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Protective Interventions (protective + intervention)

Distribution by Scientific Domains

Life Sciences	75%

Selected Abstracts

Monitoring of monocyte functional state after extracorporeal circulation: A flow cytometry study

CYTOMETRY, Issue 1 2004
Silverio Sbrana
Abstract Background Cardiovascular surgery with cardiopulmonary bypass (CPB) induces systemic inflammation and postoperative complications depending on pro- and anti-inflammatory mechanisms. Activated polymorphonuclear cells and monocytes may be responsible for morbidity associated with CPB. Knowledge of the monocyte functional state in particular may help to develop protective interventions. Methods Samples were drawn from venous peripheral blood (basal condition, at 4 and 24 h after CPB) and coronary blood (before and after cardioplegic arrest) of 14 patients undergoing cardiac surgery. The following phenotypic and functional parameters of the monocyte population were studied by flow cytometry: surface molecules expression (CD18, CD11a, CD11b, CD14, CD15, CD45, HLA-DR, and Toll-like receptor [TLR]-4), myeloperoxidase (MPO) content, and intracellular cytokine production (tumor necrosis factor [TNF]-,, interleukin [IL]-1,, IL-6, and IL-8). Results Cardiac surgery with CPB induced down-modulation of surface molecules expression on peripheral monocytes, especially at 24 h after CPB, for CD18, CD11a, and CD11b (P < 0.003) and for the CD15 adhesive cluster (P = 0.0028) and HLA-DR (P < 0.001). At 4 h after CPB, downregulation was observed for CD14 (P = 0.004), CD45 (P = 0.014), and CD15 (P = 0.0056). A loss of MPO was detected in venous peripheral (at 24 h after CPB, P = 0.01) or coronary (at reperfusion, P < 0.02) blood. The CD15 cluster complex exhibited a down-modulation in coronary blood (at reperfusion, P = 0.0003). Spontaneous intracellular production of IL-1,, IL-6, and IL-8 decreased at 24 h after CPB (P < 0.05). Conclusions The down-modulation of integrins and adhesive receptor expression and the loss of MPO suggest a strong activation and shedding reaction of circulating monocyte after CPB, further exacerbated by contact with coronary ischemic vessels. The changes of differentiation antigens may reflect the appearance of a partially immature population immediately after CPB. The reduced proinflammatory cytokine production, observed at 24 h after CPB, suggests a functional polarization of circulating monocytes. © 2003 Wiley-Liss, Inc. [source]

A randomized trial of delayed extubation for the reduction of reintubation in extremely preterm infants,

PEDIATRIC PULMONOLOGY, Issue 2 2008
Claude Danan MD
Abstract Objective To compare immediate extubation versus delayed extubation after 36 hr in extremely low-birth weight infants receiving gentle mechanical ventilation and perinatal lung protective interventions. Our hypothesis was that a delayed extubation in this setting would decrease the rate of reintubation. Study design/Methodology A prospective, unmasked, randomized, controlled trial to compare immediate extubation and delayed extubation after 36 hr. Optimized ventilation in both groups included continuous tracheal gas insufflation (CTGI), prophylactic surfactant administration, low oxygen saturation target and moderate permissive hypercapnia. Successful extubation for at least 7 days was the primary criterion and ventilatory support requirements until 36 weeks gestational age the main secondary criteria. Patient selection Eighty-six infants under 28 weeks gestational age in a single neonatal intensive tertiary care unit. Results Delayed extubation (1.9,±,0.8 days vs. 0.5,±,0.7 days) did not improve the rate of successful extubation but had no long-term adverse effects. CTGI and the lung protective strategy we describe resulted in a very gentle ventilation. The rate of survival without bronchopulmonary dysplasia (BPD, defined as any respiratory support at 36 weeks gestational age) was similar in the two groups and remarkably high for the global population (78%) and for the subgroup of infants <1,000 g at birth (75%). Conclusions Adding 36 hr of optimized mechanical ventilation before first extubation does not improve the rate of successful extubation but has no adverse effects. Pediatr Pulmonol. 2008; 43:117,124. © 2007 Wiley-Liss, Inc. [source]

Exchange, affiliation, and protective interventions in semifree-ranging brown capuchin monkeys (Cebus apella)

AMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2006
Renata G. Ferreira
Abstract The "social intelligence" hypothesis proposes that intelligence evolved as a consequence of the need for behavioral maneuvering to deal with the complexities of social life. As a result, coalitions have received considerable attention. Here we present the patterns of coalitionary behavior observed in a semifree-ranging group of Cebus apella and explore the effects of kinship, spatial proximity, and rank. In contrast to descriptions of Old World monkeys and to some descriptions of capuchins, kinship did not influence the pattern of coalitionary behavior, although individuals tended to help those that remained in close proximity. Rank had the greatest influence on coalitions: those that interfered in conflicts (often the alpha) were higher ranking than both contestants and supported the most subordinate (younger) interactant. However, rank did not influence the coalitionary support when conflicts involved only adults. We found no evidence that individuals were making use of triadic knowledge, and most of the coalitions can best be described as protective interventions involving immatures. The overall low rate of coalitions may be due to a period of social stability. Am. J. Primatol. 68:765,776, 2006. © 2006 Wiley-Liss, Inc. [source]