Prognostic Factors for Pediatric Acute Encephalopathy Associated with Severe Brain Edema

2021 ◽  
pp. 1-8
Author(s):  
Goichiro Tamura ◽  
Takayuki Inagaki
Keyword(s):  
Brain Edema ◽  
Cytokine Storm ◽  
Acute Encephalopathy ◽  
Brainstem Compression ◽  
Life Threatening ◽  
Group 3 ◽  
Group 2 ◽  
Diffuse Brain ◽  
Group 1

<b><i>Background and Objective:</i></b> Acute encephalopathy is a life-threatening brain dysfunction in children, often associated with a preceding infection and diffuse noninflammatory brain edema. At present, the role of decompressive craniectomy (DC) over the swollen area of the brain is unclear. The risk factors for predicting clinical deterioration also need clarification. <b><i>Methods:</i></b> A retrospective study of pediatric patients admitted between 2015 and 2019 with acute cerebral encephalopathy was carried out. Patients were classified according to: (1) the preceding pathogens, (2) the syndromic classification, and (3) the extent of brain edema. The syndromic classification is a relatively new classification of acute encephalopathy proposed in 2016 and divides patients into 3 groups: those with systemic inflammatory reactions or “cytokine storms” (group 1), those with status epilepticus but no cytokine storm (group 2), and others (group 3). Glasgow Outcome Scale (GOS) scores of 1–3 were defined as unfavorable, while a GOS score of 4 or 5 was defined as a favorable outcome in this study. DC was performed for select patients with life-threatening signs of brainstem compression. <b><i>Results:</i></b> Nineteen patients (mean age: 23.3 months) were included in the study, 8 (42.1%) of whom had an unfavorable outcome. There was no significant correlation between the types of pathogens and outcome. Unfavorable outcomes were observed in significantly more patients in group 1 (87.5%) than group 2 (14.3%) and group 3 (0%). There was a significant association between diffuse brain edema and unfavorable outcomes (72.7%). Neurosurgical DC was performed in 2 patients to alleviate life-threatening brainstem compression: one with a cytokine storm and diffuse bilateral brain edema, and the other with prolonged status epilepticus causing diffuse right-sided brain edema. The GOS score was 3 and 4, respectively. <b><i>Conclusion:</i></b> The risk factors for clinical deterioration in pediatric acute encephalopathy were evaluated based on a variety of classifications, including the new syndromic classification. Laboratory features of cytokine storms and radiological evidence of diffuse brain edema were associated with unfavorable outcomes. The role of surgical decompression is still controversial and should be assessed on a case-by-case basis.

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

REACTIONS OF DRUG-DEPENDENT ANTIBODIES WITH METABOLITES OF QUININE (Qn) AND QUINIDINE (Qd)

1987 ◽  
Author(s):  
D J Christie ◽  
H Diaz-Arauzo ◽  
J M Cook
Keyword(s):  
Ring Structure ◽  
Quinoline Ring ◽  
Drug Induced ◽  
Group 3 ◽  
Methyl Derivatives ◽  
Drug Dependent ◽  
Group 2 ◽  
Asymmetric Carbon ◽  
Group 1

In many cases of drug-induced immunologic thrombocytopenia (DITP), a metabolite, rather than the native drug, is suspected of provoking the destructive drug-dependent antibodies (DDAB) responsible for this severe hemorrhagic disorder. However, this has not previously been investigated for Qn- and Qd-DDAB. We report evidence that the native drugs, and not their metabolites, are the provocative agents in Qn and Qd DITP. Reactions of Qn- and Qd-DDAB with platelets were studied with the native drugs and four of their metabolites: the N-oxide and 10,11-diol derivatives (quinuclidine ring modifications), the des-methyl derivatives (aromatic quinoline ring modification), and 2'-quininone and 2'-quinidinone (2'-oxo derivatives) (also quinoline ring modifications on Qn and Qd, respectively). Five antibodies were studied:two Group 1 DDAB (specific for compounds with native configuration at asymmetric carbon positions), two Group 2 DDAB (similar to Group 1 DDAB but also known to require the methoxy group on the quinuclidine ring for full activity), and one Group 3 DDAB (reactive with the native drug, its stereoisomer, and several nonmetabolic analogs of both compounds) . Using a complement-dependent 51Cr-lysis assay, the reactions of all DDAB with platelets and the four metabolites were similar to 100-fold weaker when compared to reactions obtained with the native drug, with these exceptions:Group 2 DDAB failed to react with the desmethyl and 2'-oxo metabolites and the Group 3 DDAB failed to react with 2'-oxo Qd. This observation shows that the activity of certain DDAB is critically dependent on the native quinoline ring structure. Importantly, none of the DDAB reacted more strongly with any of the metabolites tested when compared with reactions in the presence of the native drug. These findings indicate that DDAB react with platelets preferentially in the presence of the unaltered Qn and Qd molecules and suggest that, while the role of metabolites cannot be entirely ruled out, the native structure of the drug molecule is sufficient to stimulate production of the antibodies responsible for DITP.

P5392Epicardium derived cells promote sympathetic ganglionic outgrowth towards myocardium in vitro

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Ge ◽  
A M Smits ◽  
J C Van Munsteren ◽  
T Van Herwaarden ◽  
A M D Vegh ◽  
...  
Keyword(s):  
Neurite Outgrowth ◽  
Autonomic Innervation ◽  
Cardiac Damage ◽  
Group 4 ◽  
Group 3 ◽  
Cervical Ganglia ◽  
Group 2 ◽  
Group 1

Abstract Background The autonomic nerve system is essential to maintain homeostasis in the body. In the heart, autonomic innervation is important for adjusting the physiology to the continuously changing demands such as stress responses. After cardiac damage, excessive neurite outgrowth, referred to as autonomic hyperinnervation, can occur which is related to ventricular arrhythmias and sudden cardiac death. The cellular basis for this hyperinnervation is as yet unresolved. Here we hypothesize a role for epicardium derived cells (EPDCs) in stimulating sympathetic neurite outgrowth. Purpose To investigate the potential role of adult EPDCs in promoting sympathetic ganglionic outgrowth towards adult myocardium. Method Fetal murine superior cervical ganglia were dissected and co-cultured with activated adult mesenchymal epicardium-derived cells (EPDCs) or/and adult myocardium in a 3D collagen gel culture system. Four experiment groups were included: Group 1: Vehicle cultures (ganglia cultured without EPDC/myocardium) (n=48); Group 2: ganglia co-cultured with EPDCs (n=38); Group 3: ganglia co-cultured with myocardium (n=95); and group 4: ganglia co-cultured with both EPDCs and myocardium (n=96). The occurrence of neurite outgrowth was assessed in each group. The density of neurites that showed directional sprouting (i.e. sprouting towards myocardium) was assessed as well with a semi-automatic quantification method. Finally, sub-analyses were made by taking gender into account. Results Cervical ganglia cultured with EPDCs alone (group 2) showed increased neurite outgrowth compared to vehicle cultures (group 1), however the neurites did not show directional sprouting towards EPDCs. When co-cultured with myocardium (group 3), directional neurite outgrowth towards myocardium was observed. Compared to the ganglia-myocardium co-cultures, directional outgrowth was significantly increased in co-cultures combining myocardium and EPDCs (group 4), and the neurite density was also significantly augmented. Comparison between males and female ganglia demonstrated that more neurite outgrowth occurred in female-derived ganglia than in male-derived ganglia under the same co-culture conditions. Conclusion Activated adult EPDCs promote sympathetic ganglionic outgrowth in vitro. Sex differences exist in the response of ganglia to EPDCs, and female-derived ganglia appear more sensitive to EPDC-signalling. Results support a role of EPDCs in cardiac autonomic innervation and open avenues for exploring of their role in ventricular hyperinnervation after cardiac damage.

scholarly journals Odour-Evoked Memory in Dogs: Do Odours Help to Retrieve Memories of Food Location?

Animals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1249
Author(s):  
Angelo Quaranta ◽  
Serenella d’Ingeo ◽  
Marcello Siniscalchi
Keyword(s):  
Learning Task ◽  
Spatial Task ◽  
Spatial Memories ◽  
Group 3 ◽  
Group 2 ◽  
Odor Group ◽  
With Memory ◽  
Specific Odor ◽  
Group 1

The ability of odors to spontaneously trigger specific memories has been widely demonstrated in humans. Although increasing evidence support the role of olfaction on dogs’ emotions and cognitive processes, very little research has been conducted on its relationship with memory in this species. The present study aimed at investigating the role of olfaction in the recall of detailed memories originally formed in the presence of a specific odor (i.e., vanilla). To test this, three groups of participants were trained with the same spatial learning task while a specific odor (i.e., vanilla) was dispersed in the testing room. Subjects were then divided in three experimental groups and after 24 h delay, they were presented with the same spatial task. The first group (Group 1) performed the task in the presence of a novel odor (i.e., control), whereas the second (Group 2) and the third group (Group 3) carried out the test in the presence of the vanilla odor and no odor (Group 3), respectively. After a brief delay, the test was presented again to the three groups of dogs: subjects of Group 1 were now tested in the presence of the vanilla odor, whereas the Group 2 was tested with the control odor. The Group 3 received no odor in both tests. A significant improvement of dogs’ performance was registered in the control-vanilla odors condition (Group 1), suggesting that the exposure to the odor presented at the encoding time would prompt the recall of spatial memories in dogs.

scholarly journals THE LATENT OF RHINOSINUSITIS AS A MANIFESTATION OF NEURO-IMMUNE INTERACTIONS

2019 ◽  
Vol 19 (1S) ◽  
pp. 111-112
Author(s):  
I V Stagniyeva ◽  
P A Stateshnaya
Keyword(s):  
Immune Deficiency ◽  
Inflammatory Cytokines ◽  
Pain Symptom ◽  
Cytokine Balance ◽  
Acute Bacterial Sinusitis ◽  
Group 3 ◽  
Group 2 ◽  
Th 1 ◽  
Group 1

Purpose: to determine the role of a pain symptom in the diagnosis of rhinosinusitis on the background of immune deficiency. 240 patients with rhinosinusitis without pain symptom were divided into 3 groups: group 1 - patients with acute viral rhinosinusitis (AVRS), group 2 - patients with acute bacterial sinusitis (ABRS), group 3 (n = 32) - control. All patients underwent a complete otorhinolaryngological examination, assessment of the pain symptom, an immunogram, the level of SP in the blood serum. At SP > 100 pg/ml in group 1, the change in indicators was typical for viral infection, in group 2, for bacterial infection. With an SP < 100 pg/ml, the cytokine balance is predominantly biased towards anti-inflammatory cytokines, and the direction of differentiation of Th-1/Th-2 lymphocytes towards the Th-2 pathway, which is manifested by immune deficiency, which leads to severe or prolonged course of the disease, which may indicate impaired neuro-immune interactions.

scholarly journals Role of Ajwa dates in ameliorating diclofenac sodium-induced nephrotoxicity and cardiovascular risk factors in mice

2019 ◽  
Vol 17 ◽  
pp. 205873921986157
Author(s):  
Heba M Eltahir ◽  
Naif Aljuhani ◽  
Sara A Alsubhi ◽  
Ghada M Alahmadi ◽  
Hossein M Elbadawy ◽  
...  
Keyword(s):  
Antioxidant Capacity ◽  
Diclofenac Sodium ◽  
Protective Effects ◽  
Group 3 ◽  
Group 2 ◽  
Endogenous Antioxidant ◽  
Per Oral ◽  
Altered Lipid ◽  
Group 1

The study aims at evaluating the protective effects of Ajwa dates extract against diclofenac sodium (DFS)-induced nephrotoxicity. A total of 30 male albino mice were divided into three groups. Group 1 received water per oral gavage for 14 days and saline per intra-peritoneal (IP) dose for the days 12–14. Group 2 received water like Group 1 and a daily IP dose of DFS for the days 12–14. Group 3 received 1 gm/kg Ajwa extract in water for 14 days and a daily IP dose for the days 12–14. Biochemical investigation revealed DFS-induced increase in serum urea and creatinine levels along with depleted antioxidant capacity, altered lipid profile, and hyperglycemia. Ajwa extract successfully protected against DFS-induced adverse effects, normalizing renal parameters biochemically and histologically, and prevented its hyperlipidemic and hyperglycemic effects. Ajwa protected against endogenous antioxidant capacity depletion in treated animals. Hydroalcoholic Ajwa extract is a promising candidate for protection against DFS-induced hyperlipidemia and nephrotoxicity.

Bacteriophages of Clostridium botulinum

1972 ◽  
Vol 18 (1) ◽  
pp. 67-76 ◽  
Author(s):  
C. E. Dolman ◽  
Eva Chang
Keyword(s):  
Clostridium Botulinum ◽  
Phage Type ◽  
Phage Group ◽  
Flexible Tail ◽  
Group 4 ◽  
Group 3 ◽  
Type C ◽  
Group 2 ◽  
Group 1

Temperate bacteriophages of diverse morphology were demonstrated by electron microscopy in toxigenic cultures of Clostridium botulinum. The 41 strains examined included 23 type E and multiple representatives of all other types. Cultures induced with mitomycin-C generally gave better yields, but phages were also demonstrable in untreated cultures.A provisional grouping of toxigenic types into four categories is suggested, based mainly upon associated phage patterns. Group 1 comprises types A, B, and F (all proteolytic), many of whose cultures showed an icosahedral contractile phage; others contained a "bullrushy" phage with elongated head and long flexible tail; some strains yielded both. Group 2, types B and F (non-proteolytic), were associated with icosahedral contractile phages; the latter also had an octahedral flexible phage. Group 3, types C and D, yielded conspicuously large phages with octahedral heads and very long sheathed tails. One type C strain produced a long-tailed icosahedral phage. Type E phages constituted group 4. These were icosahedral with tails generally contracted but sometimes flexible, often accompanied by superfluous sheathed tail-like structures resembling certain bacteriocins. Although non-toxigenic "OS" mutants of types A, B, E, and F were phageless, two non-toxic type E strains yielded phages. The possible role of lysogeny in the toxigenicity of certain types of this species is likely to prove difficult to elucidate.

scholarly journals Predictive Markers of Missed Miscarriage

2021 ◽  
Vol 11 (1) ◽  
pp. 65-67
Author(s):  
Agamurad Orazmuradov ◽  
Anastasiya Akhmatova ◽  
Khalid Haddad ◽  
Alexander Lopatin ◽  
Irina Bekbaeva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Potential Role ◽  
Serological Markers ◽  
Liquid Chromatography Mass Spectrometry ◽  
Immunoglobulin Kappa ◽  
Serologic Marker ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of this study was to find useful the serological markers for missed miscarriage (MM) in order to predict the outcome of pregnancy. The study included 141 pregnant women aged between 18 and 45 years at gestational age under 11 weeks. All women were divided into 3 groups. Group 1 included 68 women with MM; Group 2 included 43 women with spontaneous miscarriage; Group 3 included 30 pregnant women without pathology. Proteomic analysis of the blood serum was performed using liquid chromatography-mass spectrometry. The results of our study show that immunoglobulin kappa variable 3-15 (KV315) can be considered as the most promising serologic marker for MM in early gestation. The potential role of KV315 as the serological marker is very important for predicting the course of pregnancy.

scholarly journals Establishment of an orthodontic retention mouse model and the effect of anti-c-Fms antibody on orthodontic relapse

2019 ◽  
Author(s):  
Jiawei Qi ◽  
Hideki Kitaura ◽  
Wei-Ren Shen ◽  
Akiko Kishikawa ◽  
Saika Ogawa ◽  
...  
Keyword(s):  
Mouse Model ◽  
Osteoclast Formation ◽  
Nickel Titanium ◽  
Clinical Issue ◽  
Retention Period ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Orthodontic Retention

AbstractOrthodontic relapse after orthodontic treatment is a major clinical issue in the dental field. However, the biological mechanism of orthodontic relapse is still unclear. This study aimed to establish a mouse model of orthodontic retention to examine how retention affects the rate and the amount of orthodontic relapse. We also sought to examine the role of osteoclastogenesis in relapse using an antibody to block the activity of M-CSF, an essential factor of osteoclast formation. Mice were treated with a nickel-titanium closed-coil spring that was fixed between the upper incisors and the upper-left first molar to move the first molar in a mesial direction over 12 days. Mice were randomly divided into three groups: group 1, no retention (G1); group 2, retention for 2 weeks (G2); and group 3, retention for 4 weeks (G3). In G2 and G3, a light-cured resin was placed in the space between the first and second molars as a model of retention. Orthodontic relapse was assessed by measuring changes in the dimensions of the gap created between the first and second molars. To assess the activity and role of osteoclasts, mice in G3 were injected with anti-c-Fms antibody or PBS, and assessed for changes in relapse distance and rate. Overall, we found that a longer retention period was associated with a slower rate of relapse and a shorter overall amount of relapse. In addition, inhibiting osteoclast formation using the anti-c-Fms antibody also reduced orthodontic relapse. These results suggest that M-CSF and/or its receptor could be potential therapeutic targets in the prevention and treatment of orthodontic relapse.

scholarly journals Connective tissue dysplasia in the genesis of cervical incompetence

2021 ◽  
Vol 15 (1) ◽  
pp. 41-50
Author(s):  
E. V. Fotina ◽  
R. R. Zakirova ◽  
M. V. Alekseenkova ◽  
O. B. Panina
Keyword(s):  
Connective Tissue ◽  
Preterm Labor ◽  
Clinical Signs ◽  
Pregnancy And Childbirth ◽  
Cervical Incompetence ◽  
Connective Tissue Dysplasia ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: to study a role of undifferentiated connective tissue dysplasia (uCTD) in etiology of cervical incompetence and its effect on pregnancy and childbirth course.Material and Methods. There were enrolled 60 patients with cervical incompetence. Patients were divided into 3 groups according to the modified CTD scale: group 1 - patients without uCTD (n = 21); group 2 - patients with mild uCTD (n = 25); group 3 - patients with moderate-to-severe uCTD (n = 14). Intensity of CTD clinical signs was assessed based on health status, gynecological and obstetric history, the course of pregnancy, labor and the postpartum period.Results. It was found that patients with more prominent CTD developed earlier (r-Spearman = -0.26) and more marked (r-Spearman = -0.29) cervical shortening and opening of the internal orifice of the uterus (r-Spearman = 0.28). It was also noted that likelihood of occurring preterm labor was significantly higher in patients with CTD (p = 0.02).Conclusion. The data obtained evidence that uCTD affects intensity of manifested cervical insufficiency and rate of preterm delivery.

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