Peripheral vasoconstriction influences thenar oxygen saturation as measured by near-infrared spectroscopy

Purpose: Near-infrared spectroscopy has been used as a noninvasive monitoring tool for tissue oxygen saturation (StO2) in acutely ill patients. This study aimed to investigate whether local vasoconstriction induced by body surface cooling significantly influences thenar StO2 as measured by InSpectra model 650. Methods: Eight healthy individuals (age 26 ± 6 years) participated in the study. Using a cooling blanket, we aimed to cool the entire body surface to induce vasoconstriction in the skin without any changes in central temperature. Thenar StO2 was noninvasively measured during a 3-min vascular occlusion test using InSpectra model 650 with a 15-mm probe. Measurements were analyzed for resting StO2 values, rate of StO2 desaturation (RdecStO2, %/min), and rate of StO2 recovery (RincStO2, %/s) before, during, and after skin cooling. Measurements also included heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), capillary refill time (CRT), forearm-to-fingertip skintemperature gradient (Tskin-diff), perfusion index (PI), and tissue hemoglobin index (THI). Results: In all subjects MAP, CO, SV, and core temperature did not change during the procedure. Skin cooling resulted in a significant decrease in StO2 from 82% (80-87) to 72% (70-77) (P\0.05) and in RincStO2 from 3.0%/s (2.8-3.3) to 1.7%/s (1.1-2.0) (P\0.05). Similar changes in CRT, Tskin-diff, and PI were also observed: from 2.5 s (2.0-3.0) to 8.5 s (7.2-11.0) (P\0.05), from 1.0 (-1.6-1.8) to 3.1 (P\0.05), and from 10.0% (9.1-11.7) to 2.5

P-hydroxyphenylpyruvate, an intermediate of the Phe/Tyr catabolism, improves mitochondrial oxidative metabolism under stressing conditions and prolongs survival in rats subjected to profound hemorrhagic shock

The aim of this study was to test the effect of a small volume administration of p-hydroxyphenylpyruvate (pHPP) in a rat model of profound hemorrhagic shock and to assess a possible metabolic mechanism of action of the compound. The results obtained show that hemorrhaged rats treated with 2-4% of the estimated blood volume of pHPP survived significantly longer (p<0.001) than rats treated with vehicle. In vitro analysis on cultured EA.hy 926 cells demonstrated that pHPP improved cell growth rate and promoted cell survival under stressing conditions. Moreover, pHPP stimulated mitochondria-related respiration under ATP-synthesizing conditions and exhibited antioxidant activity toward mitochondria-generated reactive oxygen species. The compound effects reported in the in vitro and in vivo analyses were obtained in the same millimolar concentration range. These data disclose pHPP as an efficient energetic substrates-supplier to the mitochondrial respiratory chain as well as an antioxidant supporting the view that the compound warrants further evaluation as a therapeutic agent. © 2014 Cotoia et al

An analysis of pathomorphic forms and diagnostic difficulties in tarso-metatarsal joint injuries

Tarso-metatarsal injuries are rare but frequently missed. Due to the large variation in pathomorphic forms of these injuries, great precision is required when carrying out clinical and X-ray diagnostic procedures. The aim of the study was to describe the different forms of Lisfranc joint injuries and analyse the causes of delayed treatment. The treatment results of acute and chronic injuries were compared in 41 patients, with an average follow-up period of 16 years. Statistically significant poorer results were obtained in the group of chronic cases, based on two functional scores – the AOFAS evaluation questionnaire and the Lublin functional questionnaire. The main factor delaying the start of the proper treatment was diagnostic error during initial admission. The best results were achieved after closed reduction and percutaneous Kirschner wire fixation in acute cases