Blood Withdrawal Research Articles

The Effect of Back Massage Using VCO (Virgin Coconut Oil) on Sleep Quality in the Elderly in Banjar Jambe Working Area of UPTD Puskesmas Utara

Poor sleep quality has physiological and psychological consequences, including weakness, elevated blood pressure, decreased activity, diminished endurance, emotional instability, and withdrawal. Sleep quality can be assessed using the Pittsburgh Sleep Quality Index questionnaire. Many things can be done to improve sleep quality in the elderly, one of which is back massage combined with VCO (Virgin Coconut Oil). This research aims to determine the effect of back massage using VCO (Virgin Coconut Oil) on sleep quality in the elderly. This is a pre-experimental study with a one-group pre-and post-test design. The sample for this study was drawn using a non-probability sampling technique, namely purposive sampling of 28 senior respondents who reported poor sleep quality. In bivariate analysis, the Wilcoxon signed rank test was employed to compare pretest and posttest scores. Based on the results of data analysis using the Wilcoxon Signed Range Test at a significance level of α = 0.05, a p-value of 0.000 < 0.05 was obtained. This shows that there is an effect of back massage using VCO (Virgin Coconut Oil) on sleep quality in the elderly in Banjar Jambe, Region Area of UPTD Puskesmas Kuta Utara. It is hoped that this research can be used for health services, nursing education and the community to overcome sleep disorders in the elderly.

Influence of volatile anaesthetics on haematology and clinical chemistry in ferrets

BackgroundDuring our years of working with ferrets in our laboratory animal facility, we observed that in several healthy young female ferrets, signs of anaemia could be detected during the entry examination although none of the ferrets expressed any clinical symptoms at the time of blood withdrawal. We aimed to compare the influence of inhalation anaesthesia with isoflurane and sevoflurane to restrained, awake ferrets on several blood parameters. After arrival at our facility all ferrets received a hormone chip to subdue oestrus. Routine blood withdrawal was conducted followed by routine blood work including haematology, clinical chemistry and electrolytes. Since the size of the cannula for implementation of the hormone chip is relatively large and the insertion probably quite painful the procedure was always performed during a short inhalation anaesthesia with isoflurane or sevoflurane. In ferrets showing anaemia (haemetocrit below 0.37 l/L, haemoglobin below 11 g/dL), we performed a control blood work (venous blood) the following week. In order to rule out an effect of inhalation anaesthesia on the laboratory results, the blood withdrawal was performed in restraint and awake ferrets without anaesthesia. The study was performed as randomized controlled crossover design.ResultsThirty ferrets were enrolled, and divided in three groups. Comparison of the three methods (isoflurane, sevoflurane or restraint and awake without anaesthesia) of blood withdrawal showed statistically significant (p < 0.05) differences in most haematological parameters (e.g. red blood cell count, haematocrit), clinical chemistry parameters (e.g. total protein, albumin, alkaline phosphatase) and electrolytes (e.g. sodium, chloride and potassium). Restraint ferrets without anaesthesia showed no signs of anaemia. In anaesthetized ferrets, reticulocytes were about four to six times lower compared to ferrets anaesthetized with isoflurane or sevoflurane.ConclusionsThe results of the study suggest that inhalation anesthesia has a significant effect on hematological and biochemical parameters in ferrets. In particular, the detection of anemia in an animal undergoing inhalation anesthesia needs to be contextualized in a clinical setting and in research context.

Withdrawal Signs and Symptoms Among Patients Positive for Fentanyl With and Without Xylazine.

Xylazine is not approved for human use, yet it has emerged as a common adulterant of illicit fentanyl. It is currently unclear whether there is a withdrawal syndrome associated with xylazine and the potential impact of fentanyl coexposure. A retrospective cohort study of patients with opioid use disorder admitted to an inpatient medically monitored withdrawal facility was performed. Patients positive for fentanyl were compared to patients copositive for fentanyl and xylazine. Outcomes were self-directed discharge and completion of treatment. Independent variables included Clinical Opioid Withdrawal Scale (COWS) scores, heart rate, and blood pressure. Associations between individuals with or without xylazine were measured. Among 71 patients admitted for opioid withdrawal management positive for fentanyl, 51.4% were copositive with xylazine. There was no difference detected in average COWS scores (P = 0.12-0.78) or average heart rate (P = 0.33-0.80) between groups. Xylazine copositive patients had higher average systolic blood pressure on days 1 (129.0 vs 123.0, P = 0.01) and 2 (127.9 vs 116.3, P = 0.04) although unclear if clinically meaningful. Individuals copositive for xylazine were less likely to complete treatment (43.2% vs 55.9%, P = 0.23) and more likely to have self-directed discharge (67.6% vs 44.1%; OR, 2.64; 95% CI, 1.0-6.9) although not statistically significant. Among 71 patients admitted for medically monitored withdrawal, individuals who were copositive for xylazine at the time of admission had higher average blood pressure and were more likely to have a self-directed discharge. Additional research is needed to determine the impact of xylazine on withdrawal.

Flow Cytometry Analysis of Tissue Factor Expression in Human Platelets.

A subset of circulating human platelets stores Tissue Factor (TF) intracellularly, the key activator of the blood coagulation cascade and thrombus formation. Upon platelet activation, TF is exposed on the cell membrane, where it binds to FVII, ultimately leading to thrombin generation. Considering that (1) levels of TF-positive platelets increase in various clinical settings, contributing to the patient's prothrombotic phenotype, and (2) different drugs can modulate platelet-associated TF expression, a standardized method for assessing TF-positive platelets is valuable, as its evaluation has been controversial in the past. Here, we outline a protocol for measuring the percentage of TF-positive platelets using flow cytometry in whole blood and platelet-rich plasma (PRP)/washed platelets. This protocol aims to provide detailed instructions for quantifying the percentage of TF-positive platelets by assessing the protein (1) intracellularly in resting conditions, and (2) on the cell surface, in both resting and activated conditions. The first section provides essential information for correctly performing blood withdrawal to ensure that pre-analytical procedures do not affect the results. Next, the protocol focuses on sample preparation and labeling procedures for flow cytometry analysis. Detailed steps for cell stimulation, labeling, fixation, and permeabilization -- where necessary -- are outlined. Finally, instructions for flow cytometry settings to correctly identify the platelet population and analyze TF-positive events are described. Lastly, the method includes the procedure for preparing PRP if TF-positive platelets are to be measured in isolated platelets. Since only a subset of platelets contains TF, it is important to ensure that these platelets are not lost during the centrifugation steps required to obtain PRP.

Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit.

Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. To identify the incidence and risk factors for Central Venous Catheter-Related Thrombosis (CVC-RT) among patients admitted to the Pediatric Intensive Unit. This was a prospective, observational, single-center study that was conducted over 17 months from September 2019 to January 2021 at King Abdulaziz Medical City, Jeddah. Prospective observational study. King Abdulaziz Medical City, a tertiary care center in the western region of Saudi Arabia. Pediatric patients aged 1 to 168 months who were admitted to the PICU and required central line insertion (whether inserted centrally or peripherally) for more than 48 hours were included. Screening for thrombosis was performed within day 4-7 post-line insertion and again on the 14th day. A total of 255 patients were enrolled over 17 months. The incidence rate of CVC-RT was 5.4%. The type of CVC was significantly different between the two groups; in the no thrombosis group, 59.2% had a central line while in the CVC-RT groups, 51.9% had a PIC line (p = 0.027). In a multivariate regression analysis including patients' clinical profile, high D-dimer as baseline and low platelets were both significant risk factors for CVC-RT [adjusted OR = 3.22, CI (1.25-8.28), p = 0.015 and adjusted OR = 7.38, CI (2.18-25.02), p = 0.001], respectively. The current study found that PIC line was associated with an increased risk of CVC-RT, which is congruent with the literature. As children with CVC can have multiple risk factors for developing CVC-RT, it is important to conduct further large prospective studies to identify such factors and decrease the incidence of CVC-RT.

Humanin-G Ameliorates Hemorrhage-Induced Acute Lung Injury in Mice Through AMPKα1-Dependent and -Independent Mechanisms.

Background/Objectives: The severity of acute lung injury is significantly impacted by age and sex in patients with hemorrhagic shock. AMP-activated protein kinase (AMPK) is a crucial regulator of energy metabolism but its activity declines with aging. Humanin is a mitochondrial peptide that exerts cytoprotective effects in response to oxidative stressors and is associated with longevity. Using a mouse model of hemorrhagic shock that mimics the clinical condition of adult patients, we investigated whether treatment with a humanin analog, humanin-G, mitigates lung injury and whether its mechanisms of action are dependent on the catalytic AMPKα1 subunit activation. Methods: Male and female AMPKα1 wild-type (WT) and knock-out (KO) mice (8-13 months old) were subjected to hemorrhagic shock by blood withdrawal, followed by resuscitation with shed blood and lactated Ringer's solution. The mice were treated with PEGylated humanin-G or vehicle and euthanized 3 h post-resuscitation. Results: Sex- and genotype-related differences were observed after hemorrhagic shock as lung neutrophil infiltration was more pronounced in the male AMPKα1 WT mice than the female WT mice; also, the male AMPKα1 KO mice experienced a significant decline in mean arterial blood pressure when compared to the male WT mice after resuscitation. The scores of histological lung injury were similarly elevated in all the male and female AMPKα1 WT and KO mice when compared to the control mice. At molecular analysis, acute lung injury was associated with the downregulation of AMPKα1/α2 catalytic subunits in the WT mice, whereas an increased activation of the signal transducer and activator of transcription-3 (STAT3) was observed in all the vehicle-treated groups. The in vivo administration of humanin-G ameliorated histological lung damage in all the groups of animals and ameliorated mean arterial blood pressure in the male AMPKα1 KO mice. The in vivo administration of humanin-G lowered lung neutrophil infiltration in the male and female AMPKα1 WT mice only but not in the KO mice. The beneficial results of humanin-G correlated with the lung cytosolic and nuclear activation of AMPKα in the male and female AMPKα1 WT groups, whereas STAT3 activation was not modified. Conclusions: In adult age, hemorrhage-induced acute lung injury manifests with sex-dependent characteristics. Humanin-G has therapeutic potential and the AMPKα1subunit is an important requisite for its inhibitory effects on lung leucosequestration, but not for the amelioration of lung alveolar structure or the hemodynamic effects of the peptide.

Response of the nephron arterial network and its interactions to acute hypertension: a simulation.

We simulated the dynamics of a group of 10 nephrons supplied from an arterial network and subjected to acute increases in blood pressure. Arterial lengths and topology were based on measurements of a vascular cast. The model builds on a previous version exercised at a single blood pressure with 2 additional features: pressure diuresis and the effect of blood pressure on efferent arteriolar vascular resistance. The new version simulates autoregulation, and reproduces tubule pressure oscillations. Individual nephron dynamics depended on mean arterial pressure and the axial pressure gradient required to cause blood flow through the arteries. Rhythmic blood withdrawal into afferent arterioles caused blood flow fluctuations in downstream vessels. Blood pressure dependent changes in nephron dynamics affected synchronization metrics. The combination of vascular pressure gradients and oscillations created a range of arterial pressures at the origins of the 10 afferent arterioles. Because arterial blood pressure in conscious animals has 1/f dynamics, we applied an arterial pressure pattern with such dynamics to the model. Amplitude of tubule pressure oscillations were affected by the 1/f blood pressure fluctuations, but the oscillation frequencies did not change. The pressure gradients required to deliver blood to all afferent arterioles impose a complexity that affects nephrons according to their locations in the network, but other interactions compensate to ensure the stability of the system. The sensitivity of nephron response to location on the network, and the constancy of the tubular oscillation frequency provide a spatial and time context.

Point-of-care viscoelastic coagulation monitoring device shows promise for informing resuscitation strategies in a canine hemorrhagic shock model.

To use a point-of-care viscoelastic coagulation monitoring device (VCM-Vet; Entegrion) and traditional tests to assess hemostatic changes during hemorrhagic shock in dogs. 8 healthy, purpose-bred Beagles were enrolled in a hemorrhagic shock model conducted from September through December 2021. Dogs were anesthetized, had baseline hemostatic variables measured after blood pressure was stabilized at 70 to 80 mm Hg for 10 minutes (T1), had blood withdrawn from a jugular vein to achieve a mean blood pressure of 40 ± 5 mm Hg for 10 minutes (T2), were resuscitated with 100% shed blood, and then had hemostatic variables evaluated 10 minutes later (T3). At each time point, hemostatic variables were measured with traditional tests (Hct, WBC count, platelet count, mean platelet volume, prothrombin time, activated partial thromboplastin time [aPTT], and concentrations of fibrinogen, antithrombin, and D-dimer) and the VCM-Vet device (clot time, clot formation time, α-angle, maximum clot formation, amplitude at 10 minutes [A10], amplitude at 20 minutes [A20], clot lysis index at 30 minutes [LI30], and clot lysis index at 45 minutes [LI45]). All dogs survived without complication. At T2 and T3 (vs T1), samples had significantly higher coagulability (increased median α-angle, A10, and A20) and fibrinolysis (decreased median LI30 and LI45) and significantly longer aPTT; however, all values remained within reference limits. The use of VCM-Vet helped identify complex hemostatic disturbances in dogs with hemorrhagic shock. The use of VCM-Vet shows promise in aiding veterinarians in optimizing resuscitation strategies based on real-time clotting data.

The role of neutrophils-lymphocytes ratio (NLR), lymphocytes-monocytes ratio (LMR), platelets-lymphocytes ratio (PLR) in oral cancer and acute dental infections

Objectives: The present study was a cross-sectional observational study, which was carried out on patients reported to the Department of Oral Medicine and Radiology. This study aims to evaluate the hemogram parameters NLR, LMR, and PLR among 90 Patients. Methods: Patients were divided into 3 groups: Group A consists of 30 patients with histopathological confirmed oral cancer. Group B consists of 30 patients who presenting acute dental infections. Group C consists of 30 patients clinically healthy subjects. The hemogram parameters NLR, LMR and PLR were compared in the 3 groups and we studied their correlation to the clinical prognostic indicators like T stage, to the presence or absence of lymph node metastasis, and to differentiation of cancer. After obtaining personal informed consent, a thorough examination of the oral cavity and the lesion was conducted with an illuminated light and mouth mirror. Blood tests were performed on all the subjects before treatment. Under aseptic conditions, Venous blood (2 ml) was collected by venepuncture of the median cubital vein in the cubital fossa of the forearm using a disposable syringe with a 24-gauge needle. The withdrawn blood was transferred into an EDTA-containing test tube. Haematological parameters were analysed using an automated haematology analyzer. NLR, LMR, and PMR were calculated as the ratio of absolute peripheral neutrophil to lymphocyte, lymphocyte to monocyte, and platelet to lymphocyte count, respectively. Results: The present study revealed that NLR is significantly elevated in oral carcinoma compared to healthy individuals, but is lesser than in patiemts with acute dental infections. LMR is higher in oral carcinoma than in acute dental infections and healthy individuals, but no statisticaly significant difference was detected among the groups. PLR is higher in oral carcinoma than in Acute dental infections and healthy individuals, and it is statistaicaly significant. There are significant correlations in oral carcinoma between NLR, LMR, and PLR. NLR has a positive correlation with PLR and a negative correlation with LMR, which showed clinical significance as determined by the Spearman correlation coefficient. In Acute dental infections and healthy individuals, there is a significant correlation of NLR with LMR and PLR but no significant correlations between LMR and PLR and vice versa. NLR, LMR, and PLR were correlated to clinical prognostic indicators like T stage, presence or absence of lymph node metastasis, and differentiation of cancer. There is no significant difference in NLR, LMR, or PLR ratios concerning Clinical T staging since the p-value is greater than 0.05 for NLR, LMR, and PLR (p= 0.072, 0.446, 0.446, respectively). A statistically significant difference is found in LMR to the clinical presence or absence of Lymph node metastasis since the p-value is less than 0.05 only for LMR (p=0.018). The mean values of LMR in N0, N1, and N2 were 9.49, 5.65, and 4.40, respectively; this implies that the mean value of LMR decreases in advanced oral carcinoma as the nodal stage increases with lymph node metastases. A statically significant difference is found in NLR (p=0.011) and PLR (p =0.013) for differentiation of tumour (p-value is less than 0.05), which implies NLR &amp; PLR values are elevated in moderate differentiated oral carcinomas when compared to well-differentiated oral carcinoma. Conclusions: A significant elevation exists in haematological parameters like NLR, LMR, and PLR in oral carcinoma and acute dental infections.

Stability of the thromboxane B2 biomarker of low-dose aspirin pharmacodynamics in human whole blood and in long-term stored serum samples

BackgroundSerum thromboxane B2 (sTXB2) is a validated biomarker of low-dose aspirin pharmacodynamics. In the original method, nonanticoagulated blood samples must be incubated at 37 °C immediately after withdrawal, centrifuged and serum supernatant should be frozen until assayed. Timely completion of all preanalytical steps may affect the feasibility and quality of sTXB2 measurements. The storage duration of frozen serum can also affect sTXB2 stability. ObjectivesWe assessed the stability of sTXB2 in clotted blood samples stored at 4 °C before further processing and in sera stored at −40 °C for over a decade. MethodsVenous whole blood withdrawn from individuals on chronic low-dose aspirin was dispensed in different tubes and immediately incubated at 37 °C for 1 hour. The reference tube was promptly processed following the original protocol; the remaining tubes were stored at 4 °C for 12 to 72 hours before further processing. Sera stored at a controlled −40 °C temperature for <1 to 15 years were reassayed. Values within the interassay variation limits (±9%) vs baseline were considered acceptable. ResultsBaseline sTXB2 values (median, 5.4 ng/mL; IQR, 2.4-13.4 ng/mL; n = 40) were comparable with those in samples at 4 °C up to 48 hours (median, 97% [IQR, 86%-104%] of the reference; n = 26), but at 72 hours, the variability exceeded the interassay variation. Thromboxane B2 levels were stable in frozen sera for up to 10 years (median, 101% [IQR, 87%-108%] of the reference; n = 32) but decreased significantly afterward (median, 87% [IQR, 74%-109%] at 15 years; P = .005; n = 32). ConclusionThromboxane B2 is stable in clotted blood samples stored at 4 °C for up to 48 hours before further processing and in serum samples stored at −40 °C over 10 years.

Therapeutic effect of bloodletting on bone deterioration induced by hypobaric hypoxia in young rats

ObjectivesHigh-altitude regions, comprising hypoxic condition, are associated with different altitude-induced pathologies, including a reduction in bone density. Elucidating the mechanisms underlying bone degradation in such environments and developing targeted interventions and therapeutics is important. Bloodletting therapy has promising clinical applications, but its effects on the skeletal system and bone homeostasis are not well understood. The aim of this study was to investigate the effects of a hypobaric hypoxia environment on specific femoral morphological and structural properties, including the bone volume, cortical thickness, and trabecular microarchitecture, in juvenile Sprague–Dawley (SD) rats, and to explore the potential modulating effects of a bloodletting intervention on these parameters. MethodsMale SD rats, 6 weeks of age, were subjected to a simulated hypobaric hypoxia environment, replicating a 5000-m altitude, for 12 weeks. For the bloodletting intervention group, rats were subjected to a weekly 500 μL tail vein blood withdrawal. Micro-CT technology, hematoxylin and eosin staining, and tartrate-resistant acid phosphatase staining were employed to comprehensively assess the femoral microstructure, tissue architecture, and cellular morphology. Additionally, immunofluorescence analysis was conducted to quantify the expression of key proteins, and transcriptome analysis was performed to identify differentially expressed genes. ResultsExposing rats to hypobaric hypoxia led to a significant reduction in the bone mineral content, trabecular bone number, and cortical bone thickness, suggesting a deterioration of bone microstructure. Additionally, the hypoxic environment upregulated the expression of RANKL and HIF-1α, while downregulating RUNX2 expression. Notably, although bloodletting intervention did not significantly reverse these bone structural changes, transcriptome analysis revealed its regulatory influence on the expression of key genes, particularly Mmp2, Fosl2, and URS0000B2A65A, which are implicated in pathways governing the hypoxic response, osteoclast differentiation, and PI3K–Akt signaling. ConclusionThis study highlights the detrimental effect of hypobaric hypoxia on the bone microstructure of juvenile rats and underscores the therapeutic potential of bloodletting to ameliorate this condition. Additionally, our study on the regulatory mechanisms mediating the effects of bloodletting on gene expression offers new perspectives on bone alterations. It suggests promising avenues for the development of novel preventative measures and targeted therapies to address the challenges posed by related bone disorders.

Impact of sterile gloving during proximal manipulation of central line catheter hub: the multicenter observational study CleanHandPROX

BackgroundPatients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors.MethodsWe conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs’ hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation.ResultsA total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups.ConclusionsOur data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient’s skin and surroundings during proximal manipulation.

Study the Effect of Drakshasava on Dopamine, Serotonin and Cortisol Levels and Behavioural Changes in Acute and Chronic Stress Model in Wistar Rats

Drakshasava is a formulation used as a general tonic also for anxiety, anaemia in the Ayurveda. Our previous study reports for antidepressant property were very promising. This study aims to elucidate the antidepressant mechanisms of Drakshasava by examining its effects on key neurotransmitters and stress hormones, as well as observing related behavioral changes in Wistar rats under stress models. Methods: Wistar rats weighing 150-200 gms were divided into six groups consisting of 6 rats in each group. Two animal models, acute stress (AS) and unpredictable chronic mild stress (UCMS) were used. Drug treatment was given as per groups orally, Drakshasava in the dose of 2ml &amp; 4ml/kg and Fluoxetine standard comparator 10mg/kg for next 7 days for AS. In UCMS group stress was given for 15 days and drug treatment was given along with the stress from day 15-21. Sucrose preference test (SPT) done on day 0 &amp; 8 in AS and on day 0, 15, 22 in UCMS model rats and at the end Forced Swim test (FST) was performed. Blood withdrawal done for estimation of serum Dopamine, Serotonin and cortisol levels with ELISA kit on day 8 in AS &amp; 22 in UCMS. Data obtained analysed with Graph Pad Prism 6. Result: Decrease in Dopamine (p&lt;0.05) and Serotonin (p&lt;0.01) while increase (p&lt;0.01) in cortisol levels was seen in (depressed) disease control group rats in comparison with control group. Both doses of Drakshasava showed significant reduction in immobility time in FST and improved sucrose preference and was found to be effective in both the models of depression. Increase in serum serotonin (p&lt;0.01) and dopamine (p&lt;0.05) levels was evident while at the same time, (p&lt;0.05) cortisol level reduction was seen in all drug treated rats. Findings observed in the FST and SPT were correlated with the biochemical findings. Effects seen with Drakshasava were comparable with that of Fluoxetine. Conclusion: Drakshasava increased serum serotonin and dopamine levels while decreasing cortisol levels in both acute and chronic animal models of depression. These effects were comparable to those observed with the standard antidepressant drug, Fluoxetine.

Comparison between standard hematological parameters and blood doping biomarkers in dried blood spots within the athlete population of Swiss Sport Integrity.

The study demonstrated the feasibility of incorporating RNA biomarkers, specifically 5-aminolevulinic acid synthase (ALAS2) and carbonic anhydrase 1 (CA1), to improve the hematological module of the Athlete Biological Passport (ABP) in routine antidoping context. The aim was to investigate the implementation of reticulocyte (RET) related biomarkers, specifically ALAS2 and CA1, using quantitative reverse transcription polymerase chain reaction (RT-qPCR) on dried blood spots (DBS) from elite athletes. Hemoglobin changes over time in DBS samples was measured as well. Combining hemoglobin and messenger RNA (mRNA) analyses allowed to monitor alterations of the established marker, "DBS OFF-score". Ten athletes were selected for sampling by the Swiss national antidoping organization, Swiss Sports Integrity (SSI). Samples were collected, transported and analyzed for ABP following the World Anti-Doping Agency (WADA) procedures and spotted onto Protein Saver DBS cards. Most athletes exhibited stable biomarker levels, except for one individual involved in ski mountaineering, who demonstrated a sustained increase in ALAS2 compared to the individual baseline. This elevation could be due to blood withdrawal or other factors, such as doping with substances outside the targeted test menu. In this study, RNA-biomarkers were successfully analyzed in routine blood samples, and the project demonstrated promising results for the implementation of ALAS2 and CA1 in routine analysis to complement the ABP.

Transpulmonary cardiac output with room temperature saline is accurate and tracks directional changes in anesthetized dogs.

To assess the performance of transpulmonary thermodilution (TPTD) using room-temperature saline (CORT) and waveform-derived continuous CO (CCO) compared with TPTD using iced saline (COICED) as the indicator for measurements of CO in isoflurane-anesthetized dogs. 8 Beagles aged 1 to 2 years (7.4 to 11.2 kg) were enrolled in this experimental study from March 21 to 31, 2023. Dogs were anesthetized with 0.01 mg/kg acepromazine, 5 to 6 mg/kg propofol, and isoflurane and were mechanically ventilated. Dogs were instrumented with a central venous catheter and a femoral arterial catheter equipped with a thermistor. The COICED, CORT, and pulse wave-derived CCO values were obtained at baseline, during infusions of phenylephrine and norepinephrine, and during blood withdrawal and replacement. Data were analyzed with a mixed effect model, Bland-Altman plots, and concordance. Percent error was calculated. P < .05 was used for significance. Data were collected from 8 dogs. Significant effects of time and the interaction of time and method were found. Bland-Altman plots showed negligible bias with limits of agreement between -0.35 and 0.25 L/min for CORT versus COICED and -1.23 and 1.15 L/min for CCO versus COICED. Percent errors were 17.7% and 66.6%, respectively. In the 4-quadrant plots, the concordance rate was 95% and 68% for measurements obtained with CORT and for CCO, respectively. Transpulmonary thermodilution using room temperature saline was accurate and able to track changes in CO. Continuous CO had a large percent error and low tracking ability. Transpulmonary thermodilution using room temperature saline is reliable for monitoring CO and obviates the need for iced preparations in clinical scenarios.

407. MICRONUTRIENT INSUFFICIENCY AFTER SURGERY FOR OESOPHAGOGASTRIC NEOPLASMS: A PROSPECTIVE INTERVENTION STUDY CALLED THE VITAMIN STUDY

Abstract Background Oesophageal and gastric cancer have major impact on nutritional status and quality of life (QoL). Preoperative malnutrition is reported in 42–80%. However, studies investigating postoperative nutritional status are scarce and postoperative identification and treatment of micronutritional deficiencies are currently lacking in (inter-)national guidelines. The aim of this study is to identify micronutrient deficiencies after surgery for oesophagogastric neoplasms and target them by supplementation. Methods This is a recently closed multicenter trial in the Netherlands. Patients receive a tailormade multivitamin supplement which differs per group and a calcium supplement. Baseline measurements consist of blood withdrawal, faecal elastase-1 (FE-1) analysis, QoL questionnaires and dietary behaviour. After 6 (T=1), 12 (T=2) and 24 (T=3) months from baseline, measurements are repeated, and a supplement questionnaire is added. The primary objective is micronutrient deficiency (yes/no). Secondary objectives include occurrence and symptoms of exocrine pancreas insufficiency (EPI) and QoL. Results Inclusion spanned from December 2021 to December 2023. Preliminary results from 95 patients are available, whereby 68 patients underwent oesophagectomy and 27 gastrectomy. Of these, 55 patients received 6 months of supplementation (T=1). At T=0, 77.0% had at least one micronutrient deficiency. Identified deficiencies are shown in table 1. Deficiencies were more common in patients undergoing gastrectomy compared to those undergoing oesophagectomy (88.0% vs. 72.1%). Reduced FE-1 (&amp;lt;200 mg/kg) was found in 22.2% at baseline and 26.7% at T=1. 16.7% experienced EPI symptoms at baseline, which resolved at follow-up. Conclusion The most common micronutrient deficiencies decreased substantially after 6 months of supplementation. The follow-up extends until November 2024. Routine monitoring and supplementation could potentially be implemented in standard postoperative care for gastric and oesophageal cancer.

Endogenous Adult Telomerase Positive Stem Cells Increase in Equine Peripheral Blood Following Exercise

Stout, et al., 2007 reported a base-line level of primitive endogenous adult Telomerase Positive Stem Cells (aTPSCs) circulating within adult porcine peripheral blood which increased dramatically, i.e., 23.5-fold, after just 90 minutes of trauma. Ongoing studies from our laboratory have shown the presence of similar primitive stem cells in adult equine blood and that the base-line levels of stem cells varied according to the particular breed of horse. The current study was undertaken to test the hypothesis that aTPSCs would increase in number in the peripheral blood following stress in the same horse. Stress in this study was defined as moderate exercise, i.e., 10 minutes of cantering. Blood withdrawal followed the guidelines of Fort Valley State University’s IACUC. Adult horses had their blood withdrawn immediately prior to and immediately after exercising. The blood was obtained by venipuncture. Isolated aTPSCs were assayed by trypan blue staining, CEA-CAM-1 for totipotent stem cells and SSEA-4 for pluripotent stem cells. This study demonstrates that moderate exercise will increase the level of these primitive pluripotent stem cells in the blood of adult equines. Studies are ongoing to address their functional significance during injury and repair.

Micronutrients, Frailty, and Cognitive Impairment: Design and Preliminary Results from the CogLife 2.0 Study.

Among preventive strategies against dementia, nutrition is considered a powerful one and the recently established "nutritional cognitive neuroscience of aging" is a highly active research field. The present study was designed to deeply characterize older adults across the continuum from cognitive integrity to mild cognitive impairment (MCI) and better elucidate the prognostic role of lipophilic micronutrients within their lipidomic signature. 123 participants older than 65 years across the continuum from cognitive integrity to MCI were included [49 with subjective cognitive impairment, 29 women, 72.5±5.4 years, 26 MCI, 9 women, 74.5±5.8 years and 50 without cognitive impairment, 21 women, 70.8±4.3 years]. All participants underwent neuropsychological and nutritional examination as well as comprehensive geriatric assessment with calculation of the Multidimensional Prognostic Index (MPI) as a proxy of frailty and biological age and blood withdrawal for the analyses of lipophilic micronutrients, metabolomics and oxylipidomics. One year after the evaluation, same tests are ongoing. After adjustment for age, sex, daily fruit and vegetable intake and cholesterol, we found a significant positive correlation between lutein and the number of correct words in category fluency (p = 0.016). This result supports the importance of carotenoids as robust biomarkers of cognitive performance independent of the nutritional status and frailty of the participants, as the entire present study collective was robust (MPI 0-0.33). The complete analyses of the metabolome and the oxylipidome will hopefully shed light on the metabolic and prognostic signature of cognitive decline in the rapidly growing population at risk of frailty.

On-admission serum 25(OH)D level and mortality within one year in older patients

BackgroundMounting evidence suggests that vitamin D deficiency is associated with a higher risk of many chronic non-skeletal, age-associated diseases as well as mortality.AimTo determine, in older patients aged ≥ 80, the prevalence of vitamin D deficiency and its association with comorbidity, laboratory tests, length of stay and mortality within one year from blood withdrawal on admission to acute geriatrics ward.MethodsWe retrospectively surveyed electronic hospital health records of 830 older patients. The recorded data included patient demographics (e.g., age, sex, stay duration, readmissions number, death within one year from blood withdrawal on admission), medical diagnoses, laboratory results, including 25-hydroxyvitamin D [25(OH)D], and medications. We compared the characteristics of the patients who survived to those who died within one year.ResultsOn admission, in 53.6% patients, vitamin D levels were lower than 50 nmol/L, and in 32%, the levels were ≤ 35 nmol/L. Persons who died were likely to be older, of male sex, were likely to be admitted for pneumonia or CHF, were likely to have lower level of albumin or hemoglobin, lower level of vitamin D or higher vitamin B12 and higher level of creatinine, were also likely to have had a lengthier hospitalization stay, a greater number of hospitalizations in the last year, a higher number of comorbidities, to have consumption of ≥5 drugs or likely to being treated with insulin, diuretics, antipsychotics, anticoagulants or benzodiazepines. Higher age, male sex, on-admission CHF, higher number of drugs, lower albumin, higher vitamin B12, vitamin D < 50 nmol/L, and consumption of antipsychotics and anticoagulants – were predictors of mortality.ConclusionHypovitaminosis D is predictive of mortality in older patients within one year from hospitalization in the acute geriatric ward, but a causal relationship cannot be deduced. Nevertheless, older patients in acute care settings, because of their health vulnerability, should be considered for vitamin D testing. In the acutely ill patients, early intervention with vitamin D might improve outcomes. Accurate evaluation of mortality predictors in this age group patients may be more challenging and require variables that were not included in our study.

Evaluation of Antifertility Potential of &lt;i&gt;Entada rheedii&lt;/i&gt; Spreng Seed Kernel Extract in Female Wistar Rats

Background: Population growth has created a global dilemma, putting burden on economic, social, and ecological resources. Entada rheedii Spreng (ERS) seeds have many medicinal properties. In folkloric medicine, seeds are used as contraceptives, but no studies available. Aim: To evaluate antifertility potential of ERS seed kernel extract in female Wistar rats. Method: 90 Female Wistar rats with regular oestrus cycles and proven fertility were included. Methanol extract of ERS seed kernel was used in dose of 200 mg/kg and 400 mg/kg by oral route. Part I-Reproductive outcome rats were kept for mating after 8 days’ initial drug treatment which continued for 21 days, number of litters was measured. Mothers were observed for regain of fertility and pubs for teratogenicity. Part II-Animals kept for mating followed by 7 days’ drug treatment, Laparotomy done on the 10th day, number of implants checked and after delivery litter size counted. Part-III Abortifacient effect rats kept for mating. Laparotomy done on day 10, drug treatment was given for 21 days and again laparotomy was done and resorption of implants was measured. Blood withdrawal done from the rats of reproductive outcome for hormonal estimation. Data analyzed with Graph Pad Prism 6. Results: The control rats showed a significant increase in litter numbers compared to treated animal in both the doses of ERS low (P &lt; 0.001) and high (P &lt; 0.001). Pubs appeared normal and reversal of effect in the form of gain of fertility after 21 days of treatment was evident. The treatment with ERS extract resulted in a statistical increase in the resorption index (P &lt; 0.001) suggesting a failure of embryonic development. Anti-implantation and abortifacient action were seen with both doses of ERS. Conclusion: Results show that ERS seed kernel has potential and reversible antifertility effect in female Wistar rats.