An experimental study on the preventive effects of N-acetyl cysteine and ozone treatment against contrast-induced nephropathy

Abstract Purpose: To compare the preventive effects of N-acetyl cysteine (NAC), ozone preconditioning and ozone treatment against contrast-induced nephropathy (CIN) in an experimental rat model. Methods: Thirty adult male Wistar rats were randomly distributed into five groups (n=6 for each group). Group I served as control and Group II had only contrast agent, while Group III received NAC and Group IV received intraperitoneal ozone 6 hours before and 6 hours after introduction of contrast agent. Ozone treatment was applied for 5 days after the contrast agent was introduced in Group V. After induction of CIN, groups were compared in terms of serum levels of urea, creatinine, neutrophil gelatinase associated lipocalin, protein carbonyl, total antioxidant capacity (TAC) as well as degree of renal injury at histopathologic level. Results: Groups II-V displayed more obvious histopathological alterations such as hemorrhage and renal tubular injury compared with Group I. TAC (p=0.043) and creatinine (p=0.046) levels increased significantly in Group II after the intervention. In Group III, protein carbonyl level diminished remarkably (p=0.046), while creatinine level was increased (p=0.046) following the intervention. TAC level was higher in Group IV (p=0.028) and Group V (p=0.026) following the procedure. Conclusion: The N-acetyl cysteine and ozone treatment may alleviate the biochemical and histopathological deleterious effects of contrast-induced nephropathy via enhancement of total antioxidant capacity and decreasing oxidative stress.

Could ozone treatment be a promising alternative for osteomyelitis? an experimental study / O tratamento com ozônio pode ser uma alternativa promissora para a osteomielite? um estudo experimental

ABSTRACT Objective: The aim of the present study was to investigate the biochemical and histopathological impact of ozone treatment in an experimental model of osteomyelitis in rats. Methods: A total of 24 adult male Sprague-Dawley rats (3 months old, each weighing 300 to 400 g) were randomly allocated into three groups. Group I (n=8) served as a control and received no interventions or medications. In Group II (n=8), osteomyelitis was induced in the femur and no treatment was applied. Group III (n=8) received intraperitoneal ozone treatment for 3 weeks after the formation of osteomyelitis in the femur. Serum samples were taken to assess total antioxidant capacity (TAC), protein carbonyl content (PCO), and lactate dehydrogenase (LDH). Bone specimens obtained from the femur were histopathologically evaluated for inflammation, necrosis, osteomyelitis, and abscess formation. Results: Serum TAC levels were notably higher (p<0.001), while LDH levels were lower (p=0.002) in Group III than Group II. No significant difference was detected between groups with respect to PCO level. Similarly, Group III displayed more favorable histopathological outcomes with respect to osteomyelitis (p=0.008), inflammation (p=0.001), necrosis (p=0.022), and abscess formation (p=0.022). Conclusion: Ozone may be a useful adjunct treatment for osteomyelitis. Further studies in animals and humans are needed to clarify and confirm these preventive effects, understand the underlying pathophysiology, and establish guidelines. Level of Evidence II; Prospective comparative study.

RESUMO Objetivo: O objetivo do presente estudo foi investigar o impacto bioquímico e histopatológico do tratamento de ozônio em modelo experimental de osteomielite em ratos. Métodos: Vinte e quatro ratos Sprague-Dawley machos adultos (3 meses de idade, pesando de 300 a 400 g) foram alocados randomicamente em três grupos. O grupo I (n = 8) serviu como controle. No Grupo II (n = 8), o modelo de osteomielite experimental foi induzido no fêmur e não foi aplicado nenhum tratamento. O grupo III (n = 8) recebeu tratamento com ozônio intraperitoneal por 3 semanas depois da formação de osteomielite no fêmur. Foram coletadas amostras de sangue para avaliar a capacidade antioxidante total (CAT), a concentração da proteína carbonil (PCO) e da lactato desidrogenase (LDH) no soro. As amostras do fêmur foram avaliadas por histopatologia quanto a inflamação, necrose, osteomielite e formação de abscesso. Resultados: Os níveis séricos de TAC foram notavelmente maiores (p < 0,001), enquanto os níveis de LDH foram menores (p = 0,002) no Grupo III em comparação com o Grupo II. Nenhuma diferença significativa foi detectada entre os grupos com relação ao nível de PCO. Do mesmo modo, o Grupo III apresentou resultados histopatológicos mais favoráveis para osteomielite (p = 0,008), inflamação (p = 0,001), necrose (p = 0,022) e formação de abscesso (p = 0,022). Conclusão: O ozônio pode ser um tratamento adjuvante útil na osteomielite. Mais estudos com animais e com seres humanos são necessários para esclarecer e confirmar esses efeitos preventivos, compreender a fisiopatologia subjacente e estabelecer diretrizes. Nível de Evidência II; Estudo prospectivo comparativo.

An experimental study of ascorbic acid effects in acute renal failure under general anesthesia

Abstract Purpose: To evaluate the preventive effect of ascorbic acid on sevoflurane-induced acute renal failure in an experimental rat model. Methods: Twenty-four adult male Wistar rats were randomly distributed into three groups. Subjects were allocated into 3 groups: Group I received sevoflurane only, whereas Groups II and III had moderate (150 mg/kg) and high (300 mg/kg) doses of AA in addition to sevoflurane, respectively. Rhabdomyolysis and myohemoglobinuric ARF was formed by intramuscular administration of glycerol on the upper hind limb on the 15th minute of inhalation anesthesia. Biochemical parameters consisted of serum levels of blood urea nitrogen, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), total antioxidant capacity (TAC), and protein carbonyl content. Histopathological variables were tubular necrosis, fibrin, and cast formation. Results: NGAL levels were significantly lower in Group III than Group II and Group I. On the other hand, TAC, PCO, urea and creatinine levels were notably higher in Group I compared with Groups II and III. There was a significant difference between 3 groups on frequencies of acute tubular necrosis (p=0.003), fibrin (p<0.001) and cast (p<0.001). Acute tubular necrosis and fibrin formation were more prominent in Group I. Casts were more common in Groups II and III. Conclusions: The ascorbic acid serve as a prophylactic agent against renal damage in patients receiving sevoflurane anesthesia and higher doses were associated with more apparent protective effects.

Effect of ozone and methylprednisolone treatment following crush type sciatic nerve injury

ABSTRACT PURPOSE: To assess and compare the histopathological effects of ozone therapy and/or methylprednisolone (MPS) treatment on regeneration after crush type sciatic nerve injury. METHODS: Forty Sprague-Dawley male rats were randomly allocated into four groups. Four groups received the following regimens intraperitoneally every day for 14 days after formation of crush type injury on sciatic nerve: Group I: ozone (20mcg/ml); Group II: methylprednisolone (2mg/kg); Group III: ozone (20 mcg/ml) and methylprednisolone (2mg/kg); Group IV: isotonic saline (0.9%). The histomorphological evaluation was made after biopsies were obtained from the sites of injury. RESULTS: Significant differences were noted between groups in terms of degeneration (p=0.019), nerve sheath cell atrophy (p=0.012), intraneural inflammatory cellular infiltration (p=0.002), perineural granulation tissue formation (p=0.019), perineural vascular proliferation (p=0.004), perineural inflammatory cellular infiltration (p<0.001) and inflammation in peripheral tissue (p=0.006). Degeneration was remarkably low in Group III, while no change in nerve sheath cell was noted in Group II. CONCLUSION: The combined use of methylprednisolone and ozone treatment can have beneficial effects for regeneration after crush type nerve injury.

Spinal anesthesia for inguinal hernia repair in an infant with congenital tracheomalacia

Tracheomalacia is a rare and serious condition associated with high mortality in children receiving intensive care. There have been only a few reports of anaesthetic management of the patients with tracheomalacia

We present a case report of a seven month old boy with congenital tracheomalacia, scheduled for right inguinal hernia repair under spinal anesthesia. During the operation the blood pressure, the peripheral oxygen saturation and the heart rate remained within the normal ranges

The recovery of motor block took 55 minutes after spinal anesthesia. We want to highlight that spinal anesthesia may be performed by skilled and trained practitioners in children with tracheomalacia or for other specific indications