The analysis on the expression of gasotransmitters in early trauma patients

Summary Objective: Nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S) were endogenously-generated molecules gas. They owned important biological activity and participated in many pathophysiological processes. This study aimed to examine the levels of three gasotransmitters in the early phase of trauma patients. Method: Blood samples were collected from 60 trauma patients and ten healthy volunteers. Concentration of serum iNOS and HO-1 were analyzed by enzyme linked immunosorbent assay and plasma H2S was determined by colorimetric method. Meanwhile, the occurrence of multiple organ dysfunction syndrome (MODS) was also monitored. Results: The levels of iNOS, HO-1 and endogenous H2S in the patients group were significantly different from the healthy control group, and the difference was more obvious with the increase of ISS score. iNOS levels were positively correlated with ISS scores and blood lactic acid values, and HO-1 and endogenous H2S were negatively correlated with ISS scores and blood lactic acid values. Of 60 trauma patients, eight (13.33%) developed MODS. The level of iNOS in the MODS group was higher than that in non-MODS group, while HO-1 and H2S were significant lower in the MODS group. Conclusion: The three gasotransmitters participated in systemic inflammatory responses during early trauma and could be used as important indicators for trauma severity. Their measurements were meaningful for evaluating the severity and prognosis of trauma.

Indoor pollution and its effect on the pregnancy outcome in cluster and non cluster areas

Indoor pollution is one of the causes of death and disease in the world's poorest countries. Indoor pollution remains a silent and unreported killer, women and children are the most at risk. Smoke rising from stoves and fires inside homes is associated with million deaths per year in developing countries. Indoor air pollution is caused by poor water/ sanitation/ hygiene/ ventilation/ housing conditions. This study was aiming to evaluate the effect of indoor pollution on the pregnancy outcome in cluster and non cluster areas. The study aim was achieved through assessing the pregnant women socio-demographic characteristics, Assessing indoor environment and assessing the pregnant women [pre and postnatal] as well as the newborn. The study was conducted at Ain shames maternity university hospital the MCH Center at EL Dowika Maternal and Child Health Center, Manshiat Naser Maternal and Child Health Center [cluster areas] and El Daher Maternal and Child health Center [non cluster area] and at homes through home visits, started in November 2006 and was completed by Feb. 2008 study design: a descriptive comparative study, Sample type: a purposeful sampling. The selected sample included 200 pregnant women in the 3rd trimester, 100 in each group,. The study revealed an increased level of exposure to indoor pollution, increased level of CO and blood lead of the pregnant women in the cluster area more than the non cluster area. Increased complications during pregnancy, labor and increased adverse newborn outcomes as prematurity, stillbirth, SIDS, congenital malformation were more frequent in cluster areas than non- cluster areas. There were correlations between exposure to indoor pollution and adverse effect on women and newborn outcomes in both cluster and non cluster areas. The study recommended educational programs for the pregnancy women in MCH centers about indoor pollution and its effect on health

Heme oxygenase-carbon monoxide system in patients with cirrhosis: relation to splanchnic hemodynamics

Carbon monoxide [CO], an end product of the heme-oxygnase [HO] pathway,is a potent vasodilator and an important modulator of vascular cell function. The present work was designed to study the HO-1/CO system in patients with cirrhosis in relation to severity of liver disease, blood viscosity and splanchnic haemodynamics. Plasma HO-1 levels and blood carboxyhaemoglobin [COHB] concentration,an index of CO production were measured in 30 patients with liver cirrhosis and variable degrees of hepatic dysfunction and in 15 healthy subjects as a controls group. Both patients and control were non smokers. Blood viscosity was measured using the red blood cell pipette viscometer. The blood volume of the portal vein,superior mesenteric artery and splenic artery as well as pusatility index of the arteries were measured using doppler ultrasonography. Plasma [HO-1] levels and blood carboxy haemoglobin concentration were significantly higher in patients with liver cirrhosis than in healthy subjects [p< 0.001]. Also, patients who had esophageal varices, history of bleeding varices, portal hypertensive gastropathy and ascites showed significant increase in HO-1/COHB levels compared with those who did not have these complications [p < 0.001]. The increases in plasma HO-1 level and COHB level showed positive correlation with Child-Pugh score, blood viscosity and the increases in the blood flow volume of the portal vein, superior mesenteric artery and splenic artery and inverse correlation with the decreases in the pulsatility index and the resistive index of the arteries in patients with liver cirrhosis [P< 0.05]. Increased HO-1 activity with enhanced endogenous CO generation may play a role in the development of splanchnic vasodilation and serious manifestations of portal hypertension in liver cirrhosis

Expression of heme oxygenase-1 in the peripheral blood mononuclear cells from asthmatic patients / 华中科技大学学报（医学）（英德文版）

To explore the expression of heme oxygenase-1 (HO-1) in the peripheral blood mononuclear cells (PBMCs) and its relationship with pulmonary ventilation function in asthmatic patients, 18 asthmatic patients and 18 healthy subjects were selected. HO-1 protein and mRNA levels in PBMCs were measured by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR), respectively. Blood carbon monoxide Hb (COHb), serum total IgE and pulmonary ventilatory function were observed. Our results showed that the percentage of cells positive for immunohistochemical staining of HO-1 were significantly higher in asthmatic patients (41.72 +/- 7.44) % than that in with healthy subjects (10.45 +/- 4.36) % (P < 0.001) and the optical density of PBMC HO-1 mRNA was higher in asthmatic patients (26.05 +/- 4.14) than that in healthy subjects (10. 82 +/- 4.26) (P < 0.001). The relation analysis showed that PBMC HO-1 protein and mRNA levels had significantly negative relation with FEV1%, PEFR, MEFR50%, respectively (r = -0.51-0.89, P < 0.05-0.001, respectively) and a positive relation with COHb and serum total IgE (r = 0.48-0. 85, 0.05-0.001, respectively). It is concluded that the expression of PBMC HO-1 protein and mRNA increased significantly in asthmatic patients, and HO-1 may play a significant role in the pathogenesis of asthma. The expression of HO-1 may bear a relation with severity of asthma.

A study on the effect of methanal during determination of carbon monoxide in blood / 法医学杂志

OBJECTIVE@#To confirm whether formaldehyde disturb detecting carbon monoxide in blood. To give an evidence that can be used for detecting carboxyhemoglobin more accurately in carbon monoxide posioning appraises.@*METHODS@#Blood samples came from carbon monoxide poisoning and the health were collected. Regular methods for detecting carboxyhemoglobin were used. Observing and comparing the detection results between which were spiked with methanal and no spiked one were performed.@*RESULTS@#Methanal will affect the result of following experiments such as heating, adding NaOH, absorbed by PdCl2 and spectrophotometry.@*CONCLUSION@#The samples which contaminated by formaldehyde couldn't be used for detecting carboxyhemoglobin.

Comparación de los niveles de monóxido de carbono espirado por transeúntes de un área urbana y de un área rural / Comparison of carbon monoxide levels in air expired from pedestrian in an urban area and a rural area

Los daños a la salud producidos durante una exposición aguda al monóxido de carbono (CO) son bien conocidos. En cambio, sus efectos crónicos aún son controvertidos. El objetivo de este estudio fue evaluar el grado de exposición al CO, de algunos transeúntes de la ciudad de México, mediante la medición de la concentración de CO en el aire espirado. Material y métodos: Se realizaron mediciones de la concentración de CO en el aire espirado de 892 transeúntes del Distrito Federal (D.F.), México, empleando un analizador de CO marca Spirometrics, modelo 3100 CMD/I que además estima el contenido de carboxihemoglobina (COHb) en la sangre. La determinación de la concentración del CO en el aire espirado de los transeúntes urbanos y rurales, se realizó en los meses de febrero y marzo de 1996 en diferentes áreas del D.F.: zonas centro (CE), noroeste (NO), noreste (NE), sureste (SE) y suroeste (SO), como grupo control se seleccionó al azar una muestra de transeúntes de una zona rural (RU) de la Delegación Milpa Alta. Resultados: De los 892 sujetos seleccionados para el estudio, 366 fueron del sexo femenino (41 por ciento) y 526 del masculino (59 por ciento). La edad media fue de 36.3 años. Se registraron 303 fumadores (34 por ciento) y 589 (66 por ciento) no fumadores. En el grupo total, la concentración media de CO fue 7.14 partes por millón (ppm), con rango de 1.4 a 40.1 ppm, mientras que la cifra media del COHb fue 1.01 por ciento con un rango de 0 a 15 por ciento. Al realizar análisis multivariado con regresión múltiple, encontramos que los predictores del aumento en la concentración del CO medido en el aire espirado de los transeúntes fueron: 1) sexo masculino; 2) número diario de cigarros consumidos; 3) las zonas NE y NO, y 4) tránsito intenso. En este estudio el promedio resultó 6.1 ppm en no fumadores y 9.1 ppm en fumadores. La norma ambiental extramuros para el CO es 11 ppm, y en nuestro estudio hubieron reportes que la sobrepasaron. Conclusiones: El CO espirado es un excelente marcador de exposición, muy útil para estudiar grupos de riesgo, como es el caso de las personas que permanecen varias horas en cruceros viales con tránsito intenso o en los fumadores en quienes, de acuerdo al nivel de CO en aire espirado es posible estimar su grado de tabaquismo. Por otra parte, este procedimiento adquiere relevancia si se considera que se ha relacionado la intoxicación crónica por CO con la vasculopatía de los fumadores y con la aterogénesis.

Utilidad clínica de la diferencia arteriovenosa de pH y de CO2 en pacientes críticos

Este trabajo se realizó para determinar la utilidad de los gases venosos y de parámetros como la Diferencia arterio-venosa de pH (DpHav) y diferencia arterio-venosa de CO2 (DPCO2 av) en pacientes críticos. En forma prospectiva, en 35 pacientes que ingresaron a la UCI del Hospital Universitario de Cartagena, se recolectaron 105 series de muestras gasimétricas (arteriales, venosas centrales y venosas mixtas) y se hicieron mediciones hemodinámicas completas para clasificar cada serie en uno de los tres grupos del estudio. 71 series fueron del grupo I (pacientes estables), 24 al grupo II (índice cardíaco menor de 2.5) y 10 al grupo III (sepsis severa). Al comparar la muestra venosa central (tomada a través de la vía proximal de un CAP) con la muestra venosa mixta (tomada de la vía distal del mismo catéter) no encontramos diferencia estadísticamente significativa entre los dos tipos de muestras, tal similitud se mantuvo en los tres grupos. La DpHav para el grupo I fue de 0.024, pero aumentó a 0.046 para el grupo II y a 0.119 para el grupo III. La DPCO2av fue de 2.71 en el grupo I, aumentado a -6.86 en el grupo II y a -8.67 en el grupo III. Al comparar estos resultados todos tuvieron significancia estadística. Encontramos que los pacientes con IC entre 2.5-4 tenían una DpHav y DPCO2av mínimas (0.01 y -2.75 respectivamente) mientras que en los pacientes con IC menor 2.5 aumentaron notoriamente (0.06 y -5.9), hallazgo similar a los pacientes con IC mayor 4 (0.05 y -3.62). Como predictores de normalidad y sobrevida encontramos que sólo tuvieron significancia estadística el pHv, la DpHav, la PCO2v y la DPCO2av, siendo ésta última la más importante. Para el presente estudio una DPCO2av inicial mayor de 5 tuvo una sensibilidad del 93 por ciento y una especifidad del 85 por ciento para predecidir sobrevida en nuestros 35 pacientes. Concluimos que: Los Gases Venenosos Centrales (GCV) son tan similares a los Gases Venosos Mixtos (GVM) que pueden reemplazarlos obviando costos, riesgos y complicaciones. 2. La DpHav y de DPCO2av puede reflejar una alteración hemodinámica y/o metabólica. 4. La DPCO2av puede ser índice pronóstico inicial con gran sensibilidad y especifidad. 5. Se necesita determinar la utilidad del monitoreo continuo y sistemático el CO2 venoso como alternativa a los índices empleados actualmente.

Difusión pulmonar de monóxido de carbono en individuos sanos no fumadores en Santafé de Bogotá (2.640 m de altura sobre el nivel del mar)

Con el propósito de comparar las ecuaciones de predicción para la prueba de la difusión pulmonar con monóxido de carbono en individuos sanos de Santafé de Bogotá, con las publicadas previamente en la literatura médica y las correciones propuestas para altura sobre el nivel del mar, se presenta una serie de 40 mediciones realizadas en población sana no fumadora, habituada a la altura de esta ciudad. Se encontraron valores de difusión pulmonar de monóxido de carbono mucho que los esperados a nivel del mar, incluso aplicando las ecuasiones de correción publicadas. Esta es la primera serie que se pública sobre mediciones realizadas a niveles tan altos sobre el mar. En vista de los hallazgos, se propone la realización de un estudio cooperativo con el fin de reunir una muestra más representativa y establecer la que sería la ecuación patrón de comparación de la capacidad de difusión de monóxido de carbono a nivel de Santafé de Bogotá.

Effects of cigarette smoking on serum lipids and lipoproteins patterns on adult and middle age Egyptians

196 volunteers were examined to dertermine the effect of cigaratte smoking on the cardiovascular system. Special reference was given to the role played by cigarette smoking in increasing risk of CHD. It has been found that there is a significant increase in the Co-Hb% in smokers with a positive correlation to the number of cigarettes smoked / day. The role played by nicotine and Co was discussed. It has been also found that cigarette smoking has an atherogenic effect with increased levels of triglyceride, LDC and Apo-B lipoprotcins, a decrease in the HDC and Apo-A lipoproteins. The value of Apo-B / Apo-A ratio as a better index for CHD predection was discussed

Alteraçöes sanguíneas na populaçäo infantil de Cubatäo Säo Paulo, Brasil causadas pela exposiçäo a poluentes químicos do ambiente: carboxihemoglobinemia e metemoglobinemia / Serum changes in the infantile population in Cubatäo (Säo Paulo, Brasil) caused by the exposure to enviromental chemical pollutants: carboxyhemo-globinemia and methemoglobinemia

Para avaliar o grau de exposiçäo ao monóxido de carbono e aos agentes metemoglonizantes da populaçäo infantil do Município de Cubatäo (Säo Paulo, Brasil), procedeu-se a determinaçäo da porcentagem de carboxiemoglobina e metemoglina pelo método espectrofotométrico no sangue de criança na idade pré-escolar (4 a 5 anos) e matriculados nas Escolas Municipais de Educaçäo Infantil - EMEIs. Foram realizadas 251 determinaçöes de carboxiemoglobina e, entre 12 EMEIs, as médias variaram de 0,28% (na EMEI Estado de Goiás - Cubatäo-Centro) a 0.58% (na EMEI Estado de Säo Paulo - Cubatäo-Centro). Fez-se total de 270 determinaçöes de metemoglobina e a faixa de variaçäo das médias foi de 0,37% (na EMEI Rio de Janeiro - Vila Elizabeth) até 0,15% (na EMEI Estado do Ceará - Cubatäo-Centro)