Lactate Solution Research Articles

Hemoglobin-albumin clusters as an artificial O2 carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats.

A bovine hemoglobin (HbBv) or human adult hemoglobin (HbA) wrapped covalently by human serum albumins (HSAs), hemoglobin-albumin clusters (HbBv-HSA3 and HbA-HSA3 ), are artificial O2 carriers used as a red blood cell substitute. This article describes the physicochemical properties of the HbBv-HSA3 and HbA-HSA3 solutions, and their abilities to restore the systemic condition after resuscitation from hemorrhagic shock in anesthetized rats. The HbBv-HSA3 and HbA-HSA3 , which have high colloid osmotic activity, showed equivalent solution characteristics and O2 binding parameters. Shock was induced by 50% blood withdrawal. Rats exhibited hypotension and significant metabolic acidosis. After 15 min, the rats were administered shed autologous blood (SAB), HbBv-HSA3 , HbA-HSA3 , or Ringer's lactate (RL) solution. Survival rates, circulation parameters, hematological parameters, and blood gas parameters were monitored during the hemorrhagic shock and for 6h after administration. All rats in the SAB, HbBv-HSA3 , and HbA-HSA3 groups survived for 6h. The HbBv-HSA3 and HbA-HSA3 groups restored mean arterial pressure after the resuscitation. No remarkable difference was observed in the time courses of blood gas parameters in any resuscitated group except for the RL group. Serum biochemical tests showed increases in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the HbBv-HSA3 and HbA-HSA3 groups compared to the SAB group. Therefore, we observed other rats awakened after resuscitation with HbA-HSA3 for 7 days. The blood cell count, AST, and ALT recovered to the baseline values by 7 days. All the results implied that HbBv-HSA3 and HbA-HSA3 clusters provide restoration from hemorrhagic shock as an alternative material for SAB transfusion.

Effectiveness of Ozone Therapy in The Treatment of Endometritis in Mares

Endometritis is defined as inflammation of the endometrium that may be acute or chronic, infectious, or non-infectious. Endometritis is an important cause of subfertility in mares. Considering the antimicrobial characteristics, immune-stimulating ability, and low cost of ozone (O3) therapy, we aimed to evaluate the effectiveness of intrauterine O3 therapy as an alternative treatment for endometritis in mares. Twenty-five mares with a known reproductive history of uterine infection and inflammation were allocated into three groups: Group 1 (control; n = 7), uterine lavage with Ringer's lactate solution; Group 2 (O3-gas; n = 9), uterine lavage with Ringer's lactate solution followed by uterine insufflation with O2-O3 gas mixture containing 40 µg O3 mL−1 for 10 minute; and Group 3 (O3-oil; n = 9), uterine infusion of ozonized sunflower oil. Uterine inflammation was evaluated through a uterine cytological examination (cytobrush) and uterine culture (swab) for microbiological content before and after all treatments. In assessments of uterine cytology, the average number of neutrophils/field changed from 9.14 ± 3.02 to 7.71 ± 3.59 in the control group, from 10.67 ± 3.84 to 2.89 ± 3.59 in the O3-gas group, and from 6.44 ± 2.79 to 6.55 ± 7.18 in the O3-oil group post-treatment. The pre- and post-treatment findings in the mares treated with ozonized gas were significantly different (P < .05), unlike the findings for the mares in the control and O3-oil groups. All mares (25/25) showed a positive uterine culture before treatment. After treatment, the percentage of mares showing positive culture results was 57%, 11%, and 22% in the control, O3-gas, and O3-oil groups, respectively. Our results showed the effectiveness of two groups (O2-O3 gas mixture and ozonized sunflower oil) for the treatment of uterine infections in mares. Thus, direct intrauterine O3 gas infusion has been shown to be effective in treating endometritis in mares, reducing both inflammation and uterine infection.

Trichlorfon for Treatment of Cutaneous Habronemosis - Evaluation of Intravenous Regional Perfusion in the Distal Equine Limbs

Background: Equine cutaneous habronemiasis is common in the distal regions of the limbs. Organophosphates, applied systemically, one previously used treatment, which is highly effective, but currently in disuse, due to the risks of intoxica-tion. Regional perfusion is a potential technique for distal limb wounds, since, in addition to being used in low doses, it prevents systemic circulation of the drug and possible intoxication, and has a lower treatment cost. The current work aimed to perform clinical, laboratory, and venography evaluations of the use of trichlorfon in regional intravenous perfusion, as a possible form of treatment for cutaneous habronemosis in the distal region of equine limbs.Materials, Methods &amp; Results: Twelve horses were used, divided into two groups, with the left thoracic limb (LTL) being the test limb, and the right thoracic limb (RTL) the control limb. At moment zero (M0), distal radiography and venography were performed. The tourniquet was then loosened and after five minutes, at moment one (M1), the tourniquet was repositioned for 1.25 mg/kg (G1) and 5.5mg/kg (G2) trichlorfon injections into the left thoracic limb, diluted in 20 mL of Ringer's lactate solution, and 20 mL of Ringer's lactate solution was applied to the right thoracic limb. The tourniquet was maintained for 30 minutes after infusion in both groups. At moment two (M2), four days later, blood tests, radiography, and venography were repeated. Every day between M0 and M2, physical examinations were performed, including measurement of the pastern, fetlock, and coronet band, and a lameness examination. There were no significant alterations in clinical parameters, behavior, and appetite. In the blood cell count, there was an increase in leukocytes on D4 in G2, although remaining within the reference values for the species. The biochemical tests showed no alterations. There were no changes in the circumferences evaluated and 4 horses from G2 presented lameness in the LTL and one in the RTL. In the venograms, one G2 animal was noticed to be hypoperfused in all LTL plexuses. Discussion: The use of trichlorfon in regional perfusion at a dose of 1.25 mg/kg demonstrated safety, with no clinical, laboratory, and lameness changes in any of the animals. At the highest dose (5.5 mg/kg), individual reactions were observed, such as different degrees of lameness, swelling, and heat in foot. Serial venographies document the response to treatment used, it was decided to perform the second venography 4 days after the trichlorfon perfusion and the first initial venography evaluation, following the recommendations for the repetition time of the examination and evaluation of the use of the drug. The evaluation of radiographic images of venography, in a grading system created considering the range of contrast in five regions by the three examiners experienced in podiatry and the analysis of radiographic images of limbs of horses, without having participated in the previous procedures was important for the reliability of the assessment. The areas of hypoperfusion observed in the venography were not related to trichlorfon perfusion. It is essential that the application of trichlorfon be performed correctly, intravenously, to avoid reactions such as necrosis, pain, edema, erythema, lameness, and even more severe inflammatory reactions, such as phlegmon and thrombophlebitis. Although a small number of animals were used in this study, trichlorfon regional perfusion of equine limbs, at a dose of 1.25 mg/kg may be a technique appears to be inert to hoof vascularization.

Biodegradable properties of AZ31-0.5Ca magnesium alloy

ABSTRACT In this work, the effect of Ca addition on the microstructure, mechanical properties, electrochemical corrosion and biocompatibility of AZ31 Mg alloy was investigated. Scanning electron microscopy and electron probe microanalyzer were used to analyse microstructural characteristics of both alloys. Open circuit potential , potentiodynamic polarisation and electrochemical impedance spectroscopy techniques were carried out in Ringer lactate solution at 37 ± 1°C to determine the mechanism of corrosion and rate of deterioration of AZ31 and AZ31-0.5Ca. The results revealed that addition of Ca significantly enhanced the corrosion resistance of AZ31 (20.21 mpy and 10.08 mpy for AZ31 and AZ31-0.5Ca, respectively), which was attributed to the presence of second phase particles. the cell viability and biocompatibility of the both alloys were determined by performing the cytotoxicity test after 24 h, 48 h and 72 h incubation in L929 and MC3T3-E1 cell extract. Both the alloys demonstrated adequate cell viability and biocompatibility.

Effect of heparin sodium on postoperative inflammation after adult cataract surgery

To evaluate the effect of use of ringer lactate solution supplemented with heparin sodium in patients undergoing cataract surgery.In a prospective, double-blind, interventional study, 200 patients were included and were randomized to undergo cataract surgery using ringer lactate solution with or without 10 IU/ml heparin. All patients underwent phacoemulsification with hydrophobic acrylic foldable intraocular lens (IOL) implantation. The severity of anterior chamber inflammation and amount of pigment deposition of IOL was assessed by slit lamp biomicroscopy on day 1, 7, 28 and after 8 weeks postoperatively. Mean age in treatment and control group was 63.0± 11.5 years and 65.1±12.7 years respectively. A significant reduction in the severity of inflammatory cellular activity (p=0.001), flare (p=0.001) and pigment deposition on IOL (p=0.001) was noted on day 1 in the heparin treated group compared to the control group. However, no significant difference was observed in the amount of inflammatory activity as well as IOL pigment deposition beyond 1 week postoperatively. The inflammatory activity resolved almost completely in both the groups by the end of 8 weeks postoperatively. : Our study showed the beneficial effect of addition of heparin to irrigating solution during cataract surgery. Heparin treated eyes demonstrated a reduction in the early postoperative inflammation and IOL pigment deposition. The anti-inflammatory effect was observed in the early postoperative period.

Effects of N-acetylcysteine on the inflammatory response and bacterial translocation in a model of intestinal obstruction and ischemia in rats.

To evaluate effect of N-acetylcysteine (NAC) associated with Ringer lactate or hypertonic saline in inflammation and bacterial translocation on experimental intestinal obstruction (IO). Wistar rats was subjected to IO. Six or 24 hours after, rats were subjected to enterectomy and fluid resuscitation: IO, RL (subjected to the same procedures but with fluid resuscitation using Ringer's lactate solution); RLNAC (added NAC to Ringer's solution); and HSNAC (surgical procedure + fluid reposition with 7.5% hypertonic saline and NAC). After 24 h, tissues were collected to cytokines, bacterial translocation, and histological assessments. In kidney, interleukin-1beta (IL-1beta) was lower in the groups with fluid resuscitation compared to IO group. The RLNAC showed lower levels compared to the RL. Interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), and (IFN-gamma) were lower in the treatment groups than in IO. In lung, IL-1beta and IL-6 were lower in RLNAC compared to IO. IL-10 was lower in RL, RLNAC and HSNAC compared to IO. TNF-alpha was higher in HSNAC compared to both RL and RLNAC. Bacterial translocation was observed in all animals of IO group. In kidneys, inflammation and congestion degrees were lower in HSNAC compared to RL. In lungs, inflammation levels were higher in RLNAC compared with the sham group. The data indicates that NAC associated with RL can promote a decrease in the inflammatory process in the kidneys and lungs in rats, following intestinal obstruction and ischemia in rats.

Dexmedetomidine suppresses serum syndecan-1 elevation and improves survival in a rat hemorrhagic shock model.

Hemorrhagic shock causes vascular endothelial glycocalyx (EGCX) damage and systemic inflammation. Dexmedetomidine (DEX) has anti-inflammatory and EGCX-protective effects, but its effect on hemorrhagic shock has not been investigated. Therefore, we investigated whether DEX reduces inflammation and protects EGCX during hemorrhagic shock. Anesthetized Sprague-Dawley rats were randomly assigned to five groups (n=7 per group): no shock (SHAM), hemorrhagic shock (HS), hemorrhagic shock with DEX (HS+DEX), hemorrhagic shock with DEX and the α7 nicotinic type acetylcholine receptor antagonist methyllycaconitine citrate (HS+DEX/MLA), and hemorrhagic shock with MLA (HS+MLA). HS was induced by shedding blood to a mean blood pressure of 25–30 mmHg, which was maintained for 30 min, after which rats were resuscitated with Ringer’s lactate solution at three times the bleeding volume. The survival rate was assessed up to 3 h after the start of fluid resuscitation. Serum tumor necrosis factor-alpha (TNF-α) and syndecan-1 concentrations, and wet-to-dry ratio of the heart were measured 90 min after the start of fluid resuscitation. The survival rate after 3 h was significantly higher in the HS+DEX group than in the HS group. Serum TNF-α and syndecan-1 concentrations, and the wet-to-dry ratio of heart were elevated by HS, but significantly decreased by DEX. These effects were antagonized by MLA. DEX suppressed the inflammatory response and serum syndecan-1 elevation, and prolonged survival in rats with HS.

Influence of calcium lactate and sodium fluoride solution mouthwashes on enamel microhardness and dentin permeability during in-office bleaching

Objective: This study evaluated the influence of calcium lactate and sodium fluoride mouthwashes on enamelmicrohardness and dentin permeability during in-office bleaching. Material and Methods: For the microhardnessevaluation, enamel blocks were randomly submitted to different treatments associated with in-office bleachingagent using 40% hydrogen peroxide (Opalescence Boost PF 40%/ Ultradent; 3 sessions x 40-minute each)(n = 10): 1) Control: application of bleaching agent; 2) Calcium lactate: 1-minute immersion before bleachingtreatment; 3) Sodium fluoride: immersion for 1 minute before bleaching treatment; 4) Calcium lactate +sodium fluoride: 1 minute immersion in calcium lactate solution, followed by 1 minute immersion in sodiumfluoride before bleaching treatment. Dentin discs received the same treatment protocols (n = 10) to evaluatepermeability. Knoop microhardness and dentin permeability assessments were performed twice (at baseline and48 hours after the end of bleaching treatment). Results: The generalized linear model considering the design ofrepeated measures over time showed that there was no significant difference between treatments (p = 0.9577)and between assessments (p = 0.3267) regarding Knoop microhardness. Kruskal Wallis and Dunn tests showedthat calcium lactate immersion before bleaching treatment provided higher dentin permeability than othergroups (p = 0.0009). Conclusion: The use of sodium fluoride solution and calcium lactate in association within-office bleaching treatment did not influence the microhardness of tooth enamel, although calcium lactatemay increase dentin permeability.KEYWORDSTooth bleaching; Dentin; Sodium fluoride; Calcium lactate; Hardness tests.

PYRUVATE DEHYDROGENASE COMPLEX ACTIVITY IN THE RAT`S KIDNEYS UNDER CONDITIONS OF TOXIC ACETAMINOPHEN DAMAGE WITH PROTEIN DEFICIENCY

The aim of this work was to study the research the enzymatic activity of pyruvate dehydrogenase complex and lac-tate dehydrogenase and determination of the lactate/pyruvate ratio in rat kidneys under conditions of toxic damage by acetaminophen against the background of protein deficiency.The activity of the pyruvate dehydrogenase complex activity was determined according to a method based on the reaction of oxidative decarboxylation of pyruvate with simultaneous reduction of NAD+, which is measured spectrophotometrically at 340 nm. LDH activity was studied by an optimized optical method, which is based on the reaction of conversion of pyruvate to lactate with concomitant oxidation of NADH, which was measured using a spectrophotometer at λ = 340 nm. Lactate content was measured spectrophotometrically by the ability of FeCl3 to interact with lactate ions, resulting in the formation of a bright yellow iron lactate solution, which is recorded at a wavelength of 390 nm. The concentration of pyruvate was deter-mined by the modified Umbright method, which is based on the reaction of the interaction of pyruvate with 2,4-Dinitrophenylhydrazine (2,4-DNPH) in an alkaline medium, during which hydrazine is formed, which was recorded using a photoelectrocolorimeter at λ = 440 nm. The study was conducted on 4 groups of experimental animals: I - control animals (K); II – rats kept on a low-protein diet (LPD); ІІІ – animals in which acute toxic damage was caused by acetaminophen (TI); IV – rats on a low-protein diet, simulated acute toxic damage with acetaminophen (LPD/TI). It is demonstrated that under the conditions of dietary protein deficiency in the kidneys, there is a decrease in the activi-ty of the pyruvate dehydrogenase complex while maintaining the control indicators of the lactate/pyruvate ratio and lactate dehydrogenase activity. However, under the conditions of the toxic effect of acetaminophen against the back-ground of dietary protein deficiency in the kidneys, an intensification of the anaerobic pathway of energy supply is observed, as evidenced by a significant decrease in the activity of the pyruvate dehydrogenase complex, an increase in the lactate/pyruvate ratio against the background of lactate dehydrogenase activation. The obtained results can be used to justify approaches to correct energy deficit in animals under the conditions of acetaminophen overdose against the background of protein deficiency.

Thermal stability of a functional probiotic food ingredient based on encapsulated microorganisms Lactobacillus plantarum SP-A3

Recently, there has been increased interest in the production of functional probiotic food products such as cheese, yogurt and ice cream, as well as beverages and products based on meat, fruit, chocolate, etc. However, the range of such products is extremely limited, partly due to the difficulty of maintaining the viability of probiotic microorganisms. The thermal stability of the encapsulated L. plantarum SP-A3 culture was evaluated under conditions simulating the heat treatment of fortified food products. The object of the study is nearly pure culture of L. plantarum SP-A3 from the probiotic drug Lactobacterin (Mitrogen NPO). We used deep culture method on a dense nutrient medium – MRS agar at 37°C. The test culture was encapsulated in a 2 % alginate gel by B-390 apparatus (Buchi) using a 2 % calcium lactate solution as a fixative. Two types of microcapsules were obtained and studied: 200-300 µm and 400-600 µm in size. The capsules had a rounded regular shape, matte white, uniform color and were elastic. The efficiency of encapsulation with the proposed parameters was about 89%. We studied the possibility of using a model system simulating cooling of a food product after heat treatment. Both objects pass the most critical temperature ranges from 70 to 60 °C in a similar way, the use of a model system to study the survival of microorganisms when cooling a real food product after heat treatment is adequate. The study did not identify statistically significant differences between the capsule size (200-300 µm and 400-600 µm) and the survival after heat treatment (74,7±0,7% and 68,8±1,2%, respectively). Compared to unencapsulated cells (0% in three independent experiments), microencapsulated probiotics showed higher survival rates of up to 75,4%. Thus, with the use of microencapsulated probiotics, the range of probiotic foods can be expanded.

Randomized trial of bolus ephedrine or mephentermine for maintenance of arterial pressure and fetal outcome during spinal anesthesia for the cesarean section

Background and Aims: Spinal anesthesia remains the preferred choice for cesarean deliveries, but hypotension is one of the common complications which may have detrimental effects on both the mother and fetus. In this study, we compared the efficacy and adverse effects of bolus doses of ephedrine hydrochloride and mephentermine sulfate administered intravenously to treat spinal-induced hypotension and the fetal outcomes through Apgar scores and umbilical cord blood gas analysis in the lower segment cesarean section. Material and Methods: In this prospective, randomized, double-blind study, 60 patients undergoing the lower segment cesarean section (LSCS) under spinal anesthesia were randomized into two groups of 30 each using computer-generated random numbers which were kept in an opaque envelope. Patients were pre-loaded with Ringer's lactate solution 10 ml/kg before the spinal anesthesia. Hypotension was defined as the fall in systolic blood pressure of less than or equal to 20% of the baseline or systolic blood pressure of less than 90 mmHg. Whenever hypotension occurred, patients in group E (ephedrine) received a bolus dose of ephedrine 6 mg intravenous and patients in group M (mephentermine) received a bolus dose of mephentermine 6 mg intravenous. Intra-operative recording included maternal hemodynamic parameters and the number of bolus doses of study drugs required to treat maternal hypotension and the adverse effects of study drugs. The Apgar score and umbilical cord blood gas values were recorded. Data were analyzed by analysis of variance test, Student's t-test, and Chi-square test. A P value of < 0.05 was considered as significant. Results: There was a statistically significant (p < 0.05) increase in systolic and mean arterial blood pressure at the second min and fourth min after administration of ephedrine in group E compared to mephentermine in group M. The systolic blood pressure at the second min in the ephedrine group was 114.3 ± 12.06, whereas in the mephentermine group, it was 106.10 ± 8.41 and was statistically significant (p < 0.05). At the fourth min, the systolic blood pressure in the ephedrine group was 115.03 ± 8.87, whereas in the mephentermine group, it was 108.46 ± 8.10 and was statistically significant (p < 0.05). There was a transient increase in heart rate immediately after administration of spinal anesthesia. The mean number of bolus doses of vasopressor consumption was 2.4 (14.4 mg) in the ephedrine group and 2 (12 mg) in the mephentermine group. The umbilical cord blood gas analysis and Apgar scores were similar in both the groups. Three patients (10%) developed bradycardia in the mephentermine group compared to the ephedrine group (0%). The incidence of nausea (13.3% vs 3.3%) and vomiting (10% vs 1%) was higher in the ephedrine group compared to the mephentermne group, and it was not statistically significant (p > 0.05). No significant differences were observed in the umbilical arterial blood pH and Apgar scores. Conclusion: In conclusion, after hypotension, ephedrine and mephentermine administration as bolus doses are equally efficacious in preventing spinal-induced hypotension in patients undergoing the cesarean section and are associated with similar neonatal outcomes.

In English

The interfacial properties (dynamic and equilibrium surface tension, viscosity and elasticity moduli) of chitosan lactate have been studied at the liquid/air interface by the oscillating drop shape method. Isotherms of dynamic surface tension of chitosan lactate are similar to dependences for other polyelectrolyte solutions, in particular for proteins. Chitosan is a weak cationic polyelectrolyte which can change its conformation from a linear rod to a chaotic and compacted coil. Therefore, the experimental dependence of the equilibrium surface tension on concentration of chitosan lactate was analyzed with the adsorption model proposed earlier for proteins. This model accounts the possibility of polyelectrolyte molecules existence in surface layer in n states with different molar surface varying from the maximum value at very low surface coverage by polyelectrolyte molecules to a minimum value at high surface coverage. Good agreement between the calculated and experimental values of surface tension was observed. The dependences of the elasticity and viscosity moduli of chitosan lactate solutions on the drop oscillations frequency are conditioned by the influence of exchange processes both between the surface layer and the bulk solution and in the surface layer itself. An increase of the solution concentration intensifies the exchange processes, and an increase of the oscillation frequency suppresses them. It is shown that the dependence of the surface viscoelasticity modulus of chitosan lactate is extreme in nature with a pronounced maximum. The reason for such behavior is the possibility of changing the molar surface area of the polyelectrolyte at the interface dependent on the amount of adsorption and its structural properties. Attempt of theoretical description of the viscoelasticity modulus within the framework of model accounting mono- or bilayer adsorption did not lead to a satisfactory result, possibly due to barrier adsorption mechanism of chitosan. But bilayer model provide qualitative description of extreme behavior of surface viscoelasticity on concentration. The values of the surface viscoelasticity modulus of chitosan lactate occupy an intermediate position in comparison with the data available in the literature for globular and flexible-chain proteins, that is consistent with their molecular structure. In addition, the work shows the applicability of the adsorption model, developed earlier for proteins in the framework of a nonideal two-dimensional solution theory, for describing the surface properties of other polyelectrolytes. This makes it possible to obtain qualitative and quantitative information about the processes occurring in the systems under study.

Intraarticular injections of platelet rich plasma and plasma rich in growth factors with arthrocenthesis or arthroscopy in the treatment of temporomandibular joint disorders: A systematic review

Intra-articular platelet rich plasma injections [PRP] or platelet rich growth factors [PRGF] injections have been used as therapeutic treatment options for patients with temporomandibular joint disorder [TMD] in recent years. The purpose of this paper is to evaluate the level of the available scientific evidence in the current literature on the benefits of applying PRP or PRGF injections to patients with TMD simultaneously or after arthrocentesis or arthroscopy to reduce post-operative pain and improve temporomandibular joint function. This systematic review was conducted according to PRISMA criteria and an electronic database search was carried out in the PubMed, Scopus and Cochrane databases during May 2021. The patients in the study group were injected with intra-articular PRP or PRGF simultaneously or after arthrocentesis or arthroscopy while the patients in the control group had arthrocentesis or arthroscopy without an intra-articular injection or received an injection of hyaluronic acid or Ringer's lactate solution. Eight randomised controlled clinical trials were selected. The PRP and PRGF intra-articular injections demonstrated significant differences in terms of pain reduction in three studies and improved mandibular function in two. The treatment with PRP or PRGF intra-articular injections demonstrated slightly better clinical results but of little significance in comparison with the control group. Evidence of their effectiveness is crucial to establish them as non-invasive treatments and as an affordable option for treating some types of TMDs. In accordance with Evidence-based dentistry principles, this review has been assigned a C recommendation.

Calcium pretreatment enhances fluoride reactivity with enamel and dentine

ObjectiveHigh fluoride concentration treatments are known to react with enamel and dentine forming calcium fluoride (CaF2)-like deposits, but strategies to improve this reactivity beyond increasing fluoride concentration/reducing pH in fluoride treatments have not been explored. Here we investigated the ability of a calcium pre-treatment to improve fluoride reactivity. DesignIn a blind and randomized in vitro study, sound and carious enamel and dentine slabs (n = 11/group) were randomly allocated into one of the following treatments: Deionized water (negative control); 0.05% sodium fluoride (F, positive control); 150 mM calcium lactate solution followed by 0.05% sodium fluoride solution (Ca→F); 150 mM calcium lactate solution premixed with 0.05% sodium fluoride solution (CaF2, active control). Alkali-soluble fluoride (representing CaF2-like deposits formed on the substrates) was extracted from the slabs using 1 M KOH for 24 h and measured by an ion-specific electrode. Carious slabs were further observed under scanning electron microscopy (SEM). Data were analyzed by two-way ANOVA followed by Tukey test. ResultsThe Ca→F treatment enhanced fluoride reactivity with all tested substrates when compared with F alone. Carious substrates had a greater reactivity with F and Ca→F than their respective sound substrates, confirming that increased porosity enhances the reactivity with fluoride. Alkali-soluble fluoride concentration after the CaF2 treatment did not differ among the different substrates, suggesting this treatment causes only contamination with preformed CaF2, which was noted under SEM. ConclusionA calcium pretreatment enhances the reactivity of fluoride with enamel and dentine.

Features of treatment of severe acute pancreatitis in obese patients

The purpose of the work is to improve the results of treatment of severe acute pancreatitis in obese patients and to develop an algorithm for comprehensive treatment. Materials and methods. Patients with severe acute pancreatitis and obesity (mean BMI 37.48 ± 2.19 kg/m2) were randomized into two groups. In the experimental group (n = 18; step-up approach),early resuscitation with Ringer's lactate solution and ulinastatin in the first 5 days of the disease was used. Unilastatin was administered at a dose of 200,000IU by 1-hourintra­venous infusion TID for 5 days. The first stage of surgery was a drainage under ultrasound control, the second stage (if necessary) was laparos­copic retroperitoneal necrectomy (video-assisted­retroperitoneal debri­de­ment — VARD). Open surgery was performed in case of development of abdominal compartment syndrome. In the control group (n = 18; standard approach), resuscita­tion was performed with 0.9 % sodium chlo­ride solution without ulinastatin. The first stage of surgery was draina­ge under ultrasound control, the second stage was traditional median laparotomy with laparostomy. Results. The use of resuscitation with Ringer’s lactate solution in combination with ulinastatin for 5 days contributed to a decrease of procalcitoninlevels by 1.8 times (2.89 ± 0.88 compared with 1.8 ± 0.23 ng/mg; p = 0.001; α = 0.05). The level of CRP during the period of ulinastatin decreased by 41.68 mg/l (267.28 ± 114.11 compared with 225.6 ± 84.9 mg/l; p = 0.01; α = 0.05). There was a statistically significant difference in procalcitonin levels between groups on the 10th day (1.83 compared with 3.32 ng/mg; p = 0.001; α = 0.05), on the 15th day (1.15 compared with 1 .83 ng/mg; p = 0.001; α = 0.05) and on the 45th day (0.35 compared with 0.55 ng/mg; p = 0.001; α = 0.05). These results confirm the effect of the proposed method of treatment by reducing the risk of infection. Conclusions. The effectiveness of the proposed treatment algorithm is evidenced by a statistically significant difference in the level of CRP between groups on the 10th day (p = 0.035; α = 0.05). The use of VARD in the experimental group as a second stage of surgery is a less traumatic but effective method (p = 0.001; α = 0.05), which reduces the total number of complications (χ² = 4.012; p = 0.046). Evaluation of data «before—after» revealed the effectiveness of treatment by step-up approach (χ² = 5.4; p = 0.021).

Stroke Volume Variation-Guided Goal-Directed Fluid Therapy Did Not Significantly Reduce the Incidence of Early Postoperative Complications in Elderly Patients Undergoing Minimally Invasive Esophagectomy: A Randomized Controlled Trial

Study Objective: This study aimed to investigate whether stroke volume variation (SVV)-guided goal-directed therapy (GDT) can improve postoperative outcomes in elderly patients undergoing minimally invasive esophagectomy (MIE) compared with conventional care.Design: A prospective, randomized, controlled study.Setting: A single tertiary care center with a study period from November 2017 to December 2018.Patients: Patients over 65 years old who were scheduled for elective MIE.Interventions: The GDT protocol included a baseline fluid supplement of 7 ml/kg/h Ringer's lactate solution and SVV optimization using colloid boluses assessed by pulse-contour analysis (PiCCO™). When SVV exceeded 11%, colloid was infused at a rate of 50 ml per minute; if SVV returned below 9% for at least 2 minutes, then colloid was stopped.Measurements: The primary outcome was the incidence of postoperative complications before discharge, as assessed using a predefined list, including postoperative anastomotic leakage, postoperative hoarseness, postoperative pulmonary complications, chylothorax, myocardial injury, and all-cause mortality.Main Results: Sixty-five patients were included in the analysis. The incidence of postoperative complications between groups was similar (GDT 36.4% vs. control 37.5%, P = 0.92). The total fluid volume was not significantly different between the two groups (2,192 ± 469 vs. 2,201 ± 337 ml, P = 0.92). Compared with those in the control group (n = 32), patients in the GDT group (n = 33) received more colloids intraoperatively (874 ± 369 vs. 270 ± 67 ml, P <0.05) and less crystalloid fluid (1,318 ± 386 vs. 1,937 ± 334 ml, P <0.05).Conclusion: The colloid-based SVV optimization during GDT did not significantly reduce the incidence of early postoperative complications after minimally invasive esophagectomy in elderly patients.Clinical Trial Number and Registry URL: ChiCTR-INR-17013352; http://www.chictr.org.cn/showproj.aspx?proj=22883

Fabrication of GQD-Electrodeposited Screen-Printed Carbon Electrodes for the Detection of the CRP Biomarker.

The traditional three-electrode electrochemical system used in the development of biosensors for detecting various biomarkers of interest necessitates the use of bulk electrodes, which precludes the deployment of handheld electrochemical devices in clinical applications. Affordable screen-printed carbon electrodes (SPCEs) modified with functional interfaces are being developed to enhance the sensitivity of a compact sensing system as a whole. In this work, SPCEs were fabricated on an overhead projection (OHP) sheet in three different active areas of 2 × 2, 3 × 3, and 4 × 4 mm2 using a screen printing technique, and then ∼2 nm sized graphene quantum dots (GQDs) were electrodeposited over the SPCE surface to add functionality for the detection of ultralow levels of one of the cardiac biomarkers, C-reactive protein (CRP). The proposed mediator-dependent voltammetric biosensor exhibited good sensitivity, a low detection limit, and a linear range of 2.45 μA ng–1 mL–1 cm–2, 0.036 ng mL–1, and 0.5–10 ng mL–1, respectively. The fabricated SPCE/GQDs/anti-CRP biosensor could rapidly detect CRP in less than 25 s. The intra- and interassays were performed with five sensor strips, which showed a minimum standard deviation of 1.85 and 2.8%, respectively. The SPCE/GQDs/anti-CRP electrode was used to detect CRP concentrations in a ringer lactate solution. Thus, the developed biosensor has all of the characteristics such as rapidity, inexpensive disposable electrodes, miniaturization, and a lower detection limit needed to evolve as a point-of-care (PoC) application.

Non-cultured epidermal cells suspended in either platelet-rich plasma or ringer lactate for stable vitiligo: A prospective comparative study.

Noncultured epidermal cell suspension (NCES) transplantation is a commonly used surgical treatment for resistant stable vitiligo. The combination of platelet-rich plasma (PRP) with different therapeutic modalities for vitiligo yielded higher repigmentation response, probably due to platelet-derived growth factors. To evaluate the efficacy of PRP-suspended NCES compared to NCES suspended in Ringer's lactate (RL) solution in the treatment of stable vitiligo. A prospective comparative study was conducted on 40 patients with stable vitiligo. They were divided into two equal groups: group A (treated with RL-suspended NCES) and group B (treated with PRP-suspended NCES). All patients were followed-up for 6months for assessment of their therapeutic response regarding clinical outcomes and immunohistochemical expression of HMB-45 in lesional skin. Patients treated with PRP-suspended NCES showed a significantly higher repigmentation response compared to those treated with RL-suspended NCES at 1, 3, and 6months after treatment (p=0.015, 0.023, 0.029, respectively). The expression of HMB-45significantly increased in both groups after therapy, but without a significant difference between the two groups. The repigmentation response of NCES can be enhanced by suspending the melanocytes in autologous PRP.

Comparison of intravenous bolus doses of phenylephrine vs ephedrine along with crystalloid co-loading in the prevention of hypotension during spinal anesthesia for caesarean section

Caesarean section was the first obstetrical operation that saves the life of the baby when normal delivery fails. Spinal anaesthesia is the most appropriate method for caesarean section. But hypotension is the most common side effect of it in patient with pregnant uterus. To compare the vasopressor effects of ephedrine and phenylephrine in ameliorating hypotension in elective caesarean delivery receiving crystalloid coloading, during intrathecal bupivacaine injection.: Study participants were randomly divided into two groups of 50 patients each. After subarachnoid block, all the parturients were given rapid administration of ringer lactate solution 20ml/kg, during the initial 5 minutes of surgery the parameters such as oxygen saturation, blood pressure and pulse rate recorded for every one minute followed by every five minutes until the completion of the surgery. The incidence of hypotension, bradycardia, nausea/vomiting, block height and requirements of vasopressor (ephedrine and phenylephrine) were recorded. Apgar score, and blood sample from umbilical cord was taken and sent for blood gas analyses to determine the neonatal outcome.: Vasopressor consumption was more in phenylephrine group (92±112 µg) compared to ephedrine group (4.8±5.5 mg) which was statistically significant p=0.0001. The neonatal outcome was statistically significant regarding umbilical cord pH (Group E-7.2±0.06 and Group P-7.37±0.04 with p=0.002) but clinically no true fetal acidosis in either groups and no significant changes regarding Apgar score in the two groups.: Thus we conclude that that ephedrine 6 mg and phenylephrine 100 µg does not differ in their efficacy to manage hypotension during spinal anaesthesia for caesarean delivery. However, maternal bradycardia was more in the phenylephrine group with equal incidence of fetal acidosis in the study groups.

Study of renal function indices to determine hypoxic hypoxia resistance in divers

Aim: using oral stress kidney tests to reveal changes in renal function and water-electrolyte metabolism in divers with different initial resistance to hypoxic hypoxia.Materials and methods. 44 men were studied. All subjects were evaluated for their initial resistance to hypoxic hypoxia. Oral renal stress tests were performed to determine the status of kidney function.Results and their discussion. For the selection of divers, it is necessary to carry out oral stress tests with water, 10% potassium chloride solution and 7.5% calcium lactate solution. In divers with low and medium resistance to hypoxic hypoxia, there is a deterioration in the calcium and potassium uretic function of the kidneys after oral stress renal tests. The method for determining the resistance of divers to hypoxic hypoxia should be supplemented by the regularity developed by us.