scholarly journals A Novel Fragmentation Sensitivity Index Determines the Susceptibility of Red Blood Cells to Mechanical Trauma

2021 ◽  
Vol 12 ◽  
Author(s):  
Elif Ugurel ◽  
Evrim Goksel ◽  
Polat Goktas ◽  
Neslihan Cilek ◽  
Dila Atar ◽  
...  
Keyword(s):  
Mechanical Damage ◽  
Accurate Method ◽  
Critical Parameters ◽  
Mechanical Trauma ◽  
Control Group ◽  
Sensitivity Index ◽  
Shear Stresses ◽  
Close Monitoring ◽  
Fragmentation Sensitivity ◽  
Rbc Deformability

Supraphysiological shear stresses (SSs) induce irreversible impairments of red blood cell (RBC) deformability, overstretching of RBC membrane, or fragmentation of RBCs that causes free hemoglobin to be released into plasma, which may lead to anemia. The magnitude and exposure tisme of the SSs are two critical parameters that determine the hemolytic threshold of a healthy RBC. However, impairments in the membrane stability of damaged cells reduce the hemolytic threshold and increase the susceptibility of the cell membrane to supraphysiological SSs, leading to cell fragmentation. The severity of the RBC fragmentation as a response to the mechanical damage and the critical SS levels causing fragmentation are not previously defined. In this study, we investigated the RBC mechanical damage in oxidative stress (OS) and metabolic depletion (MD) models by applying supraphysiological SSs up to 100 Pa by an ektacytometer (LORRCA MaxSis) and then assessed RBC deformability. Next, we examined hemolysis and measured RBC volume and count by Multisizer 3 Coulter Counter to evaluate RBC fragmentation. RBC deformability was significantly impaired in the range of 20–50 Pa in OS compared with healthy controls (p < 0.05). Hemolysis was detected at 90–100 Pa SS levels in MD and all applied SS levels in OS. Supraphysiological SSs increased RBC volume in both the damage models and the control group. The number of fragmented cells increased at 100 Pa SS in the control and MD and at all SS levels in OS, which was accompanied by hemolysis. Fragmentation sensitivity index increased at 50–100 Pa SS in the control, 100 Pa SS in MD, and at all SS levels in OS. Therefore, we propose RBC fragmentation as a novel sensitivity index for damaged RBCs experiencing a mechanical trauma before they undergo fragmentation. Our approach for the assessment of mechanical risk sensitivity by RBC fragmentation could facilitate the close monitoring of shear-mediated RBC response and provide an effective and accurate method for detecting RBC damage in mechanical circulatory assist devices used in routine clinical procedures.

Cluster of erythrocyte band 3: a potential molecular target of exhaustive exercise-induced dysfunction of erythrocyte deformability

2013 ◽  
Vol 91 (12) ◽  
pp. 1127-1134 ◽  
Author(s):  
Yanlian Xiong ◽  
Yaojin Li ◽  
Yanlei Xiong ◽  
Yajin Zhao ◽  
Fuzhou Tang ◽  
...  
Keyword(s):  
Band 3 ◽  
Exhaustive Exercise ◽  
Control Group ◽  
Shear Stresses ◽  
Control Groups ◽  
Exercise Induced ◽  
And Function ◽  
And Control ◽  
Insight Into ◽  
Rbc Deformability

The aim of this study is to explore the effect of exhaustive exercise on erythrocyte band 3 (SLC4A1; EB3). The association between the alterations of EB3 and red blood cell (RBC) deformability induced by exercise-induced dysfunction has been investigated. Rats were divided among 2 groups: (i) control (C), and (ii) exercise exhausted (E). RBC deformability was investigated in the rats in the exhaustive exercise and control groups. Erythrocytes from the control and exercise-exhausted groups were evaluated for the expression of erythrocyte band 3 through immunoblotting and immunofluorescence studies. Exhaustive exercise led to significant increments in the levels of clustering of erythrocyte band 3 along with the conjugation of membrane proteins to form high-molecular-weight complexes (P < 0.05). Under shear stresses, RBC deformability was found to decline significantly in the exhaustive exercise groups compared with the control group. These data suggest that the RBC dysfunction observed during exercise-induced oxidative stress could be associated with alterations in the structure and function of erythrocyte band 3, which in turn leads to dysfunction in the rheological properties of RBCs. These results provide further insight into erythrocyte damage induced by exhaustive exercise.

scholarly journals Improvement of the heart failure patient process for the prevention of new events through tele-education and continuous tele-optimization of the treatment by nursing staff

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Perez Serrano ◽  
CNP Carlos Nicolas Perez Garcia ◽  
DEV Daniel Enriquez Vazquez ◽  
MFE Marcos Ferrandez Escarabajal ◽  
JDD Jesus Diz Diaz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Randomized Study ◽  
Primary Objective ◽  
Control Group ◽  
Close Monitoring ◽  
Chronic Patients ◽  
Face To Face ◽  
Funding Sources

Abstract Funding Acknowledgements Type of funding sources: None. Introduction patients with heart failure (HF) are especially vulnerable to SAR-CoV-2 infection especially due to their worse prognosis for this disease. Purpose to demonstrate that patients with HF will present similar health outcomes if their education and pharmacological treatment is optimised remotely by a nurse rather than through conventional care. Methods  A single-centre, observational, prospective, non-randomized study was carried out in which two groups were compared. The experimental group had most of their care provided virtually by a nurse who could optimise their medication according to the clinical guides whilst the control group received conventional face-to-face care. During a follow-up period of 6 months, patients included in the study have an initial face-to-face consultation with a cardiologist and an evaluation of the patient where the treatment objectives are established. The rest of the follow-ups were done through videoconsultation with the nurse every 15 days for 6 months where the neurohormonal treatment was optimized and an educational program was carried out with different cardiovascular educational topics. Results   Thirty-seven patients have been included. Sex: 30 men (81.0%) and 7 women (19.0%) Mean age: 67.9 years (12.8). Range 42-87 years. Etiology: 61.2% ischemic and 38.8% non-ischemic mean LVEF at inclusion = 30.2%. A total of 17 patients have completed the study: a 13% average improvement of FEVI, a reduction of NT-proBNP of and improvement in functional heart failure class. The primary objective was to compare the proportion of neurohormonal drugs prescribed, as well as the mean of the maximum doses reached in each after 6 months of follow-up, as well as mean ejection fraction, NYHA class and mean NT-proBNP (Table 1) Conclusions Telemedicine offers us valuable tools that allow us to take care of chronic patients, reducing exposure to the virus as much as possible. Efficient use of virtual tools and human resources makes close monitoring possible. Specialized nursing is a key element in the education, pharmacological optimization and monitoring of these patients. Parámetros analíticos Valores iniciales Valores finales NT-proBNP ( pg/mL) 3469,7 (± 4057,3) 1446,4 (± 1305,2) Creatinina (mg/dL) 1,10 (± 0,24) 1,12 (± 0,39) TFG (mL/min/1,73m2 ) 65,4 (± 21,2) 62,7 (± 23, 6) Potasio (meq /L) 4,5 (± 0,5) 4,6 (± 0,4) Fevi 29,4 % (± 7,2) FEVI 42,7 % (± 9,6)

scholarly journals Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system

2018 ◽  
Vol 47 (2) ◽  
pp. 754-764 ◽  
Author(s):  
Ebtisam A. Al-ofi ◽  
Hala H. Mosli ◽  
Kholoud A. Ghamri ◽  
Sarah M. Ghazali
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Advice ◽  
Control Group ◽  
Close Monitoring ◽  
Pregnancy Weight Gain ◽  
Glucose Levels ◽  
Pregnancy Weight

Objectives The purpose of this study was to investigate the effect of remotely delivered telemedicine dietary advice on monitoring of blood glucose levels and weight gain of women with gestational diabetes mellitus (GDM). Methods Women with GDM were recruited and randomly allocated into two groups: a Tele-GDM group that received a telemonitoring device, and a control group that was followed-up traditionally. A telemonitoring service calculated the ratio of reaching or exceeding the pregnancy weight gain target (according to pre-pregnancy weight), following Institute of Medicine guidelines for healthy pregnancy weight gain. Results The sample comprised 27 women in the Tele-GDM group and 30 in the control group. At the end of pregnancy, the Tele-GDM group showed significantly lower 2-hour postprandial glucose levels than the control group. Most women in the Tele-GDM group reached their recommended range of weight gain at the end of pregnancy. Additionally, the Tele-GDM group showed significantly lower weight gain than the control group. Conclusions Telemonitoring can facilitate close monitoring of women with GDM and motivate patients to adopt a healthy lifestyle.

scholarly journals Catalase activity as signal of antioxydant system affection under influence of limb ischemia-reperfusion

2021 ◽  
pp. 24-30
Author(s):  
Nataliya Volotovska
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Catalase Activity ◽  
Ischemia Reperfusion ◽  
Limb Ischemia ◽  
Mechanical Injury ◽  
Male Rats ◽  
Mechanical Trauma ◽  
Control Group ◽  
Ischemic Reperfusion

The use of hemostatic tourniquet is a proved means of primary care. However, systemic disorders, as well as ultrastructural, in the area of compression can significantly worsen the condition of the injured organism. The aim. Estimation of catalase level in rats’ liver on the background of modifications of ischemic-reperfusion syndrome to know the severest pathogenic combination for organism. Materials and methods. 260 white adult male rats were divided into 5 groups: control (KG), EG1 – simulation of isolated ischemia-reperfusion syndrome (IRS) of the limb, EG2 – simulation of isolated volumetric blood loss, EG3 – combination of IRS of the limb with blood loss, EG4 – simulation of isolated mechanical injury of the thigh, EG5 – combination of IRS of the limb and mechanical injury. The variability of catalase level in liver was analyzed. Results. It was found that each of the experimental interventions has led to changes of catalase activity in the liver. The most expressed pathological expressions were observed on the 3rd after interventions, when the studied index in EG3 was lower than in EG1 and EG2 in 6,2 times and by 33,1 %. On the 7th day catalase activity in EG3 was in 9,4 times and by 44,5 % times lower than in EG1 and in EG2 data concordantly. The combination of limb ischemia-reperfusion with blood loss in EG3 led to exhausting of liver antioxydant enzyme catalase in the most critical posttraumatic period (day 3). The same, but less significant effect was registered in the group of combination of mechanical trauma with ischemia-reperfusion in EG5. This proved the role of the tourniquet as a factor that complicated the course of traumatic disease due to ischemic reperfusion. Conclusions. In this experiment, founded risk factors of combination of ischemia-reperfusion with heavy blood loss emphasized the importance and particular attention on such widespread method of bleeding tratment, as the imposition of a tourniquet, as in our experiment it triggered risk factors of ischemia-reperfusion. It was shown katalase activity depression respectively to the periods of increasing of lipid peroxydation. There was peculiarity, that on the base of isolated IRS catalase activity was increased in 2,5 times comparely to control group, whereas the hardest depression of it was found on the background of IRS, combined with blood loss – catalase activity was lower, comparely to KG – in 2,5 times. The importance of understanding the suppression of hepatocytes’ antyoxydants is great, as it might help in prevention the development of liver failure or hepatorenal syndrome on the background of limb ischemia-reperfusion.

Primary Cardioprotection Reduces Mortality in Lymphoma Patients with Increased Risk of Anthracycline Cardiotoxicity, Treated by R-CHOP Regimen

Chemotherapy ◽  
2018 ◽  
Vol 63 (4) ◽  
pp. 238-245 ◽  
Author(s):  
Monika Długosz-Danecka ◽  
Alicja M. Gruszka ◽  
Sebastian Szmit ◽  
Agnieszka Olszanecka ◽  
Tomasz Ogórka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Overall Survival ◽  
High Risk ◽  
Cardiovascular Mortality ◽  
Control Group ◽  
Close Monitoring ◽  
Historical Cohort ◽  
Anthracycline Cardiotoxicity ◽  
Clinical Issue ◽  
Increased Risk

Background: Advances in anti-lymphoma therapy prolong overall survival, making late adverse effects, like doxorubicin-related cardiotoxicity, an even more important clinical issue. The effectiveness of cardioprotective strategies with close monitoring, angiotensin-converting enzyme inhibitors and/or β-blockers as well as liposomal doxorubicin are still unconfirmed in clinical practice. Methods: This study evaluated the role of a primary cardioprotection strategy in preventing cardiovascular mortality and heart failure occurrence in non-Hodgkin lymphoma (NHL) patients with a high risk of anthracycline cardiotoxicity. Thirty-five NHL patients were subjected prospectively to ramipril and/or bisoprolol at NHL diagnosis, before implementing doxorubicin-containing regimens. Additionally, patients with a diagnosis of asymptomatic/mild heart failure received the liposomal form of doxorubicin. The clinical outcome and frequency of all serious cardiac events were compared with the results in a historical cohort of 62 high-risk cases treated without primary cardioprotection. Results: NHL patients with a primary cardioprotection strategy did not experience cardiovascular deaths in contrast to the retrospective control group where cardiovascular mortality was 14.5% at 3 years (p < 0.05). Primary cardioprotection also decreased the frequency of new cardiotoxicity-related clinical symptoms (2.8 vs. 24.1%; p < 0.05) and prevented the occurrence of cardiac systolic dysfunction (0 vs. 8.5%, respectively; p < 0.05). Although the study was not planned to detect any survival benefit, it demonstrated a trend towards increased response rates (complete response 82 vs. 67%; p not significant) and prolonged survival (projected 5-year overall survival 74 vs. 60%; p < 0.05) for patients treated with primary cardioprotection. Conclusions: A primary personalized cardioprotection strategy decreases the number of cardiac deaths and may potentially prolong overall survival in NHL patients with increased risk of anthracycline cardiotoxicity.

Long-Term Outcomes of Treatments for Central Precocious Puberty or Early and Fast Puberty in Chinese Girls

2019 ◽  
Vol 105 (3) ◽  
pp. 705-715 ◽  
Author(s):  
Junfen Fu ◽  
Jianwei Zhang ◽  
Ruimin Chen ◽  
Xiaoyu Ma ◽  
Chunlin Wang ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Adult Height ◽  
Central Precocious Puberty ◽  
Critical Parameters ◽  
Control Group ◽  
Target Height ◽  
Height Gain ◽  
Chinese Girls ◽  
Rhgh Treatment

Abstract Context Gonadotropin-releasing hormone analogues (GnRHa) and recombinant human growth hormone (rhGH) have been widely used to treat idiopathic central precocious puberty (CPP) or early and fast puberty (EFP). However, large-scale studies to evaluate the treatment effects on final adult height (FAH) are still lacking. Objective To assess the effects of long-term treatment for CPP/EFP on FAH and its main influencing factors. Design and Setting Retrospective, multicenter observational study from 1998 to 2017. Participants Four hundred forty-eight Chinese girls with CPP/EFP received GnRHa and rhGH treatment (n = 118), GnRHa alone (n = 276), or no treatment (n = 54). Main Outcome Measures FAH, target height (Tht), and predictive adult height (PAH). Results The height gain (FAH–PAH) was significantly different among the GnRHa and rhGH treatment, GnRHa alone, and no treatment groups (P &lt; 0.05; 9.51 ± 0.53, 8.07 ± 0.37, and 6.44 ± 0.91 cm, respectively). The genetic height gain (FAH–Tht) was 4.0 ± 0.5 cm for the GnRHa + rhGH group and 2.0 ± 0.27 cm for the GnRHa group, while the control group reached their Tht. In addition, 5 critical parameters derived from PAH, bone age, and Tht, showed excellent performance in predicting which patients could gain ≥5 cm (FAH–PAH), and this was further validated using an independent study. Conclusions The overall beneficial effect of GnRHa + rhGH or GnRHa on FAH was significant. The control group also reached their genetic target height. Clinicians are recommended to consider both the potential gains in height and the cost of medication.

scholarly journals Measuring the Uniaxial Compressive Strength of Ice

1977 ◽  
Vol 19 (81) ◽  
pp. 213-223 ◽  
Author(s):  
F. D. Haynes ◽  
M. Mellor
Keyword(s):  
Compressive Strength ◽  
Accurate Method ◽  
Conventional Technique ◽  
Circular Cylinders ◽  
Specimen Preparation ◽  
Shear Stresses ◽  
Compression Tests ◽  
Strength Tests ◽  
Polycrystalline Ice ◽  
Measured Strength

AbstractAn attempt was made to develop a simple but accurate method for making compressive strength tests on right circular cylinders. Compliant loading platens were designed to apply uniform normal stress without introducing significant interface radial shear stresses. The compliant platens gave reproducible results that agree well with results obtained by a precise conventional technique. Accurate results were obtained with simple specimen preparation, and with short specimens where the length-to-diameter ratio was less than unity. Platens were made from a rubber-like urethane which was molded in aluminum cylinders to provide lateral restraint. Uniaxial compression tests on cylindrical polycrystalline ice specimens were made to determine the characteristics of the platens. For 21 specimens with ends prepared on a lapping plate to obtain a mirror finish, the measured strength showed a variation of only 13% for length-to-diameter ratios from 0.74 to 2.5, with no systematic trend. Another 21 specimens with length-to-diameter ratios of about 2.35 were tested with various platens and various methods of specimen end preparation. The strength for specimens with saw-cut ends and for those with ends lapped showed very little difference when tested with the rubber platens.

scholarly journals STEP-BY-STEP THERAPY OF INTRACRANIAL HYPERTENSION IN THE ACUTE PERIOD OF SEVERE MECHANICAL TRAUMA IN CHILDREN

2018 ◽  
Vol 22 (6) ◽  
pp. 296-300
Author(s):  
Irina A. Kolykhalkina ◽  
V. G. Amcheslavsky ◽  
T. F. Ivanova ◽  
V. I. Lukyanov ◽  
L. M. Roshal
Keyword(s):  
Intracranial Hypertension ◽  
Intensive Therapy ◽  
Time Frame ◽  
Mechanical Trauma ◽  
Control Group ◽  
Acute Period ◽  
Results Of Treatment ◽  
Treatment Measures ◽  
Group Control Group ◽  
Step Therapy

Aim of the study to improve the results of treatment of children with intracranial hypertension in the acute period of severe mechanical trauma by virtue of the use of the “Protocol of step-by-step therapy” Material and methods. The article is devoted to the problem of intracranial hypertension in children with severe mechanical trauma. An analysis of 148 case histories of children with severe mechanical trauma, including brain trauma hospitalized in an intensive care unit. 27 patients out of 148 were excluded from the inclusion criteria: 6 patients (22.2%) due to the “late” admission (more than 72 hours from the time of injury); 21 patients - (77,8%) due to the persistent condition of atonic coma from the moment of trauma. 121 patients, according to indications, monitored intracranial pressure and intensive therapy of intracranial hypertension. All patients were divided into two groups: one group (the main one - 84 patients), in which the treatment was carried out according to the “Protocol of step-by-step therapy of intracranial hypertension” and approved in the Scientific Research Institute of Emergency Children’s Surgery and Traumatology, characterized by a strict sequence of treatment measures (“steps”), with clear indications for prescribing each subsequent “step” and the time frame for the duration of the “steps” taken; 2 group (control group - 37 patients), in which the treatment was carried out according to existing international guidelines for the management of patients with severe head injury. Conclusion. Comparative evaluation of treatment results showed outcomes of trauma in the main group to be better, including a statistically significantly less mortality rate (p = 0.0002, p < 0.05).

scholarly journals Measuring the Uniaxial Compressive Strength of Ice

1977 ◽  
Vol 19 (81) ◽  
pp. 213-223 ◽  
Author(s):  
F. D. Haynes ◽  
M. Mellor
Keyword(s):  
Compressive Strength ◽  
Accurate Method ◽  
Conventional Technique ◽  
Circular Cylinders ◽  
Specimen Preparation ◽  
Shear Stresses ◽  
Compression Tests ◽  
Strength Tests ◽  
Polycrystalline Ice ◽  
Measured Strength

AbstractAn attempt was made to develop a simple but accurate method for making compressive strength tests on right circular cylinders. Compliant loading platens were designed to apply uniform normal stress without introducing significant interface radial shear stresses. The compliant platens gave reproducible results that agree well with results obtained by a precise conventional technique. Accurate results were obtained with simple specimen preparation, and with short specimens where the length-to-diameter ratio was less than unity. Platens were made from a rubber-like urethane which was molded in aluminum cylinders to provide lateral restraint. Uniaxial compression tests on cylindrical polycrystalline ice specimens were made to determine the characteristics of the platens. For 21 specimens with ends prepared on a lapping plate to obtain a mirror finish, the measured strength showed a variation of only 13% for length-to-diameter ratios from 0.74 to 2.5, with no systematic trend. Another 21 specimens with length-to-diameter ratios of about 2.35 were tested with various platens and various methods of specimen end preparation. The strength for specimens with saw-cut ends and for those with ends lapped showed very little difference when tested with the rubber platens.

scholarly journals SONOGRAPHIC EVALUATION OF FETAL GROWTH IN THE THIRD TRIMESTER OF LOW RISK PREGNANCY: A RANDOMIZED TRIAL

2020 ◽  
Author(s):  
Catarina Policiano ◽  
Jorge Mendes ◽  
Andreia Fonseca ◽  
Joana Barros ◽  
Sara Vargas ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Fetal Growth ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Control Group ◽  
Study Group ◽  
Close Monitoring ◽  
Operating Characteristics ◽  
Vaginal Deliveries ◽  
The Impact

Objective To evaluate the accuracy of 35-37 weeks‘ ultrasound for fetal growth restriction (FGR) detection and the impact of 30th-33rd weeks vs 35th-37th weeks ultrasound on perinatal outcomes. Design A prospective randomized trial Setting Tertiary referral hospital in Portugal. Population Low risk pregnant women Methods We enrolled 1061 women: 513 in the control group (ultrasound at 30th-33rd weeks) and 548 in the study group (with an additional ultrasound at 35th-37th weeks). FGR was defined as an estimated fetal weight (EFW) below 10th percentile. We calculated the overall accuracy of the 35-37 weeks’ ultrasound and compared perinatal outcomes between both groups. Main outcome measure Detection of late FGR Results The ultrasound at 35-37 weeks had an overall accuracy of FGR screening of 94%. Spearman’s correlation coefficient between EFW and birthweight centile was higher for at 35-37 weeks’ ultrasound (ρ = 0.75) compared with 30-33 weeks’ ultrasound (ρ = 0.44). The study group had a lower rate of operative vaginal deliveries (24.4% vs 39.3%, p = 0.005) and cesarean deliveries for nonreassuring fetal status (16.8% vs 38.8%, p < 0.001). For FGR prediction, the area under the receiver-operating characteristics curve of EFW centile at 35-37 weeks’ ultrasound was 0.90 (95% CI, 0.86-0.95). Conclusions A later ultrasound (35-37 weeks) had a higher correlation between EFW and birthweight centiles and was associated with a lower rate of cesarean and operative deliveries for nonreassuring fetal status compared to an earlier ultrasound, which reinforces that antenatal identification of FGR allows close monitoring and appropriate management.

Sign in / Sign up

Export Citation Format

Share Document