Biomarkers of system inflammation in local and diffuse peritonitis

2020 ◽  
Vol 66 (5) ◽  
pp. 411-418
Author(s):  
E.V. Mikhalchik ◽  
I.V. Borodina ◽  
I.V. Vlasova ◽  
T.V. Vakhrusheva ◽  
N.P. Gorbunov ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Healthy Volunteers ◽  
Normal Values ◽  
Diffuse Peritonitis ◽  
Surgical Operation ◽  
Neutrophil Activity ◽  
Plasma Antioxidant Capacity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In cases of any acute surgical abdominal disease the progression of purulent inflammation can lead to local or diffuse peritonitis. The indicators of the degree and specificity of the inflammatory response in blood such as cytokine concentration, neutrophil activity, plasma antioxidant capacity (thiols concentration) could be considered as potential predictors of complications. The luminol-dependent chemiluminescence (CL) response of blood activated by the phorbol ester (PMA), and the concentration of cytokines IL-6, IL-8, IL-10, myeloperoxidase (MPO) and thiols in plasma were measured in patients with uncomplicated condition (group 1, n=8), local peritonitis (group 2, n=9) or diffuse peritonitis (group 3, n=9) at admission to surgery (before surgical operation, b/o), immediately after surgical operation (a/o) and a day after surgery (1 day) as well as in healthy volunteers (norm, n=12). In all time-points the cytokines and MPO concentrations measured by ELISA, in group 3 were higher than in healthy volunteers and in patients in groups 1 and 2. Blood CL demonstrated a more than 5-fold increase above the normal values in all patients, and was also higher in group 2 as compared to group 1 (b/o and a/o). Patients in group 3 had shown both maximum and minimum of CL values, which could be a consequence of neutrophil priming or exhaustion (“immune paralysis”), respectively. The same patients' plasma exhibited low thiol concentration (≤30% vs normal values). In patients with fatal outcomes (group 3, n=2) within a day after surgery, either a decrease of the CL to zero values concurrently with elevated IL-8 and IL-6 concentrations and low thiol levels was observed, or CL exceeded normal values more than 20 times with concurrent complete exhaustion of the plasma thiol pool. No clear dependency between the plasma parameters and neutrophil activity was found. Hence a parameter set for prognosis and/or early diagnosis of infectious complications in acute abdominal pathology should include different biomarkers of the inflammatory response: cytokine profile (IL-6, IL-8, IL-10), MPO and neutrophil activity, antioxidant plasma capacity (e.g., total thiols concentration).

Specificities in mechanism of erythrocyte deformability disorders in various diseases

2021 ◽  
Author(s):  
Н.П. Александрова ◽  
В.И. Карандашов ◽  
Д.А. Кудлай
Keyword(s):  
Disease Duration ◽  
Normal Values ◽  
Common Factors ◽  
Erythrocyte Deformability ◽  
Mechanical Resistance ◽  
Hematocrit Level ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Введение. Нарушение текучести крови, обусловленное повышением ее вязкости и снижением эластичности эритроцитов, может привести к столь значительным расстройствам центральной гемодинамики и микроциркуляции, что возникает дисфункция органов. Цель исследования: изучение доминирующих специфических механизмов, вызывающих нарушение деформируемости эритроцитов при различных заболеваниях. Материалы и методы. Обследован 121 пациент: с геморрагическим панкреонекрозом (n = 16) без острой сопутствующей сердечно-сосудистой патологии (группа 1); с тромбоэмболией магистральных артерий нижних конечностей (n = 37) с локализацией в подвздошной, бедренной и подколенной артериях, со сроком заболевания от 2 до 3 сут (группа 2); с острым тромбозом магистральных артерий нижних конечностей (n = 32) с ишемией II степени и длительностью заболевания от нескольких недель до нескольких месяцев (группа 3); с острым венозным тромбозом (n = 36), срок заболевания варьировал от 24 ч до 30 сут (группа 4). Для контроля изучены показатели 26 практически здоровых лиц (группа 5). Проведено исследование деформируемости эритроцитов методом фильтруемости, изучали распределение эритроцитов по диаметру, определяли показатель гематокрита и механическую резистентность эритроцитов, исследование белкового состава плазмы проводили спектрофотометрическим способом, измеряли содержание сиаловой кислоты в плазме и в эритроцитах. Результаты. Самые тяжелые нарушения морфологических и физико-химических свойств эритроцитов выявлены у больных геморрагическим панкреонекрозом (группа 1): скорость фильтрации эритроцитов была в 1,8 раза меньше, чем у здоровых людей; диаметр эритроцитов в 1,2 раза, а уровень гематокрита на 9% превышали норму; механическая резистентность была в 2 раза ниже нормальной. По сравнению с нормальными значениями у больных группы 2 диаметр эритроцитов был увеличен на 18%, гематокрит — на 7%, механическая резистентность была снижена на 27%. У пациентов группы 3 деформируемость была снижена на 14%, диаметр эритроцитов превышал норму на 11%, гематокрит — на 5%, механическая резистентность была снижена на 18%. У больных группы 4 деформируемость эритроцитов была практически не нарушена, все остальные параметры эритроцитов также не отличались от нормальных. Заключение. Существуют как специфические факторы, обусловливающие нарушение деформируемости эритроцитов и присущие только конкретному заболеванию, так и общие факторы, изменяющие деформационные свойства эритроцитов, которые сопровождают практически любую патологию. Общими факторами, снижающими деформационные свойства эритроцитов при исследованных нами заболеваниях, являются выраженная диспротеинемия и ацидоз. Background. Blood flow disorders due to its viscosity increasing and erythrocytes elasticity decreasing, may cause significant disturbances of central hemodynamics and microcirculation that lead to organ dysfunction. Objectives: to studythe basic specific mechanisms of erythrocyte deformability impairment in various diseases. Patients/Methods. We examined 16 patients: with hemorrhagic pancreonecrosis (n = 16) without acute comorbid cardiovascular pathology (group 1); with thrombembolia of the main arteries (iliac, femoral and popliteal) of lower extremities (n = 37), and disease duration of 2 to 3 days (group 2); with acute thrombosis (II degree ischemia) of the main arteries in the lower extremities (n = 32), and disease duration from several weeks to several months (group 3); with acute venous thrombosis (n = 36) and disease duration from 24 hours to 30 days (group 4). Group 5 consisted of 26 practically healthy individuals. We measured erythrocytes deformability (by filterability method), erythrocytes diameter distribution, hematocrit and erythrocytes mechanical resistance, plasma proteins composition (spectrophotometrically), sialic acid concentration in plasma and erythrocytes. Results. The most expressive disorders of erythrocytes morphological and physicochemical properties were found in patients with hemorrhagic pancreonecrosis (group 1): erythrocytes filtration rate was 1.8 times less than in healthy people; erythrocytes diameter was 1.2 times and the hematocrit level was 9% above normal; mechanical resistance was 2 times lower than normal. In patients of group 2 erythrocytes diameter was increased by 18%, hematocrit level — by 7%, mechanical resistance was reduced by 27% compared with normal values. In patients of group 3, deformability was reduced by 14%, erythrocytes diameter exceeded the norm by 11%, the hematocrit was by 5% above the norm, mechanical resistance was reduced by 18%. In patients of group 4, erythrocyte deformability practically was not impaired; all other erythrocytes parameters also did not differ from normal values. Conclusions. Erythrocyte deformability impairment caused by both specific factors that are attributable only for specific disease and by common factors that exists in almost any disease. Expressed dysproteinemia and acidosis are common factors that reduce erythrocyte deformability in examined diseases.

scholarly journals The Effects of Insufflation Conditions on Rat Mesothelium

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Andrew K. Davey ◽  
Jessica Hayward ◽  
Jean K. Marshall ◽  
Anthony E. Woods
Keyword(s):  
Inflammatory Response ◽  
Mesothelial Cell ◽  
Surface Group ◽  
Control Group ◽  
Cell Nuclei ◽  
Tissue Samples ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. The aim of this investigation was to examine the alterations in the peritoneum after cold dry CO2, heated dry CO2, and humidified heated CO2at pressures equivalent to intraperitoneal pressures used in human laparoscopy.Methods. Eighteen rats were divided into 4 treatment groups—group 1: untreated control; group 2: insufflation with cold dry CO2; group 3: insufflation with heated, dry CO2; group 4: insufflation with heated and humidified CO2. The abdomen was insufflated to 5 mm/Hg (flow rate 50 mL/min) for 2 h. Twelve hours later, tissue samples were collected for analysis by light microscopy (LM) and scanning electron microscopy (SEM).Results. Group 1: no abnormalities were detected. Group 2: specimens revealed an inflammatory response with loss of mesothelium and mesothelial cell nuclei showing lytic change. Cells were rounded with some areas of cell flattening and separation. Group 3: some animals showed little or no alteration, while others had a mild inflammatory response. Mesothelial cells were rounded and showed crenation on the exposed surface. Group 4: specimens showed little change from the control group.Conclusions. The LM results indicate that insufflations with heated, humidified CO2are the least likely to induce mesothelial damage.

scholarly journals Assessment of Electrolytes, Urea and Creatinine in Patients with Renal Impairment Attending Yobe State Specialist Hospital Damaturu

2021 ◽  
pp. 114-122
Author(s):  
Abubakar El-Ishaq ◽  
Amina M. Garba ◽  
Deji Dairo Emanuel
Keyword(s):  
Renal Impairment ◽  
Normal Values ◽  
Gender Ratio ◽  
Blood Samples ◽  
Group 3 ◽  
Group 2 ◽  
Kidney Impairment ◽  
Male To Female ◽  
Group 1

Electrolytes, urea and creatinine are major factor in the determining a healthy kidney performance. Renal impairment is one of the kidney stages that can alter the concentration of these electrolytes. This study was carried out in order to access the biochemical concentrations of urea, electrolytes and creatinine in patients with renal impairment attending Yobe state specialist hospital Damaturu. One hundred (100) blood samples were collected randomly from the patients. Automated chemistry analyzer (Selectra proS) was used for determination of urea and creatinine. For the determination of concentration of electrolytes in blood samples, electrolytes analyzer known as Ion selective electrolyte (ISE) was used. Electrolytes determined and compare with normal values includes: bicarbonate (HCO3-) 20-30 mmol/l, potassium (K+) 2.5-5.0 mmol/l, chloride (Cl-) 95-110 mmol/l, and sodium (Na+) 135-145 mmol/l. The results obtained was distributed into three (3) groups depending on the age categories; group 1 (1-30years), group 2 (31-60 years), and group 3(60-90 years). The gender ratio male to female patients examined was 52:48. Generally, the obtained result showed that females age 31-60 years are the most affected by the renal impairment, and this called for Government intervention in order to solve the causes of kidney impairment in the society.

scholarly journals VALIDATION OF A NEW WATER-PERFUSED HIGH-RESOLUTION MANOMETRY SYSTEM

2020 ◽  
Vol 33 (4) ◽  
Author(s):  
Rogério MARIOTTO ◽  
Fernando A. M. HERBELLA ◽  
Vera Lucia Ângelo ANDRADE ◽  
Francisco SCHLOTTMANN ◽  
Marco G. PATTI
Keyword(s):  
High Resolution ◽  
Normal Values ◽  
Ph Monitoring ◽  
Low Cost ◽  
Normative Values ◽  
High Resolution Manometry ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: High-resolution manometry is more costly but clinically superior to conventional manometry. Water-perfused systems may decrease costs, but it is unclear if they are as reliable as solid-state systems, and reference values are interchangeable. Aim: To validate normal values for a new water-perfusion high-resolution manometry system. Methods: Normative values for a 24-sensors water perfused high-resolution manometry system were validated by studying 225 individuals who underwent high resolution manometry for clinical complaints. Patients were divided in four groups: group 1 - gastroesophageal reflux disease; group 2 - achalasia; group 3 - systemic diseases with possible esophageal manifestation; and group 4 - dysphagia. Results: In group 1, a hypotonic lower esophageal sphincter was found in 49% of individuals with positive 24 h pH monitoring, and in 28% in pH-negative individuals. In groups 2 and 3, aperistalsis was found in all individuals. In group 4, only one patient (14%) had normal high-resolution manometry. Conclusions: The normal values determined for this low-cost water-perfused HRM system with unique peristaltic pump and helicoidal sensor distribution are discriminatory of most abnormalities of esophageal motility seen in clinical practice.

scholarly journals Renovasal relationship in patients with uncomplicated hypertensive disease

2019 ◽  
Vol 36 (4) ◽  
pp. 5-12
Author(s):  
A. I. Chernyavina ◽  
N. A. Koziolova ◽  
S. V. Mironova
Keyword(s):  
Arterial Stiffness ◽  
Cystatin C ◽  
Normal Values ◽  
Hypertensive Disease ◽  
Arterial Lesion ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Level Group ◽  
Group 1

Aim. To assess the influence of arterial stiffness on the renal filtration function in patients with uncomplicated hypertensive disease. Materials and methods. The study included 88 patients of able-bodied age, suffering from stage III hypertensive disease. The mean age was 50.38 5.19 years. All the patients underwent sphigmopletismography with assessment of cardio-malleolar-vascular index (CAVI1), evaluation of renal filtration function by creatinine and cystatin C levels as well as by calculated glomerular filtration rate (GFR) by creatinine and cystatin C. All the patients were divided into 3 groups according to CAVI1 level: group 1 patients without arterial lesion and CAVI1 8; group 2 patients with borderline changes in arteries and CAVI1 8.08.9; group 3 patients with arterial lesion and CAVI19. Results. No statistically significant differences by clinicoanamnestic characteristics were found out in patients of all groups. In patients of group 1, cystatin level appeared to be statistically significantly lower than in patients of group 2 and 3 (pmg = 0.013). Patients of all groups statistically significantly differed according to GFR by cystatin C (pmg = 0.015). No difference according to creatinine level and GFR by creatinine were registered in the groups. Conclusions. As arterial stiffness by CAVI1 level is increased, there occurs statistically significant aggravation of renal filtration function, assessed by cystatin C level and GFR using the formula CKD-EPI by cystatin C. Changes in the renal filtration function indices were observed within the normal values that shows early preclinical changes.

Treatment of Serum Ferritin Deficiency Regardless Haemoglobin Level

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5166-5166
Author(s):  
Hassan A. Al-Jafar
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Normal Level ◽  
Normal Values ◽  
Normal Value ◽  
Normal Functions ◽  
General Weakness ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Abstract 5166 Introduction The concentration of serum ferritin is positively correlated with the size of the total body iron stores in the absence of inflammation. [1] It is mainly concentrated in the liver, spleen and bone marrow in humans. The serum ferritin is present in all cells of the body. [ 2] Normal values are generally 12 – 300 ng/mL for men and 12 – 150 ng/mL for women. Some patients have clinical symptoms of iron deficiency anaemia as fatigue, general weakness, hair loss, depressed mode although their haemoglobin and serum ferritin are in the lower normal values [3]. Method Patients sample are 1- females 2- aged from 15–70 years 3-who have problems with oral iron either not getting benefit from it or can't tolerated it or not compliant with oral iron treatment. On presentation patients subjected for the following tests and then repeated after one month of intravenous iron infusion 1- complete blood count, 2- serum ferritin, 3- serum vitamin B12 and folate, 4- HPLC, 5-G6PD, 6- Coagulation profile (INR, APTT), 7 – LFT and RFT. Results Group 1: responded laboratory and clinically to treatment. Group 2: responded laboratory and clinically to treatment. Group 3: responded laboratory and clinically to treatment. Discussion Three group of patients noticed: Group 1 Low Hb and low s. ferritin where symptoms of iron deficiency are exist in this group of patients. Group 2 Hb is normal and s. ferretin where symptoms of iron deficiency are exist in this group of patients. Group 3 both Hb and s. ferretin where symptoms of iron deficiency are exist in this group of patients. Group 4 control group was just observed and reassured. Iron is essential element in all cells of human [4], so when it is low it means dysfunctions in other cells and organs like hair, muscles and brain. Conclusion Lower normal level of Serum Ferritin is enough for normal Hb level but it is may be not enough for normal functions in other organs where the iron is needed. So that why it might be need to treat S. ferritin deficiency and shouldn't wait to reach to the level of IDA. According to that it might be indicated to: 1- Treat patients when s. ferritin is low even if Hb is normal. 2 - Lower normal value has to be increased to at least to 50mg to ensure that not only Hb will become normal but also other organ function. Putting in mind that the range of Hb could reach to 305ng/ml without reaching to the toxic level of iron overload. Reference Aim Is to assess the benefit of raise up Serum Ferritin level to a new higher reference lower value as 50 ng/mL instead of the present lower values, because the present lower normal value 11 ng/mL, may be enough to get haemoglobin to the normal level and function, but it seems not enough for normal functions of other different organs as the hair, muscles, brain, which could be the reason of hair lose, general weakness, fatigue, depressed mode, . ect although haemoglobin is normal and s. ferritin is low or in lower normal value. Disclosures: No relevant conflicts of interest to declare.

scholarly journals EFFECT OF HYALURONIC ACID ON THE HEALING OF COLONIC ANASTOMOSIS IN RATS TREATED WITH CORTICOID

2020 ◽  
Vol 11 (2) ◽  
pp. 81-92
Author(s):  
Iana Campinho Braga de Araújo Lima ◽  
´´Italo Medeiros Azevedo ◽  
Keyla Borges Ferreira Rocha ◽  
Aldo Cunha Medeiros
Keyword(s):  
Hyaluronic Acid ◽  
Inflammatory Response ◽  
Systemic Corticosteroid ◽  
Colonic Anastomosis ◽  
Anastomosis Site ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Objective: This study aimed at examining whether topical treatment of colon anastomosis with hyaluronic acid can influence the healing of colonic anastomosis in rats treated with systemic corticosteroid. Methods: Three groups of Wistar rats weighing 252 ± 7g were used, with six rats each, all submitted to anastomosis of the proximal colon: Group 1 - control rats, without treatment. Group 2 - rats treated with subcutaneous (s.c) corticosteroid, and topical application of 0.9% saline solution over the anastomosis. Group 3 - rats treated with corticosteroid s.c. and topical application of 0.4% hyaluronic acid (10 mg/ml) on colonic anastomosis. On the 7th postoperative day, under anesthesia and laparotomy, the anastomosis site was subjected to the determination of rupture pressure. Then, samples containing the anastomosis site were resected and fixed in 10% buffered formaldehyde and embedded in paraffin. Masson H-E and trichrome staining. Histometry evaluated the infiltration of inflammatory cells at the anastomosis site, using a numerical scale from 0 to 4. Continuous variables were assessed using the Tukey test. Differences considered significant with p<0.05. Results: All animals survived the experiments. There were no abscesses, fistulas and macroscopically detectable dehiscences in the anastomosis site. The weight of the animals on the 7th postoperative day showed a statistically significant difference (p<0.001) between the control (253.6±6.3g) and corticoid (221.6±15.4g) groups, as well as between the corticoid +. hyaluronic acid group (257.8±9.7g) and corticosteroids (221.6±15.4). There was no significant difference in the comparison between the control and corticoid + hyaluronic acid groups (p>0.05). In the analysis of intraluminal pressure of colonic anastomosis, there was a statistically significant difference when comparing groups 1 (286.8±9.9 mmHg) and 2 (155±6.0 mmHg), 1 (286.8±9,9 mmHg) and 3 (199.1±7.7) and 2 (155±6.0 mmHg) and 3 (199.1±7.7), with p<0.001 for all comparisons. Histopathological classification by the numerical scale: Group 1 - inflammatory response (H-E) grade 3 and collagen deposition by Masson Trichomic grade 1; Group 2 - inflammatory response (H-E) grade 4 and deposition of collagen and fibroblasts by Masson's Trichrome grade1\2; Group 3 - inflammatory response (H-E) grade 3 and deposition of collagen and fibroblasts by Masson's Trichrome grade 1\2. There was no significant difference between groups. Conclusion: The topical use of hyaluronic acid has a positive influence on the initial healing phase of colonic anastomosis in rats treated with systemic corticosteroid.

The effect of haemodilution on blood/biomaterial contact-mediated CD11b expression on neutrophils: ex vivo studies

Perfusion ◽  
2003 ◽  
Vol 18 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Terence Gourlay ◽  
Ioannis Samartzis ◽  
Kenneth M Taylor
Keyword(s):  
Inflammatory Response ◽  
Surface Area ◽  
Neutrophil Activation ◽  
Cd11b Expression ◽  
Group 4 ◽  
Priming Volume ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Modern cardiopulmonary bypass (CPB) systems are getting smaller, both in terms of the exposed surface area of biomaterials and the priming volume. In a series of studies utilizing a rat recirculation model, we demonstrated that the magnitude of the inflammatory response seen under these conditions is proportional to the surface area of exposed material, a finding that supports the use of miniature systems in terms of moderating the inflammatory response. However, the second impact of miniature perfusion systems, the reduced priming volume with concomitant reduction in haemodilution, was not investigated with reference to inflammation. The present study was designed to determine whether this change in CPB haematocrit profile has any effect on the inflammatory response. In common with previous studies by this group, we employed the expression of the integrin CD11b on neutrophils as a marker of neutrophil activation, and hence the inflammatory response, in a rat recirculation biomaterial testing model, containing di-(2-ethyl-hexyl)-phthalate plasticized polyvinyl chloride of the type commonly employed in CPB circuits. The results demonstrated that neutrophil activation is influenced by haemodilution. We studied five groups of animals, each with different mean induced haematocrit: Group 1 (41.39 /1.27%); Group 2 (30.939 /2.85%); Group 3(24.839 /1.36%); Group 4 (20.609 /3.47%); Group 5(20.489 /1.31%). Groups 1 and 5 animals were controls, neither of which underwent the period of recirculation. Rather, these controls were employed to isolate the noncontact effect of haemodilution on CD11b expression. We found that there were differences in per cent change in CD11b expression from start to end of the recirculation period between Group 1 (109.549 /49.53%), Group 2(189.19 /18.68%), Group 3 (224.289 /43.97), Group 4(368.979 /24.28%) and Group 5 (1279 /57.8%). There were intergroup statistically significant differences (p B /0.05). These results confirm that there is a relationship between haematocrit level and biomaterial contact-mediated activation of neutrophils. Furthermore, these studies confirm that haemodilution alone has no effect on neutrophil activation. One possible explanation for this outcome is that with higher levels of haemodilution, neutrophils have a greater opportunity to contact surface ‘receptor’ sites on the biomaterial, resulting in more neutrophil activation. Whatever the mechanism, these data tend to support the modern trend towards lower circuit surface area and higher haematocrit.

scholarly journals COVID-19, inflammatory response, iron homeostasis and toxicity: a prospective cohort study in the Emergency Department of Piacenza (Italy).

2021 ◽  
Author(s):  
Lorena Duca ◽  
Isabella Nava ◽  
Daniele Vallisa ◽  
Giovanni Battista Vadacca ◽  
Andrea Magnacavallo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Inflammatory Response ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Transferrin Saturation ◽  
Short Period ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Dysregulation of iron metabolism and hyper-inflammation are two key points in the pathogenesis of coronavirus disease 2019 (COVID-19). Since high hepcidin levels and low serum iron can predict COVID-19 severity and mortality, we decided to investigate iron metabolism and inflammatory response in 32 COVID-19 adult patients with a diagnosis of COVID-19 defined by a positive result of RT-PCR nasopharyngeal swab, and admitted to an Italian emergency department for acute respiratory failure at different degree. Patients were stratified in 3 groups based on PaO2/FiO2 ratio at admission: 13 (41%) were normoxemic at rest and suffered from exertional dyspnea (group 1); 14 (44%) had a mild respiratory failure (group 2), and 5 (15%) a severe hypoxiemia (group 3). White blood cells were significantly higher in group 3, while lymphocytes and hemoglobin were significantly reduced. Serum iron, transferrin saturation, non-transferrin-bound iron (NTBI) and ferritin were significantly increased in group 2. All the groups showed high hepcidin levels, but in group 3 this parameter was significantly altered. It is noteworthy that in group 1 inflammatory and oxidative indices were both within the normal range. We are aware that our study has some limitations, the small number of enrolled patients and the short period of data collection, but few works have been performed in the Emergency Room. However, we strongly believe that our results confirm the pivotal role of both iron metabolism dysregulation and hyper-inflammatory response in the pathogenesis of tissue and organ damage in COVID-19 patients.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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