Fuganlin oral liquid ameliorates airway remodeling through TGF-β1/Smad3 signaling pathway in asthmatic mice / 中国药理学通报

Aim To explore the effect of Fuganlin on airway remodeling in obese asthmatic mice and its mechanism.Methods A model of chronic airway inflammation in C57 BL/6 mice with obese asthma induced by OVA and high-fat diet was established,and treated with Fuganlin 5.86,11.72 and 23.44 g·kg-1 by gavage.After the last challenge,the respiratory system resistance(Rrs),respiratory system elasticity(Ers),and respiratory system compliance(Crs)were measured with a lung function oscillator; the total number of white blood cells in whole blood was measured; tissue HE and MASSON staining were employed to observe the pathological changes.ELISA was used to detect the levels of IgE in serum and the levels of TGF-β1,Smad3 and SP in lung tissues; IHC was used to detect the expression levels of Smad3,SARA and protein in lung tissues.Results Fuganlin reduced the increase in the number of white blood cells in blood and inhibited the content of IgE in serum.Fuganlin could reduce the Rrs and Ers,enhance the Crs and regulate the respiratory function.Histopathological results showed that Fuganlin could reduce inflammatory cell infiltration and collagen deposition in the chronic airway inflammation model of obese mice,and inhibit bronchial mucosal proliferation; ELISA results showed that Fuganlin inhibited the expression of TGF-β1,Smad3,and SP; IHC results showed that Smad3 and SARA protein expression decreased.Conclusions The anti-obesity asthma effect of Fuganlin may help to improve respiratory function,control airway inflammation,and antagonize airway remodeling.

Diagnosing sub-acute rumen acidosis in cows in the post-calving period with digital technologies / [Diagnóstico de acidose ruminal subaguda em vacas no período pós-parto usando tecnologias digitais]

This study aims to determine the relationship between indicators of the motor activity, pH factor, rumen and rectal temperature within 10 days after calving and to analyze the possibility of using the studied parameters as prognostic signs for diagnosing sub-acute rumen acidosis (SARA). The measurements were taken using bolus with sensors designed to monitor cow health. The motor activity, pH factor and ruminal temperature of 10 cows were measured during 10 days at a measurement interval of every 60 seconds. Next, the researchers calculated the average values of the obtained readings, which were divided into 2 groups according to a measurement interval of every 12 hours. Rectal temperature was measured using a veterinary thermometer every 12 hours (at 8 a.m. and at 8 p.m.). As a result, 200 measurements were obtained. Descriptive sampling statistics were calculated using the SPSS Statistics program. An increase in motor activity reduces the pH level of the rumen environment. Lowering the pH factor of the rumen environment leads to an increase in ruminal temperature. There is a positive statistically significant correlation between ruminal and rectal temperature. The nosology of SARA can be predicted by measuring the motor activity and rectal temperature of dairy cows.(AU)

Este estudo visa determinar a relação entre indicadores de atividade motora, fator de pH, temperatura ruminal e retal em até 10 dias após o parto e analisar a possibilidade de utilizar os parâmetros estudados como sinais prognósticos para o diagnóstico de acidose ruminal subaguda (SARA). As medições foram feitas usando bolus com sensores projetados para monitorar a saúde das vacas. A atividade motora, o fator de pH e a temperatura ruminal de 10 vacas foram medidos durante 10 dias em intervalos de medição de 60 segundos. A seguir, os pesquisadores calcularam os valores médios das leituras obtidas, que foram divididos em 2 grupos de acordo com um intervalo de medição a cada 12 horas. A temperatura retal foi medida com um termômetro veterinário a cada 12 horas (às 8h e às 20h). Como resultado, foram obtidas 200 medições. As estatísticas de amostragem descritiva foram calculadas usando o programa SPSS Statistics. Um aumento na atividade motora reduz o nível de pH do ambiente ruminal. A redução do fator de pH do ambiente ruminal leva a um aumento da temperatura ruminal. Existe uma correlação positiva estatisticamente significativa entre a temperatura ruminal e retal. A nosologia com SARA pode ser prevista medindo a atividade motora e a temperatura retal de vacas leiteiras.(AU)

Hypericin enhances -lactam antibiotics activity by inhibiting expression in methicillin-resistant

Bacteremia is a life-threating syndrome often caused by methicillin-resistant (MRSA). Thus, there is an urgent need to develop novel approaches to successfully treat this infection. Staphylococcal accessory regulator A (SarA), a global virulence regulator, plays a critical role in pathogenesis and -lactam antibiotic resistance in . Hypericin is believed to act as an antibiotic, antidepressant, antiviral and non-specific kinase inhibitor. In the current study, we investigated the impact of hypericin on -lactam antibiotics susceptibility and mechanism(s) of its activity. We demonstrated that hypericin significantly decreased the minimum inhibitory concentrations of -lactam antibiotics (.., oxacillin, cefazolin and nafcillin), biofilm formation and fibronectin binding in MRSA strain JE2. In addition, hypericin significantly reduced expression, and subsequently decreased and virulence-related regulators (.., ) and genes (.., and ) expression in the studied MRSA strain. Importantly, the synergistic effect of hypericin with -lactam antibiotic (.., oxacillin) translated into therapeutic outcome in a murine MRSA bacteremia model. These findings suggest that hypericin plays an important role in abrogation of -lactam resistance against MRSA through inhibition, and may allow us to repurpose the use of -lactam antibiotics, which are normally ineffective in the treatment of MRSA infections (.., oxacillin).

A Review On Herbo Mineral Formulations Containing Lauha (iron) W.s.r To Rasendra Sara Sanghraha

Rasendra Sara Sangraha is the oldest and most exhaustive treatise of Rasa Shastra, an important branch of Ayurveda, which revolutionised Ayurveda Pharmacopeia in the medieval period. It is one of classical works of 14th century period written by Sri Gopala Krishna Bhatt consists of 5 chapters with 2531 verses. Rasendra Sara Sangraha comprising the compilation of various times tested and therapeutically proved Rasayoga formulations. Lauha (iron) is a very essential element of the body system for treating many disease conditions as well as for physiological existence. Iron used as medicine from the Vedic period. Lauha preparations are extensively used from Acharya Charaka’s period in the form of Ayasruti and Navayasa loha. Rasendra Sara Sangraha has mentioned a total of 222 herbo mineral formulations having Lauha (iron). The present study deals with the chapter wise review of formulations of Rasendra Sara Sangraha containing Lauha as an ingredient mentioned in various disease conditions like Jwara, Arsas, krimi, Pandu, Soola, Pradara, Sodha and Gulma etc. These Lauha containing Herbo mineral Formulations has been elaborately compiled in 222 formulations.

Describing the health service delivery network of an urban poor area and a rural poor area

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to assess the health workforce's service capacities within a health Service Delivery Network (SDN) of an urban poor and a rural poor setting.</p><p style="text-align: justify;"><b>METHODS:</b> This is a concurrent mixed-methods study implemented in Navotas and Masbate, an urban poor and a rural poor area, respectively. Health needs of the residents were assessed through records review, qualitative methods and a household survey. Health facilities in the identified SDN were assessed using the Service Availability and Readiness Assessment (SARA) tool. Training data of Human Resource for Health (HRH) were also obtained.</p><p style="text-align: justify;"><b>RESULTS:</b> SDN in the two areas are different in terms of formality where memoranda of agreement were prepared between Masbate facilities but not in Navotas. Health worker to population ratios were 12.1 per 10,000 in Navotas and 2.7 in Masbate, respectively. The primary care facilities in the two sites met the recommended level of trainings for health workers in obstetric care, immunization, childhood nutrition and tuberculosis. There was a lack of post-graduate training in non-communicable diseases in all facilities. Poverty and geography were significant factors affecting health service delivery.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> In terms of human resources, both sites have limited number of health workers and the ratios fall far below WHO guideline. Recommendations include: Primary health care staff complement should be increased in the two SDNs. HHRDB should conduct a study to settle the issue of continuing medical education requirements that are not congruent with WHO recommendations. The SDNs should include the access of medicines and commodities by poor patients in private facilities during times of stock outs. Also, during stock outs or unavailability of government health personnel, transportation should be made available via the SDN to transport poor patients to private or nongovernment facilities with the needed personnel. The DOH and HHRDB should investigate innovative strategies for telehealth services that do not require continuous electricity, nor telephone or cellphone signal.</p>

Síndrome de insuficiencia respiratoria aguda, 50 años después / Acute respiratory distress syndrome. 50 years later / Síndrome da angústia respiratória aguda 50 anos depois

Resumen: La condición clínica llamada síndrome de insuficiencia respiratoria aguda es una entidad que se conoce desde antes de la Segunda Guerra Mundial; no obstante, no fue hasta el año de 1967 cuando el grupo del Dr. Ashbaugh describió una serie de 12 pacientes con las características clínicas e histológicas particulares a las que llamaron síndrome de dificultad respiratoria aguda. No sólo se describió por primera vez esta entidad clínica, sino que además el grupo del Dr. Ashbaugh hizo mención a la posibilidad del uso de esteroides y ventilación mecánica como probables pilares del tratamiento. Desde entonces y hasta la fecha los criterios diagnósticos, el tratamiento farmacológico, así como las técnicas de soporte mecánico ventilatorio han cambiado, pese a ello esta entidad clínica sigue siendo un reto terapéutico, ya que puede llegar a tener un alto índice de mortalidad, cerca de 40%. La finalidad de este texto es hacer un resumen de las aportaciones más significativas relacionadas con esta entidad en el marco de los 50 años de su descripción.

Abstract: The clinical condition known as acute respiratory distress syndrome, is an entity that has been known since before the Second World War, however it was not until 1967 that the group of Ashbaugh, described a series of 12 patients with clinical and histological special features that called acute respiratory distress syndrome. Not only first he described this clinical entity, if not also the group of Ashbaugh is mention of the possibility of steroid use and mechanical ventilation, as probable gol of treatment. Diagnostic criteria, drug treatment and techniques mechanical support ventilatory have changed, despite which, this clinical entity remains a therapeutic challenge because they can have a high rate of mortality, almost 40%. The purpose of this paper is to summarize the most significant contributions related to this entity, within 50 years of its description.

Resumo: A condição clínica conhecida como síndrome da angústia respiratória aguda (SARA), é uma entidade que temos conhecimento desde antes da Segunda Guerra Mundial, no entanto, não foi até 1967 que o grupo do Dr. Ashbaugh descreveu uma série de 12 pacientes com características clínicas e histológicas especiais que denominou Síndrome da Angústia Respiratória Aguda. Não só se descreveu esta entidade clínica, se não também o grupo do Dr. Ashbaugh fez menção à possibilidade da utilização de esteróides e ventilação mecânica como pilares prováveis ​​do tratamento. Desde então e até os dias de hoje, os critérios de diagnóstico e tratamento medicamentoso, assim como as técnicas de suporte mecânico ventilatório mudaram, apesar de que, esta entidade clínica continua sendo um desafio terapêutico já que pode ter uma alta taxa de mortalidade, quase 40%. O objetivo deste artigo é resumir as contribuições mais significativas relacionadas com esta entidade após 50 anos da sua descrição.

Ventilación mecánica en decúbito prono: estrategia ventilatoria temprana y prolongada en SIRA severo por influenza / Prone mechanical ventilation: ventilatory strategy early and prolonged in severe ARDS by influenza / Ventilação mecânica em decúbito prono: Estratégia ventilatória precoce e prolongada

Resumen: Introducción: El síndrome de dificultad respiratoria aguda (SIRA) de causa pulmonar es actualmente una condición que pone en peligro la vida del paciente cuando se desarrolla hipoxemia severa y refractaria. Las estrategias terapéuticas son limitadas e incluso controversiales. La ventilación mecánica en decúbito prono llevada a cabo de manera temprana y prolongada se asocia a incremento en la sobrevida. Objetivos: Determinar la mortalidad asociada al SIRA severo por influenza utilizando como estrategia la ventilación mecánica en decúbito prono prolongada. Materiales y métodos: Estudio prospectivo, transversal, descriptivo y de intervención. Se reclutaron pacientes de marzo de 2016 a abril de 2016 con diagnóstico de SIRA severo por influenza que ingresaron a la Unidad de Cuidados Intensivos (UCI). Se agrupó a los pacientes de acuerdo con el desenlace (mejoría o defunción). Resultados: Se incluyeron nueve pacientes con una media de edad de 47 ± 16 años. En 78% fueron hombres. La comorbilidad más frecuente fue la HAS con 44%. Ocho pacientes fueron sometidos durante su estancia a ventilación mecánica en decúbito prono y se agruparon según el desenlace. Tres pacientes fallecieron y seis fueron dados de alta de la UCI por mejoría. No se observó diferencia significativa en edad, tiempo de evolución, niveles de pH, PaO2, PaCO2, HCO3, o SOFA a su ingreso en ambos grupos (p > 0.05 en todos los casos). Después de 96 horas de la pronación los valores de la PEEP fueron más altos en los pacientes fallecidos (p = 0.026) y en los parámetros de gasometría arterial se detectó disminución en los niveles O2 y la relación PaO2/FiO2, además de aumento en los requerimientos de FiO2 en los pacientes que fallecieron, siendo estadísticamente significativo (p < 0.05). Otros factores que se analizaron fueron antecedente de HAS, DM 2, tabaquismo, tiempo de pronación, manejo con esteroide y uso de antibióticos previo al ingreso a la UCI. (Prueba exacta de Fisher con p > 0.05 y OR no significativa en todos los casos). Conclusiones: La hipoxemia refractaria es el factor más importante involucrado en la mortalidad en pacientes con influenza y SIRA severo. La ventilación mecánica en decúbito prono temprana y prolongada por 48 horas debería considerarse una práctica habitual en este grupo de pacientes.

Abstract: Background: Acute respiratory distress syndrome (ARDS) due to pulmonary disease is currently a condition that endangers the patient's life, when severe and refractory hypoxemia develops, therapeutic strategies are limited and even controversial. Mechanical ventilation in prone position conducted early and prolonged is associated with increased survival. Objetives: To determine the mortality associated with severe ARDS by influenza using a strategy of prolonged mechanical ventilation in prone position. Materials and Methods: A prospective, cross-sectional, descriptive study intervention. March 2016 patients were recruited to April 2016 with the diagnosis of severe ARDS, which will enter the Intensive Care Unit (ICU). They were grouped patients according to outcome (improvement or death). Results: Nine patients were included, with a mean age of 47 ± 16 years. 78% were men. The most frequent comorbidity was hypertension with 44%. During their stay, eight patients underwent mechanical ventilation in prone position and were grouped according to the outcome. Three patients died and six were discharged from the ICU for improvement. No significant difference was observed in age, duration, pH levels, PaO2, PaCO2, HCO3 or SOFA at admission in both groups (p > 0.05 in all cases). Ninety six hours after pronation values PEEP were higher in patients who died (p = 0.026) and parameters ABG decrease in O2 levels and PaO2/FiO2 was observed, in addition to increase in FiO2 requirements in the patient who died, were statistically significant (p < 0.05). Other factors that were analyzed were history of hypertension, diabetes mellitus, smoking, time pronation, handling and use of steroid antibiotics prior to admission to the ICU. (Fisher exact test with p > 0.05 and no significant OR in all cases). Conclusions: Refractory hypoxemia is the most important factor involved with mortality in patients with severe ARDS. Mechanical ventilation in the prone position early and prolonged by 48 hours should be considered a standard practice in this patient group.

Resumo: Introdução: A Síndrome da Angústia Respiratória Aguda (SARA), devido a doença pulmonar é atualmente uma condição que põe em risco a vida do paciente quando desenvolve hipoxemia grave e refratária, as estratégias terapêuticas são limitadas e até mesmo controversas. A ventilação mecânica em decúbito prono realizada mais cedo e prolongada está associada com aumento da sobrevida. Objetivo: Determinar a mortalidade associada com SARA grave por influenza usando como estratégia a ventilação mecânica em decúbito prono prolongada. Materiais e metodos: Estudo prospectivo, transversal, descritivo, de intervenção. Foram recrutados pacientes de março de 2016 a abril de 2016 com diagnóstico de SARA grave por influenza, que foram admitidos na unidade de terapia intensiva (UTI). Os pacientes foram agrupados de acordo com o resultado (melhora ou morte). Resultados: Foram incluídos 9 pacientes, com idade média de 47 ± 16 anos. 78% do sexo masculino. A comorbidade mais frequente foi a HAS com 44%. Durante a estância, oito pacientes foram submetidos a ventilação mecânica na posição decúbito prono e agrupados de acordo com o resultado. Três pacientes faleceram e seis tiveram alta da UTI por melhora. Não foi observada diferença significativa na idade, tempo de evolução, níveis de pH, PaO2, PaCO2, HCO3 ou SOFA na admissão em ambos os grupos (0 > 0.05 em todos os casos). 96 horas após a pronação os valores da PEEP foram maiores nos pacientes que faleceram (p = 0.026) e nos parâmetros da gasometria arterial observou-se uma diminuição nos níveis de O2 e na relação PaO2/FiO2, ademais de um aumento nas necessidades FiO2 nos pacientes que faleceram, sendo estatisticamente significativa (p < 0.05). Outros fatores que foram analisados: antecedente​ de HAS, DM 2, tabagismo, tempo de pronação, tratamento com esteróides e uso de antibióticos prévia admissão na UTI. (Prova exata de Fisher com p > 0.05 e OR não significativa em todos os casos). Conclusões: A hipoxemia refratária é o fator mais importante envolvido com a mortalidade em pacientes com influenza e SARA grave. A ventilação mecânica em decúbito prono precoce e prolongada por 48hrs deve ser considerado uma prática padrão neste grupo de pacientes.

Propiedades psicométricas del manual para la valoración del riesgo de violencia contra la pareja (SARA) en agresores chilenos / Psychometric properties of the manual for the evaluation of the risk of violence against the couple (SARA) in Chilean aggressors

La finalidad de este estudio instrumental fue evaluar las propiedades psicométricas del Manual para la Valoración del Riesgo de Violencia contra la Pareja SARA (The Spousal Assault Risk Assessment) por medio de la adaptación y de la obtención de indicadores de validez concurrente y diagnóstica y de consistencia interna. La muestra estuvo conformada por 62 participantes, 32 agresores contra la pareja y 30 no agresores contra la pareja (muestra de contraste). Se administró el Manual SARA adaptado, junto al Eysenck Personality Questionnaire (EPQ-R) versión chilena y el Parental Bonding Instrument (PBI) versión chilena. Los resultados sugieren buenos coeficientes de consistencia interna, validez concurrente y validez diagnóstica. Se discuten las implicancias de los hallazgos.

The purpose of this instrumental study was to evaluate the psychometric properties of the Spousal Assault Risk Assessment (SARA) through an adaptation process and evaluating concurrent and diagnostic validity and internal consistency. The participants were 62, 32 offenders against their couple and 30 non-offenders against their couple (comparison sample). The instruments were SARA adapted, the chilean version of the Eysenck Personality Questionnaire (EPQ-R) and the chilean version of the Parental Bonding Instrument (PBI). The results suggest good reliability coefficients, concurrent validity and diagnostic accuracy. The implications of these findings are discussed.

Sub-Acute Ruminal Acidosis and non-structural carbohydrates: a study model in nutritional immunology / Acidosis Ruminal Sub-Aguda y carbohidratos no estructurales: un modelo de estudio en inmunología nutricional / Acidose ruminal subaguda e carboidratos não estruturais: um modelo de estudo em imunologia nutricional

Nutritional immunology combines two areas of knowledge that did not interact until recently. One of the best examples studied to date is the bovine rumen. The symbiotic relationship between the host and rumen microorganisms can be altered causing a breakdown of immunological tolerance and imbalance of animal homeostasis. Dietary inclusion of supplements rich in non-structural carbohydrates is required for high yielding cows to meet their energy requirements. However, the use of those diets can lead to substantial changes in the rumen ecosystem, reducing the pH and promoting the development of subacute rumen acidosis. This generates lysis of gram-negative bacteria, release of lipopolysaccharides, breaking of immune tolerance, and activation of a cascade of inflammatory mediators with systemic effects that affect milk yield and quality. The gastrointestinal tract is the most important place where lipopolysaccharides are produced and its translocation mechanism from the rumen to peripheral circulation is still controversial. This review proposes a biological model integrating nutritional and immunological aspects of production, absorption, and mechanisms of action of lipopolysaccharides and its effects on milk production and compositional quality.

La inmunología nutricional combina dos áreas del conocimiento que no interactuaban hasta hace algunos años. Uno de los mejores ejemplos estudiados hasta la fecha lo constituye el rumen bovino. La relación simbiótica entre hospedero y microorganismos ruminales puede alterarse provocando una ruptura de la tolerancia inmunológica y un desequilibrio en la homeostasis del animal. Para cubrir los requerimientos energéticos de las vacas de alta producción lechera es necesario incluir en la alimentación suplementos de elevado contenido en carbohidratos no estructurales. Sin embargo, el uso de estas dietas puede provocar cambios sustanciales en el ecosistema ruminal, disminuyendo el pH y promoviendo el desarrollo de acidosis ruminal subaguda. Esto genera la lisis celular de las bacterias gram negativas, la liberación de lipopolisacáridos, la ruptura de la tolerancia inmunológica y la activación de una cascada de mediadores inflamatorios que tienen consecuencias sistémicas y afectan el rendimiento productivo del animal y la calidad composicional de la leche. El tracto gastrointestinal es el lugar más importante donde se producen los lipopolisacáridos, pero el mecanismo de translocación del rumen a la circulación periférica es aún controversial. En esta revisión de literatura se propone un modelo biológico que integra aspectos nutricionales e inmunológicos relacionados con la producción, absorción y mecanismos de acción de los lipopolisacáridos y los efectos sobre la producción y la calidad composicional de la leche.

A imunologia nutricional combina duas áreas de conhecimento que não interagiam até alguns anos atrás. Um dos melhores exemplos estudados até o presente consiste no rúmen bovino. A relação simbiótica entre hospedeiro e microrganismos do rúmen pode ser alterada causando uma quebra da tolerância imune e um desequilíbrio na homeostase do animal. Para satisfazer as necessidades energéticas de vacas de alta produção leiteira é necessário fornecer suplementos alimentares de elevado conteúdo em carboidratos não estruturais. No entanto, o uso dessas dietas pode provocar alterações importantes no ecossistema ruminal, reduzindo o pH e promovendo o desenvolvimento de acidose ruminal subaguda. Isto gera a lise de bactérias gram-negativas, a liberação de lipopolissacarídeos, a quebra da tolerância imune e a activação de uma cascata de mediadores inflamatórios que têm efeitos sistémicos e afetam o desempenho produtivo do animal e a composição do leite. O trato gastrointestinal é o lugar mais importante na produção dos lipopolissacarídeos, mas o mecanismo de translocação do rúmen para a circulação periférica é ainda controversa. Nesta revisão de literatura se propõe um modelo biológico que integra aspectos nutricionais e imunológicos relacionados com a produção, absorção e mecanismos de ação de os lipopolissacarídeos e os efeitos sobre a produção e composição do leite.

The use of sodic monensin and probiotics for controlling subacute ruminal acidosis in sheep / O uso de monensina sódica e probióticos para o controle de acidose ruminal subaguda em ovinos

It was to validated a protocol for induction of subacute ruminal acidosis (SARA) (Experiment 1) and test the efficiency of probiotic Saccharomyces cerevisiae or monensin to avoid pH ruminal drops in sheep (Experiment 2). In Experiment 1, six ewes were fasted for two days and then fed most with concentrate during four days. Ewes in this protocol had ruminal fluid pH below 6.0 and kept it for 75 consecutive hours. In Experiment 2, 18 sheep were distributed into three groups: Control (CG, n = 6), monensin (MG, n = 6) and probiotic group (PG, n = 6). SARA was induced according Experiment 1. PG had lower pH (5.7 ± 0.1) than CG (6.0 ± 0.1) (P = 0.05), while MG (5.7 ± 0.1) was similar to both during SARA induction. SARA induction reduced ruminal protozoa population (P < 0.05) and increased chloride concentrations in ruminal fluid (P < 0.01). In serum, SARA increased concentrations of phosphorus (P < 0.01), AST (P < 0.01) and GGT (P < 0.01), but reduced LDH (P < 0.01). In conclusion, the protocol used for SARA induction was able to maintain ruminal pH between 5.5-6.0 for more than 48 hours. However, monensin and probiotics supplementation was not effective in preventing changes in ruminal and serum parameters during SARA.

Foi validado um protocolo para a indução de acidose ruminal subaguda (SARA) (Experimento 1) e testar a eficácia do probiótico Saccharomyces cerevisiae ou monensina na prevenção da queda do pH do fluido ruminal em ovinos (Experimento 2). No Experimento 1, seis ovelhas foram mantidas em jejum por dois dias e, em seguida, alimentadas basicamente com concentrado durante quatro dias. Nesse protocolo as ovelhas mantiveram o pH do fluido ruminal abaixo de 6,0 por 75 horas consecutivas. No Experimento 2, 18 ovelhas foram distribuídas em três grupos: controle (GC, n = 6), monensina (GM, n = 6) e o grupo probiótico (GP, n = 6). A SARA foi induzida de acordo com o Experimento 1. GP apresentaram valores de pH mais baixos (5,7 ± 0,1) do que o GC (6,0 ± 0,1) (P = 0,05), enquanto GM (5,7 ± 0,1) foi semelhante durante a indução de SARA. A indução SARA reduziu a população de protozoários no rúmen (P < 0,05) e aumentou a concentração de cloreto no líquido ruminal (P < 0,01). Durante a SARA observou-se aumento das concentrações séricas de fósforo (P < 0,01), AST (P < 0,01) e GGT (P < 0,01), mas reduziu a de LDH (P < 0,01). Em conclusão, o protocolo utilizado para a indução de SARA foi capaz de manter o pH do rúmen entre 5,5-6,0 por períodos superiores a 48 horas. No entanto, a suplementação com monensina e probióticos não foi eficaz na prevenção das alterações nos parâmetros ruminais e séricos durante SARA.

Serum acute phase proteins in cows with SARA (Subacute Ruminal Acidosis) suspect / Proteínas séricas de fase aguda em vacas com suspeita de SARA (Subacute Ruminal Acidosis)

The aim of this study was to evaluate the variations of Acute Phase Proteins (APPs) and other blood constituents during the onset of the sub-acute ruminal acidosis (SARA) pathological status. A total of 108 cows from 12 dairy herds were randomly selected and divided into three Groups of 36 animals each. All animals were subjected to a rumenocentesis. Group A was composed by subjects with a rumen pH>5.8, Group B was composed by subjects with a rumen pH ≤5.5≤5.8 and Group C was composed by subjects with a rumen pH<5.5. Blood samples were collected by jugular venipuncture and Haptoglobin (Hp), Serum Amyloid A (SAA), Total Proteins, Albumin and White Blood Cells (WBC) were determined. One-way ANOVA showed a statistical significance on Rumen pH, Hp, SAA. SARA seems not stimulate the APPs production from liver.

O objetivo deste estudo foi avaliar as variações de Proteínas de Fase Aguda (APPs) e outros constituintes sanguíneos durante o início do status patológico de sub-acute ruminal acidosis (SARA). O total de 108 vacas de 12 rebanhos leiteiros foram aleatoriamente selecionados e divididos em três grupos com 36 animais cada. Todos os animais foram submetidos a ruminocentesis. O Grupo A foi composto por sujeitos com rumen pH>5.8, o Grupo B foi composto por sujeitos com rumen pH ≤5.5≤5.8 e o Grupo C foi composto por sujeitos com rumen pH<5.5. Amostras sanguíneas foram coletas por punção venosa jugular e Haptoglobin (Hp), Serum Amyloid A (SAA), Proteínas totais, Albumin e células brancas do sangue (WBC) foram determinadas. ANOVA em via única mostrou significância estatística em Rumen pH, Hp, SAA. SARA não parece estimular a produção de APPs pelo fígado.

Related factors of ICARS and SARA scores on spinocerebellar ataxia type 3/Machado-Joseph disease / 中南大学学报(医学版)

Objective To investigate the related factors of international cooperative ataxia rating scale (ICARS) and scale for the assessment and rating of ataxia scores (SARA) in patients with spinocerebellar ataxia type 3/Machado-Joseph disease. Methods A total of 126 SCA3/MJD patients were assessed by ICARS and SARA. The relation between ICARS or SARA scores and age of onset, disease duration and CAG repeat size was analyzed. Results Either the total ICARS or the total SARA score was positively related with the disease duration(r=0.586,P＜0.05；r=0.643,P＜0.05). Simple linear regression equations were: Y1(total ICARS score)=13.072+2.388 X2(disease duration)(F=68.874,P＜0.05); Y2(total SARA score)=4.403+ 0.961 X2(disease duration)(F=87.254, P＜0.05). Either age adjusted the total ICARS score or age adjusted the total SARA score was positively related with CAG repeat size(r=0.328, P＜0.05; r=0.335, P＜0.05). Both the ICARS subscores and the SARA subscores were positively related with the disease duration(r=0.257-0.589, P＜0.05; r=0.432-0.623, P＜0.05). Both age adjusted ICARS subscores and age adjusted SARA subscores were positively related with CAG repeat size(r=0.263-0.403, P＜0.05; r=0.189-0.366, P＜0.05). Analysis of variance showed that the total ICARS score and the total SARA score increased with the disease stage. Conclusion ICARS and SARA are both reliable and effective scales in assessing the severity of ataxia in patients with SCA3/MJD, and researchers can choose the most suitable scale according to specific requirement.

Síndrome da angústia respiratória aguda na criança: relato de caso / Acute respiratory distress syndrome in a child: case report

Os autores apresentam um caso de Síndrome da Angústia Respiratória Aguda (SARA), numa criança de 5 anos de idade, como fator complicador de um pós-operatório de artrite séptica no quadril. A paciente evoluiu com edema agudo de pulmão não cardiogênico, além de bronco e laringoespasmo, configurando uma insuficiência respiratória aguda grave. O ecocardiograma indicou diminuição do débito cardíaco e aumento do diâmetro ventricular. A radiografia de tórax demonstrou hipotransparência pulmonar, com infiltrado peri-hilar. O diagnóstico foi Síndrome da Angústia Respiratória do Adulto na Criança. O tratamento proposto foi a manutenção das atividades vitais, ventilação mecânica, surfactante pulmonar e agressivo controle da hipertensão pulmonar com óxido nítrico e administração de diurético. Recebeu alta hospitalar com acompanhamento pelo pneumologista pediátrico e alta clínica posterior em bom estado geral.

The authors present a case of Acute Respiratory Distress Syndrome (ARDS) in a five year old child, as a complicating factor after surgery of septic arthritis of the hips. The patient developed acute lung edema, besides bronchial and laryngeal spasm, resulting in respiratory failure. Echocardiography showed reduced cardiac output and increased ventricles. Chest radiography showed low transapency with perihlar infiltrates suggestive of the ARDS. The indicated treatment was ventilatory support, pulmonary surfactant, and aggressive control of the pulmonary hypertension with nitric oxide terapy and diuretics. After hospital discharge, follow-up with a pediatric pulmonologist showed good general health.

Pneumonia por varicela associada com síndrome da angústia respiratória aguda: relato de dois casos / Varicella pneumonia complicated with acute respiratory distress syndrome: two cases report

JUSTIFICATIVA E OBJETIVOS: A varicela é uma doença exantemática causada pela infecção primária do vírus varicela zoster (VVZ). A pneumonia pelo VVZ complicada com a síndrome da angústia respiratória aguda (SARA) é rara e associa-se a altas taxas de morbimortalidade. O objetivo deste estudo foi apresentar dois casos de pneumonia por varicela que evoluíram com SARA e outras disfunções orgânicas. RELATO DOS CASOS: Paciente de 15 anos, imunocomprometido com a síndrome da imunodeficiência adquirida (SIDA) e uma paciente do sexo feminino imunocompetente, foram admitidos na UTI com quadro clínico de varicela, SARA, trombocitopenia e acidose graves. Além disso, disfunção cardiovascular e falência renal ocorreram no primeiro e segundo casos, respectivamente. Foram tratados com aciclovir além de ventilação mecânica protetora. CONCLUSÕES: Os dois casos de pneumonia por varicela, que apresentaram SARA e disfunções de múltiplos órgãos, obtiveram boa evolução clínica.

BACKGROUNG AND OBJECTIVES: Varicella is an exantematic disease caused by varicella-zoster virus. Varicella pneumonia complicated with acute respiratory distress syndrome (ARDS) is very rare in adults and is associated with high morbimortality. We report two cases of ARDS secondary to varicella-zoster virus pneumonia. CASES REPORT: We report two cases of ARDS and multiple organ dysfunction syndrome (MODS) secondary to varicella-zoster virus pneumonia. A 15-year-old man with human immunodeficiency virus (HIV) infection and a 29-year-old immunocompetent female were admitted in the ICU with primary varicella infection and pneumonia. Both cases progressed towards ARDS, severe thrombocytopenia and acidosis. In addition cardiovascular and renal failure occurred in the first and second patients, respectively. Treatment consisted of immediate administration of intravenous acyclovir and a lung-protective ventilation strategy. CONCLUSIONS: Both cases of varicella-zoster pneumonia, complicated with ARDS and MODS, had a favourable outcome.

SARACAP Monitoring of Anesthesia Machines during Anesthesia / 대한마취과학회지

With recent rise in medico-legal problems, there is also an increase in number of problems involved with anesthesia. Major causes of anesthetic accident are malfunctioning anesthetic machine and inappropriate gas flow and concentration of anesthetic gas, resulting from malfunctioning ventilatory circuit. Therefore, anesthesiologist needs an apparatus to determine the appropriateness of ventilation and a monitoring system to measure a concentration of inspired O2 and inhalation anesthetics. To prevent circulatory and respiratory abnormalities and to promote the safty during anesthesia, we used the SARA monitoring system, as an indicator of safty measure. We monitored the anesthesia machines (n=17), using in operating room in Shinchon Severance hospital, by using the SARA monitoring system which was connected to the distal portion of endotracheal tube. We intended to analysis the relationships between anesthetic machines, vaporizers, ventilators and parameters measured form each machine, in clinical use. The results were as follows; 1) Average used year of anesthesia machines was 7.7 years, that of vaporizers was 7.6 years and that of ventilator's was 4.0 years. 2) When vaporizers dial was fixed at enflurane 2.0%, average measured-FiEnf was 2.02+/-0.22%, equal to dial setting and average FiEnf was 1.70+/-0.25%, usually lower than dial setting. 3) In some anesthesia machines, CO2 rebreathing occured always during ansthesia and FiEnf & FeEnf were decreased in case of CO2 rebreathing. 4) FiEnf by vaporizers was decreased as following orders, Draeger, Ohio and Cyprene.