Incidence of orthostatic hypotension and cardiovascular response to postoperative early mobilization in patients undergoing cardiothoracic and abdominal surgery

Background: In cardiothoracic and abdominal surgery, postoperative complications remain major clinical problems. Early mobilization has been widely practiced and is an important component in preventing complications, including orthostatic hypotension (OH) during postoperative management. We investigated cardiovascular response during early mobilization and the incidence of OH after cardiothoracic and abdominal surgery. Methods: In this prospective observational study, we consecutively analyzed data from 495 patients who underwent elective cardiothoracic and abdominal surgery. We examined the incidence of OH, and the independent risk factors associated with OH during early mobilization after major surgery. Multivariate logistic regression was performed using various characteristics of patients to identify OH-related independent factors. Results: OH was observed in 191 (39%) of 495 patients. The incidence of OH in cardiac, thoracic, and abdominal groups was 39 (33%) of 119, 95 (46%) of 208, and 57 (34%) of 168 patients, respectively. Male sex (OR 1.538; p = 0.03) and epidural anesthesia (OR 2.906; p < 0.001) were independently associated with OH on multivariate analysis. Conclusions: These results demonstrate that approximately 40% patients experience OH during early mobilization aftercardiothoracic and abdominal surgery. Sex was identified as an independent factor for OH during early mobilization after all three types of surgeries, while epidural anesthesia was only identified after thoracic surgery. Therefore, the frequent occurrence of OH during postoperative early mobilization should be recognized

Granulocyte macrophage colony stimulating factor activity in cerebrospinal fluid

Abstract OBJECTIVES: The purpose of this study was to analyse the presence of the granulocyte-macrophage colony-stimulating factor (GM-CSF) in human cerebrospinal fluid (SF) of patients affected by multiple sclerosis (MS) in comparison with non-inflammatory neurological diseases. MATERIAL AND METHODS: All SFs were collected from 59 patients for diagnostic purpose. The presence of GM-CSF was revealed by measuring its activity and by immunoassay. The data obtained were statistically evaluated. RESULTS: We found that GM-CSF is constitutively present in human SF; this presence was confirmed by its stimulating activity of colony-forming-unit granulocyte-macrophage (CFU-GM) production. No significant changes of the GM-CSF concentration in the SFs were observed among different neurological disorders (degenerative or vascular) and MS. CONCLUSION: Our data suggest that GM-CSF is a constitutive component of human SF, relatively uninfluenced by the different morbid conditions of the nervous system

Unraveling the Hydrolysis of Z2Cu2+to ZCu2+(OH)-and Its Consequences for the Low-Temperature Selective Catalytic Reduction of NO on Cu-CHA Catalysts

As the state-of-the-art catalyst for the selective catalytic reduction (SCR) of NOx, Cu-CHA has been extensively investigated in both its practical and fundamental aspects. Among the latter, how Z2Cu2+, an active site for SCR, participates in low-temperature (LT) SCR reactions remains debated. Here, we propose a scheme involving the hydrolysis of Z2Cu2+ to ZCu2+(OH)-, a thermodynamically and kinetically favorable process under LT-SCR conditions, based on multiple pieces of evidence from a probe reaction (transient CO oxidation), transient Cu2+ reduction kinetic runs, in situ FTIR spectroscopy, and first-principles calculations. Such an integrated investigation reveals unambiguously that the hydrolysis of Z2Cu2+ to ZCu2+(OH)- occurs facilely in the presence of NH3, which may thus reconcile the identical quadratic kinetics of Z2Cu2+/ZCu2+(OH)- reduction with the inactivity of Z2Cu2+ in the formation of Cu2+ pairs. Accordingly, we highlight that NH3-assisted hydrolysis plays a critical role in LT-SCR and should be taken into account especially when discussing SCR reaction details over Z2Cu2+