Monitoring prohemostatic treatment in bleeding patients

Acutely bleeding patients are commonly found in the trauma and major surgery scenarios. They require prompt and effective treatment to restore an adequate hemostatic pattern, to avoid serious and sometimes life-threatening complications.Different prohemostatic treatments are available, including allogeneic blood derivatives (fresh frozen plasma, platelet concentrates, and cryoprecipitates), prothrombin complex concentrates, specific coagulation factors (fibrinogen, recombinant factor XIII, recombinant activated factor VII), and drugs (protamine for patients under heparin treatment, desmopressin, antifibrinolytics).For decades, prohemostatic treatment of the acutely bleeding patient was based on empirical strategies and clinical judgment, both in terms of a correct diagnosis of the mechanism(s) leading to bleeding, and of an assessment of the effects of the treatment. This empirical strategy may lead to excessive or unnecessary use of allogeneic blood products, as well as to an incorrect, inefficacious, or even dangerous treatment. Different monitoring devices are nowadays available for guiding the diagnostic and therapeutic decision-making process in an acutely bleeding patient. This review addresses the available tools for monitoring prohemostatic treatment of the bleeding patient, with a specific respect for point-of-care tests (thromboelastography, thromboelastometry, platelet function tests, and heparin monitoring systems) at the light of the existing evidence

Effect of preoperative P2Y12 and thrombin platelet receptor inhibition on bleeding after cardiac surgery

BACKGROUND: Drugs that act on the platelet P2Y12 receptor are responsible for postoperative bleeding in cardiac surgery. However, protease-activated receptor (PAR) that reacts to thrombin stimulation might still be active in patients treated with P2Y12 inhibitors. Preoperative platelet function testing could possibly guide the timing of surgery. We investigated the association between P2Y12 receptor and PAR inhibition and bleeding after cardiac surgery. METHODS: A retrospective cohort study of 361 patients undergoing cardiac surgery and treated with P2Y12 anti-platelet agents was undertaken. All patients received a preoperative multiplate electrode aggregometry testing of platelet P2Y12 receptor activity (ADPtest) and PAR reactivity with thrombin receptor-activating peptide (TRAP) stimulation. ADPtest and TRAPtest data measured before surgery were analysed for association with postoperative bleeding (ml per 12 h) and severe postoperative bleeding. RESULTS: Both the ADPtest and the TRAPtest were significantly (P=0.001) associated with postoperative bleeding. A threshold of 22 U for the ADPtest yielded a negative predictive value (NPV) of 94% and a positive predictive value (PPV) of 20%, and a threshold of 75 U for the TRAPtest yielded an NPV of 95% and a PPV of 23%. In the subgroup of patients with ADPtest <22 U, TRAPtest ≥75 U was not associated with severe bleeding (NPV of 100% and PPV of 37%). CONCLUSIONS: In patients taking P2Y12 receptor inhibitors, residual platelet reactivity to thrombin stimulation limits the risk of severe postoperative bleeding

Effect of selected starter cultures on physical, chemical and microbiological characteristics and biogenic amine content in protected geographical indication Ciauscolo salami

The aim of the study was to evaluate the biogenic amine (BA) content of Ciauscolo salami made with and without the use of a selected started culture. Two batches of salami were made following the guidelines of the Protected Geographical Indications: with and without adding a commercial starter culture made of Lactobacillus plantarum and Staphylococcus xylosus. Six samples of salami per batch were collected at different ripening times (0, 15, 30, 45 and 60 days) for physical, chemical and microbiological analyses and for the determination of BA content. No differences were recorded for physical, chemical and microbiological analyses except for Staphylococcus spp. count at the time of casing (T0) and total volatile basic nitrogen (TVBN) from 30 days (T2) to the end of the ripening time (60 days, T4). After 60 days of ripening, the use of selected starter culture significantly affected the amount of putrescine (195.15 vs 164.43 mg/100 g in salami without and with starters, respectively), cadaverine (96.95 vs 104.40 mg/100 g in salami without and with starters, respectively), histamine (81.94 vs 69.89 mg/100 g in salami without and with starters, respectively), and spermine (36.88 vs 33.57 mg/100 g in salami without and with starters, respectively). Despite significantly higher values of TVBN, the use of selected starter culture determined no significant effects on the BA content of the products

Differences in chemical, physical and microbiological characteristics of Italian burrata cheeses made in artisanal and industrial plants of Apulia Region

The burrata cheese is a traditional product from Southern Italy, consisting of an envelope of pasta filata (stretched curd) filled with cream and pasta filata strips (usually leftovers from mozzarella production). Physical [water activity (aw), pH], chemical (moisture, NaCl content) and microbiological [total viable count (TVC), Listeria monocytogenes, Salmonella spp., Yersinia enterocolitica, Bacillus cereus, Escherichia coli, Enterobacteriaceae, coagulase-positive staphylococci] characteristics of burrata cheeses manufactured in artisanal and industrial plants were evaluated. The artisanal burrata showed lower aw values in the filling and the final product. The same was recorded in the filling for the moisture, probably due to differences between the types of cream used in the artisanal and the industrial cheesemaking. The pH value of the filling differed between the two groups but no difference was recorded in the final product. Microbiological differences were also recorded, with higher values for TVC and E. coli in artisanal than industrial burrata. All samples were negative for the other microbialdeterminations, with the exception of coagulase-positive staphylococci and Y. enterocolitica, which were detected in artisanal burrata. Differences in cheesemaking process were probably responsible for the strong variability of the physical and chemical data between the two cheeses; furthermore, differences in the hygienic features were also recorded. Even though artisanal products showed lower aw and pH values and higher NaCl concentration, the higher E. coli loads highlighted the need for a more accurate compliance with hygienic procedures along the artisanal cheesemaking process

QED Corrections to the Scattering of Solar Neutrinos and Electrons

We discuss recent calculations of the O(alpha) QED corrections to the recoil electron energy spectrum in neutrino electron scattering, and to the spectrum of the combined energy of the recoil electron and a possible accompanying photon emitted in the scattering process. We then examine the role of these corrections in the interpretation of precise measurements from solar neutrino electron scattering experiments.Comment: (16 Pages, 4 Figures) Presented at the Symposium in Honor of Professor Alberto Sirlin's 70th Birthday: ``50 Years of Precision Electroweak Physics'', New York University, October 27-28, 200

Dietary oregano (Origanum vulgare L.) aqueous extract improves oxidative stability and consumer acceptance of meat enriched with CLA and n-3 PUFA in broilers.

Abstract The effect of a dietary oregano aqueous extract on meat fatty acid profile, quality, and consumer acceptance in chickens fed a diet rich in polyunsaturated fatty acids (PUFA) was evaluated in 3 consecutive trials. For each trial, 171 day-old Ross 308 chicks were randomly divided in replicates of 19 birds each and assigned to one of 3 experimental diets: 1) basal control diet, 2) basal diet supplemented with 0.2 g/kg of oregano aqueous extract, and 3) basal diet supplemented with 150 ppm of vitamin E (as positive control). To better analyze the antioxidant activity of both oregano and vitamin E, all the experimental diets were enriched with a fatty acid supplement consisting in a mixture of PUFA at the same dose (1.16 %) in both starter and finisher feeds. Oregano supplementation positively influenced (P Results obtained in the present study allow stating that using oregano aqueous extract in diets enriched with PUFA can represent a valid solution to increase live weight of chickens, improve resistance to oxidation of meat, and positively influence consumer perception of poultry meat

Tuning Polyamidoamine Design to Increase Uptake and Efficacy of Ruthenium Complexes for Photodynamic Therapy

Nanomedicine holds great promises to change the way drugs are delivered to their target, owing to the use of nano-sized drug carriers capable to enter cells and be trafficked intracellularly via energy dependent pathways [1, 2]. This is very different from the way most drugs arrive to their target, often based simply on their solubility and partition coefficients in lipids and water. Despite some valuable successes, drug delivery remains rather challenging and several factors are still limiting its potential. Among such factors, it has emerged, for instance, that most nano-sized carriers entering cells via endocytosis are later trafficked along the endolysosomal pathway to the lysosomes, where the low pH and abundant proteases can degrade and destroy the internalised cargo. Strategies to escape the endosomes and lysosomes are being investigated. Among the many polymer species employed as drug delivery vectors, linear polyamidoamines (PAAs) are very interesting and promising materials. In this communication it will be presented a new polycationic PAA endowed with a luminescent Ru complex (Ru-PhenAN) and its ability to target the cell nucleus. It shows unique trafficking to the cell nucleus of all the treated cells, also at polymer doses as low as cytotoxicity is very low. Also, it will be shown the efficacy of Ru-PhenAN as photosensitizers for photodynamic therapy (PDT), a treatment of pathological conditions based on the photo-activation of a bioactive compound, which is not harmful in the absence of light irradiation [3]

Transfer of bioactive compounds from pasture to meat in organic free-range chickens

Abstract The aim of this study was to analyze the transfer of bioactive compounds from the pasture to the body and meat of organic free-range chickens and to verify the effect of these compounds on the oxidative processes of the meat. Starting at 21 d of age, 100 male naked-neck birds were divided into two homogeneous groups: an indoor group (0.12 m2/bird) and an outdoor group (0.12 m2/bird indoor and 10 m2/bird of forage paddock). At slaughter (81 d of age), blood samples were collected, and the carcasses were stored for 24 h at 4°C (20 birds/group). The grass samples had higher values of carotenoids, tocopherols, and flavonoids respect to standard feed (based on dry matter comparison). The polyunsaturated fatty acid (PUFA) content was also greater in grass, especially the n-3 series (so named because its first double bond occurs after the third carbon atom counting from the methyl at the end of the molecule). The antioxidant profile of the grass improved the antioxidant status of the crop and gizzard contents in the outdoor chickens. The higher antioxidant intake resulted in a higher plasma concentration of antioxidants in outdoor birds; thiobarbituric acid reactive substances (TBARs) and the antioxidant capacity of the plasma were also better in the outdoor than the indoor group. The meat of the outdoor birds had higher levels of antioxidants, mainly due to the higher amount of tocopherols and tocotrienols. Despite the higher antioxidant protection in the drumstick of the outdoor group, the TBARs value was greater, probably due to the kinetic activity of birds, the higher percentage of PUFAs, and the peroxidability index. In conclusion, grazing improved the nutritional value of the meat (PUFA n-3 and the ratio between n-6 and n-3 PUFA) with a minor negative effect on the oxidative stability. Suitable strategies to reduce such negative effects (e.g., reduction of kinetic activity in the last days of rearing) should be studied