Jugular Venous Blood Research Articles

Serial paired arterial and jugular venous point-of-care values in dogs undergoing manual basic life support.

To evaluate differences in point-of-care (POC) variables obtained from arterial and jugular venous blood in dogs undergoing manual basic life support (BLS) and report changes over time. Experimental study. Small animal research facility. Twenty-four purpose-bred research dogs. Dogs were anesthetized, and arterial catheters were placed before euthanasia. One minute after cardiopulmonary arrest, BLS consisting of manual chest compressions and ventilation delivered via endotracheal intubation, face mask, mouth-to-nose, or no ventilation was initiated. Paired arterial and jugular venous blood samples were obtained for POC testing before euthanasia (T0), at 3minutes (T3), and at 6minutes (T6) into BLS. The association of POC variables with arterial or venous sample type while controlling for type of ventilation and sampling timepoint was determined using a generalized linear mixed model. Variables obtained from arterial and venous blood samples were compared over time using repeated measures ANOVA or Friedman test. Pao2, anion gap, potassium, chloride, glucose concentration, and PCV were significantly higher in arterial blood samples compared with venous samples (P<0.03). By T6, arterial glucose concentration, arterial and venous base excess, venous pH, and plasma lactate, potassium, creatinine, bicarbonate, and sodium concentrations were significantly increased, and arterial and venous Po2, ionized calcium concentration, PCV, and total plasma protein concentration were significantly decreased from T0 (P<0.05). Although statistically significant, arteriovenous differences and changes in POC blood variables during BLS were small and not clinically relevant over time. Given the challenges of arterial blood sampling, it may be reasonable to pursue venous blood sampling during CPR. Further studies in dogs undergoing BLS and advanced life support are needed to better understand the potential clinical role of POC testing during CPR.

Age-dependent changes in plasma concentrations of 25-hydroxyvitamin D may complicate vitamin D status assessment of immature cats.

Vitamin D deficiency and excess in clinically presented cats conventionally is diagnosed by comparison of patient plasma 25-hydroxyvitamin D (25 (OH)D) concentration with plasma reference intervals determined in healthy adult cats. For immature cats, validity of this vitamin D status assessment method is uncertain. The overall objective was determination of whether plasma concentration of 25 (OH) D and other vitamin D metabolites in immature cats markedly change with developmental age as has been reported in other species. Four male and 4 female domestic short-hair kittens from weaning were continuously presented a single nutritionally adequate growth-diet. Concentrations of 25 (OH) D and 24,25-dihydroxyvitamin D (24,25 (OH)2D), and calcitriol were quantified in plasma of jugular venous blood collected at 12, 15, 18, and 21 weeks and 1 year of age. Plasma was liquid and solid-phase extracted and fractionation by normal-phase HPLC, and 25 (OH) D and 24,25 OH)2D quantified by reverse-phase HPLC-UV and calcitriol by RIA. Plasma 3-epi-25 (OH) D and 25 (OH) D concentrations increased (p < 0.001) with age so that by study end the concentrations rose by 1-and 2-fold, respectively. Concentrations of 3-epi-25 (OH) D relative to 25 (OH) D were 30% at 12 weeks and 20% at 1 year. Between ages 12 and 21 weeks, rises in 25 (OH) D concentration were positively correlated with body weight gains (ρ = 0.952, p < 0.001) and 24,25 (OH)2D concentrations were consistently greater than 25 (OH) D concentrations (p < 0.001). At 1 year of age, concentrations of 24,25 (OH)2D declined below those of 25 (OH) D and 3-epi-24,25 (OH)2D consistency occurred in low concentrations. Vitamin D2 metabolites and sex differences in metabolite concentrations were not observed. Reliance on quantification of plasma 25 (OH) D concentration for vitamin D status assessment in kittens may be confounded by developmental changes in 25 (OH) D independent of vitamin D intake. High 24,25 (OH)2D concentration and occurrence of 3-epi-25 (OH) D in plasma additionally may interfere with the quantification.

Cerebral venous biomarkers and veno-arterial gradients: untapped resources in Alzheimer's disease.

Blood based biomarkers (BBB) derived from forearm veins for estimating brain changes is becoming ubiquitous in Alzheimer's Disease (AD) research and could soon become standard in routine clinical diagnosis. However, there are many peripheral sources of contamination through which concentrations of these metabolites can be raised or lowered after leaving the brain and entering the central venous pool. This raises the issue of potential false conclusions that could lead to erroneous diagnosis or research findings. We propose the use of simultaneous sampling of internal jugular venous and arterial blood to calculate veno-arterial gradient, which can reveal either a surplus or a deficit of metabolites exiting the brain. Methods for sampling internal jugular venous and arterial blood are described along with examples of the use of the veno-arterial gradient in non-AD brain research. Such methods in turn could help better establish the accuracy of forearm venous biomarkers.

Analysis of fecal microbiome and metabolome changes in goats with pregnant toxemia

BackgroundPregnancy toxemia is a common disease, which occurs in older does that are pregnant with multiple lambs in the third trimester. Most of the sick goats die within a few days, which can seriously impact the economic benefits of goat breeding enterprises. The disease is believed to be caused by malnutrition, stress, and other factors, that lead to the disorder of lipid metabolism, resulting in increased ketone content, ketosis, ketonuria, and neurological symptoms. However, the changes in gut microbes and their metabolism in this disease are still unclear. The objective of this experiment was to evaluate the effect of toxemia of pregnancy on the fecal microbiome and metabolomics of does.ResultsEight pregnant does suspected of having toxemia of pregnancy (PT group) and eight healthy does during the same pregnancy (NC group) were selected. Clinical symptoms and pathological changes at necropsy were observed, and liver tissue samples were collected for pathological sections. Jugular venous blood was collected before morning feeding to detect biochemical indexes. Autopsy revealed that the liver of the pregnancy toxemia goat was enlarged and earthy yellow, and the biochemical results showed that the serum levels of aspartate aminotransferase (AST) and β-hydroxybutyric acid (B-HB) in the PT group were significantly increased, while calcium (Ca) levels were significantly reduced. Sections showed extensive vacuoles in liver tissue sections. The microbiome analysis found that the richness and diversity of the PT microbiota were significantly reduced. Metabolomic analysis showed that 125 differential metabolites were screened in positive ion mode and enriched in 12 metabolic pathways. In negative ion mode, 100 differential metabolites were screened and enriched in 7 metabolic pathways.ConclusionsEvidence has shown that the occurrence of pregnancy toxemia is related to gut microbiota, and further studies are needed to investigate its pathogenesis and provide research basis for future preventive measures of this disease.

Proteomic analysis of jugular venous blood in acute large vessel occlusion stroke with futile recanalization

Futile recanalization (FR) after endovascular treatment (EVT) remains a significant challenge for acute ischemic stroke (AIS) with large vessel occlusion (LVO). The pathogenesis of FR has not been well elucidated. We prospectively enrolled anterior circulation LVO-AIS patients who achieved successful recanalization after EVT. The jugular venous blood ipsilateral to stroke was collected before and immediately after recanalization. Plasma proteomic analysis based on liquid chromatography-mass spectrometry was performed using data-independent acquisition method. Differentially expressed proteins (DEPs) among patients with or without FR in the whole or propensity score matching (PSM) cohorts were screened according to the absolute value of fold change ≥1.5 and P value <0.05. We identified 104 and 34 DEPs between patients with or without FR in the whole cohort and PSM cohort, respectively. Bioinformatic analysis indicated that the identified proteins were primarily related to specific biological processes including immune response, complement activation, oxidative stress, lipid metabolism, protein ubiquitylation as well as autophagy, suggesting that these may be mechanisms in FR pathogenesis. Collectively, we discovered proteins that may be potential research targets for FR. The combination of proteomic and bioinformatic analysis could provide a better understanding of the pathogenesis of FR in a comprehensive manner.

Study on the dynamic metabolic characteristic of main active ingredients in Danggui Buxue Decoction by liquid chromatography-tandem mass spectrometry based on in situ sequential metabolism strategy.

Danggui Buxue Decoction is a classic formula for replenishing qi and nourishing blood. Despite its widespread use, its dynamic metabolism involved remains unclear. Based on the sequential metabolism strategy, blood samples from different metabolic sites were obtained via in situ closed intestine ring integrated with a jugular venous continuous blood supply technique. An ultra-high-performance liquid chromatography-linear triple quadruple-Orbitrap-tandem mass spectrometry method was developed for the identification of prototypes and metabolites in rat plasma. The dynamic absorption and metabolic landscape of flavonoids, saponins, and phthalides were characterized. Flavonoids could be deglycosylated, deacetylated, demethylated, dehydroxylated, and glucuronicated in the gut and then absorbed for further metabolism. Jejunum is an important metabolic site for saponins biotransformation. Saponins that are substituted by Acetyl groups tend to lose their acetyl groups and convert to Astragaloside IV in the jejunum. Phthalides could be hydroxylated and glucuronidated in the gut and then absorbed for further metabolism. Seven components serve as crucial joints in the metabolic network and are potential candidates for the quality control of Danggui Buxue Decoction. The sequential metabolism strategy described in this study could be useful for characterizing the metabolic pathways of Chinese medicine and natural products in the digestive system.

Experimental and Clinical Investigation of Cytokines in Migraine: A Narrative Review.

The role of neuroinflammation in the pathophysiology of migraines is increasingly being recognized, and cytokines, which are important endogenous substances involved in immune and inflammatory responses, have also received attention. This review examines the current literature on neuroinflammation in the pathogenesis of migraine. Elevated TNF-α, IL-1β, and IL-6 levels have been identified in non-invasive mouse models with cortical spreading depolarization (CSD). Various mouse models to induce migraine attack-like symptoms also demonstrated elevated inflammatory cytokines and findings suggesting differences between episodic and chronic migraines and between males and females. While studies on human blood during migraine attacks have reported no change in TNF-α levels and often inconsistent results for IL-1β and IL-6 levels, serial analysis of cytokines in jugular venous blood during migraine attacks revealed consistently increased IL-1β, IL-6, and TNF-α. In a study on the interictal period, researchers reported higher levels of TNF-α and IL-6 compared to controls and no change regarding IL-1β levels. Saliva-based tests suggest that IL-1β might be useful in discriminating against migraine. Patients with migraine may benefit from a cytokine perspective on the pathogenesis of migraine, as there have been several encouraging reports suggesting new therapeutic avenues.

92 Seasonal variation in plasma vitamin A and E concentrations in horses with or without pasture access

Vitamins A and E are essential nutrients for horses and often provided in the diet by fresh forage but become depleted when forage is cut and dried for hay and can lead to potentially fatal health problems in horses. This study evaluated seasonal changes in plasma vitamin A and E for a mature horse herd in the Upper Midwest to determine the impact of pasture access on the prevalence of vitamin deficiency. Researchers hypothesized horses on dry lot would be deficient all year while horses with pasture access would have increased vitamin A and E concentrations during the grazing season. The study took place between February and November 2022 in River Falls, Wisconsin. Twenty-seven mature horses were divided into 2 treatments based on management practices including 1) horses consuming a hay-only diet in a dry lot (n = 13) and 2) horses with pasture access in the summer (n = 14). All horses had ad libitum access to water and a vitamin and mineral mix (200 IU/kg Vitamin E; 176,320 IU/kg Vitamin A) for the duration of the study and received ad libitum cool-season grass hay round bales from September through May. Hay-only horses continued this diet from June through August while pastured horses continuously grazed cool-season grass pasture. Jugular venous blood samples were taken in February (winter), May (spring), August (summer), and November (fall) and plasma samples were sent theMichigan State Veterinary Diagnostic Lab for analysis of plasma vitamin A and E concentrations. Data were analyzed using PROC MIXED in SAS with significance set at P ≤ 0.05. Adequate vitamin A was classified as 175 to 300 ng/ml, and adequate vitamin E was classified as 2.0 to 4.0 µg/ml. Vitamin A deficiency was observed in 81% and 85% of horses in winter and spring, respectively, with an average concentration of 145 ng/ml. Pastured horses exhibited an increase in plasma vitamin A in the summer compared with dry lot horses (P ≤ 0.05), however 64% of pastured horses remained deficient. In the fall, vitamin A deficiency increased to 97% for all horses and plasma vitamin A averaged 139 ng/ml. When evaluating vitamin E, 70 to 74% of horses were deficient in the winter and spring, respectively, with an average concentration of 1.83 µg/ml. Plasma vitamin E concentrations did not change over time for dry lot horses and remained inadequate in the summer at 1.43 µg/ml (P > 0.05) while concentrations in pastured horses rose to 2.4 µg/ml (P ≤ 0.05). These results confirm recommendations to provide additional vitamin A and E to horses on a hay-only diet and demonstrates the short-lived increases in vitamin A and E for horses provided limited pasture access.

Plasma Creatine Kinase and Aspartate Aminotransferase Activities Before, During, and After 5 Days of Intramuscular Penicillin Administration in Sedentary Horses.

Muscle damage can result in leakage of intracellular enzymes such as creatine kinase (CK) and aspartate transaminase (AST) into plasma. There are no controlled documentations of the effects of intramuscular antibiotic drug administration on plasma CK and AST activities in horses. The objective of this experiment was to test the hypothesis that 5 days of intramuscular procaine penicillin G injection in normal horses would result in increased plasma activities of CK and AST. Nine healthy adult horses were sampled for 7 days preceding, 5 days during, and 32 days following procaine penicillin G (22,000 IU/kg) administration intramuscularly twice daily. Heparinized jugular venous blood samples were obtained daily before treatment and were analyzed the same day for plasma activities of CK and AST. Repeated measures ANOVA and post hoc Tukey's Test were used to identify days where CK or AST were elevated compared to control means at a significance level of P < .05. Beginning the day after first injection, plasma CK increased above the reference range, peaking at 2,046 ± 627 U/L after 3 days, and returned to 227 ± 57.3 U/L (within the reference range) 9 days after treatment began. Beginning the day after first injection, plasma AST increased, peaking at 703 ± 135 U/L on the day after the last injection. Plasma AST did not return to the reference range in all individual horses until 29 days after the last injection (mean 247 ± 33 U/L). Compared to the control period, plasma CK and AST elevations lasted for 8 and 28 days, respectively, after the onset of treatment (P < .001 to P=.03) and lasted for 4 and 24 days, respectively, after the last day of treatment (P < .001 to P=.03).

Role of nuc gene in Staphylococcus aureus to phagocytic activity in different cattle infections.

Staphylococcus aureus is a typical pathogenic agent that causes several morbidities and mortalities which variable largely following the severity of bacteria and activity of host immunity. Isolation of S. aureus from different cattle infections, molecular detection of nuc gene in positive S. aureus isolates, and identification of the effectiveness of the phagocytic activity. Totally, 100 cattle with various infections (25 wounds, 25 abscesses, 25 nasal discharges, and 25 ear swaps) were selected and subjected to collection of swabs under controlled conditions. All collected samples were cultured on mannitol salt agar (MSA) and assessed by biochemical tests. Targeting the nuc gene, all study MSA positive isolates were examined molecularly by conventional polymerase chain reaction (PCR), and then subjected to antibiotic susceptibility test. Jugular venous blood was collected from all infected animals in addition to 20 healthy cattle that were selected as a control group to estimate the phagocytic activity of S. aureus isolates. The findings of MSA culture revealed a total of 80 positive samples of S. aureus as 23, 21, 20, and 16 positive isolates for nasal discharge, abscess, wound, and ear swab, respectively; based on its morphology, cultural trait, and biochemical test. Subsequently, PCR assaying of MSA-positive isolates demonstrated an overall 59 positive samples as 14, 16, 12, and 17 positive isolates for nasal discharge, abscess, wound, and ear swabs, respectively. Antibiotic susceptibility testing of S. aureus-positive PCR isolates reported a significantly high sensitivity to chloramphenicol and vancomycin, and a high resistance to penicillin. Finally, there was a considerable decline in phagocytic activity in particular 2 weeks post-infection as a result of bacterial invasion. This study shows a high prevalence of S. aureus in cattle infections, and the protocol includes a regular screening of cattle infection and suitable therapy based on antibacterial susceptibility test is of great importance in the long-term control of the pathogen. However, additional molecular studies targeting other genes of S. aureus and the role of immune markers in different infections should be aimed.

Metabolic Profile in Dairy Cattle with Displacement of the Abomasum

The objective of this research was to evaluation metabolic, biochemical and hematological parameters in dairy cattle with displacement of the abomasum (DA). In this study, 80 dairy cattle with DA and 10 healthy dairy cattle in early lactation were used. Jugular venous blood samples for blood gases, hematological parameters and serum biochemical analysis of all cattle were taken. Glucose, lactate, triglycerides, BHB, NEFA, insulin, VLDL, GGT, CK concentrations and pH and hematocrit value of cattle with DA were significantly (P

Venous dynamics in anesthetized sheep govern postural-induced changes in cerebrospinal fluid pressure comparable to those in humans.

Sheep are popular large animals in which to model human disorders and to study physiological processes such as cerebrospinal fluid dynamics. However, little is known about vascular compensatory mechanisms affecting cerebrospinal fluid pressures during acute postural changes in sheep. Six female white Alpine sheep were anesthetized to investigate the interactions of the vascular and cerebrospinal fluid system by acquiring measurements of intracranial pressure and central and jugular venous pressure during passive postural changes induced by a tilt table. The cross-sectional area of the common jugular vein and venous blood flow velocity was recorded. Anesthetized sheep showed bi-phasic effects of postural changes on intracranial pressure during tilting. A marked collapse of the jugular vein was observed during head-over-body tilting; this is in accordance with findings in humans. Active regulatory effects of the arterial system on maintaining cerebral perfusion pressure were observed independent of tilting direction. Conclusion: Anesthetized sheep show venous dynamics in response to posture-induced changes in intracranial pressure that are comparable with those in humans.

Can expected pCO2 be calculated by pCO2=HCO3+15 formula in central venous blood gas samples?

In mixed acid-base disorders, it is essential to identify the dominant disorder, either metabolic or respiratory. The calculation of expected partial carbondioxide (pCO2) value obtained from arterial blood gas sample can give a clue to the physician about the main disorder. There are several formulas to calculate the expected pCO2 which are not practical to use and require an arterial blood gas sample. The aim of this study is to investigate whether expected pCO2 could be calculated with a simple formula by adding 15 to the bicarbonate (HCO3) value obtained from a central venous blood gas sample. 50 (42.7%) female and 67 (57.3%) male patients aged 18 years and older, hospitalized in the Intensive Care Unit (ICU) between January 2022 and June 2022, whose arterial and central venous blood gas samples were drawn at the same time, were included in this study. Expected pCO2 values were calculated with both Winter's (pCO2 = 1.5 × HCO3 + 8) and simple (pCO2 = HCO3 + 15) formulas from the data obtained from arterial and jugular central venous blood gas samples. A statistically significant strong positive correlation was identified between arterial and venous expected pCO2 values, which were calculated by using both Winter's and simple formulas [Pearson's correlation coefficient (r) = 1, p<0.001]. In ICU patients, (pCO2 = HCO3 + 15) formula can be used to calculate expected pCO2 in central venous blood gas samples to identify the primary disorder as metabolic or respiratory in mixed acid-base disorders.

Stretch‐induced Myocardial Injury and Inflammation After Transient Vasopressin‐Mediated Left Ventricular Pressure Overload in Swine

ObjectiveUsing the α1‐adrenergic agonist phenylephrine (PE), we have previously demonstrated that an acute episode of transient pressure overload (TPO) elicits stretch‐induced myocardial injury and reversible left ventricular (LV) systolic dysfunction. Although this was accompanied by leukocyte mobilization, a rise in inflammatory cytokine levels, and increased pro‐inflammatory gene expression in the heart, the extent to which this resulted from direct activation of α1‐adrenergic receptors on immune cells vs. an inflammatory response to mechanical stretch‐induced myocardial injury is unclear. Accordingly, the present study was designed to determine if an inflammatory response to myocardial injury is evident when TPO is produced by vasopressin (VP), a vasoconstrictor without direct α1‐adrenergic agonist properties.MethodsHemodynamic and echocardiographic parameters were assessed in propofol‐anesthetized swine before, during, and after a 30‐minute infusion of VP (VP‐TPO; 0.04 U/kg/min, n=7) to increase LV end‐diastolic pressure (EDP) to ~30mmHg. Serial jugular venous blood sampling was performed to quantify circulating cardiac troponin I (cTnI), leukocytes, and inflammatory cytokines (TNF‐α and IL‐6) at baseline and 3‐hours after cessation of VP‐TPO. Leukocyte and cytokine levels were compared with those observed after PE‐mediated TPO in a separate group of animals (PE‐TPO; n=6).ResultsVP elicited a significant rise in mean arterial pressure (91±5 to 165±11 mmHg) and LV EDP (10±1 to 29±2 mmHg; both p&lt;0.05 vs. baseline). This was accompanied by a significant rise in LV end‐diastolic volume (73±5 to 110±7 mL) and end‐systolic volume (20±3 to 53±6 mL), as well as a reduction in LV ejection fraction (EF; 72±3 to 52±3 %; all p&lt;0.05 vs. baseline). One hour after cessation of VP‐TPO, LV EF remained depressed vs. baseline (60±3 %; p&lt;0.05) and circulating cTnI levels began to rise, reaching a concentration that was ~10‐fold higher than baseline concentrations at the 3‐hour post‐TPO timepoint (18±5 to 118±21 ng/L; p&lt;0.05). These changes were accompanied by a significant rise in circulating neutrophils, monocytes, TNF‐α, and IL‐6 that was similar to that observed after PE‐TPO (Figure).ConclusionsVP‐TPO elicits myocardial injury, leukocyte mobilization, and an acute rise in circulating pro‐inflammatory cytokines, thereby recapitulating several features of PE‐TPO in the absence of direct α1‐adrenergic stimulation. These findings suggest that stretch‐induced myocardial injury provokes an inflammatory response that may play an important role in promoting the development of cardiac fibrosis and diastolic dysfunction after exposure to repetitive episodes of TPO.

Comparative Studies on Blood Serum Profiles of Liver Enzymes, Proteins, Total Bilirubin and Liver Organ Morphometry of Muscovy Ducks

Twenty adult apparently healthy Muscovy ducks Cairina moschata (10 males, 10 females) were used in a study to compare between sexes blood serum alanine aminotransferase (ALT), aspartate aminotransferase (ALT), alkaline phosphatase (ALP), total protein, albumin, and total bilirubin profiles using jugular venous blood. Comparative biometric measurements (weight, length, width and thickness) of their liver organs were also done. Total protein and albumin were significantly (P 0.05) by sex. The biometric measurements of the liver of Muscovy ducks according to sex were significantly (P &lt; 0.05) higher in males than females. Liver biometric measurements according to lobation were significantly (P &lt; 0.05) higher in the right lobe than in the left lobe, particularly, in terms of liver lobe weight and length of both sexes of ducks while liver lobe width and thickness were statistically similar (P &gt; 0.05) in both sexes. Therefore, sex had a significant influence on serum total protein and albumin, as well as the biometric measurements of the liver of Muscovy ducks studied.

Nitric oxide contributes to cerebrovascular shear-mediated dilatation but not steady-state cerebrovascular reactivity to carbon dioxide.

Cerebrovascular CO2 reactivity (CVR) is often considered a bioassay of cerebrovascular endothelial function. We recently introduced a test of cerebral shear-mediated dilatation (cSMD) that may better reflect endothelial function. We aimed to determine the nitric oxide (NO)-dependency of CVR and cSMD. Eleven volunteers underwent a steady-state CVR test and transient CO2 test of cSMD during intravenous infusion of the NO synthase inhibitor NG -monomethyl-l-arginine (l-NMMA) or volume-matched saline (placebo; single-blinded and counter-balanced). We measured cerebral blood flow (CBF; duplex ultrasound), intra-arterial blood pressure and . Paired arterial and jugular venous blood sampling allowed for the determination of trans-cerebral NO2- exchange (ozone-based chemiluminescence). l-NMMA reduced arterial NO2- by ∼25% versus saline (74.3±39.9 vs. 98.1±34.2nM; P=0.03). The steady-state CVR (20.1±11.6nM/min at baseline vs. 3.2±16.7nM/min at +9 mmHg ; P=0.017) and transient cSMD tests (3.4±5.9nM/min at baseline vs. -1.8±8.2nM/min at 120 s post-CO2 ; P=0.044) shifted trans-cerebral NO2- exchange towards a greater net release (a negative value indicates release). Although this trans-cerebral NO2- release was abolished by l-NMMA, CVR did not differ between the saline and l-NMMA trials (57.2±14.6 vs. 54.1±12.1ml/min/mmHg; P=0.49), nor did l-NMMA impact peak internal carotid artery dilatation during the steady-state CVR test (6.2±4.5 vs. 6.2±5.0% dilatation; P=0.960). However, l-NMMA reduced cSMD by ∼37% compared to saline (2.91±1.38 vs. 4.65±2.50%; P=0.009). Our findings indicate that NO is not an obligatory regulator of steady-state CVR. Further, our novel transient CO2 test of cSMD is largely NO-dependent and provides an in vivo bioassay of NO-mediated cerebrovascular function in humans. KEY POINTS: Emerging evidence indicates that a transient CO2 stimulus elicits shear-mediated dilatation of the internal carotid artery, termed cerebral shear-mediated dilatation. Whether or not cerebrovascular reactivity to a steady-state CO2 stimulus is NO-dependent remains unclear in humans. During both a steady-state cerebrovascular reactivity test and a transient CO2 test of cerebral shear-mediated dilatation, trans-cerebral nitrite exchange shifted towards a net release indicating cerebrovascular NO production; this response was not evident following intravenous infusion of the non-selective NO synthase inhibitor NG -monomethyl-l-arginine. NO synthase blockade did not alter cerebrovascular reactivity in the steady-state CO2 test; however, cerebral shear-mediated dilatation following a transient CO2 stimulus was reduced by ∼37% following intravenous infusion of NG -monomethyl-l-arginine. NO is not obligatory for cerebrovascular reactivity to CO2 , but is a key contributor to cerebral shear-mediated dilatation.

One-lung ventilation patients: Clinical context of administration of different doses of dexmedetomidine.

BackgroundOpen and endoscopic thoracic surgeries improve surgical exposure by One-lung ventilation (OLV). The aim of this study was to investigate the effects of different doses of dexmedetomidine on inflammatory response, oxidative stress, cerebral tissue oxygen saturation (SctO2) and intrapulmonary shunt in patients undergoing one-lung ventilation (OLV).MethodsSeventy-five patients undergoing open pulmonary lobectomy in our hospital from January 2016 to December 2017 were enrolled and randomly divided into high-dose dexmedetomidine group (group D1, 1 mg/kg, n=25), low-dose dexmedetomidine group (group D2, 0.5 mg/kg, n=25) and control group (group C, n=25). Then, arterial blood and internal jugular venous blood were taken before anesthesia induction (T0) and at 15 min after twolung ventilation (T1) and 5 min (T2) and 30 min (T3) after OLV for later use. Next, the changes in hemodynamic parameters [mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2)] of patients were observed in each group. Enzyme-linked immunosorbent assay (ELISA) was carried out to detect serum inflammatory factors such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) and oxidative stress indicators [superoxide dismutase (SOD) and malondialdehyde (MDA)]. The changes in SctO2, arterial partial pressure of oxygen (PaO2) and intrapulmonary shunt Qs/Qt (a measurement of pulmonary shunt: right-to-left shunt fraction) were observed. Additionally, the changes in lung function indicators like lung dynamic compliance (Cdyn) and airway peak pressure (Ppeak) were determined.ResultsThere were no statistically significant differences in the MAP, HR and SpO2 among three groups at each observation time point (P>0.05). At T2 and T3, the levels of serum IL-6, TNF-α and IL-8 were obviously decreased in group D1 and D2 compared with those in group C (P<0.05), and the decreases in group D1 were overtly larger than those in group D2, and the decreases at T3 were markedly greater than those at T2 (P<0.05). In comparison with group C, group D1 and D2 had notably reduced levels of serum reactive oxygen species (ROS) and MDA (P<0.05) and remarkably increased SOD content (P<0.05) at T2 and T3, and the effects were markedly better in group D1 than those in group D2. Besides, they were significantly superior at T3 to those at T2 (P<0.05). The SctO2 in group D1 and D2 was evidently lowered at T2 and T3 compared with that at T0, and the decrease in group D1 was distinctly smaller than that in group D2 (P<0.05). The Qs/Qt was significantly lower in group D1 and D2 than that in group C at T2 and T3 (P<0.05), while the PaO2 content was notably raised (P<0.05), and the decrease and increase were significantly larger in group D1 than those in group D2, and they were obviously greater at T3 to those at T2 (P<0.05). At T0 and T1, no significant differences were detected in the Cdyn, Pplat and Ppeak among three groups. At T2 and T3, the Cdyn was significantly elevated, while the Pplat and Ppeak overtly declined (P<0.05), and group D1 had greater changes in comparison with group D2, and the changes were obviously more evident at T3 to those at T2 (P<0.05).ConclusionsDexmedetomidine effectively ameliorates inflammatory response and oxidative stress, lowers oxygenation, Qs/Qt and the decrease in SctO2 and improves lung function during OLV, with good efficacy.

CGRP outflow into jugular blood and cerebrospinal fluid and permeance for CGRP of rat dura mater

BackgroundCalcitonin gene-related peptide (CGRP) is released from activated meningeal afferent fibres in the cranial dura mater, which likely accompanies severe headache attacks. Increased CGRP levels have been observed in different extracellular fluid compartments during primary headaches such as migraine but it is not entirely clear how CGRP is drained from the meninges.MethodsWe have used an in vivo preparation of the rat to examine after which time and at which concentration CGRP applied onto the exposed parietal dura mater appears in the jugular venous blood and the cerebrospinal fluid (CSF) collected from the cisterna magna. Recordings of meningeal (dural) and cortical (pial) blood flow were used to monitor the vasodilatory effect of CGRP. In a new ex vivo preparation we examined how much of a defined CGRP concentration applied to the arachnoidal side penetrates the dura. CGRP concentrations were determined with an approved enzyme immunoassay.ResultsCGRP levels in the jugular plasma in vivo were slightly elevated compared to baseline values 5-20 min after dural application of CGRP (10 μM), in the CSF a significant three-fold increase was seen after 35 min. Meningeal but not cortical blood flow showed significant increases. The spontaneous CGRP release from the dura mater ex vivo was above the applied low concentration of 1 pM. CGRP at 1 nM did only partly penetrate the dura.ConclusionsWe conclude that only a small fraction of CGRP applied onto the dura mater reaches the jugular blood and, in a delayed manner, also the CSF. The dura mater may constitute a barrier for CGRP and limits diffusion into the CSF of the subarachnoidal space, where the CGRP concentration is too low to cause vasodilatation.

Comparison of selected serum biochemistry measurements between the Nova Prime Plus VET, Nova pHOx Ultra, and Beckman Coulter AU680 analyzers in dogs.

Blood gas chemistry analyzers typically produce results faster and use smaller sample volumes than reference chemistry analyzers. However, results may not be comparable between blood gas chemistry analyzers and reference chemistry analyzers or between different models of blood gas chemistry analyzers. This could suggest the use of separate reference intervals and, thus, has implications when making clinical decisions. We aimed to perform method comparison studies to evaluate selected canine serum biochemical values obtained using the Nova Stat Profile Prime Plus VET (Prime Plus VET), Stat Profile Nova pHOx Ultra (Ultra), and Beckman Coulter AU680 (Beckman) analyzers. We hypothesized that the three analyzers would be identical within inherent imprecision. Jugular venous blood samples were collected from 103 endurance-trained sled dogs, and serum was harvested and stored for analysis. Results for serum chloride, potassium, sodium, creatinine, and urea nitrogen concentrations obtained from the Prime Plus VET and Ultra analyzers were compared with results from the Beckman analyzer, which was considered to be a reference method. Results for serum chloride, potassium, sodium, creatinine, urea nitrogen, and L-lactate concentrations obtained from the Prime Plus VET and Ultra analyzers were compared. Passing-Bablok regression and Bland-Altman plots were used for method comparison. Significant (P<0.05) constant or proportional bias was found for many analytes for all three method comparison studies. Due to the presence of statistically significant differences between all three analyzers that may be clinically relevant, it is recommended that reference intervals be created for new blood gas analyzers, even when similar methodologies are used.

Erenumab-aooe: A promising monoclonal antibody for prophylactic pharmacotherapy in migraine.

Migraine is one form of disorder affecting the quality of life of patient. The term chronic migraine refers to a clinical condition summarized by migraines headache on fifteen days usually per monthly episode. Most commonly patients on pharmacotherapy of migraine include Ergot derivatives, Opioids, and Analgesics for a period range of ten days per month. The CGRP is involved in pathology and physiology of origin of neurovascular headaches via migraine at both peripheral and central levels. The CGRP is highly expressed in trigeminal neurons (small myelinated Ad and unmyelinated C fibers) co-localized with other neuropeptides (e.g., substance P). The CGRP levels are increased into external jugular venous blood ipsilateral to pain during headache phase of migraine attack. Also the saliva and serum CGRP levels are increased during migraine and interracially in patients with CM. Scope: Erenumab-aooe, CGRPr antagonist, being the latest approved drug administered via subcutaneous route as 70 mg per month for prophylactic regime of migraine in adult patients, the results documented as per clinical trials data are very promising and thus Erenumab-aooe is an emerging hope to improve quality of life. Conclusion: CM is not fully treated as the pharmacotherapy response is at the poor level and also limited pharmacotherapy is available, however the emergence of Erenumab- aooe, CGRPr antagonist as the one of the latest drug approval for the prophylaxis of migraine in adults.