Učinak retrobulbarno apliciranoga pentadekapeptida BPC 157 na djelovanje retrobulbarno aplicirane L-NAME u štakora [Effect of retrobulbar application pentadecapeptide BPC 157 on effect of retrobulbar application L-NAME in rats]

Female Wistar rats, 200 g, randomly assigned, were treated retrobulbary with: L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2μg/eye 20 minutes after L-NAME application); L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2ng/eye 20 minutes after L-NAME); L-NAME (0.1ml/0.2 mg/eye) and 0.9% NaCl (0.1ml/eye 20 minutes after L-NAME application). Control animals simultaneously received retrobulbar equivolume of 0.9% NaCl. With a USB microscope camera „Veho discovery VMS-004 deluxe“ and "VOLK" digital wide field loupe for indirect ophthalmoscope eye fundus was recorded in the following time periods: before retrobulbar application of L-NAME (or 0.9% NaCl); 20 minutes after L-NAME (or 0.9% NaCl); again after BPC 157 (or 0.9% NaCl), and 20 minutes after. Furthermore, recording was performed at the post-application day 1, 2, and 7, 14, 28 (last day, just before the sacrifice). The fundus was analysed by photo analysis software and by histopathologic eyeball analysis on standard sections, paraffin embedded and hemalaun-eosin stained. The animals behavior was filmed, observing the following parameters: time of immobility and reaction time to visual stimuli (blue-green glove). The retrobulbar application of L-NAME causes the vasoconstriction of the retina's arteries, retinal ischemia, while retrobulbar application of BPC 157 leads to retinal ischemia recovery, prevents its atrophy and restores normal animal behavior

PATIENTS WITH PRESSURE ULCERS IN THE UNIFIED EMERGENCY ADMISSION DEPARTMENT – OUR REALITY

Bolesnik s dekubitusom u Objedinjeni hitni bolnički prijem (OHBP) dolazi najčešće zbog drugih bolesti, iz obitelji ili iz ustanova socijalne skrbi. Nakon procesa trijaže i tretmana u OHBP-u bolesnik biva hospitaliziran ili se otpušta kući. Cilj rada bio je ispitati pojavnost, razloge dolaska, te daljnje postupanje s bolesnicima koji su zaprimljeni na OHBP, a imali su dekubitus. Podatci su analizirani restrospektivno u Bolničkom informacijskom sustavu (BIS) za bolesnike s dekubitusom zaprimljene na OHBP Opće bolnice “Dr. T. Bardek” u Koprivnici u razdoblju od 1. siječnja do 31. svibnja 2016. godine. Uključeni su demografski podatci, mjesto odakle je bolesnik upućen, trijažna kategorija te daljnje postupanje s bolesnikom. Podatci su analizirani metodama deskriptivne statistike. U OHBP je zaprimljeno ukupno 18 bolesnika s dekubitusom, 13 (72 % ) žena i 5 (28 %) muškaraca. Iz ustanova socijalne skrbi upućeno je 5 (28 %) bolesnika, a iz obitelji 13 (72 %). U trijažnu kategoriju 2 ušlo je 7 (38,8 %) bolesnika, 4 (22 %) u 3. i 4. kategoriju te 3 (16 %) u 5. trijažnu kategoriju. Hospitalizirano je 10 (55,5 %), a otpušteno kući 8 (44,4 %) bolesnika. Samo je jedan bolesnik zaprimljen u prvom redu zbog komplikacija dekubitusa. Suprotno pretpostavci, manji broj bolesnika upućen je iz ustanova socijalne skrbi, a veći iz obitelji. Podatci su rezultat dugogodišnje aktivne edukacije medicinskih sestara i implementacije Sestrinskog otpusnog pisma.Patients with pressure ulcers usually arrive to the Unifi ed Emergency Admission Department (UEAD) due to other illnesses, from the family or social care institutions. After triage and treatment at UEAD, the patient is hospitalized or discharged from the hospital. The objective of this study was to examine the incidence, reasons for presenting to UEAD and further procedure that patients with pressure ulcers admitted to UEAD were subjected to. Data in the Hospital Information System on patients with pressure ulcers admitted to UEAD, Dr Tomislav Bardek General Hospital in Koprivnica in the period between January 1, 2016 and May 31, 2016 were retrospectively analyzed. The analysis included demographic data, location from which the patient arrived, triage category and further procedure the patient was subjected to. Data were analyzed by using the methods of descriptive statistics. A total of 18 patients with pressure ulcers were admitted to UEAD, 13 (72%) women and fi ve (28%) men. Five (28%) patients were referred from social care institutions and 13 (72%) from the family. Triage category 2 included 7 (38.8%) patients, four (22%) patients were included in triage categories 3 and 4, while three (16%) patients were included in triage category 5. Ten (55.5%) patients were hospitalized, while eight (44.4%) patients were discharged from the hospital. Only one patient was admitted primarily due to pressure ulcer complications. Contrary to our assumptions, a lower number of patients were referred from social care institutions, i.e. more patients were referred from the family. These data resulted from a long lasting active training of nurses and implementation of the nurse’s discharge letter

KMAT- kontinuirano mjerenje arterijskog tlaka

Zapaženo je da sredina u kojoj se pacijent nalazi može imati veliki utjecaj na izmjerenu vrijednost, a varijabilnost istih utjecala je na širu upotrebu KMAT-a, kontinuiranog 24-satnog mjerenja arterijskog tlaka. Primjena ove dijagnostičke metode omogućava točniju dijagnostiku i adekvatniji terapijski pristup

KMAT- kontinuirano mjerenje arterijskog tlaka

Zapaženo je da sredina u kojoj se pacijent nalazi može imati veliki utjecaj na izmjerenu vrijednost, a varijabilnost istih utjecala je na širu upotrebu KMAT-a, kontinuiranog 24-satnog mjerenja arterijskog tlaka. Primjena ove dijagnostičke metode omogućava točniju dijagnostiku i adekvatniji terapijski pristup

Pentadekapeptid BPC 157 skraćuje trajanje anestezije rožnice izazvane tetrakainom i oksibuprokainom kod štakora

We focused on the relationship of 0.5% tetracaine- and 0.4% oxybuprocaine-induced corneal anesthesia in rats, and pentadecapeptide BPC 157 (0.4 μg/eye), along with nitric oxide synthase (NOS) inhibitor N(gamma)-nitro-L-arginine methyl ester (L-NAME) (0.1 mg/eye) and/or NOS substrate L-arginine (2 mg/eye), applied in the form of eye drops. We assessed corneal sensitivity recovery (Cochet-Bonnet esthesiometer), corneal lesion elimination (staining with 10% fluorescein) and decrease in tear volume (Schirmer test). BPC 157 administration had a full counteracting effect. Recovery also occurred in the presence of NOS blockade and NOS substrate application. L-arginine eventually shortened duration of corneal insensitivity and exerted corneal lesion counteraction (and counteraction of tetracaine-induced decrease of tear volume) only in earlier but not in later period. L-NAME application led to longer duration of corneal insensitivity, increase in corneal lesions and decrease in tear volume. When L-NAME and L-arginine were applied together, they antagonized each other’s effect. These distinctions may indicate particular NOS involvement (corneal insensitivity vs. corneal lesion along with tear production), distinctively affected by the administration of NO agents. However, additional BPC 157 co-administration would re-establish counteraction over topical ophthalmic anesthetic-induced effect, be it in its early or late course. We suggest BPC 157 as an antidote to topical ophthalmic anesthetics.U ovom istraživanju ispitivali smo međuodnos anestezije rožnice uzrokovane 0,5% tetrakainom odnosno 0,4% oksibuprokainom i pentadekapeptida BPC 157 (0,4 μg/oko) u kombinaciji s inhibitorom nitrid oksida L-NAME (0,1 mg/oko) i/ili supstratom nitrid oksida L-argininom (2 mg/oko) primijenjenim u obliku kapi za oči. Procjenjivali smo anesteziju rožnice (Cochet-Bonnetov esteziometar), nestajanje lezija rožnice (bojenje 10% fluoresceinom) te volumen nastajanja suza (Schirmerov test). Učinak potpunog poništavanja anestezije rožnice uočen je u skupinama koje su primale BPC 157. Oporavak je također nastupio u skupinama koje su primale i supstrat i blokator nitrid oksida. L-arginin skraćuje vrijeme neosjetljivosti rožnice, a uočeno je i smanjenje lezija rožnice te poništavanje smanjenja lučenja suza, ali samo u ranijem kraćem razdoblju, dok se kasnije taj učinak gubi. L-NAME je uzrokovao produženje vremena neosjetljivosti rožnice kao i povećanje lezija rožnice te dodatno smanjenje stvaranja suza. Kada se L-arginin i L-NAME daju zajedno njihov učinak se poništava. Opažene razlike mogu ukazivati na određeni utjecaj i uključenost nitrid oksida (neosjetljivost rožnice naspram nastajanja lezija rožnice i stvaranja suza), što je pokazano primjenom supstrata/blokatora nitrid oksida. Međutim, u bilo kojoj kombinaciji prije ili kasnije, dodatak BPC 157 doveo bi do poništavanja učinka primijenjenih anestetika

BPC 157 as a Therapy for Retinal Ischemia Induced by Retrobulbar Application of L-NAME in Rats

Providing NO-system importance, we suggest that one single application of the NOS-blocker L-NAME may induce retinal ischemia in rats, and that the stable pentadecapeptide BPC 157 may be the therapy, since it may interact with the NO-system and may counteract various adverse effects of L-NAME application. A rat retinal ischemia study was conducted throughout 4 weeks, including fundoscopy, behavior presentation, tonometry, and histology assessment. Retrobulbar L-NAME application (5 mg/kg; 0.5 mg/0.1 ml saline/each eye) in rats immediately produced moderate generalized irregularity in the diameter of blood vessels with moderate atrophy of the optic disc and faint presentation of the choroidal blood vessels, and these lesions rapidly progressed to the severe stage. The specific L-NAME–induced vascular failure points to normal intraocular pressure (except to very transitory increase upon drug retrobulbar administration). When BPC 157 (10 μg; 10 ng/kg, as retrobulbar application, 1 μg; 1 ng/0.1 ml saline/each eye) is given at either 20 min after L-NAME or, lately, at 48 h after L-NAME, the regular retrobulbar L-NAME injection findings disappear. Instead, fundoscopy demonstrated only discrete generalized vessel caliber irregularity with mild atrophy of the optic disc, and then, quite rapidly, normal eye background and choroidal blood vessels, which remain in all of the subsequent periods. Also, histology assessment at 1, 2, and 4 weeks shows that BPC 157 counteracted the damaged inner plexiform layer and inner nuclear layer, and revealed normal retinal thickness. The poor behavioral presentation was also rescued. Thus, while further studies will be done, BPC 157 counteracted L-NAME–induced rat retinal ischemia

Effect of retrobulbar application pentadecapeptide BPC 157 on effect of retrobulbar application L-NAME in rats

Ženke Wistar štakora, 200g, randomizirano podijeljene, retrobulbarno su tretirane sa: L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2μg/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2ng/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i 0,9% NaCl (0,1ml/oko, 20 minuta nakon primjene L-NAME). Kontrolne su životinje istovremeno retrobulbarno primale jednaki volumen 0,9% NaCl. USB mikroskopskom kamerom „Veho discovery VMS-004 deluxe“ i „VOLK“ digital wide field lupom za indirektnu oftalmolskopiju snimana je očna pozadina. Inicijalno, životinje su snimane: prije retrobulbarne aplikacije L-NAME (odnosno 0,9% NaCl); 20 minuta nakon aplikacije L-NAME (odnosno 0,9% NaCl); ponovno nakon aplikacije BPC 157 (odnosno 0,9% NaCl) te nakon 20 minuta. Nadalje snimane su 1. i 2. dan nakon aplikacije te nakon 1., 2. i 4. tjedna (neposredno prije žrtvovanja). Očna je pozadina analizirana računalnim programom za analizu fotografija te patohistološkom analizom bulbusa na standardnim rezovima, uklopljenog u parafin i bojenog hemalaun eozinom. Snimano ponašanje životinja uključivalo je vrijeme imobilnosti životinja nakon stavljanja na nepoznatu podlogu i reakciju životinja na podražaj plavo-zelenom rukavicom. Retrobulbamo aplicirana L-NAME uzrokovala je vazokonstrikciju arterija mrežnice, ishemiju mrežnice te značajnu imobilnost životinja. Retrobulbarna primjena BPC 157 dovela je do oporavka mrežnične ishemije te je spriječila njenu atrofiju. Ponašanje životinja bilo je normalno.Female Wistar rats, 200 g, randomly assigned, were treated retrobulbary with: L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2μg/eye 20 minutes after L-NAME application); L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2ng/eye 20 minutes after L-NAME); L-NAME (0.1ml/0.2 mg/eye) and 0.9% NaCl (0.1ml/eye 20 minutes after L-NAME application). Control animals simultaneously received retrobulbar equivolume of 0.9% NaCl. With a USB microscope camera „Veho discovery VMS-004 deluxe“ and "VOLK" digital wide field loupe for indirect ophthalmoscope eye fundus was recorded in the following time periods: before retrobulbar application of L-NAME (or 0.9% NaCl); 20 minutes after L-NAME (or 0.9% NaCl); again after BPC 157 (or 0.9% NaCl), and 20 minutes after. Furthermore, recording was performed at the post-application day 1, 2, and 7, 14, 28 (last day, just before the sacrifice). The fundus was analysed by photo analysis software and by histopathologic eyeball analysis on standard sections, paraffin embedded and hemalaun-eosin stained. The animals behavior was filmed, observing the following parameters: time of immobility and reaction time to visual stimuli (blue-green glove). The retrobulbar application of L-NAME causes the vasoconstriction of the retina's arteries, retinal ischemia, while retrobulbar application of BPC 157 leads to retinal ischemia recovery, prevents its atrophy and restores normal animal behavior

Effect of retrobulbar application pentadecapeptide BPC 157 on effect of retrobulbar application L-NAME in rats

Ženke Wistar štakora, 200g, randomizirano podijeljene, retrobulbarno su tretirane sa: L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2μg/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2ng/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i 0,9% NaCl (0,1ml/oko, 20 minuta nakon primjene L-NAME). Kontrolne su životinje istovremeno retrobulbarno primale jednaki volumen 0,9% NaCl. USB mikroskopskom kamerom „Veho discovery VMS-004 deluxe“ i „VOLK“ digital wide field lupom za indirektnu oftalmolskopiju snimana je očna pozadina. Inicijalno, životinje su snimane: prije retrobulbarne aplikacije L-NAME (odnosno 0,9% NaCl); 20 minuta nakon aplikacije L-NAME (odnosno 0,9% NaCl); ponovno nakon aplikacije BPC 157 (odnosno 0,9% NaCl) te nakon 20 minuta. Nadalje snimane su 1. i 2. dan nakon aplikacije te nakon 1., 2. i 4. tjedna (neposredno prije žrtvovanja). Očna je pozadina analizirana računalnim programom za analizu fotografija te patohistološkom analizom bulbusa na standardnim rezovima, uklopljenog u parafin i bojenog hemalaun eozinom. Snimano ponašanje životinja uključivalo je vrijeme imobilnosti životinja nakon stavljanja na nepoznatu podlogu i reakciju životinja na podražaj plavo-zelenom rukavicom. Retrobulbamo aplicirana L-NAME uzrokovala je vazokonstrikciju arterija mrežnice, ishemiju mrežnice te značajnu imobilnost životinja. Retrobulbarna primjena BPC 157 dovela je do oporavka mrežnične ishemije te je spriječila njenu atrofiju. Ponašanje životinja bilo je normalno.Female Wistar rats, 200 g, randomly assigned, were treated retrobulbary with: L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2μg/eye 20 minutes after L-NAME application); L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2ng/eye 20 minutes after L-NAME); L-NAME (0.1ml/0.2 mg/eye) and 0.9% NaCl (0.1ml/eye 20 minutes after L-NAME application). Control animals simultaneously received retrobulbar equivolume of 0.9% NaCl. With a USB microscope camera „Veho discovery VMS-004 deluxe“ and "VOLK" digital wide field loupe for indirect ophthalmoscope eye fundus was recorded in the following time periods: before retrobulbar application of L-NAME (or 0.9% NaCl); 20 minutes after L-NAME (or 0.9% NaCl); again after BPC 157 (or 0.9% NaCl), and 20 minutes after. Furthermore, recording was performed at the post-application day 1, 2, and 7, 14, 28 (last day, just before the sacrifice). The fundus was analysed by photo analysis software and by histopathologic eyeball analysis on standard sections, paraffin embedded and hemalaun-eosin stained. The animals behavior was filmed, observing the following parameters: time of immobility and reaction time to visual stimuli (blue-green glove). The retrobulbar application of L-NAME causes the vasoconstriction of the retina's arteries, retinal ischemia, while retrobulbar application of BPC 157 leads to retinal ischemia recovery, prevents its atrophy and restores normal animal behavior

Effect of retrobulbar application pentadecapeptide BPC 157 on effect of retrobulbar application L-NAME in rats

Ženke Wistar štakora, 200g, randomizirano podijeljene, retrobulbarno su tretirane sa: L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2μg/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i BPC 157 (0,1ml/0,2ng/oko, 20 minuta nakon primjene L-NAME); L-NAME (0,1ml/0,2mg/oko) i 0,9% NaCl (0,1ml/oko, 20 minuta nakon primjene L-NAME). Kontrolne su životinje istovremeno retrobulbarno primale jednaki volumen 0,9% NaCl. USB mikroskopskom kamerom „Veho discovery VMS-004 deluxe“ i „VOLK“ digital wide field lupom za indirektnu oftalmolskopiju snimana je očna pozadina. Inicijalno, životinje su snimane: prije retrobulbarne aplikacije L-NAME (odnosno 0,9% NaCl); 20 minuta nakon aplikacije L-NAME (odnosno 0,9% NaCl); ponovno nakon aplikacije BPC 157 (odnosno 0,9% NaCl) te nakon 20 minuta. Nadalje snimane su 1. i 2. dan nakon aplikacije te nakon 1., 2. i 4. tjedna (neposredno prije žrtvovanja). Očna je pozadina analizirana računalnim programom za analizu fotografija te patohistološkom analizom bulbusa na standardnim rezovima, uklopljenog u parafin i bojenog hemalaun eozinom. Snimano ponašanje životinja uključivalo je vrijeme imobilnosti životinja nakon stavljanja na nepoznatu podlogu i reakciju životinja na podražaj plavo-zelenom rukavicom. Retrobulbamo aplicirana L-NAME uzrokovala je vazokonstrikciju arterija mrežnice, ishemiju mrežnice te značajnu imobilnost životinja. Retrobulbarna primjena BPC 157 dovela je do oporavka mrežnične ishemije te je spriječila njenu atrofiju. Ponašanje životinja bilo je normalno.Female Wistar rats, 200 g, randomly assigned, were treated retrobulbary with: L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2μg/eye 20 minutes after L-NAME application); L-NAME (0.1ml/0.2mg/eye) and BPC 157 (0.1ml/0.2ng/eye 20 minutes after L-NAME); L-NAME (0.1ml/0.2 mg/eye) and 0.9% NaCl (0.1ml/eye 20 minutes after L-NAME application). Control animals simultaneously received retrobulbar equivolume of 0.9% NaCl. With a USB microscope camera „Veho discovery VMS-004 deluxe“ and "VOLK" digital wide field loupe for indirect ophthalmoscope eye fundus was recorded in the following time periods: before retrobulbar application of L-NAME (or 0.9% NaCl); 20 minutes after L-NAME (or 0.9% NaCl); again after BPC 157 (or 0.9% NaCl), and 20 minutes after. Furthermore, recording was performed at the post-application day 1, 2, and 7, 14, 28 (last day, just before the sacrifice). The fundus was analysed by photo analysis software and by histopathologic eyeball analysis on standard sections, paraffin embedded and hemalaun-eosin stained. The animals behavior was filmed, observing the following parameters: time of immobility and reaction time to visual stimuli (blue-green glove). The retrobulbar application of L-NAME causes the vasoconstriction of the retina's arteries, retinal ischemia, while retrobulbar application of BPC 157 leads to retinal ischemia recovery, prevents its atrophy and restores normal animal behavior