-54.13 mg/dl, 109.4- 69.4mg/dl, 33.6-28.7mg/dl) in group I, In group II the results are (50.3-49.86kg, 23.7-23.4, 168.6-161.0mg/dl, 145.4-129.6mg/dl, 44.2-45.2 mg/dl, 95.3-90.0mg/dl, 29.1-28.3mg/dl).In group III the tesults aere (50.7-49.6kg, 24.5-23.9, 143.2-139.3mg/dl, 139-134.5mg/dl, 38.2-38.7mg/dl 76.8-74.1 mg/dl, 25.6-28.1mg/dl) .From the results it was clear that when compared to group II and III group I has shown better results.

scholarly journals Relationships between urinary neural and immune factors in the patients with interstitial cystitis/ bladder painful syndrome

2020 ◽  
Vol 22 (5) ◽  
pp. 879-886
Author(s):  
R. F. Sholan
Keyword(s):  
Mast Cells ◽  
Interstitial Cystitis ◽  
Pearson Correlation ◽  
Control Level ◽  
Clinical Manifestations ◽  
Control Group ◽  
Bladder Tissue ◽  
Bladder Pain ◽  
Group I ◽  
Group Ii

The purpose of this work was to study the relationships between urinary cytokines, mast cells and nerve growth factor (NGF) in the patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Sixty-eight women with clinically diagnosed IC/BPS were under study. Their mean age was 54.2±12.4 years. Urinary concentrations of interleukins (IL-1β, IL-6, IL-8), tumor necrosis factor-α (TNFα), and NGF were determined by ELISA technique. Mast cells were identified in biopsies of mucous membranes from urinary bladder harvested during cystoscopy. Statistical evaluation was performed by Statistica program in Microsoft Excel. Pearson correlation quotients were calculated. Depending on the type of IC/BPS, the patients were divided into 2 groups: group I included 36 patients with classic type of disease; group II comprised 32 patients with non-ulcer type of IC/BPS. No significant differences were revealed between the groups. In 13.9% of patients from group I, the onset of clinical manifestations of the disease was observed at the age of less than 40 years; in group II, 28.1% of the examined mentioned appearance of the disease symptoms at this age. The levels of IL-1β in the patients from group I was 2.4 times higher than in controls (p < 0.05). IL-6, IL-8 and TNFα concentrations exceeded control values by 2.0 (p < 0.05), 2.5 (p < 0.05) and 2.0 times (p < 0.05), respectively. In the patients from group II, the content of IL-1β, IL-6, IL-8 and TNFα was 2.4 (p < 0.05), 2.0 (p < 0.05), 2.0 (p < 0.05) and 1.9 (p < 0.05) times higher than in the control group, respectively. There were no significant differences between groups I and II, in IL-1β, IL-6, and TNFα levels, except of IL-8 in women of group I that was 20.3% higher than in group II. The urinary NGF level in the patients with IC/BPS exceeded the control level 1.6 times (p < 0.05) for group I, and 1.5 times (p < 0.05) for group II. The number of mast cells in the patients of group I was significantly higher than in controls and in group II, i.e., 1.6 (p < 0.05) and 1.4 times (p < 0.05), respectively. In most cases, a direct weak correlation was revealed between the indices. Only in group I, a moderate correlation (r = + 0.508) could be detected between IL-1β and mast cells. Determination of cytokine levels allows to detect activation of inflammatory cells in bladder tissue and provides an opportunity for developing diagnostic strategies. Increased numbers of mast cells may indicate the importance of these cells in the disease progression, whereas elevated levels of NGF in urine suggests that IC/BPS may be caused by chronic inflammation.

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