Intraperitoneal Oxygen/Ozone Treatment Decreases the Formation of Experimental Postsurgical Peritoneal Adhesions and the Levels/Activity of the Local Ubiquitin-Proteasome System

We have investigated whether an oxygen/ozone (95%O2/5%O3) mixture would have potential against the formation of experimental postsurgical peritoneal adhesions. In two groups of rats, one control intraperitoneally injected with 3 mL/rat of O2 and one intraperitoneally injected with oxygen/ozone mixture (3 mL/rat equivalent to 300 μg/kg ozone), we induced a midline laparotomy and an enterotomy at the level of the ileum to encourage the formation of peritoneal adhesions. Samples were taken from the parietal peritoneal tissue to assess the formation of adhesions 0 and 10 days after the surgical procedure and to assess the levels of ubiquitin and 20S proteasome. We found decreased formation of postsurgical peritoneal adhesions after treatment of the rats with 300 μg/kg ozone associated with a decreased levels of ubiquitin and 20S proteasome subunit within the adhered tissue. Oxygen/ozone mixture is potentially useful for approaching the post-surgical peritoneal adhesions, and the UPS system is involved in this

Lipocalin-2 promotes adipose-macrophage interactions to shape peripheral and central inflammatory responses in experimental autoimmune encephalomyelitis

Objective: Accumulating evidence suggests that dysfunctional adipose tissue (AT) plays a major role in the risk of developing multiple sclerosis (MS), the most common immune-mediated and demyelinating disease of the central nervous system. However, the contribution of adipose tissue to the etiology and progression of MS is still obscure. This study aimed at deciphering the responses of AT in experimental autoimmune encephalomyelitis (EAE), the best characterized animal model of MS. Results and methods: We observed a significant AT loss in EAE mice at the onset of disease, with a significant infiltration of M1-like macrophages and fibrosis in the AT, resembling a cachectic phenotype. Through an integrative and multilayered approach, we identified lipocalin2 (LCN2) as the key molecule released by dysfunctional adipocytes through redox-dependent mechanism. Adipose-derived LCN2 shapes the pro-inflammatory macrophage phenotype, and the genetic deficiency of LCN2 specifically in AT reduced weight loss as well as inflammatory macrophage infiltration in spinal cord in EAE mice. Mature adipocytes downregulating LCN2 reduced lipolytic response to inflammatory stimuli (e.g. TNFα) through an ATGL-mediated mechanism. Conclusions: Overall data highlighted a role LCN2 in exacerbating inflammatory phenotype in EAE model, suggesting a pathogenic role of dysfunctional AT in MS

Translaryngeal open ventilation for percutaneous endoscopic tracheostomy

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Antioxidant property of Propofol in the ischemic and reperfused human skeletal muscle

Background. Oxygen-derived free radicals (ROS) are involved in tissue damage during muscle ischemia and reperfusion. Recent in vitro studies have demonstrated that a beneficial effect of Propofol (2,6 diisopropylphenol) lies on its free radical scavenging properties. The current study therefore examined whether Propofol is effective against the peroxidative damage induced by ROS in human skeletal muscle in the course of acute ischemia and reperfusion. Methods. A homogeneous group of patients (n=20) undergoing orthopedic surgery was subjected to handline tourniquet at 350 At for 60 min following by 20 min postischemic reperfusion. In skeletal muscle samples (m. vastus lat.) malondyaldeide (MDA), catalase (CAT) and uric acid levels were analyzed before tourniquet application, after 60 min of ischemia and then after 20 min following reperfusion. To ten subjects Propofol was supplied as bolus (5 mg/kg, body weight) during the ischemic interval. The tissue concentrations of MDA, CAT and Uric Acid were measured by spectrophotometric and phluorimetric methods comparing the values with the data obtained in an untreated group of patients (n = 10). Results. In all patients ischemic injury significantly increased MDA, and Uric Acid contents with a concomitant decrease in CAT levels. When reperfused the Propofol treated group showed an evident decrease in MDA Uric, and CAT gradients in respect of ischemic tissue. On the contrary rapid reoxygenation implies a highly significant increase in MDA as far as Uric Acid contents, while Catalase levels were unchanged. Conclusions. The current study demonstrated that in the human skeletal muscle Propofol attenuates the lipid peroxidation induced by ischemia and reperfusion and this beneficial action of Propofol is probably correlated with the free radical scavenging properties of this molecule

Caval filters in intensive care: a retrospective study

Aim: To evaluate the effectiveness of a caval vein filter (CVF) peri-implant monitoring protocol in order to reduce pulmonary embolism (PE) mortality and CVF-related morbidity. BACKGROUND: The reduction in mortality from PE associated with the use of CVF is affected by the risk of increase in morbidity. Therefore, CVF implant is a challenging prophylactic or therapeutic option. Nowadays, we have many different devices whose rational use, by applying a strict peri-implant monitoring protocol, could be safe and effective. MATERIALS AND METHODS: We retrospectively studied 62 patients of a general Intensive Care Unit (ICU) scheduled for definitive, temporary, or optional bedside CVF implant. A peri-implant monitoring protocol including a phlebocavography, an echo-Doppler examination, and coagulation tests was adopted. RESULTS: In our study, no thromboembolic recurrence was registered. We implanted 48 retrievable and only 20 definitive CVFs. Endothelial adhesion (18%), residual clot (5%), cranial or caudal migration (6%), microbial colonization of the filter in the absence of clinical signs of infection (1%), caval thrombosis (1%), and pneumothorax (1%) were reported. Deep-vein thrombosis (DVT) was reported (8%) as early complication. All patients with DVT had a temporary or optional filter implanted. However, in our cohort, definitive CVFs were reserved only to 32% of patients and they were not associated with DVT as complication. CONCLUSION: CVF significantly reduces iatrogenic PE without affecting mortality. Generally, ICU patients have a transitory thromboembolic risk, and so the temporary CVF has been proved to be a first-line option to our cohort. A careful monitoring may contribute to a satisfactory outcome in order to promote CVF implant as a safe prophylaxis option