INFLUENCE OF OXYGENATOR EXTRACORPORAL CIRCUIT TREATMENT WITH ADAPTATION COMPOSITION (AdC) ON MORPHOLOGICAL CHANGES OF ERYTHROCYTES.

Summary. The study highlights a method of treatment extracorporeal circuit with «adaptation composition» (AdC) for the reduction of negative impact on state of erythrocytes. Materials and methods. A total of 90 patients were enrolled, they were divided into two groups. The group 1 (45 patients, 39/6 male/female) included patients who underwent surgical procedures without treatment of an extracorporeal circuit with AdC. The group 2 (45 patients, 39/6 male/female) included patients who underwent surgery with the treatment of an extracorporeal circuit with AdC. According to the study protocol, patient blood was sampling for complete blood cell count (CBC) and erythrocyte morphology at 4 stages of surgery: before surgery, at 10 min. CPB-time, at 60 min. CPB-time and after separation from CPB. Results. The albumin of AdC creates a protective nanolayer on the surface of the oxygenator membrane and tubes. There were no statistically significant differences of parameters in the groups before CPB. Level of Ht 2 (group 2) at 60 min CPB-time and after CPB, were lower than Ht 1 (group 1) (p=0.021 and p=0.035 correspondingly) because MCV1 was higher (р=0.025 and p<0.0001 correspondingly). The increase MCHC in groups at 10 min. CPB-time relatives with the decrease in MCV at 10 min CPB-time. At 60 min, there are changes of RDWa2 76.05 ± 5.46 and RDWa1 72.35 ± 7.26, p<0.000. After CPB higher content of reticulocytes (р <0.0001), echinocytes (р <0.0001) and spherocytes (р <0.0001) is observed in group 1. The lowering of mechanical resistance (р = 0.04) and increasing membrane permeability for urea were in group 1. After CPB the best aсid hemolysis resistance was in group 2 (р = 0.05), erythrocytes were more resistant to hypoosmotic factor (р = 0.01) in group 2. Conclusion. The treatment of oxygenator with AdC reduces the negative influence СРВ on state of RBC. Membranes of erythrocytes were more resistant to traumatic factors in the group with AdC.В роботі висвітлюється метод обробки экстракорпорального контура оксигенатора «адаптуючою композицією» (adaptation composition – AdC) для зменшення негативного впливу штучного кровообігу на стан еритроцитів. Матеріали і методи. В дослідження було включено 90 пациентов, які були розподілені на дві групи. Пацієнтам першої групи (45 хворих, 39/6 чол./жін.) оперативні втручання виконували без обробки контуру оксигенатору адаптуючою композицією (AdC). Оперативні втручання у пацієнтів другої групи (45 пацієнтів - 36/9 чол./жін.) проводились з обробкою AdC. Згідно протоколу дослідження, у пацієнтів набирали кров для загального аналізу крові та морфологічного дослідження еритроцитів на 4 етапах оперативного втручання: до початку операції, на 10 хв. ШК, на 60 хв. ШК та в кінці операції. Результати та їх обговорення. Альбумін в складі AdС створює наношар на поверхні магистралей та мембрани оксигенатора. Між групами до ШК не було статистично значущої різниці у показниках. Рівень Ht 2 (група 2) на 60 хв. ШК ти після ШК був нижче, ніж Ht 1 (група 1) (p=0,021 і p=0,035 відповідно) через зібльшення MCV 1 (р=0,025 і p <0,0001 відповідно). На 10 хв. ШК підвищення МСНС в групах пов'язано зі зниженням MCV на 10 хв. ШК. На 60 хв. від початку ШК відбувається зміна в RDWа2 76,05 ± 5,46 і RDWа1 72,35 ± 7,26, р <0,0001. Після ШК в групі 1 визначається більш високий вміст ретикулоцитів (р <0,0001), ехіноцитів (р <0,0001) і сфероцитів (р <0,0001). В групі 1 після ШК відбувається зниження механічної стійкості еритроцитів (р = 0,04) та підвищена проникність мембрани еритроцитів для сечовини. Після ШК більша резистентність еритроцитів до кислотного гемолізу була в групі 2 (р = 0,05), також в групі 2 еритроцити були більш стійкими до гіпоосмотичному фактору (р = 0,01). Висновки. Обробка оксигенатора адаптуючою композицією призводить до зменшення негативного впливу ШК на стан еритроцитів. Мембрани еритроцитів були більш резистентні до дії факторів що ушкоджують в групі з використанням AdC

Consensus Recommendations for Clinical Outcome Assessments and Registry Development in Ataxias: Ataxia Global Initiative (AGI) Working Group Expert Guidance

To accelerate and facilitate clinical trials, the Ataxia Global Initiative (AGI) was established as a worldwide research platform for trial readiness in ataxias. One of AGI’s major goals is the harmonization and standardization of outcome assessments. Clinical outcome assessments (COAs) that describe or reflect how a patient feels or functions are indispensable for clinical trials, but similarly important for observational studies and in routine patient care. The AGI working group on COAs has defined a set of data including a graded catalog of COAs that are recommended as a standard for future assessment and sharing of clinical data and joint clinical studies. Two datasets were defined: a mandatory dataset (minimal dataset) that can ideally be obtained during a routine clinical consultation and a more demanding extended dataset that is useful for research purposes. In the future, the currently most widely used clinician-reported outcome measure (ClinRO) in ataxia, the scale for the assessment and rating of ataxia (SARA), should be developed into a generally accepted instrument that can be used in upcoming clinical trials. Furthermore, there is an urgent need (i) to obtain more data on ataxia-specific, patient-reported outcome measures (PROs), (ii) to demonstrate and optimize sensitivity to change of many COAs, and (iii) to establish methods and evidence of anchoring change in COAs in patient meaningfulness, e.g., by determining patient-derived minimally meaningful thresholds of change

SCAview: an Intuitive Visual Approach to the Integrative Analysis of Clinical Data in Spinocerebellar Ataxias

With SCAview, we present a prompt and comprehensive tool that enables scientists to browse large datasets of the most common spinocerebellar ataxias intuitively and without technical effort. Basic concept is a visualization of data, with a graphical handling and filtering to select and define subgroups and their comparison. Several plot types to visualize all data points resulting from the selected attributes are provided. The underlying synthetic cohort is based on clinical data from five different European and US longitudinal multicenter cohorts in spinocerebellar ataxia type 1, 2, 3, and 6 (SCA1, 2, 3, and 6) comprising > 1400 patients with overall > 5500 visits. First, we developed a common data model to integrate the clinical, demographic, and characterizing data of each source cohort. Second, the available datasets from each cohort were mapped onto the data model. Third, we created a synthetic cohort based on the cleaned dataset. With SCAview, we demonstrate the feasibility of mapping cohort data from different sources onto a common data model. The resulting browser-based visualization tool with a thoroughly graphical handling of the data offers researchers the unique possibility to visualize relationships and distributions of clinical data, to define subgroups and to further investigate them without any technical effort. Access to SCAview can be requested via the Ataxia Global Initiative and is free of charge

IFN-α/IFN-λ responses to respiratory viruses in paediatric asthma

We analysed the influence of rhinovirus (RV) in nasopharyngeal fluid (NPF) on type I and III interferon (IFN) responses (e.g. IFN-α and IFN-λ) and their signal transduction, at baseline and during disease exacerbation, in cohorts of pre-school children with and without asthma.At the time of recruitment into the Europe-wide study PreDicta, and during symptoms, NPF was collected and the local RV colonisation was analysed. Peripheral blood mononuclear cells (PBMCs) were challenged in vitro with RV or not. RNA was analysed by quantitative real-time PCR and gene arrays. Serum was analysed with ELISA for IFNs and C-reactive protein.We found that PBMCs from asthmatic children infected in vitro with the RV1b serotype upregulated MYD88, IRF1, STAT1 and STAT2 mRNA, whereas MYD88, IRF1, STAT1 and IRF9 were predominantly induced in control children. Moreover, during symptomatic visits because of disease exacerbation associated with RV detection in NPF, IFN-α production was found increased, while IFN-λ secretion was already induced by RV in asthmatic children at baseline.During asthma exacerbations associated with RV, asthmatic children can induce IFN-α secretion, indicating a hyperactive immune response to repeated respiratory virus infection.</jats:p