Dexmedetomidine Increases MMP-12 and MBP Concentrations after Coronary Artery Bypass Graft Surgery with Extracorporeal Circulation Anaesthesia without Impacting Cognitive Function: A Randomised Control Trial.

Postoperative neurological deficits remain a concern for patients undergoing cardiac surgeries. Even minor injuries can lead to neurocognitive decline (i.e., postoperative cognitive dysfunction). Dexmedetomidine may be beneficial given its reported neuroprotective effect. We aimed to investigate the effects of dexmedetomidine on brain injury during cardiac surgery anaesthesia. This prospective observational study analysed data for 46 patients who underwent coronary artery bypass graft surgery with extracorporeal circulation between August 2018 and March 2019. The patients were divided into two groups: control (CON) with typical anaesthesia and dexmedetomidine (DEX) with dexmedetomidine infusion. Concentrations of the biomarkers matrix metalloproteinase-12 (MMP-12) and myelin basic protein (MBP) were measured preoperatively and at 24 and 72 h postoperatively. Cognitive evaluations were performed preoperatively, at discharge, and 3 months after discharge using Addenbrooke's Cognitive Examination version III (ACE-III). The primary endpoint was the ACE-III score at discharge. Increased MMP-12 and MBP concentrations were observed in the DEX group 24 and 72 h postoperatively. No significant differences in ACE-III scores were observed between the groups at discharge; however, the values were increased when compared with initial values after 3 months (p = 0.000). The current results indicate that the administration of dexmedetomidine as an adjuvant to anaesthesia can increase MMP-12 and MBP levels without effects on neurocognitive outcomes at discharge and 3 months postoperatively.

Plasma magnesium concentration in patients undergoing coronary artery bypass grafting.

[b]Introduction[/b]. Magnesium (Mg) plays a crucial role in cell physiology and its deficiency may cause many disorders which often require intensive treatment. The aim of this study was to analyse some factors affecting preoperative plasma Mg concentration in patients undergoing coronary artery bypass grafting (CABG). [b]Materials and method[/b]. Adult patients scheduled for elective CABG with cardio-pulmonary bypass (CPB) under general anaesthesia were studied. Plasma Mg concentration was analysed before surgery in accordance with age, domicile, profession, tobacco smoking and preoperative Mg supplementation. Blood samples were obtained from the radial artery just before the administration of anaesthesia. [b]Results. [/b]150 patients were studied. Mean preoperative plasma Mg concentration was 0.93 ± 0.17 mmol/L; mean concentration in patients - 1.02 ± 0.16; preoperative Mg supplementation was significantly higher than in patients without such supplementation. Moreover, intellectual workers supplemented Mg more frequently and had higher plasma Mg concentration than physical workers. Plasma Mg concentration decreases in elderly patients. Patients living in cities, on average, had the highest plasma Mg concentration. Smokers had significantly lower plasma Mg concentration than non-smokers. [b]Conclusions. [/b]1. Preoperative magnesium supplementation increases its plasma concentration. 2. Intellectual workers frequently supplement magnesium. 3. Smoking cigarettes decreases plasma magnesium concentration.

Disturbance in venous outflow from the cerebral circulation intensifies the release of blood-brain barrier injury biomarkers in patients undergoing cardiac surgery.

OBJECTIVE: Disturbances in venous outflow from the cerebral circulation may result in brain injury. Severe increases in brain venous pressure lead to brain ischemia and, subsequently, brain edema and intracranial hemorrhages. The purpose of this study was to determine the effect of changes in jugular venous bulb pressure (JVBP) on plasma blood brain-barrier biomarkers concentration and disturbances in arteriovenous total and ionized magnesium (a-vtMg and a-viMg) in brain circulation in patients undergoing coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass (CPB). DESIGN: Prospective observational study. SETTING: Department of Cardiac Surgery at a Medical University Hospital. PARTICIPANTS: Ninety-two adult patients undergoing elective CABG with CPB under general anaesthesia were studied. METHODS: Central venous pressure (CVP) was measured using a pulmonary artery catheter. The right jugular vein was cannulized retrogradely for jugular venous bulb pressure (JVBP) measurement. Concentrations of plasma S100ß protein, matrix metalloproteinase 9 (MMP-9), creatine kinase isoenzyme BB (CK-BB) a-vtMg and a-viMg were measured as the markers of blood-brain barrier dysfunction. All of them were analyzed in comparison with JVBP during surgery and the early postoperative period. RESULTS: Elevated JVBP was noted after CPB and after surgery. Its increase above 12 mmHg intensified release of S100ß, MMP-9 and CK-BB as well as disorders in a-vtMg and a-viMg. CVP correlated with JVBP, S100ß, and MMP-9. Moreover, JVBP correlated with S100ß and MMP-9. CONCLUSIONS: Cardiac surgery increased JVBP, and JVBP elevated above 12 mmHg intensified an increase in biomarkers of plasma blood-brain barrier disruption.

Raised jugular venous pressure intensifies release of brain injury biomarkers in patients undergoing cardiac surgery.

OBJECTIVES: Neurologic damage after cardiac surgery with extracorporeal circulation is multifactorial. Despite several studies, its pathophysiology is poorly understood. The purpose of this study was to determine the changes in jugular venous pressure and to analyze their effect on perioperative brain injury measured by biomarkers in patients undergoing coronary artery bypass grafting. DESIGN: Observational study. SETTING: Department of cardiac surgery in a medical university hospital. PARTICIPANTS: Adult patients undergoing elective coronary artery bypass grafting with extracorporeal circulation under general anesthesia. INTERVENTIONS: The right jugular vein was cannulated in retrograde fashion. Jugular venous pressure was measured in the jugular vein bulb (JVBP). Concentrations of plasma glial fibrillary acidic protein, tau protein, arteriovenous lactate, and jugular vein saturation were measured as the markers of brain injury during the surgery and early postoperative period. All were analyzed in relation to JVBP. MEASUREMENTS AND MAIN RESULTS: Increased JVBP was noted after extracorporeal circulation and after surgery. A significant increase >12 mmHg for JVBP, increased plasma glial fibrillary acidic protein, tau protein, arteriovenous lactate concentrations, and decreased jugular vein saturation were observed. CONCLUSIONS: Cardiac surgery increased JVBP and an increased JVBP > 12 mmHg intensified an increase in brain injury biomarker concentrations.

Influence of the zearalenone on the activity of chosen liver enzymes in a rat.

Zearalenone is a mycotoxin compound produced mainly by Fusarium species of fungi which is present in cereals cultivated all over the world. The aim of the research was to examine the toxic influence of different doses of zearalenone on liver cells through estimating mycotoxin influence on markers evaluation of biochemical liver damage. The research was carried out on male Wistar rats. The rats were divided into 9 groups of 10 animals each. Group A was orally given 8% ethyl alcohol. Group B, C, D, E was orally given once a day for 10 days a zearalenone alcohol solution properly in dose of 50, 100, 200, 500 microg/kg b.w. Single doses of zearalenone was given to the animals from groups X, Y, Z and W. Control group W - 8% ethyl alcohol, group X dose 1 mg/kg b.w., group Y dose 2 mg/kg b.w., group Z dose 3 mg/kg b.w. For the research, blood was taken from hearts. The blood was centrifuged and the plasma analyzed using spectrophotometric methods: aspartate and alanine aminotransferase, alkaline phosphatase and complete bilirubin. The results of the experiment show that liver cells are exposed to zearalenone activity increased liver aminotransferases (ALT and AST) in blood plasma. Rise of liver aminotransferase level (ALT and AST) in animal's blood plasma after giving zearalenone may confirm the hepatotoxic influence of this mycotoxin. Short-lasting zearalenone influence does not cause changes in the liver aminotransferases.

Comparison of fluorine level in the tissues of healthy teeth and teeth with decay process.

The aim of the study was to examine quantitative fluorine content in tooth tissues with the decay process, tissues of teeth without decay and tissues with diseases different than those of decay origin. It has been found that in the examined teeth decay process the average fluorine content in hard tissues amounted to 235.6 ppm of fluorine and it was lower than in healthy teeth (304.8 ppm) extracted for orthodontic or periodontological reasons, whereas the highest fluorine content--383.5 ppm--was found in teeth with diseases of non-decay etiology. Analyzing particular teeth groups depending on the age of the patients, it was observed that the fluorine level is higher in the teeth received from younger patients, especially in the group of healthy teeth and teeth with wedge defects. Susceptibility of tooth enamel to dissolution was estimated by the CRT test with the use of discs impregnated with crystal violet (hexamethylene-4 hydrochloride of fuchsin) with the range of colour change from yellow and green to violet and blue at ph 0.1-1.5. The lengthening of the time of reaction in this test testified to lower acid sensitivity of tissues and at the same time to harder demineralization of enamel, e.g. in the process of decay. Longer time of reaction was observed in teeth with higher indicated fluorine content.

Occurrence of infectious diseases in dialysed patients.

UNLABELLED: Chronic kidneys' failure as well as hemodialysis operations lead to disorders of many organs' and system's functions. We can observe a decrease in the immunulogical system's efficiency, which consequently causes the decrease in a human body's defence abilities. The dialysed patients are subject to a frequent contact with medical equipment and they require numerous examinations. All these factors, including the dialysis itself, increase the risk of occurrence of various types of infections, both bacterial and viral ones. The aim of the work was to try to define the kind and frequency of infectious diseases occurring among the dialysed patients. In order to conduct the research, the questionnaire among 50 patients in the centre of dialysis of the hospital in Chelm was made. Among the examined group, the most frequently occurring infectious diseases were infections of the ureter, bronchitis, flu and ear infection. Among 30% of the examined, inflammatory and thrombotic changes within a dialysis drainage tube occurred. 22% of the examined are the carriers of HBV. Among 36%, however, the antibodies of HCV were detected. CONCLUSIONS: 1. The hemodialysed patients make up a group that is at increased risk of infectious diseases. 2. The infection of B and C type is the exceptional problem among the hemodialysed patients. 3. The frequency of infectious diseases occurrence increases along with age and length of dialysotherapy. 4. Education of the patients about how to prevent infections brings measurable effects in the form of the decreasing number of morbidity cases.