Microcirculation and tissue oxygenation in the head and limbs during hyperbaric oxygen treatment

Introduction: Hyperbaric oxygen (HBO) exposure for 10−15 min has been shown to reduce peripheral blood flow due to vasoconstriction. However, the relationship between decreased peripheral blood flow and the therapeutic effects of HBO treatment on peripheral circulatory disorders remain unknown. Longer exposures have been reported to have vasodilatory effects and increase peripheral blood flow. This study investigated the effect of HBO treatment on blood flow and transcutaneous oxygen pressure (TcPO2). Methods: Twenty healthy volunteers aged 20-65 years (nine males) participated in this study. All participants breathed oxygen for 60 min at 253.3 kPa. Peripheral blood flow using laser Doppler flowmetry and TcPO2 on the ear, hand, and foot were continuously measured from pre-HBO exposure to 10 min post-exposure. Results: Peripheral blood flow in each body part decreased by 7-23% at the beginning of the HBO exposure, followed by a slow increase. Post-exposure, peripheral blood flow increased 4-76% in each body part. TcPO2 increased by 840-1,513% during the exposure period, and remained elevated for at least 10 min after the exposure. Conclusions: The findings of the current study suggest vasoconstriction during HBO treatment is transient, and even when present does not inhibit the development of increased tissue oxygen partial pressure. These findings are relevant to studies investigating changes in peripheral blood flow during HBO treatment in patients with circulatory disorders.

Long-term changes in the dentoalveolar system of rats after experimental intra-abdominal hypertension

Aim. To establish the effect of experimental intra-abdominal hypertension (IAH) on the teeth-jaw system of rats in the long-term period based on the study of pro-inflammatory cytokines and morphological analysis of the elements of the temporomandibular joint (TMJ) and salivary glands.Materials and methods. The experiment was carried out on 60 newborn rats; IAH was modelled by injecting collagen into the abdominal cavity to a predetermined level of intra-abdominal pressure. The rats were evenly (n = 20) divided into 3 groups: 1st - control; 2nd and 3rd - with light and severe IAH, respectively. Serum levels of IL-18, MCP-1, NGAL were determined by multiplex analysis after 10 and 120 days, VEGF-C - after 10 days - by ELISA. The morphological examination of the TMJ and salivary glands was performed using a Leica DM2000 microscope after 120 days.Results. After 10 days and 120 days, blood serum levels of NGAL, IL-18 and MCP-1 were statistically significantly increased in groups 2 and 3 compared to the control; the concentration of MCP-1 increased in proportion to the severity of the IAH with the maximum values in group 3. After 10 days, the level of VEGF was significantly increased in group 2 compared to the control group (p < 0.02). Inflammation of the TMJ was observed significantly more often in groups 2 and 3 than in the control group (p = 0.0002). In group 3, circulatory disorders and bone marrow degeneration of the TMJ, as well as inflammation, circulatory disorders and hyperplasia of the lymphoid tissue of the salivary glands were statistically significantly more often compared to groups 1 and 2.Conclusion. In the long term, experimental IAH showed an increase in the levels of markers of inflammation and hypoxia in the blood serum of rats; the severity of synovitis and sialadenitis grew with an increase in the level of intra-abdominal pressure; the maximum deviations in inflammation markers and morphological changes in the TMJ and salivary glands of rats were observed in the group with severe IAH.

The effect of percutaneous electrical stimulation of the spinal cord on autonomic reactions in the acute period of rehabilitation after ischemic stroke

The effect of percutaneous electrical stimulation of the spinal cord on the reactions of the autonomic nervous system in patients after acute cerebral circulatory disorders was evaluated. Patients in the acute period of rehabilitation treatment underwent a course of percutaneous electrical stimulation for 10 days. Before and after rehabilitation, vegetative reactions were assessed using an orthoclinostatic test, an A.M.Wein questionnaire, and neurological disorders on the Scandinavian scale. The inclusion of the course of percutaneous electrical stimulation in the program of physical rehabilitation of patients who have suffered an ischemic stroke indicates an improvement in the motor status of patients and a decrease in the imbalance of sympathetic and parasympathetic influences Keywords: ischemic stroke, percutaneous electrical stimulation of the spinal cord, vegetative reactions

Use of venous-venous extracorporeal membrane oxygenation in the treatment of postpartum pulmonary hypertension crisis

The incidence of heart disease in pregnancy ranges from 0.5% to 3.0% and is regarded as one of the top three causes of maternal death. The mortality rate of patients with pulmonary hypertension and Eisenmenger syndrome is as high as 16.7%–50%. Changes in haemodynamics during pregnancy and childbirth increase the burden on the heart, and induced pulmonary hypertension crisis is one of the main causes of maternal death. Extracorporeal Membrane Oxygenation (ECMO) is the last-resort treatment strategy to treat patients with pulmonary hypertension crisis. We report a ventricular septal defect in a pregnant woman with pulmonary hypertension and Eisenmenger’s syndrome, which is a postpartum pulmonary hypertension crisis that leads to respiratory and circulatory disorders. The patient was successfully treated with venous-venous extracorporeal membrane oxygenation.

Electrophoretic method for the study of blood serum proteins in the diagnosis of latent active rheumatism

In case of rheumatic heart defects with circulatory disorders in the inactive period, according to the literature, there is a slight increase in P - and y-globulins, a2-globulins and fibrinogen remain within normal limits.

THE DYNAMICS OF LUNG HISTOPATHOLOGY IN ACUTE BACLOFEN POISONING

Baclofen (sold under the name Baclosan©, Lioresal©) is a muscle relaxant. This drug is chemically different from other muscle relaxants. Due to its pronounced psychotropic effect the drug is often a subject of abuse especially among young people. The article deals with the dynamics of lung histopathology in acute baclofen poisoning. Experimental studies were performed on 15 Wistar rats. The animals were divided into 3 groups (the controls and two experimental groups). The controls included 5 intact rats. Each experimental group included 5 animals. Both groups were treated with baclofen at a dosage of 85 mg/kg. The duration of the experiment was 3 and 24 hours, respectively. We revealed a complex of pathological changes in the lungs of the rats. There were circulatory disorders in all the elements of the microcirculatory bed, areas of emphysema, atelectasis and dystelectasis, WBC infiltration of intralveolar septa and their thickening due to edema. The changes were even more severe 24 hours after the drug administration. These results along with the results of chemical analysis will be useful in establishing the fact of baclofen intoxication and the exact moment of the intoxication.

Infective Endocarditis in Patients with Hypertrophic Cardiomyopathy

A literature review is presented, reflecting the incidence, etiology, hemodynamics, localization, clinical manifestations, outcomes and treatment of infective endocarditis (IE) in patients with hypertrophic cardiomyopathy (HCM). Despite the relative rarity of IE in patients with HCM, the combination of these pathologies is characterized by mutual aggravation and poor prognosis. The addition of IE increases the risk of death in patients with obstructive HCM, deteriorating circulatory disorders, increasing the likelihood of uncontrolled sepsis and embolism. Conservative treatment of IE in patients with HCM does not differ from that without HCM. Interdisciplinary interaction is needed in the management of patients with IE against the background of HCM in determining the indications for cardiac surgery and choosing the optimal method. Antibacterial prophylaxis of IE before invasive medical manipulations in patients with HCM is not recommended by the current consensus documents, however, the decision for each patient should be made individually, with a mandatory assessment of the risk of IE, the severity of hemodynamic disorders and prognosis.

Microscopic Examination Of Postcapillary Cerebral Venues In Hemorrhagic Stroke

Hemorrhagic stroke among acute cerebral circulatory disorders is characterized by severe neurological complications and the need to choose between surgical intervention or therapeutic therapy. According to the World Health Organization (WHO)". Globally, stroke deaths will reach 7.8 million by 2030 unless an aggressive global response to the epidemic is put in place" 1. Subarachnoid haemorrhage, which accounts for half of the non-traumatic intracerebral haemorrhage, affects the most active and able-bodied population. The most important medical and social objectives are to monitor the course of the disease from the first hours after the onset of stroke, to prescribe adequate treatment in a timely manner, and to reduce mortality and disability rates [5,9].

Lung Histopathology in Baclofen Intoxication

The aim of the study: to assess the lung histopathology in acute intoxication with baclofen alone and its combination with alcohol (in the same dose) 3 hours after the ingestion.Materials and methods. The study was performed on 15 male Wistar rats weighing 290-350 g and aged 20 weeks. The animals were divided into 3 groups, 5 animals each: control group that included intact rats; Group 1 composed of rats received baclofen alone; Group 2 that included rats received a combination of baclofen and ethanol. Baclofen was administered orally at a dose of 85 mg/kg animal weight under anesthesia (chloralose), and 40% ethanol, 7 ml/kg animal weight, was orally administered along with baclofen at the same dose. Animals of all groups were sacrificed after 3 hours by overdosing anesthetic agent. Lung tissue samples were examined by light microscopy using a video system at x400 magnification. The following histological characteristics were evaluated: circulatory disorders (engorged capillaries and venules, hemorrhages in interalveolar septa and alveoli, sludge), atelectasis (including partial), emphysema, cellular response (increased WBCs in the interalveolar septal area), thickening of interalveolar septa due to edema, epithelial desquamation into bronchial lumen. The diameter of alveoli and thickness of interalveolar septa were measured.Results. Three hours after the baclofen administration, circulatory disorders in the lungs (engorged venules and capillaries, hemorrhages in the interalveolar septa, sludge), emphysema, atelectasis (complete and partial) as well as cellular response (leucocyte infiltration of interalveolar septa) were detected. In the Group 2, baclofen resulted in circulatory disorders (engorged venules and capillaries, sludge), emphysema, atelectasis (complete and incomplete), cellular response (infiltration with leukocytes), as well as fluid in the lumen of bronchioles. In Group 1, the alveolar diameter was significantly larger than in the control group and Group 2, while the thickness of the interalveolar septa was lower. In group 2, alveolar diameter was significantly less than in group 1, but still greater than in the control group. The thickness of the interalveolar septa in group 2 was significantly greater than in the control group and group 1.Conclusion. After administration of baclofen alone and in combination with ethanol, the following alterations were found in the lungs: circulation disorders (venular and capillary engorgement, sludge), increased vascular permeability because of developing hypoxia, leukocyte infiltration of interalveolar septa. The monitoring of morphological alterations may aid in evaluating the severity of pathological processes in intoxication with baclofen alone and in combination with ethanol and in determining the method of intoxication (baclofen alone or in combination with ethanol).