Lactatemia during treatment of status asthmaticus in children

Background: Transient increase of lactate levels with or without metabolic acidosis has been seldom reported as a complication of β2-adrenergic therapy administered during asthma attacks in children. Objective: The study is aimed to investigate the frequency of lactatemia in children with acute asthma treated with nebulized β2-agonists, and to delineate its causes and effects on prognosis. Methods: We studied 32 asthmatic children; 68.8% had intermittent asthma, and 31.2% had mild persistent asthma. Their ages ranged from 6 to 8 years with a mean of 6.48±0.68 years. Patients were enrolled during acute asthma exacerbation (62.5% had severe and 37.5% had moderate attacks)from the Cairo University Children's Hospital. Patients underwent clinical evaluation, and routine investigations (CBC, PEFR, and total serum IgE) then received nebulized salbutamol at 0.1 mg/kg/dose (minimum 2.5 mg) every 20 min for three doses together with O2. Plasma lactate was determined before, 1 h after, and 24 h following the inhalation therapy. Blood gases were also evaluated before and after the β2-agonist treatment. Results: At 1 h post-treatment, all patients had appreciable lactatemia (4.44±0.78 mmol/L, p < 0.001) compared to the pre-treatment level with a rise of 257±121.5%. Patients with severe attacks demonstrated a higher mean value compared to those with moderate attacks (4.69±0.8 mmol/L versus 4.02±0.6 mmol/L, p < 0.05). At 24 h post-treatment, lactate levels returned to the normal values in most patients (1.91±0.59 mmol/L, p < 0.001) as compared to the 1 h post-treatment level. None of our patients developed metabolic acidosis and all of them showed significant clinical improvement. Our results strongly accuse nebulized salbutamol as the possible pathogenetic factor for lactatemia during therapy of acute asthma attacks, while overworked respiratory muscles and hypoxemia have been excluded as contributing factors. Conclusion: Transient lactatemia is not uncommon during β2-agonist therapy in asthmatic children with acute exacerbation, and is harmless in most cases. Prediction of lactic acidosis prevents inappropriate intensification of therapy especially in patients with more severe attacks or impending respiratory failure.Keywords: Asthma, exacerbation, lactate, lactatemia, β2-agonist, salbutamolEgypt J Pediatr Allergy Immunol 2004; 2(2): 83-8

Predictors of contractile recovery after successful primary percutaneous coronary intervention

Background: Accurate diagnosis, characterization, and quantification of myocardial infarction (MI) are essential to assess the impact of therapy and to aid in predicting prognosis of patients with ischaemic heart disease.Objective: This study aimed to define different parameters regarding prediction of myocardial functional recovery following successful reperfusion of acute ST segment elevation myocardial infarction (STEMI).Patients and methods: This prospective study was carried out in Zagazig University and National Heart Institute (NHI) of Egypt during the period from June 2020 to June 2021. The study included 48 patients admitted with first acute STEMI. All patients were subjected to demographic data taking, electrocardiography and echocardiography examination (two examinations were done, the first was immediately after reperfusion and the second was 3 months from primary percutaneous coronary intervention (PCI).Results: There was no statistically significant difference between demographic data and risk factors except smoking habit. Regarding laboratory findings there were significant lower troponin value, peak CKMB value compared to patients had remolding (p=0.0001, p=0.027 respectively). Regarding ECG parameters, there was no statistical significant difference between the study groups regarding sum ST elevation and MI territory (p value > 0.05), but there was highly statistically significant difference between the study groups regarding 90 min ST resolution among contractile recovery (group I) p=0.0001.Conclusions: In this study patients affected by AMI with ST segment elevation and treated by primary PCI showed contractile recovery in 60.4% of the patients, while the remodeling of the LV has been observed in 39.6%

Carboxymethyl-Cellulose-Containing Ag Nanoparticles as an Electrochemical Working Electrode for Fast Hydroxymethyl-Furfural Sensing in Date Molasses

Novel biosensors based on carboxymethyl cellulose extract from date palm fronds containing Ag nanoparticles as an electrochemical working electrode for fast hydroxymethylfurfural (HMF) sensing in date molasses were prepared. The morphological, structural, and crystallinity characteristics of the prepared Ag@CMC were described via SEM, DLS, TEM, and XRD. In addition, Raman spectroscopy and UV–VIS spectroscopy were performed, and thermal stability was studied. The investigated techniques indicated the successful incorporation of AgNPs into the CMC polymer. The sensing behavior of the prepared AgNPs@CMC electrode was studied in terms of cyclic voltammetry and linear scan voltammetry at different HMF concentrations. The results indicated high performance of the designed AgNPs@CMC, which was confirmed by the linear behavior of the relationship between the cathodic current and HMF content. Besides, real commercial samples were investigated using the novel AgNPs@CMC electrode

Oral antioxidants supplementation for women with unexplained infertility undergoing ICSI/IVF: Randomized controlled trial

Good oocyte quality and maturity are important prerequisites for high fertilization and implantation rates in IVF/ICSI treatment cycles. Reactive oxygen species (ROS) are produced within ovarian follicles, especially during the ovulation process, and increased ROS activity may be a cause of impaired oocyte maturation and higher rate of failure of IVF/ICSI cycles. RCT evaluating the effect of antioxidant supplementation on ICSI/IVF outcomes. Two hundred and eighteen women with unexplained subfertility undergoing IVF/ICSI were randomized into two groups. The study group (n = 112) received daily oral antioxidants in the form of multivitamins and minerals (amino acid chelated) while the control group (n = 106) did not. Main outcomes were number of mature metaphase II (MII) oocytes and clinical pregnancy rate. There were no significant changes between the groups as regards age, BMI, basal FSH, number of mature (MII) oocytes (12.7 ± 9.4 vs. 13.2 ± 8.6, P = 0.7) and clinical pregnancy rate per woman randomized (38% vs. 34%; [OR = 1.2; 95% CI, 0.70-2.11]. Oral antioxidants in the form of a combination of multivitamins and minerals (amino acid chelated) did not improve oocyte quality and pregnancy rates in women with unexplained infertility undergoing IVF/ICSI treatmen

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs)