5th-7th Day Research Articles

Hand, foot, and mouth disease: could EPs® 7630 be a treatment option? A prospective randomized open-label multicenter clinical study.

Hand, foot and mouth disease (HFMD) is a viral contagious disease of children caused by human enteroviruses (EVs) and coxsackieviruses (CVs). There is no specific treatment option for HFMD. EPs® 7630's anti-infective and immunomodulatory properties have previously been demonstrated in several in vitro and in vivo studies; however, the use of this herbal medicine in children with HFMD has not previously been investigated. This prospective randomized multicenter clinical study included 208 children with HFMD. The diagnosis was made by pediatricians. The patients who were within the first 48 h of symptom onset (according to the first onset of fever and skin findings) were enrolled. The study participants were assigned into 2 groups as EPs® 7630 and control groups. All patients were followed up twice more, 48 h after the first admission and on the 5th-7th day. Another phone evaluation was conducted for those with continued complaints from the previous visit. The median age was 27 (12-112) months. The male-female ratio was 0.98. One hundred thirty one (63%) of 190 patients had no history of household contact. EPs® 7630 group included 94 and control group included 96 patients. A significant difference was found between the groups in terms of complaint scores at the visits made at the 48th h of the treatment and on days 5-7 (p < 0.001). The mean ± SD disease duration of EPs® 7630 users was significantly shorter 6.07 ± 0.70 days (95% CI: 5.92-6.21)] than the control group [8.58 ± 0.94 days (95% CI: 8.39-8.77)] (p < 0.001). Besides, the hospitalization rate among the EPs® 7630 users were significantly lower (p = 0.019). No side effects were observed, except for unpleasant taste, which was reported in 5 patients (EPs® 7630 group). Considering its efficacy and safety profile EPs® 7630 may represent a feasible herbal-based treatment option for children with HFMD. ClinicalTrials.gov, identifier (NCT06353477).

Morphological features of erdometrium for women with reproductive losses on a background chronic endometritis

The objective. Analysis to investigate the morphological features of endometrium in patients without aphids with chronic endometritis. Materials and methods. Conducted a prospective investigation in women with a history of chronic endometritis and infertility. The main group - 100 women of reproductive age with chronic endometritis, the control group - 40 women of reproductive age, with supra-temporal menstruation, with a medical history of history of pregnancy and childbirth. To study the morphological characteristics of endometrium in patients with chronic endometritis, an assessment of the results of endometrial biopsy, viconanization on the 5th-7th day of the menstrual cycle was carried out using an additional aspiration curette Pipelle de Cornier (France). Statistically significant differences were taken as p&lt;0.05. Results. Pathomorphological examination of the endometrium revealed characteristic signs of chronic inflammation - the presence of a large number of plasma cells in the stroma of the endometrium, lymphoid infiltrates near blood vessels and the mouth of glands, unevenly expressed fibrosis of the stroma, sclerotic changes in the walls of spiral arteries. All examinees had two or more morphological signs of chronic endometritis. The most common morphological sign of chronic endometritis in the main group was inflammatory infiltrates, consisting mainly of lymphoid elements, which occurred in 94.0%, respectively, and were absent in patients of the control group (p&lt;0.001). Focal fibrosis of the endometrial stroma covered large areas in the vast majority of women in the main group and accounted for 93.0% (р&lt;0,01). In the stroma of the endometrium, the appearance of capillary-type vessels was noted, the intensity of their development had a strong correlation with the degree of severity of inflammatory changes (r=0.69: p&lt;0.05). Conclusions. A morphological study of the endometrium in patients with infertility, against the background of chronic endometritis, shows that inflammatory changes in the tissues have clear morphological criteria, which are most pronounced on the 5-7th day of the menstrual cycle - the presence of plasma cells, stroma fibrosis, and sclerosis of the vessel walls

Cell-based therapy in thin endometrium syndrome

Of the known causes of uterine factor infertility, Ashermans syndrome or the so-called intrauterine synechia, chronic endometritis and endometrial hypoplastic processes are most often distinguished. Thin endometrial syndrome is characterized by a decrease in the thickness of the endometrium to 7 mm or less in the proliferative phase of the menstrual cycle and a multiple decrease in the frequency of embryo implantation. Numerous treatment strategies have so far been proposed for treating refractory thin endometrium syndrome. Recently, cell therapy has been proposed as an ideal alternative for endometrium regeneration, including the employment of stem cells, platelet-rich plasma, and growth factors as therapeutic agents. Single center, prospective, open-label study of efficacy of cell-based therapy in the complex treatment of thin endometrium syndrome in patients with infertility was conducted. The study involved 36 women aged 28 to 36 years, the middle age was 34.2 1.1 years. All patients included in the study received 3 cycles of intrauterine administration of a suspension of autologous stem cells isolated from bone marrow. Bone marrow was successfully aspirated from the iliac crest in all patients. Mononuclear cells was isolated by density gradient centrifugation according to the standard method. The cell material was cryopreservated and thawed immediately before administration. The procedure for intrauterine transplantation of isolated but not cultured cells was performed on the 5th7th day of the menstrual cycle. There were no significant adverse events related to harvest or administration. The thickness of the endometrium before and after treatment was 2.39 0.64 and 6.56 0.94 mm (t = 21.94, p = 0.0001), respectively. The rate of patients with an endometrial thickness of more than 7 mm after treatment was 77.8%. The effectiveness of assisted reproductive technology in patients with normal endometrial (n = 28) was 32.1%. Immunohistochemistry confirms the presence of chronic endometritis before and after treatment in 22 (61.1%) and 19 (52.8%) patients, respectively, while after treatment a significant decrease in the levels inflammatory markers was found.

Ceftriaxone-associated side effect findings in children’s abdominal ultrasonography

Ceftriaxone is a third-generation cephalosporin, which has a broad spectrum of activity against Gram-negative and Gram-positive bacteria. It can sometimes induce biliary sludge or stone formation because of the interaction with Calcium ions. The aim of this study is to describe the epidemiology of the side effects after the ceftriaxone therapy in hospitalized pediatric patients and to follow up the group of suspected Ceftriaxone-induced adverse effects. Methods: This prospective study was conducted in different Pediatric Services of the University Hospital Center “Mother Theresa”, Tirana, during the period October 2021-March 2022. We studied the ultrasonographic data of 80 patients admitted to these services, who had been on Ceftriaxone therapy. Results: All the females aged from 5-10 years old, and males aged from 6-12 years old, underwent ultrasound examination for other reasons and 21.25% of the cases resulted with pseudolithiasis, while 3.75% with nephrolithiasis. According to the total number of cases, 70.6% of them were asymptomatic. Only 29.4 % of the patients referred right upper quadrant pain and 1 of them showed nausea. The symptoms began from 5th-7th day and last 20 days. The ultrasound imaging performed from 5th- 10th days after Ceftriaxone administration, showed gallbladder sludge and pseudolithiasis in the symptomatic patients, ranged 8-12 mm, and renal microlithiasis &lt;3mm. These patients were followed with ultrasound exam after 1 month. Conclusion: From all pediatric patients treated with Ceftriaxone and followed with ultrasonography, 21.25% resulted with collateral associated gallbladder pseudolithiasis as side effect from ceftriaxone-therapy, found by ultrasonographic evaluation. None of the cases was complicated with gallbladder hydrops, pancreatitis or hydronephrosis. After the Ceftriaxone therapy was discontinued, the condition resolved spontaneously. Key Words: ceftriaxone, gallbladder pseudolithiasis, nephrolithiasis, ultrasound

ГЕНДЕРНЫЕ ОСОБЕННОСТИ СПОРТИВНОЙ ПОДГОТОВКИ КВАЛИФИЦИРОВАННЫХ СПОРТСМЕНОК В БИАТЛОНЕ

Every year the popularity of women in high performance sports, including biathlon, increases. Sports achievements of women and men have not only gender differences. This is due to morpho-constitutional differences (body size, weight, composition and structure of tissues) and individual-psychological (women's reactions are more emotional, hyperreflexive in contrast to men, their reactions are more vivid and richer). The aim of the study was the theoretical substantiation and analysis of gender features of female biathletes determining their sports training. During the theoretical study, it was found that women's adaptation to great physical exertion is closely related to the level of sex hormones. Disturbances in the function of sex glands lead to a decrease in athletic performance. There are two peaks of performance. The first one coincides with the increase in estrogen concentration (2-nd phase, the 5th-7th day of a cycle), the second one progesterone (4th phase, the 16th-18th day of a cycle). A relatively high level of performance is maintained from day 7 to 11 of the cycle (2nd phase of the cycle), as well as from day 19 to 25 (2nd phase of the cycle). Starting from the 12th-15th day the lowest level of efficiency is observed. Practical recommendations are given, determining the training pattern of women biathletes on the basis of their physiological status.

Monitoring of central corneal thickness after phacoemulsification-comparison of statical and rotating Scheimpflug pachymetry, and spectral-domain OCT.

To explore the possibility of deploying three contactless devices (static and rotating Scheimpflug technology, spectral domain optical coherence tomography) for measuring central corneal thickness (CCT) in preoperative and postoperative examinations of cataract patients. Totally 72 patients who had undergone surgery without complications were selected. The CCT was measured prior to the operation, as well as on the first, 5th-7th and 28th day following the operation using the Nidek NT 530-P, Sirius®, and Topcon OCT-2000 devices. A significant postoperative increase and subsequent decrease in CCT was identified with all three devices. The correlations were highly significant and thus reflect a very good degree of comparability at all times with the exception of the rotating Scheimpflug camera. The postoperative results from the latter differed significantly from the other devices. The correlations were Sirius/Topcon (P=0.010) and Sirius/Nidek (P<0.0005). No statistically significant difference could be identified in the comparison between Topcon and Nidek (P=0.056). All three devices are suitable for postoperative monitoring of CCT. The measurement results are only comparable to a limited extent and not interchangeable in the course of treating a single patient. This is due to the different imaging technology used in the devices and the resulting modalities for conducting the measurements.

Associations of Toll-like Receptor Gene Polymorphisms with NETosis Activity as Prognostic Criteria for the Severity of Pneumonia

The aim of the study was to determine the molecular genetic prognostic criteria for the severity of the course pneumonia based on the analysis of the association of genetic polymorphism in toll-like receptors with the severity of NETosis.Materials and MethodsThe study included 38 patients with the main diagnosis of community-acquired pneumonia with a severe course. All the patients underwent standard clinical laboratory examinations, computed tomography of the thoracic organs, microbiological examination of blood and tracheobronchial aspirate. The level of neutrophilic extracellular traps (NETs) in blood smears was determined on the 1st–2nd and 5th–7th days of hospitalization. Genotyping of rs5743551 (TLR1), rs5743708 (TLR2), and rs4986790 (TLR4) polymorphic loci was performed by pyrosequencing.ResultsThe level of NETs on the 1st day of admission was statistically significantly lower in heterozygous and homozygous carriers of rs4986790 (TLR4) polymorphism (AG and GG genotypes) compared with patients with the wild-type genotype (AA genotype) (p<0.05). When comparing the number of NETs with genotypes for rs5743708 (TLR2) and rs5743551 (TLR1) polymorphisms, no statistically significant correlation was found (p>0.05). The study of the NET level in dynamics demonstrated a decrease in the NETosis activity of neutrophils during the first week of hospitalization (p<0.05). The presence of the G allele in the patient’s genotype for rs5743551 (TLR1) polymorphism increases the risk of a poor outcome of the disease (p<0.0001) (OR=20.3; 95% CI (4.3–135.0)).ConclusionThe obtained data suggest that level of NETs is a marker of the activity of neutrophils which are closely related to the studied genetic polymorphisms, and affects the prognosis of the pneumonia outcome.

Morphological particularities and morphometry of rats' kidneys under the effect of experimental mild traumatic brain injury.

Traumatic brain injury (TBI) is one of the most serious problems of modern medicine that plays the dominant role in the morbidity and mortality of population of the economically developed countries. This article presents the findings of the experimental study of the effect of a mild TBI on the morphology of rats' kidney. The experiment was performed on 70 adult white rats 3 months of age. The mild TBI was modelled by the Impact-Acceleration Model - free fall of weight in the parieto-occipital area. For histopathological comparison, the samples were taken on the 1st, 3rd, 5th, 7th, 14th, 21st days after TBI. Examination of the rat's kidney histological slides on the 1st, 3rd, 5th, 7th, 14th, and 21st days after the TBI showed manifested changes in the bloodstream and structural changes in the kidney parenchyma, particularly, dilatation of the capillaries and veins in the initial period. It also showed perivascular lymphocytic infiltration, dystrophic and necrotic processes in the form of the focal destruction of the renal tubule, and renal corpuscles with diapedesis and perivascular haemorrhages on the 5th and 7th days after the TBI. There were also the focal signs of perivascular and glomerular sclerosis observed on the 14th and 21st days after the injury. The greatest changes in the rats' kidneys appear on the 5th-7th days after the injury, which have a clear tendency to decrease after that.

PPARγ enhanced Adiponectin polymerization and trafficking by promoting RUVBL2 expression during adipogenic differentiation.

Adipocyte differentiation is an essential part of adipose tissue development, and is closely related to obesity and obesity-related diseases. In this study, we found that the expression of PPARγ, RUVBL2 and Adiponectin were concurrently obviously increased in the 5th-7th day of 3T3-L1 cell differentiation. PPARγ overexpression or the PPARγ activator facilitated Adiponectin trafficking and secretion and upregulated RUVBL2 expression as well as AS160 phosphorylation during adipogenic differentiation of 3T3-L1 cells. Consistently RUVBL2 overexpression also enhanced the polymerization and secretion of Adiponectin, in contrast, RUVBL2 knockdown reduced Adiponectin secretion. Further, PPARγ significantly enhanced RUVBL2 promoter activity and transcription. The progressive deletions and mutations of RUVBL2 promoter for PPARγ binding sites suggested that the PPARγ binding motif situated at -804/-781bp is an essential component required for RUVBL2 promoter activity. Chromatin immunoprecipitation (ChIP) assays determined that PPARγ can directly interact with the RUVBL2 promoter DNA. Taken together, these data suggest that PPARγ promotes the expression, polymerization and secretion of Adiponectin by activating RUVBL2 transcriptionally, which accelerates 3T3-L1 cell differentiation.

Epidemiologic and Clinical Aspects of Hemorrhagic Fever with Renal Syndrome in the Samara Region

Introduction: Hemorrhagic fever with renal syndrome is the most common zoonosis in the Samara Region accounting for 90% of all zoonotic disease cases annually. Our objective was to analyze current clinical and epidemiologic data on hemorrhagic fever with renal syndrome (HFRS) in the Samara Region. Materials and methods: We conducted an epidemiologic analysis of 1,031 HFRS cases in the Samara Region in 2016–2018. The most epidemically active natural foci of HFRS were the town of Zhigulyovsk with nearby villages, the forest surrounding Samara, and the forest-steppe zone in northeastern areas. The disease was mainly transmitted in the household while cleaning of country houses (34.3%), in the forest (21.0%), suburbs (17.9%), on agricultural grounds (17.3%), in industrial settings (3.4%), and in private fruit and vegetable gardens (1.2%). The majority of HFRS cases (97.7%) were working-age adults. Results: We analyzed the results of clinical examinations of 235 patients treated in the Infectious Disease Clinic of the Samara State Medical University for HFRS of varying severity by disease phases (initial, oliguric, and polyuric). Most patients (68.5%) were admitted to the hospital on the 5th-7th day of the disease (in the beginning of the oliguric phase). The disease was characterized by an acute onset. Hyperthermia with the maximum body temperature of 40.0°C was observed in the initial and oliguric phases (100%), remaining in the phase of polyuria in 58% of severe and 33% of moderate HFRS cases. Upon admission, permanent signs of the disease, especially in severe cases, included intense general weakness, headache, and dry mouth. The headache persisted during polyuria in 68% of the patients. Half of the patients reported lower back pain already at the end of the initial phase (48%) while 93% of cases complained of lumbago during the entire phase of oliguria and the majority – in the polyuric phase (72%). Visual impairment was reported by 52% and 89% of cases with a moderate and severe disease, respectively. The severe clinical course of HFRS was noted for nose and gum bleeding in patients in the initial (about 10%) and oliguric (about 20%) phases.

Intra-abdominal infections: the blood serum interleukin-10 in perioperative period

Objective. To assess the blood serum IL-10 concentration in patients with intra-abdominal infections.&#x0D; Materials and methods. Clinical specimens were obtained from 56 patients, suffering intra-abdominal infections of various origin: 24 patients - with postoperative abscesses, 12 - with primary intra-abdominal abscesses, and 20 - with diffuse or local peritoneal collection at the day before surgical intervention, on 2nd-3rd day and on 5th-7th day after it.&#x0D; Results. There was no trustworthy difference established between the blood serum IL-10 concentrations in patients with different origin of intra-abdominal infections in perioperative period. The significant difference was established, while comparing concentrations of IL-10 in the blood serum in patients with intra-abdominal infections before and on the days 2-3 and 5-7 postoperatively, and in healthy persons.&#x0D; Conclusion. Concentration of the blood serum IL-10 ≥ 6.78 pg/mL in patients with different origin of intra-abdominal infections has significant prognostic significance: sensitivity (92.86%) and specificity (80.65%). Further studies, targeting a specific causative agent of nosocomial infection and the cytokine response, are needed.

Diagnostic value of radiography and ultrasound for suspected acute hematogenous osteomyelitis

Objective:to evaluate the informativeness of ultrasonography and radiography in the early diagnosis of acute hematogenous osteomyelitis in children.Material and methods. Children (from 3 weeks to 1 year old) with suspected acute hematogenous osteomyelitis (n = 40) were examined and X-rays and ultrasound scan of the affected skeleton were performed. 39 (97.5%) of children underwent surgery.Results.Radiography in the first 3 days of the disease gave only false-negative results. On the 5th-7th day of the disease, the fuzziness of the outline of the growth zone, the uneven contour of the ossification core, was found, which resulted in 33% sensitivity. X-ray symptoms of bone destruction were obtained in the second week of the disease in 83% of the subjects.The resultsof ultrasound examination in the first 3 days of the disease exceeded the radiographic parameters and corresponded to 66.7% of sensitivity based on the definition of increased vascularization of edematous parasal soft tissues, epiphyseal cartilage. On the 5th-7th days of the disease, local hyperechoic areas were found in the epiphyseal cartilage, with additional color signals around it, an uneven contour of the ossification nucleus, which almost equalized the sensitivity parameters of X-ray and ultrasound studies (83.33% and 88.8%, respectively).The most sensitive, specific and accurate are the studies in the third week from the onset of the disease, in determining the sites of destruction in the metaphysis and the nucleus of ossification of the epiphysis, both in X-ray and ultrasound studies.Conclusion.X-ray and ultrasound studies should be considered complementary modalities for obtaining optimally complete information about the morphological substrate of the pathological inflammatory process.

Abstract WP130: Comparison of VerifyNow System and Thrombelastography for Assessing Asprin Response in Stroke Patients in China

Objectives: The aim of the study was to compare the consistency of VerifyNow System and thrombelastography (TEG) in stroke patients treated with asprin in China. Methods: Patients hospitalized in Changhai Hospital and Yueyang Hospital with acute ischemic stroke were randomly enrolled into treatment with a 100-mg daily maintenance dose of asprin. Platelet reactivity was evaluated by VerifyNow System (Accumetrics Inc.) and TEG (Hemonetics Corporation) at the same time on the 5th-7th day of asprin treatment. Patients with asprin low response (ALR) were detected by using the methods and criteria published earlier (ARU ≥550 assayed by VerifyNow System or Inhibition% ≤50% measured by TEG). All patients were followed up for 2 years and clinical endpoint was ischemic events, including major adverse cardiac events (MACE), recurrence of stroke, transient ischemic attack (TIA),and the composite of vascular death. Results: Totally 94 patients were enrolled for the study and there were wide varieties in parameters of VerifyNow System and TEG. Results showed a total of 16 and 15 patients, respectively, identified as ALR assessed by VerifyNow System and TEG, but only three patients were detected to be asprin low responders by both tests. The kappa consistency analysis showed poor consistency between VerifyNow System and TEG results in terms of ALR (Kappa = 0.030, p &lt; 0.01). Of the patients recruited, 83 (88.3%) patients were followed up for 2 year and a total of 15 (18.1%) cases of clinical events were observed. There was no correlation between ALR assessed by TEG (TEG-ALR) and the clinical endpoints (P &gt; 0.05), but a significant relevance was found between ALR assessed by VerifyNow System (VerifyNow-ALR) and the ischemic events in 2 years of follow-up (OR adj : 3.13; 95%CI: 1.3-7.55; P = 0.011). Among the risk factors for cerebrovascular disease, we only found stroke history was related to the clinical endpoints (P = 0.005). Conclusions: There was poor correlation between VerifyNow System and TEG in platelet function detection. VerifyNow-ALR and stroke history were risk factors for ischemic events, and VerifyNow System may be available to guide individualized antiplatelet therapies in stroke patients in China.

Pattern of bacterial and fungal pathogen in patients with high risk for invasive fungal disease in an indonesian tertiary care hospital: an observational study.

IntroductionIn critically ill patients, there is a defect in host defense mechanism resulting in increased susceptibility to bacterial and fungal infection. The pattern of organisms causing infections varies between different countries and hospitals; therefore it is important that every hospital generates antibiograms to guide healthcare professionals during treatment with optimal choice of antibiotics. Our study aimed to described the pattern of fungal and bacterial pathogen in patients with high risk for invasive fungal disease (IFD).MethodsAn observational study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, within March-September 2015. Specimens were taken from blood, sputum, endotracheal aspiration, bronchoalveolar lavage (BAL), urine, pus and drainage fluid/surgical tissue specimen on 5th-7th day of hospitalization. Samples were cultured onto suitable culture media and bacterial isolates were identified using standard biochemical methods.ResultsBacteria and Candida sp. were isolated from 153 patients. C. tropicalis (44.31%) was the commonest fungal isolated. Incidence of gram-negative bacteria was higher than gram-positive bacteria. Klebsiella pneumonia was the most common gram-negative bacteria isolated, where as Enterococcus faecalis for gram-positive bacteria.ConclusionCritically ill patients were vulnerable to contracted fungal and bacterial pathogen. Candida non-albicans and Gram-negative bacteria were the most common pathogen detected among critically ill patients with high risk for IFD.

Peculiarities of &lt;i&gt;in vitro&lt;/i&gt; parthenogenesis of unpollinated maize ovaries

The maize line AT-1 is characterized by a hereditary predisposition to parthenogenesis. The aim of this investigation is to study parthenogenetic embryo development in the culture of unpollinated ovaries in vitro. The unpollinated ovaries were explanted in 1, 3, 5, 7, 10, 15 days after the appearance of stigmas from ears. The nutrient medium included mineral components of MS, vitamins, sucrose (9,0%), 2,4-D (2,0 mg/l), agar-agar. The structure of megagametophytes at the time of inoculation of the ovaries and on the 3rd, 7th, 14th, 21th, 28th day of cultivation was studied. The first divisions of unfertilized egg cells were observed on the 5th7th day after appearance of stigmas from ears, independently from whether all this time the ovaries were on the mother plant or they were inoculated into the nutrient medium. The formation of the autonomous abnormal endosperm in some cultivated ovaries was detected. The abnormal endosperm disturbed normal development of the proembryo. As a rule, the ovaries with embryo and endosperm degenerated. In the absence of endosperm, the morphogenesis of parthenogenetic proembryos was carried out in one of two directions in vitro: 1) development of plants by direct embryogenesis; 2) regeneration of plants from numerous embryoids, raised on the surface of globular proembryos. The second direction was prevailed. The culture of unpollinated ovaries can be a promising method of mass haploid regenerants not only in maize, but also in other types of agricultural plants.

Comparison of breast milk composition among lactating women in Latvia

Abstract Although benefits of breast-feeding have been known for a long time and breast milk is considered as ideal nutrition for infants, the composition of breast milk is still being studied, since breast milk differs among mothers and populations, as well as during different times of lactation. Further, no study has been performed among lactating women in Latvia during recent years. The objective of the study was to determine the breast milk composition and influencing factors among lactating women in Latvia in different lactation periods, as well as to compare the results with data from other countries. Fifty breast milk samples were obtained from 44 mothers (on the 5th-7th and 11th-28th day of lactation), whose neonates were treated in the Neonatal Care Unit, Children’s Clinical University Hospital, Rīga. Milk analysis (pH, density, protein, fat, and lactose concentration) was performed in the Latvia University of Agriculture. Breast milk composition among lactating women in Latvia on the 5th-7th lactation day more resembled transitional milk containing a higher amount of protein and a lower amount of fat. The composition of the studied milk samples on the 11th-28th lactation day was comparable to data from other countries. Concentration of lactose was correlated with neonatal weight and not gestational age.

PO-0699 Estimation Of Adhesion Molecules Intrauterine Growth Retardation (iugr) Newborns

<h3>Aim</h3> To investigate the endothelial dysfunction in term newborns with Intrauterine growth retardation (IUGR). <h3>Methods</h3> For this purpose 30 term infants were examined and divided in two groups: control group included 15 healthy newborns, main group-15 infants with IUGR. In order to determine endothelial dysfunction sICAM-1 and sVCAM-1 was detected by Uscn (Life Science Inc., USA) kits in 1st-3rd and 5th-7th days. The Student<i> t</i>-test and the Mann-Whitney test were used for comparison of parametric and non-parametric parameters. <h3>Results</h3> On the1st-3rd day the levels of the both adhesion molecules was higher in main group than the control group. The level of sVCAM in the main group increasing twice in the 5–7 th days became accurate (p?0,05). The level of sICAM-1 in the 5–7 days increased less than control group and was inaccurate by statistic. <h3>Conclusion</h3> Growth of sVCAM-1 in the main group bowth in the 1–3rd days and 5–7 th days indicates ongoing influence of damaging factor. The less increase of sICAM-1 in the main group indicates the reduction of compensator mechanism of immun system in this children.

Utility of Voriconazole Monitoring and Factors Affecting Its Levels in Patients Undergoing Hematopoietic Stem Cell Transplantation. Single Center Experience From India.

AbstractAbstract 3035 Background:Voriconazole (vori) is used for prophylaxis against fungal infections in BMT. Under and over-dosing of vori may influence the efficacy and safety of therapy, respectively. There is large variability in vori exposure following standard dose administration. Utility of Therapeutic Drug Monitoring (TDM) of vori in patients with invasive mycoses has been demonstrated and recommended that trough concentrations should be maintained between 1–5.5 μg/mL. Based on these observations we started TDM of vori in BMT patients at our centre to target trough plasma concentration of 1–6 μg/mL. Few reports are available on the TDM of vori in BMT. We report our experience. Methods:All patients (autologous-65, allogeneic-64) who received vori prophylaxis during peritransplant period between September 2008 and January 2012 were included. Vori prophylaxis was started atleast 3 days prior to start of conditioning regimen in all patients before April 2011. Since April 2011, patients undergoing autologous transplant received vori 1 day after completion of chemotherapy. All patients above 12 years received oral loading dose of 6 mg/kg (upto maximum of 400 mg) 12 hourly on first day followed by 4mg/kg as maintenance. Intravenous dosing was used if patients had severe mucositis or developed febrile neutropenia. Patients less than 12 years received 7mg/kg 12 hourly continuously. Vori levels were measured on 5th-7th day after start of loading dose. Subsequent levels were done 2– 4 weekly till discontinuation of drug. If first level was < 1 or > 6 μg/ml, each dose was increased or decreased by 50% respectively and levels repeated after a week. Vori was continued for at least 100 days for all patients undergoing allogeneic transplant and longer if patients were on steroids due to graft vs host disease. Autologous transplant patients received it for 28 days. Incidence of breakthrough fungal infection was recorded as definite (blood culture positivity or histological evidence), probable (CT scan evidence with positive fungal PCR or galactomannan positivity) or possible (CT evidence only). Demographic and laboratory factors affecting the levels evaluated were age, sex, height, weight, body surface area (BSA), liver and renal function parameters. Concomitant drugs being used were recorded for any effect on vori levels. Vori levels in plasma were determined by a validated HPLC assay. Paired samples were compared using t-test or Wilcoxin sign rank test. Influence of covariates on vori levels were analyzed by linear regression with backward elimination. Interaction between concomitant drugs and their effects on vori levels was determined by ANCOVA after adjusting for baseline values. Results:One hundred twenty-nine patients were monitored during this period. The median age was 24.6 years. The median number of TDM was 3 (1–32) per patient. High inter and intra-patient variability was observed (coefficient of variation = 73% and 45% respectively). Twenty-eight patients (21.7%) had trough levels < 1 μg/mL after the first monitoring. Twenty-one patients had their dose modified after first monitoring (16 due to very low levels and 5 due to high levels). Thirteen (80%) patients achieved target trough concentration after dose escalation. Dose reduction resulted in sub-optimal levels in 3 of 5 patients. Twenty – four patients who had adequate levels at first TDM had fall in level below 1 μg/mL subsequently during the 2nd or 3rd TDM. This coincided with the introduction of steroids for treatment. Introduction of steroids significantly reduced vori trough levels (presteroid mean- 2.67 μg/ml, post steroid mean- 1.47μg/ml; P=0.014).Similarly use of cyclosporine (CSA) also significantly decreased vori levels (pre CSA mean-2.65μg/ml, post CSA mean-1.91μg/ml; P=0.023). The effect of steroids and CSA on vori levels were independent of each other. None of the demographic or laboratory parameters influenced vori levels. Breakthrough fungal infections were seen in 5 patients (definite-1, probable-3, possible-1). Conclusions:Voriconazole level monitoring should be done in all patients who are on steroids and CSA post transplant. No demographic or laboratory parameter affected voriconazole levels in our study. Incidence of breakthrough fungal infection is low in patients who are monitored with drug levels. Disclosures:No relevant conflicts of interest to declare.

Efficacy Study of Nasal Irrigation after Radiofrequency Tissue Volume Reduction for Inferior Turbinate Hypertrophy: An Equivalence Randomized Controlled Trial

To determine the benefits of nasal irrigation after radiofrequency tissue volume reduction (RFTVR) for inferior turbinate hypertrophy (ITH) in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry. An equivalence randomized controlled trial was performed at the Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. Seventy-nine subjects with ITH planned for RFTVR were enrolled consecutively. The intervention was randomized into two groups: with and without nasal saline irrigation. Primary outcome was visual analog scale (VAS; 0-10) of postoperative nasal obstructive symptoms. Rhinorrhea, pain, nasal itching and sneezing, foul odor, bleeding, crusting and discharge, and patient satisfaction were self-assessed by the patients. Findings from endoscopic nasal examination and acoustic rhinometry (total nasal volume and cross-sectional area 2 [CSA2]) were performed before and after the intervention by blinded assessors. The study revealed no difference of nasal obstruction and other symptoms between the saline group and the control group on the 1st postoperative week, except nasal itching and sneezing. The saline group had itching and sneezing symptoms lower than the control group on the 5th-7th postoperative day. All patients had minimal or no postoperative nasal bleeding. There were also no differences of satisfaction and acoustic rhinometry findings between both groups. The nasal irrigation with normal saline had no additional benefits after RFTVR for ITH in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry except nasal itching and sneezing symptoms.

Regional short-term climate variations influence on the number of visits for renal colic in a large urban Emergency Department: results of a 7-year survey

The pathogenesis of renal stones is an intricate process and varies widely depending on the composition of stones. There is also a marked geographic variability, strongly attributable to the mean annual temperature (MAT) and, to a lesser extent, on the seasons. Previous investigations report peaks in Emergency Department (ED) visits for renal colic during the summer. The aim of the present investigation is to assess the influence of day-by-day climate changes on the number of visits due to renal colic in our ED (city of Parma, located in the Po river valley, with a temperate continental climate). A total of 8,168 colic episodes were retrieved from our database during a period of 2,557 days (from 1 January 2002 to 31 December 2008). Over the same period 557,990 patients were admitted to our ED, renal colic visits representing 1.46% of the total. The linear regression analysis fitting the mean number of colic visits per day and the mean daily temperature displays a very high and significant correlation (R = 0.88, p < 0.0001). A multiple linear regression analysis between the mean temperature of each of the 30 days preceding the colic episode also shows strong correlations, being the strongest on the 5th-7th days (R = 0.80, p < 0.0001 on the 6th day before the colic episode), and a weaker but highly significant correlation on days 14 (R = 0.77, p < 0.0001) and 20 (R = 0.70, p < 0.0001) before the colic episode. Taken together, these findings suggest a kind of "acceleration" process of stone formation caused by the hot climate and, perhaps, by dietary variations during the summer. This process might trigger a sudden growth of the stone and, finally, the resulting clinical episode.