Severe Inflammatory Process Research Articles

Sterile pyogranulomatous pericarditis in a dog

AbstractA 4‐year‐old, neutered, female crossbreed dog was presented with a chronic history of weakness and hyperthermia. Echocardiography showed mild pericardial effusion. Fluid analysis revealed a marked non‐septic neutrophilic‐macrophagic exudate. Pericardial fluid and blood culture were negative. Leishmania spp., Ehrlichia spp., Bartonella spp., Babesia spp., Mycoplasma spp. and Hepatozoon spp. reverse transcription polymerase chain reaction tests were also negative. Initially, a good response to pericardiocentesis, empirical antibiotic therapy and prednisone was observed. However, pericardial effusion recurred and a subtotal pericardiectomy was performed. Histopathology of the pericardial tissue showed a severe pyogranulomatous inflammatory process. Periodic acid–Schiff and Ziehl–Neelsen stains, pericardial tissue culture and fluorescence in situ hybridisation were negative. Clinical signs recurred, and prednisone was prescribed again. Twenty‐two months after prednisone withdrawal, the dog remains asymptomatic. This is the second report of idiopathic sterile pyogranulomatous pericarditis in a dog, and the first report using fluorescence in situ hybridisation to evaluate the presence of bacterial pericarditis.

Morphological Assessment of the Influence of Gold Nanosolution on Reparative Processes in Chronic Gingivitis

The article discusses the evaluation of the effectiveness of treating chronic gingivitis in experimental animals using a gold nanosolution. It presents the results of morphological studies aimed at studying changes in the tissues of cats suffering from chronic gingivitis after the introduction of gold nanoparticles under the mucous membrane. The aim of the study was to determine the effect of a gold nanosolution in the treatment of chronic gingivitis in 20 mongrel cats aged 2 to 4 years. Materials and methods: A group of cats diagnosed with chronic gingivitis was formed for the experiment. The experiment was carried out in accordance with the "European Convention for the Protection of Animals Used for Experimental and Scientific Purposes" dated March 18, 1986. All cats had a history of severe inflammatory processes in the oral cavity, which caused pain when eating solid food. After eating such food, the animals often had bloody saliva. Most of them suffered from weight loss, which posed a serious threat to their health. The oral cavity condition assessment included visual inspection and photo recording. The surgical process in each case included preparation of the surgical field with plaque removal and polishing of the teeth with a special paste. Before comprehensive teeth cleaning, the animals had their inflamed mucosal tissue cut off. Experimental studies conducted by the authors demonstrated the high therapeutic efficacy of gold nanosolution in the treatment of chronic gingivitis. There was a complete absence of signs of inflammation, such as bleeding, abnormal tooth mobility, or discharge during palpation of the gums, which confirmed the pronounced regenerative effect of gold nanoparticles.

Comparative analysis of the parameters of local immunity of oral fluid and the duration of the course in children with systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, juvenile idiopathic arthritis and systemic vasculitis

Immunoglobulins are considered to be the main factor of specific antimicrobial protection of oral tissues.The study was conducted on the basis of the University Children’s Clinical Hospital of the I.M. Sechenov First Moscow State Medical University of the N.F. Filatov Clinical Institute of Child Health, in the Department of Rheumatology. The study involved 316 children, with diseases: systemic lupus erythematosus (SLE), juvenile dermatomyositis (YDM), juvenile limited scleroderma (YOSD), juvenile systemic scleroderma (YSSD), juvenile idiopathic arthritis (JIA), systemic vasculitis (SV) and Behcet’s disease (BB) and were divided into age groups according to the duration of the course of the underlying disease. The analysis of the results revealed a decrease in the content of IgG, IgA, sIgA in saliva in children with rheumatic diseases in all age groups compared with the control group (children without somatic diseases). With the duration of the course of the disease up to 2 years, the most pronounced decrease in the content of IgG, IgA, sIgA in saliva was revealed, more than 4–10 times (p<0.05), and with a duration of more than 2 years, a decrease of 2–3 times (p<0.01), compared with the control group. The deficiency of these immunoglobulins shows that in children with rheumatic diseases, regardless of the nosology, there is a violation of the local immunity of the oral cavity, especially at the onset of the underlying disease (in groups up to 2 years of the duration of the course of the underlying disease), with pronounced autoimmune inflammation of tissues and blood vessels, and this is also facilitated by the reception, during this period of shock doses of glucocorticosteroids, cytostatics, immunosuppressors, which leads to severe inflammatory processes of the oral mucosa, periodontal and hard tissues of the teeth.

A patient with a severe odontogenic inflammatory process, treated in the conditions of bacterial resistance - a case report

A patient with a severe odontogenic inflammatory process, treated in the conditions of bacterial resistance - a case report

Small airway inflammation in atypical asthma

BackgroundLess attention has been paid to the pathophysiological changes in atypical asthma such as cough variant asthma (CVA) and chest tightness variant asthma (CTVA). The obstruction of large and small airways is the important component in the development of asthma. We investigated whether small airway inflammation (SAI) induced small airway dysfunction (SAD) in these atypical asthmatics. MethodsSix hundred and eighty-six patients were enrolled and analyzed in the study. The partitioned airway inflammation was assessed by fractional exhaled nitric oxide (FeNO), such as FnNO, FeNO50, FeNO200, and calculated alveolar fraction of exhaled NO (CaNOdual). Correlations between exhaled NOs and SAD-related variables were assessed, whereas cell classification was evaluated by Spearman's rank tests. Classic asthma, CVA, and CTVA about potential risk were conducted using binary logistic regression models. ResultsThe whole airway inflammation increased in classic and atypical asthma than controls, whereas the central and peripheral airway inflammation in the CVA and CTVA groups increased compared with the classic asthma group. Smoking exposure was found to increase the central and peripheral airway inflammation in patients with asthma. The exhaled NO of FeNO50 and FeNO200 was associated with SAD in classic asthma, but not in CVA and CTVA. FeNO200 was the main risk (adjusted odds ratio [OR], 1.591; 95 % CI, 1.121–2.259; P = .009) in classic asthma and (adjusted OR, 1.456; 95 % CI, 1.247–1.700; P = .000) in CVA. The blood eosinophil levels were correlated with FeNO50 and FeNO200 in classic asthma and atypical asthma. ConclusionMore severe inflammatory process was present in central and peripheral airways in CVA and CTVA, which might reflect a pre-asthmatic state. SAI was the predominant risk factor in the development of asthma before SAD.

P-324 Finding on the gut microbiome impact on non-reproductive pathologies of the uterus: an endometriosis perspective

Abstract Study question Is there any link between intestinal microbiome and endometriosis? Summary answer The aetiopathogenesis of endometriosis might be linked to intestinal dysbiosis. Microorganisms could be used as potential microbiota-mediated metabolites therapy to target the estrobolome in endometriosis. What is known already Endometriosis (EMs) is a chronic estrogenic-dependent gynaecological condition with a complex and multifactorial aetiology, characterized by the presence of endometrial glands and endometrial-like tissue outside the uterus, accompanied by a severe inflammatory process. Sampson’s theory of retrograde menstruation is considered one of the most convincing hypotheses for the origin of EMs. Recently, the human microbiome has been linked to its pathogenesis, and exits some evidence that it might modulate the immune system from the gut, therefore the generation of a dysfunctional immune response caused by intestinal dysbiosis might play an important role in the initiation and progression of EMs. Study design, size, duration A case-control study was designed to analyse intestinal microbiome from EMs patients and age-matched healthy women. Herein, we aim to investigate for potential intestinal biomarkers related to the pathology. The recruitment was through health questionnaires such as EHP-5 setting the initial cohort at 243 women. This initial cohort was screened according to inclusion and exclusion criteria. Participants/materials, setting, methods Seventy-seven women met eligibility criteria and were enrolled in the study. Stool samples from the controls group (n = 43) and patients with a positive diagnosis of EMs (n = 34) were collected and subjected to 16S rRNA gene sequencing using the V3-V4 regions. Various multivariate analysis approaches were used to assess diversity, composition and abundance of intestinal microbiota. Main results and the role of chance The number of significantly different taxa between healthy controls and EMs patients were 18 (p-value<0.05). Among these 18 taxa, we found 3 families: Bacteroidaceae, Lactobacillaceae and Desulfovibrionaceae; 3 genera: Blautia, Anaerostipes and Lachnospira; and 12 species: Roseburia intestinalis, Bacteroides uniformis, Anaerobutyricum hallii, among others), with a higher diversity of families and genera in the patient group, while the control group had a higher diversity of species, according to the results of Shannon and Simpsońs indexes. This suggests that EMs is dominated by a few species belonging to a wide variety of families and genera, while in the control group there is a greater variability of intestinal species belonging to a smaller number of families and genera. These taxa were related with molecular routes implied in the management of inflammation and estrogens signalling. Additionally, the data were correlated with clinical parameters through the Endometriosis Health Profile-5 questionnaire (EHP-5). This correlation shows significant differences specifically into the «self-image» variable and the total score with the genus diversity (positive and negative correlations were reported), with a strong positive correlations between the variable “Infertility” and the genus Anaerostipes. Limitations, reasons for caution Pronacera develops molecular tests for several conditions that involve the analysis of genes, proteins, and microbes in human samples. Neither the patients nor the healthcare professionals participating in this study have been paid or influenced whatsoever. Hence, the authors report no other potential conflicts of interest. Wider implications of the findings The aetiopathogenesis of EMs might be linked to intestinal dysbiosis. In this sense, the taxa identified in this study and its estrobolome-related metabolite could play a key role in the initiation of the disease, proposing themselves as potential prognostic, diagnostic and therapeutic targets for the future. Trial registration number not applicable

Successful management of pneumonia and pyogranulomatous cranial mediastinitis due to Coccidioides species infection with fluconazole in a 3‐year‐old horse

SummaryA 3‐year‐old Quarter Horse gelding originating from Texas presented for fever and inappetence. An encapsulated, mixed echogenic cranial mediastinal mass visible ultrasonographically in the left and right fourth intercostal space that displaced the heart caudally was identified. Histological evaluation of needle biopsies obtained under general anaesthesia revealed a severe pyogranulomatous inflammatory process associated with intralesional round, 15–25 μm in diameter, thick double‐contoured cell wall fungal structures. Sequencing of products obtained from DNA extracted from the paraffin‐embedded biopsy sample and a panfungal PCR assay targeting the large ribosomal unit region had a 99.1% identity to either Coccidioides immitis or C. posadessii. Bronchoscopy revealed purulent exudate in the right primary bronchus. Cytological evaluation of bronchial alveolar lavage fluid (BALF) contained 96% moderately degenerative neutrophils and 4% macrophages. Fungal structures were not appreciated in the BALF. However, the mediastinitis could have resulted from inhalation and dissemination of arthroconidia through lymphatics or directly from the lung parenchyma. Quantitative immunodiffusion of serum for the presence of coccidioidal IgG antibodies yielded a titre of 1:256 suggestive of disseminated coccidioidomycosis. After oral fluconazole for 24 months, the horse's general health and athletic performance had returned to normal and the mediastinal mass was not appreciated sonographically.

A hyaluronic acid hydrogel as a mild photothermal antibacterial, antioxidant, and nitric oxide release platform for diabetic wound healing

Hyaluronic acid (HA)-based biopolymer hydrogels are promising therapeutic dressings for various wounds but still underperform in treating diabetic wounds. These wounds are extremely difficult to heal and undergo a prolonged and severe inflammatory process due to bacterial infection, overexpression of reactive oxygen species (ROS), and insufficient synthesis of NO. In this study, a dynamic crosslinked hyaluronic acid (HA) hydrogel dressing (Gel-HAB) loaded with allomelanin (AMNP)-N, N′-dis-sec-butyl-N, N′-dinitroso-1, 4-phenylenediamine (BNN6) nanoparticles (AMNP-BNN6) was developed for healing diabetic wounds. The dynamic acylhydrazone bond formed between hydrazide-modified HA (HA-ADH) and oxidized HA (OHA) makes the hydrogel injectable, self-healing, and biocompatible. The hydrogel, loaded with AMNP-BNN6 nanoparticles, exhibits promising ROS scavenging ability and on-demand release of nitric oxide (NO) under near-infrared (NIR) laser irradiation to achieve mild photothermal antibacterial therapy (PTAT) (∼ 48 °C). Notably, the Gel-HAB hydrogel effectively reduced the oxidative stress level, controlled infections, accelerated vascular regeneration, and promoted angiogenesis, thereby achieving rapid healing of diabetic wounds. The injectable self-healing nanocomposite hydrogel could serve as a mild photothermal-enhanced antibacterial, antioxidant, and nitric oxide release platform for the treatment of diabetic wounds.

Pharmacological inhibition of mTORC1 reduces neural death and damage volume after MCAO by modulating microglial reactivity

Ischemic stroke is a sudden and acute disease characterized by neuronal death, increment of reactive gliosis (reactive microglia and astrocytes), and a severe inflammatory process. Neuroinflammation is an early event after cerebral ischemia, with microglia playing a leading role. Reactive microglia involve functional and morphological changes that drive a wide variety of phenotypes. In this context, deciphering the molecular mechanisms underlying such reactive microglial is essential to devise strategies to protect neurons and maintain certain brain functions affected by early neuroinflammation after ischemia. Here, we studied the role of mammalian target of rapamycin (mTOR) activity in the microglial response using a murine model of cerebral ischemia in the acute phase. We also determined the therapeutic relevance of the pharmacological administration of rapamycin, a mTOR inhibitor, before and after ischemic injury. Our data show that rapamycin, administered before or after brain ischemia induction, reduced the volume of brain damage and neuronal loss by attenuating the microglial response. Therefore, our findings indicate that the pharmacological inhibition of mTORC1 in the acute phase of ischemia may provide an alternative strategy to reduce neuronal damage through attenuation of the associated neuroinflammation.

Association between nonalcoholic fatty liver disease and incidence of inflammatory bowel disease: a nationwide population‑based cohort study.

Nonalcoholic fatty liver disease (NAFLD) is a common disease with severe inflammatory processes associated with numerous gastrointestinal diseases, such as inflammatory bowel disease (IBD). Therefore, we investigated the relationship between NAFLD and IBD and the possible risk factors associated with the diagnosis of IBD. This longitudinal nationwide cohort study investigated the risk of IBD in patients with NAFLD alone. General characteristics, comorbidities, and incidence of IBD were also compared. Patients diagnosed with NAFLD had a significant risk of developing IBD compared to control individuals, who were associated with a 2.245-fold risk of the diagnosis of IBD and a 2.260- and 2.231-fold of increased diagnosis of ulcerative colitis and Crohn's disease, respectively (P< 0.001). The cumulative risk of IBD increased annually during the follow-up of patients with NAFLD (P< 0.001). Our results emphasize that NAFLD significantly impacts its incidence in patients with NAFLD. If patients with NAFLD present with risk factors, such as diabetes mellitus and dyslipidemia, these conditions should be properly treated with regular follow-ups. Furthermore, we believe that these causes may be associated with the second peak of IBD.

Do nutritional assessment scores have a relationship with transthyretin levels?

Background and aims: nutritional screening tools assess factors like weight loss, BMI, food intake, and disease severity to determine a patient's nutritional risk and needed care. Plasma transthyretin is a practical measurement used to assess nutritional evolution due to its rapid response to food intake. This study examines the relationship between nutritional scores, transthyretin protein levels, and the possibility of death. Methods: the sample consisted of 302 patients hospitalized in the wards or intensive care unit of a public teaching hospital, using parenteral nutrition as the primary source of nutrition. Five nutritional screening tools were applied, and patient charts were verified for transthyretin levels. Results: from the sample, 260 were adults, and 42 were children, with a mean age of 48.3 years. When evaluating the patient's outcome in relation to the scores, the Malnutrition Universal Screening Tool proved to be better at predicting death (p-value = 0.02). None of the scores were related to transthyretin levels, showing that lower transthyretin values did not influence nutritional risk. Conclusion: we believe early identification of nutritional risk through nutritional scores is necessary for better nutritional monitoring to minimize unfavorable outcomes. This study corroborates the more recent concept that transthyretin is not useful for determining unfavorable outcomes in hospitalized patients with a severe inflammatory process. In clinical practice, identifying a patient at nutritional risk according to the Malnutrition Universal Screening Tool and promoting adequate nutritional monitoring may reduce mortality.

ANALYSIS OF MULTIDRUG RESISTANCE PROTEIN GENE EXPRESSION IN TUBERCULOMAS WITH DIFFERENT INFLAMMATORY ACTIVITY

The aim of the work is to investigate the expression level of the main genes of multidrug resistance proteins of macroorganism somatic cells (MDR-SCM) – ABCB1, ABCC1, ABCG2 – in pulmonary tuberculomas with different inflammatory activity. Materials and methods. Surgical material of pulmonary tuberculoma was obtained from 30 patients (16 men and 14 women). According to the results of histological examination and morphological analysis tuberculoma samples were divided into two groups: with moderate or severe inflammatory process. The level of expression of the ABCB1, ABCC1, and ABCG2 genes was evaluated for all samples by real-time polymerase chain reaction. Results. The genes ABCB1, ABCC1, ABCG2 are expressed in the perifocal zone of tuberculomas and their expression level depends on the activity of inflammation. The highest expression level was found for the ABCB1 gene encoding the P-gp transporter protein.

Terminal endpoints of systemic atherosclerotic processes in sickle cell diseases

Background: Sickle cell diseases (SCD) are severe inflammatory processes in the vasculature mainly on capillary endothelium since they are the main distributors of hardened red blood cells into the tissues. On the other hand, aging and male gender alone may be the most significant underlying risk factors of the systemic atherosclerosis since male gender lives about seven years shorter than female gender worldwide. Methods: All patients with the SCD were included into the study. Results: The study included 222 males and 212 females with similar mean ages (30.8 versus 30.3 years, p&gt;0.05). Smoking (p&lt;0.001), alcohol (p&lt;0.001), disseminated teeth losses (p&lt;0.001), ileus (p&lt;0.001), cirrhosis (p&lt;0.001), leg ulcers (p&lt;0.001), digital clubbing (p&lt;0.001), coronary heart disease (CHD) (p&lt;0.05), chronic renal disease (CRD) (p&lt;0.05), chronic obstructive pulmonary disease (COPD) (p&lt;0.001), and stroke (p&lt;0.05) were all higher in male gender. Interestingly, mean ages of stroke (33.5 years), COPD (33.6 years), clubbing (35.4 years), CHD (35.7 years), cirrhosis (37.0 years), and CRD (39.4 years) were the highest among the other atherosclerotic consequences. Conclusion: Smoking, alcohol, disseminated teeth losses, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, COPD, and stroke-like atherosclerotic risk factors or terminal endpoints were all higher in male gender with the SCD. Since aging alone may be the major associated factor of the systemic atherosclerosis, stroke, COPD, digital clubbing, CHD, cirrhosis, and CRD may be the terminal endpoints of systemic atherosclerotic processes in human body since the mean ages of the above pathologies were the highest among the other atherosclerotic consequences in the SCD. Key words: Sickle cell diseases, atherosclerosis, stroke, chronic obstructive pulmonary disease, digital clubbing, coronary heart disease, cirrhosis, chronic renal disease

Acute chest syndrome and coronavirus disease may actually be genetically determined exaggerated immune response syndromes particularly in pulmonary capillaries

Background: Sickle cell diseases (SCD) are severe inflammatory processes on vascular endothelium, particularly at the capillaries since the capillary system is the main distributor of hardened red blood cells into the tissues. Similarly, coronavirus disease (COVID-19) may also be a genetically determined inflammatory process particularly in pulmonary capillaries with much higher mortality rates in some families. Methods: All patients with the SCD were studied. Results: The study included 222 males and 212 females with similar mean ages (30.8 versus 30.3 years, p&gt;0.05, respectively). Smoking (23.8% versus 6.1%, p&lt;0.001), alcohol (4.9% versus 0.4%, p&lt;0.001), disseminated teeth losses (5.4% versus 1.4%, p&lt;0.001), ileus (7.2% versus 1.4%, p&lt;0.001), cirrhosis (8.1% versus 1.8%, p&lt;0.001), leg ulcers (19.8% versus 7.0%, p&lt;0.001), digital clubbing (14.8% versus 6.6%, p&lt;0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p&lt;0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p&lt;0.05), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p&lt;0.001), and stroke (12.1% versus 7.5%, p&lt;0.05) were all higher but not acute chest syndrome (ACS), in males (2.7% versus 3.7%, p&gt;0.05). Conclusion: Although smoking, alcohol, disseminated teeth losses, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, COPD, and stroke-like atherosclerotic end-points were all higher in males, prevalence of ACS was similar in both genders. In another definition, ACS and severe COVID-19 may be genetically determined exaggerated immune response syndromes particularly in pulmonary capillaries, and immunomodulatory drugs including dexamethasone probably should take the major role in the treatment. Key words: Acute chest syndrome, coronavirus disease, exaggerated immune response syndromes, sickle cell diseases, capillary endothelial inflammation, capillary endothelial edema, tissue hypoxia

Клиническое значение интегральной регистрации маркеров эндотоксического иммунитета и колонизационной резистентности буккальных эпителиоцитов при рецидивирующем бронхите у подростков

Recurrent bronchitis (RB) occupies one of the key places in the structure of nonspecific diseases of the respiratory tract and remains a significant medical and social problem in healthcare. The purpose — to investigate and evaluate the clinical significance of integral registration of markers of endotoxic immunity and colonization resistance of buccal epithelial cells (BE) in RB in adolescents. Material and methods. The study included 117 children (12–17 years old), including 78 with RB — the main group, 29 with acute bronchitis (AB) — the comparison group and 23 conditionally healthy children — the control group. The analysis of anamnestic, clinical, paraclinical data, verification of etiologically significant viruses, registration of artificial colonization of buccal epithelial cells (BE), colonization index (CI), micro-LAL test were carried out. Statistical processing of the results was carried out using the SPSS program. Results. A significant difference in markers of colonization resistance and anti-endotoxin protection was revealed in recurrent inflammation in the respiratory tract in comparison with AB in peers. In RB, the initial degree of Candida albicans adhesion to BE was significantly higher in relation to AB (p = 0.0427) and upon discharge from the hospital did not reach normative values, being significantly different from patients with AB (p = 0.0391). The high index of artificial colonization indicates the activation of allochthonous flora and disruption of the microbiota in the oral cavity, which negatively affects the body reactivity. In patients with RB, the titer of antiglycolipid antibodies significantly decreased and in 75% the values did not return to normal, while in AB they did not differ from the control. High levels of endotoxin were noted in RB compared to AB (p = 0.0317). Such patients were diagnosed with a more severe course of the disease with symptoms of endogenous intoxication and a long hospitalization period. Using the method of correlation analysis, a high direct relationship was established between artificial colonization and endotoxin concentration (r = 0.71). The relationship between these parameters in AB was significantly less pronounced (r = 0.3). The results obtained indicate close integration and mutual modulation of the local oral immunity and antiendotoxin defense. Conclusion. Integral registration of the markers of reactivity of specific anti-endotoxin immunity and colonization resistance reflect the severe inflammatory process in the respiratory tract and predict the risk of a chronic pathological process in the bronchopulmonary system.

Pielonefritis xantogranulomatosa: un reto actual para la laparoscopia.

To present the results of our case series on laparoscopic nephrectomy in xanthogranulomatous pyelonephritis (XGP). A retrospective study was conducted that included 143 patients treated with laparoscopic nephrectomy for non-functioning kidney, of whom 15 had XGP, within the time frame of 2011 to 2019. The demographic and clinical data were collected, along with the intraoperative results, complications, and days of hospital stay. Transperitoneal laparoscopic nephrectomy was successfully performed on 15 patients with XGP, with no need for conversion. Mean intraoperative time was 124.4 minutes (range 70-240) and intraoperative blood loss was 148.5 ml (range 30-550), with no blood transfusion required. No intraoperative complications occurred but there was one postoperative complication (6.6%), classified as Clavien-Dindo I (surgical wound infection). Mean hospital stay was 2.85 days (range 2-7). Nephrectomy is the definitive management for XGP, and the laparoscopic approach should be considered a treatment modality, despite the fact that the pathology involves a severe chronic inflammatory process. Its benefits are reduced surgery duration, less blood loss, a lower complication rate, and fewer days of hospital stay, when performed by a skilled and experienced surgeon.

HAEMATOLOGICAL ALTERATIONS IN CALVES WITH ACUTE RESPIRATORY DISTRESS SYNDROME DUE TO ASPIRATION PNEUMONIA: A PROSPECTIVE STUDY

The aim of this prospective study was to investigate the arterial blood gas (ABG) analysis, which is considered the gold standard, and complete blood count (CBC) as a complementary test in neonatal calves with acute respiratory distress syndrome (ARDS) due to aspiration pneumonia. Ten healthy and 20 calves with ARDS due to aspiration of milk/colostrum were enrolled in the study. Clinical examinations were performed at admission. ABG analyses were performed to determine the presence of ARDS and investigate the extent of lung ventilation/damage. CBC analysis was performed from venous blood samples. Heart and respiratory rates and body temperature values were higher in diseased calves than healthy ones (p &lt; 0.000). Arterial pH, partial pressure of oxygen in arterial blood (PaO2) and saturation of oxygen in arterial blood (SaO2) were lower (p &lt; 0.001) in the diseased calves, while partial pressure of carbon dioxide in arterial blood (PaCO2) and lactate levels were higher (p &lt; 0.000) than those in healthy ones. Also, leukocyte (WBC), lymphocyte, monocyte, granulocyte, mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH) levels were higher in the diseased calves than the healthy calves (p &lt; 0.032). As a result of the correlation analysis, the only correlation was determined to be between PaO2 and WBC, which was moderately negative. As a result, it was observed that leukocytosis developing in respiratory diseases that cause severe inflammatory processes such as aspiration pneumonia was negatively correlated with PaO2 and could potentially exacerbate hypoxia, and ABG evaluation with CBC could provide useful clinical data in calves with ARDS due to aspiration pneumonia.

Coenzyme Q10 exhibits anti-inflammatory and immune-modulatory thereby decelerating the occurrence of experimental cerebral malaria

Cerebral Malaria (CM) is associated with the complex neurological syndrome, whose pathology is mediated by severe inflammatory processes following infection with Plasmodium falciparum. Coenzyme-Q10 (Co-Q10) is a potent anti-inflammatory, anti-oxidant, and anti-apoptotic agent with numerous clinical applications. The aim of this study was to elucidate the role of oral administration of Co-Q10 on the initiation or regulation of inflammatory immune response during experimental cerebral malaria (ECM). For this purpose, the pre-clinical effect of Co-Q10 was evaluated in C57BL/6 J mice infected with Plasmodium berghei ANKA (PbA). Treatment with Co-Q10 resulted in the reduction of infiltrating parasite load, greatly improved the survival rate of PbA-infected mice that occurred independent of parasitaemia and prevented PbA-induced disruption of the blood-brain barrier (BBB) integrity. Exposure to Co-Q10 resulted in the reduction of infiltration of effector CD8 + T cells in the brain and secretion of cytolytic Granzyme B molecules. Notably, Co-Q10-treated mice had reduced levels of CD8 +T cell chemokines CXCR3, CCR2, and CCR5 in the brain following PbA-infection. Brain tissue analysis showed a reduction in the levels of inflammatory mediators TNF- α, CCL3, and RANTES in Co-Q10 administered mice. In addition, Co-Q10 modulated the differentiation and maturation of both splenic and brain dendritic cells and cross-presentation (CD8α+DCs) during ECM. Remarkably, Co-Q10 was very effective in decreasing levels of CD86, MHC-II, and CD40 in macrophages associated with ECM pathology. Exposure to Co-Q10 resulted in increased expression levels of Arginase-1 and Ym1/chitinase 3–like 3, which is linked to ECM protection. Furthermore, Co-Q10 supplementation prevented PbA-induced depletion of Arginase and CD206 mannose receptor levels. Co-Q10 abrogated PbA-driven elevation in pro-inflammatory cytokines IL-1β, IL-18, and IL-6 levels. In conclusion, the oral supplementation with Co-Q10 decelerates the occurrence of ECM by preventing lethal inflammatory immune responses and dampening genes associated with inflammation and immune-pathology during ECM, and offers an inimitable opening for developing an anti-inflammatory agent against cerebral malaria.

Commentary on the article “Primary intestinal anastomosis in a child with perforation of Meckel's diverticulum and peritonitis”

Commentary on the article Morozov KD, Sharkov SM, Kozlov MYu, Mordvin PA, Ayrapetyan MI, Morozov DA Primary intestinal anastomosis in a child with perforation of Meckels diverticulum and peritonitis published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):105112. (In Russ.) DOI: https://doi.org/10.17816/psaic1498&#x0D; After reading the article under discussion, serious doubts were raised about the presence of diffuse peritonitis (there was no typical response of the body to a severe inflammatory process in the abdominal cavity), and the mild course of diffuse peritonitis in surgical practice is unknown. Primary intestinal anastomosis in peritonitis cannot be recommended for pediatric surgeons to present its wide introduction in clinical practice.

Effect of sevoflurane on the pain syndrome and course of acute pancreatitis: сlinical cases

BACKGROUND: Acute pancreatitis is a potentially life-threatening disease, which is based on a severe inflammatory process and enzymatic autolysis of the pancreas. Currently, there is no effective medical treatment for acute pancreatitis. Its therapy is based on early infusion, adequate anesthesia, enteral nutrition, antibiotic therapy for infected pancreatic necrosis, and sanitizing procedures for the development of purulent and septic complications. In the last decade, experimental, and clinical studies have proven the powerful anti-inflammatory effect of the inhalation anesthetic sevoflurane. Sevoflurane reduces inflammation, both by blocking the nuclear factor kappa-bi and reducing the release of reactive oxygen species and pro-inflammatory cytokines.&#x0D; CLINICAL CASES DESCRIPTION: We used inhaled sevoflurane in three patients with acute pancreatitis. For one inhalation, 5 mL of sevoflurane was used and poured into a 200-mL container. The duration of one inhalation was approximately 40 min, during which time the anesthetic had completely evaporated. The maximum concentration of sevoflurane in exhaled air reached 0.40.5%, which did not cause the patient to fall asleep. Inhalations were performed three times a day for 2 days. In all patients, the pain syndrome decreased by three times according to the visual analog scale on day 1. The level of amylase on day 2 decreased by 2.5 times. The leukocyte count decreased by 20%. On day 2, all patients developed intestinal motility, and the patients were transferred from the anesthesiology-reanimation department to the surgical department. All the patients recovered.&#x0D; CONCLUSION: The inhalation of sevoflurane alleviated the pain syndrome, reduced amylase levels, and improved intestinal motility in acute pancreatitis.