Failures and complications of thoracic drainage

Background/Aim. Thoracic drainage is a surgical procedure for introducing a drain into the pleural space to drain its contents. Using this method, the pleura is discharged and set to the physiological state which enables the reexpansion of the lungs. The aim of the study was to prove that the use of modern principles and protocols of thoracic drainage significantly reduces the occurrence of failures and complications, rendering the treatment more efficient. Methods. The study included 967 patients treated by thoracic drainage within the period from January 1, 1989 to June 1, 2000. The studied patients were divided into 2 groups: group A of 463 patients treated in the period from January 1, 1989 to December 31, 1994 in whom 386 pleural drainage (83.36%) were performed, and group B of 602 patients treated form January 1, 1995 to June 1, 2000 in whom 581 pleural drainage (96.51%) were performed. The patients of the group A were drained using the classical standards of thoracic drainage by the general surgeons. The patients of the group B, however, were drained using the modern standards of thoracic drainage by the thoracic surgeons, and the general surgeons trained for this kind of the surgery. Results. The study showed that better results were achieved in the treatment of the patients from the group B. The total incidence of the failures and complications of thoracic drainage decreased from 36.52% (group A) to 12.73% (group B). The mean length of hospitalization of the patients without complications in the group A was 19.5 days versus 10 days in the group B. The mean length of the treatment of the patients with failures and complications of the drainage in the group A was 33.5 days versus 17.5 days in the group B. Conclusion. The shorter length of hospitalization and the lower morbidity of the studied patients were considered to be the result of the correct treatment using modern principles of thoracic drainage, a suitable surgical technique, and a careful follow-up of the patients

Protective effects of pumpkin (Cucurbita pepo L.) seed oil on rat liver damage induced by chronic alcohol consumption

Pumpkin seed oil (PSO) possesses a protective potential against liver injury due to the presence of biologically active ingredients. Adult male albino rats were administrated PSO (per os, 2 mL/kg b.w./day) and a 12% ethanol solution in water, ad libitum, with an average intake of 8.14 g of ethanol/kg bw/day for 6 weeks. Congestion, hepatic central vein dilation, portal vein branch dilation, Kupffer cell hyperplasia, fatty liver changes, hepatocyte focal necrosis were observed after daily alcohol intake. All observed changes were reduced when PSO was ingested with ethanol. PSO intake itself induced discrete cellular edema, congestion and slight dilatation of the central and portal vain branches. Chronic ethanol intake elevated catalase (CAT) activity and glutathione reductase (GR) protein expression; concomitant PSO intake had no effect on CAT activity or GR protein expression. PSO intake decreased the activities of GR, glutathione-S-transferase (GST) and xanthine oxidase (XOD) in the liver, probably due to the ingestion of antioxidants. Intake of PSO and ethanol significantly decreased cytosolic superoxide dismutase (SOD1) and increased NF-?B protein expression compared to ethanol intake, suggesting that the protective effects of PSO were mediated by the NF-?B signaling pathway. Our results reveal a therapeutic potential of PSO in alcoholic liver disease

Antipsychotic Drug-Mediated Adverse Effects on Rat Testicles May Be Caused by Altered Redox and Hormonal Homeostasis

Sexual dysfunction, as a noticeable adverse effect of atypical antipsychotic drugs (APDs) for the treatment of schizophrenia, has not been investigated in detail. A study was undertaken to investigate whether 28-day long treatment with clozapine, ziprasidone or sertindole (using a recommended daily dose for atypical antipsychotic therapy), induced histopathological changes both in rat testicles and prostate, changed the activity of the antioxidant defence system and altered blood testosterone and prolactin. Clozapine, ziprasidone and sertindole induced histopathological changes in rat testicular tissue, which could be attributed to a disturbed testicular antioxidant defence system in addition to an altered prolactin to testosterone ratio. None of the APD treatments induced histopathological changes in prostate. Our results demonstrate that APDs have the capacity to change both redox and endocrinological balance. One or both outcomes could underline testicular degeneration and disturbed spermatogenesis

The effects of whey and pumpkin seed oil on blood biochemical parameters of liver function and lipid profile in rats chronically drinking low concentrations of ethanol

We studied the effects of whey and pumpkin seed oil supplementation on the biochemical parameters in blood serum of male rats after chronic ad libitum alcohol consumption. The levels of AST, ALT, total bilirubin, ALP, LDH, triglycerides, total cholesterol, HDL, LDL, VLDL, triglyceride/HDL ratio, total cholesterol/HDL ratio (cholesterol ratio) and LDL/HDL ratio (index of atherosclerosis) were determined in rats after six weeks of treatment with: (i) ethanol (12% ethanol, ad libitum), (ii) whey (2 g/kg per day), (iii) pumpkin seed oil (2 mL/kg per day), (iv) both ethanol and whey, and (v) both ethanol and pumpkin seed oil. The results showed no changes in the levels of AST, ALT, total bilirubin, ALP, total cholesterol, HDL and VLDL in alcoholic rats when compared to the controls (fed with a standard laboratory diet ad libitum) and rats supplemented with whey and pumpkin seed oil. Our results suggest that alcohol consumption in small doses for 6 weeks changes lipid metabolism and significantly elevates the LDL/HDL ratio (index of atherosclerosis) but does not induce extensive liver damage. Ethanol consumption in our experimental conditions lowered the triglyceride level as well as the triglyceride/HDL ratio, suggesting lipid redistribution and the induction of some cardio-protective effect. However, ethanol induced a higher index of atherosclerosis. Pumpkin seed oil showed some protective potential in alcoholic rats by lowering the total cholesterol/HDL ratio, but it elevated the LDH. Whey consumption prevented elevation of the atherosclerosis index, pointing to its protective role, probably through the redistribution of lipids. However, whey in combination with ethanol elevated LDH

Osteoporoza prouzrokovana lekovima

Sve je veći broj istraživanja koja otkrivaju da mnogi lekovi ispoljavaju neželjeneefekte na mineralnu gustinu i strukturu koštanog tkiva. Brojne studije supokazale da neki lekovi mogu biti „štetni za kost” kao što su: glukokortikoidi,hormoni štitaste žlezde, antiepileptici, antidepresivi, aromatični inhibitori,gonadotropin oslobađajući agensi, kontraceptivi, antiretrovirusni lekovi, diureticiHenleove petlje, inhibitori protonske pumpe (IPP) i drugi. Uravnoteženibalans u primeni lekova za vreme dugotrajne terapije izazovan je i zahtevanposao lekara u primarnoj i sekundarnoj praksi i zavisi od njihove upućenostio odnosu između koristi i štetnosti primenjenih medikamenata. Određivanjestatusa skeleta pacijenta pre započinjanja terapije nekim od tzv. ”lekovaštetnih za kost”, veoma je važno i omogućava individualan pristup u terapiji

Inhibitori protonske pumpe – primena i bezbednost

Uvod. Inhibitori protonske pumpe (IPP) primenjuju se u terapiji acido peptičkihporemećaja uključujući peptički ulkus, gastroezofagusni reflex, erozivni ineerozivni ezofagitis, Zollinger-Elissonov sindrom, Helicobacter pylori infekcijei profilaksu stres ulkusa. Dobro dokumentovana efikasnost i relativna bezbednostprimene, doprineli su značajnom propisivanju IPP u praksi. Neželjenadejstva IPP nisu ozbiljna i javljaju se kod približno 1-3% lečenih pacijenata,bez značajnijih razlika među pojedinačnim predstavnicima. Dugotrajnaterapija IPP povećava rizik od razvoja rebound hipersekrecije želudačnekiseline, pneumonije i enteralnih bakterijskih infekcija (dijareja izazvana saClostridium difficile), preloma kostiju i kardiovaskularni rizik pri istovremenojprimeni sa klopidogrelom. IPP ne izazivaju deficit gvožđa i vitamina B12,ali povećavaju rizik od razvoja hipomagnezemije. Većina iznetih podatakapotiče iz retospektivnih kohort i case-control studija. Da bi se utvrdila tačnauzročno posledična povezanost između IPP i neželjenih događaja neophodnoje sprovesti velika prospektivna, randomizirana, kontrolisana klinička ispitivanja.Mnogo racionalnija upotreba IPP smanjila bi troškove u zdravstvu iosigurala njihovu bezbedniju primenu

The role of endocardial endothelium in the effect of histamine on myocardial contractions of histamine H1 and H2 receptor blockade

Endocardial endothelium (EE) is a barrier which controls the passage of macromolecules and fluids between the blood and the adjacent miocardial interstitium. At the same time it is the place of synthesis of numerous endothelial mediators. Histamine as an inflammation mediator increases the permeability of the endothelium, but also has a positive inotropic and chronotropic effects on the heart through the activation of histamine H1 and H2 receptors. The aim of this study was to determine the importance of the role of endocardial endothelium in the effect of histamine on myocardial contraction in the conditions of histamine receptors blockade. The study was carried out on the samples of the right ventricle of the albino Wistar rats (n = 42, age 8 weeks, body mass 180-200g) presented in two experimental models. The first experimental model presented the right ventricle of the rat heart with an intact endocardial endothelium and the second with the endothelium chemically removed by immersion of the chamber in a 1% solution of Triton X-100. Histamine (1x10-4 mol/l) increases the contraction of the right ventricle of the heart with intact endocardial endothelium but also with the removed endocardial endothelium. The effect of the histamine on the contraction was significantly increased in the absence of endocardial endothelium (p<0.05). H1 receptor antagonist, pyrilamine (1x10-6 mol/l) significantly inhibites the positive inotropic effect of histamine on the heart in both groups, with or without endocardial endothelium. Modulatory role of endocardial endothelium in the effect of histamine after the receptors blockade by pyrilamine is not significant. H2 receptor antagonist, cimetidine (1x10-4 mol/l), blocks the positive inotropic effect of histamine on the heart reagardless of the preservation of the endocardial endothelium. Our results indicate the undoubted importance of the modulatory role of endocardial endothelial in the effect of histamine on myocardial contraction

Influence of metabolism modifiers of cyclic nucleotides on contractility of right ventricle of rat heart with intact and removed endocardial endothelium

Introduction. Endocardial endothelium, a natural biological barrier between circulating blood in heart ventricle and cells, creates a complex yet finely tuned balance of interactions with the immediate environment. Objective. We investigated the roles of theophylline, nonspecific phosphodiesterase inhibitor, and imidazole, an activator of phosphodiesterase on contractility of the right ventricle of rat heart, with intact and removed endocardial endothelium. Methods. Adult rats, of both sexes, type Wistar albino, were used in this experiment. All experiments were conducted on the preparations of the right ventricle using two experimental models. In the first experimental model, an endocardial endothelium (EE) was preserved, and in the second model, an endocardial endothelium (-EE) was removed using 1% solution Triton X-100. Results. Theophylline (1x10-2 mol/l) expressed the positive inotropic effect on the heart, regardless of the presence of the endocardial endothelium. Inotropic response as multiple process can be induced by inhibition of phosphodiesterase, accumulation of cyclic nucleotides and activation of Ca2+ channels. Imidazole (2x10-3 mol/l) increased the contractility of the right ventricle of the heart with EE. The modulator effect of endocardial endothelium on contractility of imidazole proved to be significant. As imidazole influenced the contractility of the right ventricle only in the presence of the endocardial endothelium, it is assumed that its effect is mediated via deliverance of endothelial mediators with positive inotropic effect. Conclusion. An intact endocardial endothelium is necessary for completion of contractile performance of the heart

The importance of functional hemispheric asymmetry in the assessment of cognitive evoked potentials and reaction time

The aim of this study was to determine whether there is a correlation of latency and amplitude of P300 cognitive potential and the degree of lateralization of brain hemispheres. The study included 60 subjects whose age was between 45 and 56 years. Bioelectric brain activity was recorded using argentum chloride (AgCl) electrodes that were placed at central line of the scalp (over Fz and Cz regions) according to the international 10-20 standard. P300 was generated using 'oddball' paradigm with randomized stimuli: A frequent 1000 Hz tone with an occurrence of 80 % and a 2000 Hz tone (target) with a 20 % occurrence. The measurement is done with the right hand (first recording) and left hand (second recording). All subjects in this study were tested for usage lateralization and showed that they are right-handed. Based on the results of gestural lateralization subjects are divided in three groups. In the group with high degree of lateralization latencies of P300 were significantly lower when dominant hand was used in comparison to non-dominant hand, on Fz electrode (t = 4,162, p0.05) for latencies and amplitudes of P300 between dominant and non-dominant hand for the group of subjects with weak and average degree of lateralization. In both subject groups, significantly faster RT was measured when dominant hand was used. The P300 cognitive potential and reaction time can contribute to the study of indicators of the functional hemispheric asymmetry of the brain