scholarly journals Pathogenetic substantiation of preterm births prevention methods

2021 ◽  
Keyword(s):  
Preterm Birth ◽  
T Lymphocytes ◽  
Connective Tissue ◽  
Clinical Signs ◽  
Simultaneous Increase ◽  
Pronounced Increase ◽  
Group Iii ◽  
Healthy Pregnancy ◽  
Group I ◽  
Group Ii

The study of the pathogenesis of premature birth is one of the important issues of modern obstetrics. This could contribute developing a scientifically sound program for predicting and preventing this complication of pregnancy. The aim of the study was to investigate the blood variables of the immune system and connective tissue metabolism in women with preterm birth at 23-36 weeks of gestation. Materials and methods. A total of 227 pregnant women were examined, 190 of whom had clinical signs of threatened preterm birth. Group I included 48 women with a threatened preterm delivery resulted in childbirth between 23 and 27 weeks. In group II, 142 women at risk of preterm birth were observed from 28 to 36 weeks. Group III included 37 women with a healthy pregnancy, completed at 38-41 weeks. Result. The number of lymphocytes and their subpopulations, the content of connective tissue metabolites in the blood of the examined patients were studied. In women of group, I relatively to women of group III there was an evident (p < 0.001) decrease in blood level of CD3 + -marker of T-lymphocytes by an average of 23 %, which suggests the presence of immunodeficiency and considered as a stress response. In women with preterm birth at 28-36 weeks of gestation (group II), the relative level of CD3 + in the blood, on the contrary, slightly but probably (p = 0.014) increased compared to women with healthy pregnancy by an average of 13%. A significant decrease in the immunoregulatory index in women of group I is associated with the suppression of the T-helper component and emphasizes the presence of T-cell immunosuppression. The decrease in the index in women of group II occurred due to cytotoxic T-lymphocytes. Сonclusions. Thus, the work confirms the opinion of R. Romero on the role of immune "rejection" in the third trimester, associated with the HLA-incompatibility of mother and fetus. In women of group I, compared with women of group III, there was a more pronounced increase in serum free oxyproline - a marker of collagen breakdown than bound oxyproline - a marker of collagen synthesis. Group II women also had a simultaneous increase in the level of the two oxyproline fractions, but more pronounced for the protein-bound fraction. This suggests that the violation of the metabolism of connective tissue leads to the destruction of the collagen matrix of the cervix and its shortening. Studies suggest that cerclage or insertion of pessary should be used to prevent cervical incompetence in the second trimester due to metabolic disorders in the connective tissue. The use of progesterone is appropriate for prevention of "short cervix" syndrome, as well as the possible immunosuppressive effect of the latter. The established signs of autoimmune processes require screening for antiphospholipid syndrome and the appointment, if confirmed, of anticoagulants.

scholarly journals Increasing efficiency of preterm birth prediction

2021 ◽  
Keyword(s):  
Preterm Birth ◽  
Confidence Interval ◽  
Blood Serum ◽  
Preterm Labor ◽  
Group Iii ◽  
Healthy Pregnancy ◽  
Group I ◽  
Combined Use ◽  
Group Ii ◽  
Plgf Ratio

Abstract. The disturbed placentation in a certain way plays an important role in the pathogenesis of great obstetric syndromes. Therefore, the possibility of using biochemical indicators of the level of placental growth factor (PlGF) and fms-like tyrosine kinase (sFlt-1) for predicting preterm labor is of great interest. The aim of the study was developing criteria for predicting preterm labor based on the combined use of ultrasound cervicometry and the concentration of PlGF and sFlt-1. Materials and methods. A total of 227 pregnant women were examined, 190 of whom had preterm birth. Group I included 48 women whose pregnancy completed at 23 to 27 weeks. In group II, 142 women with prematurity in terms of 28 to 36 weeks were observed. Group III included 37 women with a healthy pregnancy, which completed at 38–41 weeks. All patients involved in the study underwent ultrasound cervicometry on a Voluson 730 (GE Healthcare, USA) at 16 weeks, and also the concentration of PlGF and sFlt-1 in blood serum by electrochemiluminescence immunoassay using a Cobas e411 analyzer was studied (Roche diagnostics, Switzerland). Results. The study revealed a significant (p < 0.001) decrease in the average concentration of PlGF in the blood serum by 65 % associated with an increased level of sFlt-1 by 93% in women with early termination of pregnancy – 23–27 weeks (group I) in relation to women with a healthy pregnancy. In women with preterm birth at 28–36 weeks of gestation (group II), a similar trend of changes was observed: the PlGF level significantly (p = 0.014) decreased on average by 68 % in relation to women with a healthy pregnancy. In women of group I, the value of the sFlt-1 / PlGF ratio exceeded (p < 0.001) the values of patients in group III by 14 times. But an even more pronounced imbalance of angiogenic factors was observed in women of group II – on average 16 times. Two main markers were used to predict premature birth: shortening of the cervix according to ultrasound cervicometry data of less than 30 mm, as well as the sFlt-1/PlGF ratio of more than 50 conv. units. The odds ratio (OR) of preterm birth in the case of using only the length of the cervix was 34,133 (95 % confidence interval – 12.308–94.660). OR in the case of combined use of cervicometry data and angiogenesis variables was 148.750 (95 % confidence interval – 33.243–665.593). Conclusion. Thus, the use of an additional biochemical marker significantly improved the accuracy of preterm labor prediction.

scholarly journals EPIDEMIOLOGY OF THE PREVALENCE OF PHENOTOPIC SIGNS UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA SYNDROME IN WOMAN WITH MISCARRIAGES

2021 ◽  
Vol 74 (4) ◽  
pp. 880-883
Author(s):  
Tunzala V. Ibadova ◽  
Volodymyr V. Maliar ◽  
Vitalii V. Maliar ◽  
Vasyl V. Maliar
Keyword(s):  
Preterm Birth ◽  
Connective Tissue ◽  
Pregnant Women ◽  
Premature Birth ◽  
Control Group ◽  
Cervical Insufficiency ◽  
Group I ◽  
Therapeutic Measures ◽  
Connective Tissue Dysplasia ◽  
Group Ii

The aim: Study of the relationship between cervical insufficiency and dysplastic stigma in miscarriages. Materials and methods: 80 pregnant women were examined at 23-27 weeks of gestation.) Group I included 40 pregnant women with the threat of premature birth, with habitual miscarriage and correction of cervical insufficiency (CI) by using pessary in the anamnesis. Group II consisted of 20 pregnant women with the threat of premature birth and correction of CI by using pessary without the burden of habitual miscarriage, the control group of 20 almost healthy pregnant women. Results: The studies revealed phenotypic signs of dysplastic stigmatization in 39 (97.5 + 2.5%) pregnant women of group I, in 18 (90.0 + 6.9%) group II and in 4 (20.0 + 9.2%) control, which indicates a high prevalence of connective tissue dysplasia in women with CI, which also has a laboratory reflection in the form of increased excretion per day of oxyproline and a decrease in total glycosaminoglycans in both groups at risk of preterm birth. Conclusions: The most common gestational complication in women with connective tissue dysplasia is the risk of premature birth. Improving existing and finding new diagnostic and therapeutic measures for women with UDСTD will reduce the risk of preterm birth.

scholarly journals DIAGNOSTIC CRITERIA FOR UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA IN PATIENTS WITH ARTERIAL HYPERTENSION

2020 ◽  
pp. 49-54
Author(s):  
Ye. H. Zaremba ◽  
N. O. Rak ◽  
O. V. Zaremba ◽  
O. V. Zaremba-Fedchyshyn ◽  
M. M. Virna ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Arterial Hypertension ◽  
Control Group ◽  
Severe Dysplasia ◽  
Moderate Severity ◽  
Group Iii ◽  
Group I ◽  
Connective Tissue Dysplasia ◽  
Group Ii

The aim – to improve the diagnosis efficiency of patients with arterial hypertension (AH) combined with undifferentiated connective tissue dysplasia (UCTD) based on the study of clinical course, the severity of UCTD external and internal symptoms with determining the levels of IL-1, IL-6, TNF-a, free and general blood oxyproline. Material and Methods. The study implied examination of 90 patients (52 women and 38 men) with AH of stage 2 from first to third degrees with manifestations of UCTD, who were on inpatient treatment in the Cardiology Department of the Lviv City Communal Clinical Emergency Hospital. The mean age of patients was (61.14±2.58) years. Patients were divided into 3 groups depending on the stage and degree of hypertension. Group I (n=16) included patients with hypertension of the first degree, group II (n=35) – with AH of the second degree, group III (n=39) – with AH of the third degree. The control group consisted of 20 patients with hypertension without manifestations of CTD. Patients underwent clinical (checkup, palpation, percussion, auscultation), laboratory (determination of IL-1, IL-6, TNF-a, free and general oxyprolin blood levels) and instrumental studies (ECG, echocardiography, DBPM, ultrasound examination of internal organs and vessels of the lower extremities, ultrasound duplex examination of the carotid and vertebral arteries, radiological examination of the osteoarticular system), consultations of an ophthalmologist, neurologist, traumatologist and dentist. Results. As a result of the study, in the group I of patients (n=16) UCTD of slight degree of severity was revealed in 13 (81 %), of medium degree – in 3 (19 %) persons. In the group II of patients (n=35), UCTD of moderate severity was found in 30 (86 %), severe – in 5 patients (14 %). In the group III of patients (n=39), UCTD of moderate severity was found in 32 patients (82 %), severe – in 7 (18 %). In the study of the level of TNF-a, an increase compared to the control group was detected, particularly, in the group I of patients its level exceeded in 37.4 times, in the group II – in 39.6 times, in the group III – in 46.2 times (p<0.001). IL-1b increased by 2.6-fold (р<0.05) in the group I of patients compared to the control group, 3.1-fold (р<0.01) – in the group II, and by 3.7-fold, that was the foremost (р<0.001), in patients of the group III. In turn, IL-6 in the group I of patients exceeded the indicators of the control group by 4.3 times (p<0.001), in the group II – 4.8 times (p<0.001), in the group III – 5.7 times (р<0.001). The study of the level of free oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded in 6.12 times, in the group II – in 6.81 times, in the group III – by 7.56 times (р<0.01). The study of the general of bound oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded by 6.98 times, in the group II – by 7.79 times, in the group III – by 9.42 times (p<0.01), which indicates an increase in fibrillogenesis and more pronounced destructive and inflammatory processes in connective tissue. Conclusions. Patients with AH of the stage 2 from first to third degrees with manifestations of UCTD have increased levels of IL-1, IL-6 and TNF-a, which are not only sensitive markers of inflammation, but also play an important role in the pathogenesis and progression of vascular lesions, occurrence and destabilization of atherosclerotic plaques and thrombotic vessels occlusion. The determination of blood oxyprolin in patients with hypertension combined with UCTD confirms the presence of CTD, namely the decay of collagen is more pronounced in patients with severe dysplasia.

Meloxicam induced toxicopathology studies in Wistar rats

2019 ◽  
Author(s):  
S. Pramod Bharani ◽  
A. K. Naik ◽  
S. C. Parija ◽  
S. K. Panda
Keyword(s):  
Wistar Rats ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
High Dose ◽  
Dependent Manner ◽  
Group Iii ◽  
Group I ◽  
Anti Inflammatory ◽  
Group Ii ◽  
Dose Dependent

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used class of drugs for treating inflammation and pain. Meloxicam has analgesic, anti-inflammatory and antipyretic properties and is a commonly used NSAID in veterinary practice. The present study was done to evaluate effect of meloxicam on toxico-pathological and hematological parameters in Wistar rats. Eighteen Wistar rats were equally divided into three groups i.e. Group I, Group II and Group III. Group I (negative control) rats received only Normal saline (0.9%) @ 1ml/kg. Group II (Low dose) received meloxicam@ 4 mg/kg B.W. and Group III (High dose) rats received meloxicam@8 mg/kg B.W. orally by gavage for 28 days. Dose-dependent clinical signs and lesions were observed after meloxicam treatment. Kidneys and liver were severely hemorrhagic at the high dose, while intestine and stomach had ulcers and erosions. Hematological values were altered after 28 days of administration. Total Erythrocyte Count (TEC), Packed Cell Volume (PCV), Haemoglobin values were decreased and TLC count was significantly increased in both doses of meloxicam treated groups in a dose-dependent manner. It was concluded that meloxicam caused GIT lesions, nephrotoxicity, hepatotoxicity and variation in the hematological parameters at selected dose and duration.

scholarly journals Duration of carriage and transmission of Yersinia enterocolitica biotype 4, serotype 0:3 in dogs

1994 ◽  
Vol 113 (3) ◽  
pp. 471-477 ◽  
Author(s):  
S. G. Fenwick ◽  
P. Madie ◽  
C. R. Wilks
Keyword(s):  
Yersinia Enterocolitica ◽  
Clinical Signs ◽  
Test Organism ◽  
Negative Control ◽  
Group V ◽  
Group Iii ◽  
Source Of Infection ◽  
Group I ◽  
Group Ii ◽  
Human Infections

SUMMARYHuman infections with pathogenic strains of Yersinia enterocolitica have been linked to contact with dogs excreting these microorganisms. This study examines the carriage and transmission of Y. enterocolitica biotype 4, serotype 03 in dogs. Fourteen 6-month-old cross-bred dogs were separated into 5 groups, 2 containing 4 dogs (I and II) and the others 2 dogs (III-V). Each of the 4 dogs in Group I and 2 of the dogs in Group II were inoculated orally with the test strain. Bacteriological examination of faecal samples showed that dogs can be readily infected and can carry the organism for up to 23 days. The two in-contact dogs in Group II started to shed the test organism after 5 days. Subsequent transfer of these dogs to Group III and those in Group III to Group IV showed that Y. enterocoliticabiotype 4, serotype 03 can be readily transmitted between dogs. At no time did any of the dogs show clinical signs of infection. Group V served as a negative control for the trial. These findings suggest that dogs can carry Y. enterocoliticabiotype 4, serotype 03 asymptomatically and hence might act as a potential source of infection for people.

scholarly journals Pathological conditions in newborns against the background of undifferentiated connective tissue dysplasia in their mothers

2021 ◽  
pp. 25-31
Author(s):  
O.Yu. Chumak ◽  
◽  
A.P. Volokha ◽  
◽  
Keyword(s):  
Connective Tissue ◽  
Mode Of Delivery ◽  
Clinical Signs ◽  
Obstetric Complications ◽  
Moderate Correlation ◽  
Pathological Conditions ◽  
Group I ◽  
Connective Tissue Dysplasia ◽  
Group Ii ◽  
Newborn Children

Undifferentiated connective tissue dysplasia (UCTD) in pregnant women reduces the adaptive capacity of their newborns and is an unfavorable background for the development of certain pathological conditions of the perinatal period. At the same time, information on the spectrum of diseases in children born to mothers with clinical manifestations of UCTD is rather contradictory. Purpose — to study the nature and direction of the correlation between certain pathological conditions in newborns and clinical signs of UCTD in their mothers. Materials and methods. We examined 75 women in labor aged 16 to 44 years old and their 75 newborn children (38 boys and 37 girls) during 2018–2020. The number of girls and boys is approximately the same, the gender difference between children did not affect on the results of the study. The newborns gestational age (GA) was 28–42 weeks, and their birth weight (BW) was 1500–4070 g. Among them there were 51 (68%) full-term, and 24 (32%) — preterm infants. Anthropometric indices (AI), which were used to confirm dolichostenomelia as a UCTD marker, were calculated for mothers and their children. The integral indicator of dolichostenomelia (IID) was determined by summing the standardized values of these coefficients for each mother and child. The presence of neonatal encephalopathy, congenital pneumonia, interventricular septal defect (IVSD), intrauterine growth retardation (IUGR), respiratory distress syndrome, asphyxia at birth, grade I–II of intraventricular hemorrhage (IVH), and necrotizing enterocolitis were taken into account in children. As for mothers, the presence of complications of their pregnancy and labor associated with UCTD was taken into consideration, and in addition, hypermobility of the joints was assessed according to the Beighton scale. Women were divided into two groups: group I (n=45) consisted of women with >1 anthropometric marker of UCTD, group II (n=30) involved mothers who did not have any of these markers. Newborn children were divided into two groups, respectively: group I involved newborns from mothers with signs of UCTD, group II consisted of borned from mothers without signs of UCTD. Results. It was found that mothers with UCTD markers reliably more often had children weighing less than 2500 g (ϕс=0.251; р=0.029). According to the results of the morbidity analysis, it was clarified that children borned from mothers with UCTD manifestations, were more often suffering from congenital pneumonia (ϕс=0.218; р=0.049), IVSD (ϕс=0.241; р=0.037) and IUGR (ϕс=0.31; р=0.029). According to the results of the rank correlation analysis, a direct moderate correlation was established between the presence of progression of varicose veins in women during pregnancy and IID both in them (ρ=0.463; p<0.001) and in their children (ρ=0.369; p=0.001); a similar in degree and direction correlation of >3 UCTD associated obstetric complications with IID of mothers (ρ=0.305; p=0.008) and their children (ρ=0.326; p=0.004) was also found. At the same time, a positive weak correlation was established between mothers' IID and registration of placental dysfunction (ρ=0.231; p=0.046), polyhydramnios (ρ=0.234; p=0.043) in them. As for newborns, their IID had a direct moderate correlation with their mothers' IPD (ρ=0.364; p=0.001), and a weaker correlation with joint hypermobility in their mothers (ρ=0.258; p=0.025) and obstetric ruptures (ρ=0.230; p=0.047). Simultaneously, there were no statistically reliable differences between the groups of children by gender, their GA, age of their mothers and the mode of delivery. Conclusions. Consequently, children borned from mothers with clinical markers of UCTD are more often have low BW (p=0.029); during the neonatal period they have IUGR (p=0.029), congenital pneumonia (p=0.049) and IVSD (p=0.037) more often registered. It should also be noted that integral anthropometric markers of UCTD in newborn children have the most significant correlation with similar markers in their mothers (p=0.001), on the one hand, as well as with the progression of varicose disease in women during pregnancy (p=0.001) and a combination >3 UCTD associated obstetric complications (p=0.004), on the other hand. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, postpartum women, undifferentiated connective tissue dysplasia.

Correlation of Continuous EEG Monitoring with [O-15]H2O Positron Emission Tomography Determination of Cerebral Blood Flow during Balloon Test Occlusion of the Internal Carotid Artery

1998 ◽  
Vol 4 (1) ◽  
pp. 51-55 ◽  
Author(s):  
K.J. Murphy ◽  
T. Payne ◽  
D.A. Jamadar ◽  
A. Beydoun ◽  
K.A. Frey ◽  
...  
Keyword(s):  
Internal Carotid ◽  
Clinical Signs ◽  
Eeg Monitoring ◽  
Group Iii ◽  
Balloon Test Occlusion ◽  
Group I ◽  
Continuous Eeg ◽  
Continuous Eeg Monitoring ◽  
Group Ii ◽  
O 15

The purpose of this paper was to evaluate the utility of continuous electroencephalography (EEG) during balloon test occlusion (BTO) of the internal carotid artery (ICA). Continuous EEG monitoring and [O-15] H2O PET cerebral blood flow (CBF) studies were completed in 34 patients undergoing BTO of the ICA. CBF determinations were obtained as a baseline without carotid occlusion, and following balloon occlusion, with continuous EEG monitoring. Patients were divided into three groups based on clinical and CBF response to BTO. Group I had no clinical signs or symptoms and had a CBF decrease less than 10 ml/100 g/min ipsilateral to the occlusion. Group II had no symptoms but CBF fell to 35 to 25 ml/100 g/min on the occluded side. Group III were clinically unable to tolerate occlusion or CBF fell to less than 25 ml/100 g/min on the occluded side. The results of continuous 21 channel EEG monitoring were assessed at the time of the examination and retrospectively reviewed for changes in the EEG pattern indicative of ischaemia. On the basis of PET CBF, eighteen patients were classified as Group I, four as Group II, and twelve as Group III. EEG evidence of ischaemia was seen in three patients, all members of Group III. Of the three patients, only one patient had clinical signs or symptoms of ischaemia. All four patients in Group II had PET quantitated CBF levels indicating carotid sacrifice should be done with caution or following a presacrifice by-pass procedure, and nine patients in Group III with PET quantitated CBFs below eligibility for carotid sacrifice, were not identified by EEG monitoring. Even when CBF falls below 25 ml/100 g/minute continuous EEG monitoring is insensitive to reduction in perfusion. Reliance upon EEG for detection of cerebral hypoperfusion in interventionl neuroradiological procedures will significantly underestimate ischaemic risk.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  
Keyword(s):  
Fluid Phase ◽  
Anticardiolipin Antibodies ◽  
Dual Reactivity ◽  
Group Iii ◽  
Important Group ◽  
Epitope Specificity ◽  
Glycoprotein I ◽  
Group I ◽  
Group Ii ◽  
Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

Oxygen Fraction Adjustment According to Body Surface Area during Extracorporeal Circulation

2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman
Keyword(s):  
Body Temperature ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Extracorporeal Circulation ◽  
Group Iii ◽  
Oxygen Fraction ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>

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