Authors:György Koszta, Gábor Tihamér Sira and Krisztina Béczy
A vérkészítményekhez való hozzáférés világszerte egyre korlátozottabbá válik. A
rendelkezésre álló források észszerű felhasználása emiatt is kiemelt jelentőségű
napjaink perioperatív betegellátásában. Az összes vérkészítmény-felhasználás
közel fele a cardiovascularis sebészetben történik. A jelen közleményben
összefoglaltuk a vérkészítmény-megtakarítás lehetséges módszereit a
szívsebészeti betegellátás kapcsán, kiemelve a súlyos perioperatív vérzés
kezelésével és megelőzésével kapcsolatos szempontokat. Orv Hetil. 2020; 161(37):
Authors:Csilla Molnár, Dániel Bereczki and Béla Fülesdi
A központi idegrendszeren végzett műtéti beavatkozások és a spontán
intracerebralis vérzések speciális kihívást jelentenek a vérzésmenedzsment
során, hiszen egyrészt az agy az anaemiára és a következményes hypoxiára
legérzékenyebb szervünk, másrészt a zárt koponyaüregben növekvő vérzés
intracranialis nyomásfokozódás esetén közvetlen életveszélyt okoz. A szerzők
részletesen összefoglalják a neurointenzív ellátás és a neuroanesztézia során
alkalmazott kezelési lehetőségeket. Elektív idegsebészeti műtétek esetén a
perioperatív ellátásban kiemelt szerepet kap a hemoglobinkoncentráció, a
fibrinogénszint és a thrombocytaszám szervspecifikus optimalizációja. Előzetesen
szedett antikoaguláns és antithromboticus szerek esetén sürgősségi esetekben a
célzott gyógyszeres korrekciót kell előnyben részesíteni. Intracerebralis
vérzések esetén a szervtámogató kezelés mellett etiológiától függő, célzott
diagnosztikán alapuló vérzéscsillapítás javasolt. Orv Hetil. 2020; 161(37):
Authors:Igor Ujčič-Vrhovnik, Tanja Švara, Tadej Malovrh and Breda Jakovac-Strajn
In this study, feed naturally containing Fusarium mycotoxins was fed to gilts during the perinatal period, and the effects on the thymus were investigated in one-week-old piglets. Twenty gilts were divided into equal control (0.26 mg deoxynivalenol, DON) and experimental (5.08 mg DON, 0.09 mg zearalenone and 21.61 mg fusaric acid per kg of feed) groups. One suckling piglet from each litter (n = 20) was sacrificed at one week of age to obtain thymus samples for further analysis. The cortex to medulla ratio of the thymus was morphometrically analysed using NIS Elements BR (Nikon) software. Paraffin-embedded thymus sections were stained to quantify apoptosis (with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling – TUNEL method), cellular proliferation (Ki-67) and macrophages (MAC 387). The results showed that the thymus cortex (P = 0.023) to medulla (P = 0.023) ratio was significantly lower in the experimental group. The number of apoptotic cells (cortex, P = 0.010, medulla, P = 0.001) and the number of proliferating cells in the thymus cortex (P = 0.001) and medulla (P < 0.001) were significantly higher in the experimental group. Our results indicate that feeding Fusarium mycotoxins to a parent animal during the perinatal period induces significant alterations in the thymus of one-week-old piglets, which indicates an immunosuppressive effect in piglets.
Authors:Katiuska Satué, Esterina Fazio, Cristina Cravana, Marco Quartuccio, Maria Marcilla and Pietro Medica
The aim of the study was to assess the physiological reference values for systemic and intrafollicular placental growth factor (PlGF) concentrations in different categories of follicular sizes in cycling mares, according to progesterone (P4) and oestradiol (E2) patterns. Sixty ovaries were taken after slaughter from 30 clinically healthy mares. Regarding their size, the follicles were classified into three different categories, i.e. small (20–30 mm), medium-sized (31–40 mm) and large (≥41 mm), and follicular fluid (FF) was sampled from each single follicle. Intrafollicular PlGF concentrations were significantly increased in larger and medium-sized follicles compared to small follicles, and their values were 1.48 and 1.36 times higher than the systemic values, respectively. On the other hand, systemic PlGF concentrations were 1.3 times higher than those in the FF of follicles of small size. Intrafollicular P4 concentrations were significantly higher in larger follicles than in small ones, and their concentrations were 6.74 and 3.42 times higher than the systemic values, respectively. Intrafollicular E2 concentrations were significantly higher in large and medium-sized follicles than in follicles of small size, and their concentrations were 21.1, 15.4 and 8.35 times higher than the systemic values, respectively. Intrafollicular and systemic PlGF concentrations were strongly and positively correlated; nevertheless, no correlations between intrafollicular and systemic steroid hormones, PlGF and follicle diameters, PlGF and E2, or PlGF and P4 were observed. This represents the first study to characterise systemic and intrafollicular PlGF concentrations in cycling normal mares, providing evidence that the bioavailability of this factor in follicles of medium and large sizes was higher than in small follicles, independently of steroid hormone concentrations. Further studies are needed to assess the presumable implications of PlGF in follicular angiogenesis in mares, similar to those already observed in women and primates.
Authors:Ottó Szenci, Kamal Touati, Noelita Melo De Sousa, Jean-Luc Hornick, Gijsbert Cornelis van der Weyden, Marcel Antonie Marie Taverne and Jean-François Beckers
The aim of this study was to further develop and extensively describe a surgical technique in order to realise long-term fetal blood sampling in the bovine species. Eleven Holstein–Friesian 6- to 8-month pregnant cows (4–10 years old) were used for this study. Gestational age on the day of surgery varied from approximately 180 days (n = 1) to 240 days (minimum: 232 days, maximum 252 days; n = 10). The fetal medial tarsal artery was catheterised in pregnant cows with a polyvinyl catheter in dorsal recumbency under general anaesthesia. Although 5 out of 11 operations (45.5%) performed between 232 and 252 days of gestation were lost due to different causes mainly associated with peritonitis and septicaemia, the mean interval between operations and calvings was 42.5 days (between 27 and 95 days). It is important to emphasise that a well-trained surgical team is needed for bovine fetal cannulation in order to be able to decrease the risk factors during the operations. Due to the fact that after 5 unsuccessful cases none of the pregnancies were lost, this skill can be reached, and our technique can enable bovine fetal blood sampling for long-term endocrinological and physiological investigations before and during parturition.
Authors:Piotr Sławuta, Agnieszka Sikorska-Kopyłowicz and Grzegorz Sapikowski
Metabolic acidosis is diagnosed based on the concentration of bicarbonate ions and partial pressure of carbon dioxide in arterial blood, although acid–base balance (ABB) disorders may also be diagnosed based on the serum ion concentrations in order to determine the values of strong ion difference (SID), anion gap (AG), corrected anion gap (AGcorr) and chloride/sodium ratio (Cl−/Na+). The aim of this study was to assess and compare the classic model, the value of the AG, AGcorr, and Cl−/Na+ in the diagnosis of ABB disorders in cats with chronic kidney disease (CKD). The study group consisted of 80 cats with CKD, divided into four groups based on the guidelines of the International Renal Interest Society (IRIS). The control group (C) included 20 healthy cats. Metabolic acidosis – diagnosed based on the classic model (Hendersson–Hasselbalch equation) – was found in IRIS group IV. AG, AGcorr, SID calculated for IRIS groups II, III and IV were lower than in group C, while the value of AGdiff and Cl−/Na+ in those groups was higher than in group C. We can conclude that ABB analysis using the classic model enabled the detection of ABB disorders in cats in stage IV CKD. However, the analysis of the AG, AGcorr and Cl−/Na+ values enabled the diagnosis of acid–base balance disorders in cats with IRIS stage II, III and IV CKD.
Authors:Igor Ribeiro dos Santos, Daniel Ricardo Rissi, Betânia Pereira Borges, Guilherme Reis Blume and Fabiano José Ferreira de Sant’Ana
A 10-year-old female coati (Nasua nasua) was necropsied after an 8-day history of apathy, weight loss and dehydration. Gross changes consisted of multifocal to coalescing nodules ranging from 0.5 to 2.0 cm in diameter in the wall of the small intestine, adjacent to the mesentery and in the mesenteric lymph nodes. Histologically, neoplastic CD3-positive lymphocytes infiltrated all layers of the intestine, as well as the mesenteric adipose tissue and mesenteric lymph nodes. Based on the pathological and immunohistochemical findings, a diagnosis of intestinal T-cell lymphoma was made.
Authors:Ibrahim Barrak, Zoltán Baráth, Tamás Tián, Annamária Venkei, Márió Gajdács, Edit Urbán and Anette Stájer
Implants have been considered the treatment of choice to replace missing teeth, unfortunately, peri-implant disease is still an unresolved issue. Contaminated implants may be decontaminated by physical debridement and chemical disinfectants; however, there is a lack of consensus regarding the ideal techniques/agents to be used for the decontamination. The objective of our study was to compare the decontaminating efficacy of different chemical agents on a titanium surface contaminated with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis. Commercially pure Ti grade 4 discs with a polished surface were treated with a mouthwash containing chlorhexidine digluconate (0.1%), povidone-iodine (PVP-iodine) solution (10%) or citric acid monohydrate (40%). Qualitative and quantitative assessment of cellular growth and survival were assessed by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and scanning electron microscopy (SEM). Significant differences in the quantity of P. gingivalis could be observed after 6 days of incubation. A numerical, but not statistically significant (P = 0.066) decrease in the amount of living bacteria was observed in the group treated with the PVP-iodine solution as compared to the control group. The chlorhexidine (CHX)-treated group presented with significantly higher cell counts, as compared to the PVP-iodine-treated group (P = 0.032), while this was not observed compared to the control group and citric acid-treated group. Our results have also been verified by SEM measurements. Our results suggest that for P. gingivalis contamination on a titanium surface in vitro, PVP-iodine is a superior decontaminant, compared to citric acid and chlorhexidine-digulconate solution.
Approaching the process of normal ageing with a health psychology model was an important development in health science. In earlier healing models, questions of old age were either ignored or dealt with only in the context of various diseases. Definitions of the stages of human life have changed and pushed the limits of old age to a higher level. The expanding human life course raises important medical, psychological, and sociological issues. The definition of ageing and the characteristics of normal ageing need to be reconsidered. The cognitive representations of ageing people are a good reflection of how they think about themselves, the world, and the stage of life ahead. The contribution of health psychology as a modern approach to healthy ageing has greatly altered the attitudes of healthcare professionals. The concept of active old age helps to deal with the growing number of elderly people in a new context. In this brief overview of the health psychology approach to normal ageing, we aim to help healthcare professionals better manage the problems in their daily work. In a brief introduction, we review the physical and mental symptoms of ageing. We strive to isolate the normal variants from gerontopsychiatric and neuropsychiatric disorders. While normal ageing does not require clinical attention, psychiatric disorders do, and we briefly describe the therapeutic forms. Psychoeducation, group therapy, and supportive techniques prove to be the most effective.