[Pregnant women with COVID-19 ARDS on the intensive care unit]. / Die Schwangere mit COVID-19-ARDS auf der Intensivstation.

BACKGROUND: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease progression. Comorbidities, such as chronic arterial hypertension, diabetes mellitus, advanced maternal age and high body mass index, may predispose to severe disease. The management of pregnant COVID-19 patients on the intensive care unit (ICU) is challenging and requires careful consideration of maternal, fetal and ethical issues. OBJECTIVE: Description and discussion of intensive care treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory distress syndrome (CARDS). MATERIAL AND METHODS: We analyzed the demographic data, maternal medical history, clinical intensive care management, complications, indications and management of extracorporeal membrane oxygenation (ECMO) and infant survival of all pregnant patients treated for severe CARDS in the anesthesiological ICU of a German university hospital between March and November 2021. RESULTS: The cohort included 9 patients with a mean age of 30.3 years (range 26-40 years). The gestational age ranged from 21 + 3 weeks to 37 + 2 weeks. None of the patients had been vaccinated against SARS-CoV­2. Of the nine patients seven were immigrants and communication was hampered by inadequate Central European language skills. Of the patients five had a PaO2/FiO2 index < 150 mm Hg despite escalated invasive ventilation (FiO2 > 0.9 and a positive end-expiratory pressure [PEEP] of 14 mbar) and were therefore treated with repeated prolonged prone positioning maneuvers (5-14 prone positions for 16 h each, a total of 47 prone positioning treatments) and 2 required treatment with inhaled nitric oxide and venovenous ECMO. The most common complications were bacterial superinfection of the lungs, urinary tract infection and delirium. All the women and five neonates survived. All newborns were delivered by cesarean section, two patients were discharged home with an intact pregnancy and two intrauterine fetal deaths were observed. None of the newborns tested positive for SARS-CoV­2 at birth. CONCLUSION: High survival rates are possible in pregnant patients with CARDS. The peripartum management of pregnant women with CARDS requires close interdisciplinary collaboration and should prioritize maternal survival in early pregnancy. In our experience, prolonged prone positioning, an essential evidence-based cornerstone in the treatment of ARDS, can also be safely used in advanced stages of pregnancy. Inhaled nitric oxide (iNO) and ECMO should be considered as life-saving treatment options for carefully selected patients. For cesarean section, neuraxial anesthesia can be safely performed in patients with mild CARDS if well planned but the therapeutic anticoagulation recommended for COVID-19 may increase the risk of bleeding complications, making general anesthesia a more viable alternative, especially in severe disease.

LQFM289: Electrochemical and Computational Studies of a New Trimetozine Analogue for Anxiety Treatment.

This study employs electrochemical and Density Functional Theory (DFT) calculation approaches to investigate the potential of a novel analogue of trimetozine (TMZ) antioxidant profile. The correlation between oxidative stress and psychological disorders indicates that antioxidants may be an effective alternative treatment option. Butylatedhydroxytoluene (BHT) is a synthetic antioxidant widely used in industry. The BHT-TMZ compound derived from molecular hybridization, known as LQFM289, has shown promising results in early trials, and this study aims to elucidate its electrochemical properties to further support its potential as a therapeutic agent. The electrochemical behavior of LQFM289 was investigated using voltammetry and a mechanism for the redox process was proposed based on the compound's behavior. LQFM289 exhibits two distinct oxidation peaks: the first peak, Ep1a ≈ 0.49, corresponds to the oxidation of the phenolic fraction (BHT), and the second peak, Ep2a ≈ 1.2 V (vs. Ag/AgCl/KClsat), denotes the oxidation of the amino group from morpholine. Electroanalysis was used to identify the redox potentials of the compound, providing insight into its reactivity and stability in different environments. A redox mechanism was proposed based on the resulting peak potentials. The DFT calculation elucidates the electronic structure of LQFM289, resembling the precursors of molecular hybridization (BHT and TMZ), which may also dictate the pharmacophoric performance.

Electroanalytical Enzyme Biosensor Based on Cordia superba Enzyme Extract for the Detection of Phytomarkers in Kombucha.

Antioxidants are responsible for many beneficial health effects and are highly present in natural products, such as kombucha. Biosensors' development targeting antioxidants and phytomarkers are an active research field. This work aimed to propose a voltammetric polyphenolxidase (Cordia superba) biosensor for catechin and total phenolic compounds quantification in kombucha samples. Optimizations were performed on the biosensor of Cordia superba to improve the accuracy and selectivity, such as enzyme-substrate interaction time, analytical responses for different patterns and signal differences with the carbon paste and modified carbon paste electrode. Kombucha probiotic drink samples were fermented for 7 to 14 days at a controlled temperature (28 ± 2 °C). A linear curve was made for catechin with a range of 10.00 to 60.00 µM, with a limit of detection of 0.13 µM and limit of quantification of 0.39 µM. The biosensor proposed in this work was efficient in determining the patterns of phenolic compounds in kombucha.

Bioactive Compounds of Fruit Parts of Three Eugenia uniflora Biotypes in Four Ripening Stages.

Variability of secondary metabolites in edible (peel and pulp) and inedible (seeds) parts of three pitanga varieties, red, red-orange and purple, was investigated during the maturation process. Hydrolysable tannins, anthocyanins, and flavonoids were quantified by HPLC/DAD and carotenoids by absorbance. Peel/pulp showed greater complexity of constituents (carotenoids, anthocyanins, flavonoids, and hydrolysable tannins), while only tannins were identified in seeds, but in quantities of 10 to 100 times greater. The red-orange variety showed the highest levels of phenolic compounds in seeds and peel/pulp, except anthocyanins. The analysis of the principal response curves showed that the pitanga biotype has greater influence on metabolite variation than ripening stages. During peel/pulp maturation, a reduction in the levels of flavonoids and tannins contrasted with an increase in carotenoids and cyanidin-3-O-glucoside in all varieties, whereas in the seeds oenothein B, the major tannin, increased up to 1.32 g/100 g fresh weight. Such marked differences between fruit parts demonstrate that the seeds in stages E3 and E4 are a source of hydrolysable tannins, compounds known for their antitumor activity, while peel/pulp of all varieties in the ripe stage provide natural antioxidants, such as carotenoids and flavonoids. Lastly, the purple biotype can be a rich source of the cyanidin-3-O-glucoside pigment a potent bioactive compound.

Multifocal epithelioid hemangioendothelioma derived from the spine region: case report and literature review.

BACKGROUND: Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with malignant biological behavior. It arises from endothelial cells, usually within soft tissues, and can occur in almost all locations. CASE REPORT: We report a unique case of a 25-year-old man who presented with sudden attacks of severe back pain followed by acute non-traumatic paraplegia. Emergency diagnostics revealed a pathologic fracture of the T7 vertebra with tumor tissue invasion of the spinal canal. Furthermore, multifocal metastases were found. RESULTS: To achieve en bloc resection, interdisciplinary surgical approaches were indicated. Despite multimodal therapy concepts, including radiotherapy and chemotherapy as well as endovascular embolization, the patient died within 8 weeks. CONCLUSION: Prognosis of EHE is unpredictable and mainly determined by its location. The lesions are potentially aggressive; therefore, en bloc resection should be attempted whenever possible. However, as shown in the literature, only 15% of patients are suitable for total resection.

Effects of interferon-gamma and tumour necrosis factor-alpha on CD95/Fas ligand-mediated apoptosis in human blood eosinophils.

Many cells, including eosinophils, express CD95 (Fas), a surface receptor that mediates apoptosis when ligated by specific antibodies or its natural ligand, Fas ligand (FasL). As apoptosis may play an important role in the regulation of tissue eosinophilia, factors that modulate eosinophil sensitivity to apoptosis are of great interest. It has previously been shown that interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha) together increase CD95 surface expression on eosinophils. However, the functional consequences of this increase in CD95 expression have not been demonstrated in detail. We therefore investigated whether the increase in CD95 expression mediated by IFN-gamma/TNF-alpha indeed translates into increased, FasL-mediated apoptosis of eosinophils. For this purpose, purified eosinophils from normal donors were incubated with different concentrations of FasL and induction of apoptosis was assessed by annexin-V/propidium iodide assay. Unlike Jurkat cells, which became apoptotic within 2 h after incubation with FasL, an increase in eosinophil apoptosis could first be dedicated after 6 h incubation with FasL. Prestimulation with IFN-gamma/TNF-alpha for 24 h significantly enhanced FasL-induced apoptosis in eosinophils. This increase in CD95/FasL-mediated apoptosis was correlated with an IFN-gamma/TNF-alpha-mediated increase in CD95 expression. From these findings we conclude that the combination of IFN-gamma and TNF-alpha enhances CD95 expression, which results in an increase in FasL-mediated apoptosis of eosinophils in vitro.

Fluorescence resonance energy transfer mapping of subunit delta in spinach chloroplast F1 ATPase.

Despite the considerable progress in the field of F0F1-ATPases caused by solving the 2.8-A structure of mitochondrial F1 ATPase [Abrahams, J. P., Leslie, A. G. W., Lutter, R. & Walker, J. E. (1994) Nature 370, 621-628], little is known about the position and function of the enzyme's small subunits which were not resolved in the X-ray analysis. We have previously genetically engineered Cys residues into the delta subunit of chloroplast F1 and used these mutant subunits in cross-linking studies [Lill, H., Hensel, F., Junge, W. & Engelbrecht, S. (1996) J. Biol. Chem. 271, 32737-32742]. In this work, various fluorophores have been introduced into the mutant delta subunits and used in fluorescence-resonance energy-transfer measurements. The resulting distances were fitted into the framework of existing data. Subunit delta was found to be located between two alpha/beta couples, stretching from the level of the nucleotide binding sites up to a position close to the N-termini of subunits alpha and beta. These results corroborate and further refine the previously found location of spinach CF1 delta at the periphery and membrane-distal part of CF1, where it may constitute a part of a stator in the rotatory machinery of F0F1.

[Intermaxillary immobilization using ring-screws in adults]. / Blocage intermaxillaire par pitons chez l'adulte.

We have been unsatisfied with the mandibular ligatures (binding) using Ivy type steel dental wire alone or with arch bars. The principal risks are: instability of ligature in patients with missing teeth AIDS, Hepatitis B and Hepatitis C infections periodental lesions We propose the use of anterior titanium implant screws or the monocortical "piton" which have been used up till now in maxillofacial bone reconstruction. Eight patients in one year have benefited from this procedure. This involved the implant of 32 "pitons" in fractured jaws and, for this study, in parasymphyseal areas

[Delayed mandibular osteosynthesis]. / Ostéosynthèses mandibulaires différées.

Of 52 fractures of the mandible treated over a 2-year period, sixteen involved the insertion of an osteosynthesis plate. The average period between the injury and application of the mandibular plate was 3.5 days (range: 8 hours to 14 days). Reasons for the delays in treatment are given, but it was observed that in spite of sometimes long periods before therapy the overall results could be considered as satisfactory, since poor results were reported in only 3 patients and in two of these there were particular circumstances. These findings suggest that the classical limit of the 8th hour is perhaps not the limit beyond which a mandibular osteosynthesis is valid, although delayed operation is only possible in certain well defined cases.

[Intra-arterial cisplatin chemotherapy of epidermoid carcinomas of the oral cavity. Preliminary results]. / Chimiothérapie intra-artérielle au cis-platyl des carcinomes épidermoïdes de la cavité buccale. Résultats préliminaires.

The chemotherapy schedule used for treatment of epidermoid carcinoma of the buccal cavity is described, together with the technique proposed by Richard for introduction of the intra-arterial catheters. Two sessions of intra-arterial infusion lasting 6 days are separated by an treatment-free interval of 6 days. Five patients with oropharyngeal endobuccal epithelioma were treated in this way, two of these cases receiving major surgery during chemotherapy. Analysis of a pelvimandibulectomy operative specimen from one of these patients failed to show any trace of cancer in a lesion which had been initially classified T3N3 by histology. This case, combined with other reports of clinical remission without histologic proof, and after a short follow up, suggests a certain efficacy for cisplatinum intra-arterially. This local efficacy, without however diminishing the surgical target volume, will probably give a better survival rate than when surgery alone is performed.

History of psychology: a review of the last decade.

A review of the Journal of the History of the Behavioral Sciences revealed that all of the author's opinions on historiography have been well represented. Warning against the development of the history of psychology as a parochial superspecialty, the author proposes an interactional conceptualization of historical work which explicates the historian's presuppositions and deals with issues relevant to contemporary psychology.