Lack of influence of the COX inhibitors metamizol and diclofenac on platelet GPIIb/IIIa and P-selectin expression in vitro

BACKGROUND: The effect of non-steroidal anti-inflammatory drugs (NSAIDs) for reduced platelet aggregation and thromboxane A(2 )synthesis has been well documented. However, the influence on platelet function is not fully explained. Aim of this study was to examine the influence of the COX-1 inhibiting NSAIDs, diclofenac and metamizol on platelet activation and leukocyte-platelet complexes, in vitro. Surface expression of GPIIb/IIIa and P-selectin on platelets, and the percentage of platelet-leukocyte complexes were investigated. METHODS: Whole blood was incubated with three different concentrations of diclofenac and metamizol for 5 and 30 minutes, followed by activation with TRAP-6 and ADP. Rates of GPIIb/IIIa and P-selectin expression, and the percentage of platelet-leukocyte complexes were analyzed by a flow-cytometric assay. RESULTS: There were no significant differences in the expression of GPIIb/IIIa and P-selectin, and in the formation of platelet-leukocyte complexes after activation with ADP and TRAP-6, regarding both the time of incubation and the concentrations of diclofenac and metamizol. CONCLUSIONS: Accordingly, the inhibitory effect of diclofenac and metamizol on platelet aggregation is not related to a reduced surface expression of P-selectin and GPIIb/IIIa on platelets

Effect of magnetic resonance imaging on human respiratory burst of neutrophils

AbstractIt is known that low intensity magnetic fields increase superoxide anion production during the respiratory burst of rat peritoneal neutrophils in vitro. We investigated whether the high intensity magnetic fields (1.5 T) during magnetic resonance imaging can influence the human neutrophil function under in vivo conditions. Blood samples were obtained from 12 patients immediately before and after magnetic resonance imaging (mean time 27.6(±11.4 min)). The induced respiratory burst was investigated by the intracellular oxidative transformation of dihydrorhodamine 123 to the fluorescent dye rhodamine 123 via flow cytometry. The respiratory burst was induced either with phorbol 12-myristate 13-acetate, Escherichia coli, N-formyl-methionyl-leucylphenylalanine or priming with tumor necrosis factor followed by FMLP stimulation. There was no significant difference between the respiratory burst before and after magnetic resonance imaging, irrespective of the stimulating agent. Short time exposure to a high intensity magnetic field during magnetic resonance imaging seems not to influence the production of radical species in living neutrophils

Komplikationen und Erfolgsraten des Vena-subclavia-Katheters in Abhängigkeit der Erfahrung

Zusammenfassung Hintergrund Die Punktion der V. subclavia gehört zu den Standardprozeduren eines/einer Anästhesisten/Anästhesistin. Gefürchtete Komplikationen dieser Prozedur sind der Pneumothorax und die arterielle Fehlpunktion. Zum Erlernen dieser Prozedur ist von einer gewissen Lernkurve auszugehen. Ziel der Arbeit In dieser Studie soll der Einfluss der Punktionserfahrung auf die Erfolgsquote und mechanische Komplikationen wie Pneumothorax und arterielle Punktion untersucht werden. Dazu sollen 3 Erfahrungsstufen miteinander verglichen werden: unerfahren: 0 bis 20 Punktionen, mäßig erfahren: 21 bis 50 und erfahren: über 50 Punktionen. Material und Methoden Post-hoc-Analyse einer vorab publizierten Nichtunterlegenheitsstudie zur Untersuchung des Einflusses der Beatmung auf die Pneumothoraxrate bei der V.-subclavia-Punktion in Landmarkentechnik. Es wurden 1021 Patienten ausgewertet, die in die vorab publizierte Studie zwischen August 2014 und Oktober 2017 eingeschlossen wurden. Ergebnisse Die Gesamtrate an mechanischen Komplikationen ist in der Gruppe der Unerfahrenen im Vergleich zur Gruppe der Erfahrenen signifikant höher (15 % vs. 8,5 %, p = 0,023). Ebenso ist die Rate an Punktionsversuchen in der Gruppe der Unerfahrenen (0–20) mit 1,85 ± 1,12 signifikant höher als in der Gruppe der Erfahrenen (1,58 ± 0,99, p = 0,004). Im Gegenzug war die Rate einer erfolgreichen Punktion mit 95,1 % in der Gruppe der Erfahrenen signifikant höher als in der Gruppe der Unerfahrenen (89,3 %, p = 0,001). Schlussfolgerung Für eine erfolgreiche Punktion der V. subclavia in Landmarkentechnik ist eine Lernkurve von mindestens 50 Punktionen nötig, um die Komplikationsrate zu senken und die Erfolgsrate zu steigern. </jats:sec

Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood

Abstract Background It is increasingly recognized that infectious complications in patients treated with total parenteral nutrition (TPN) may be caused by altered immune responses. Neutrophils and monocytes are the first line of defence against bacterial and fungal infection through superoxide anion production during the respiratory burst. To characterize the impact of three different types of lipid solutions that are applied as part of TPN formulations, we investigated the unstimulated respiratory burst activation of neutrophils and monocytes in whole blood. Methods Whole blood samples were incubated with LCT (Intralipid®), LCT/MCT (Lipofundin®) and LCT-MUFA (ClinOleic®) in three concentrations (0.06, 0.3 and 0.6 mg ml-1) for time periods up to one hour. Hydrogen peroxide production during the respiratory burst of neutrophils and monocytes was measured by flow cytometry. Results LCT and LCT-MUFA induced a hydrogen peroxide production in neutrophils and monocytes without presence of a physiological stimulus in contrast to LCT/MCT. Conclusion We concluded that parenteral nutrition containing unsaturated oleic (C18:1) and linoleic (C18:2) acid can induce respiratory burst of neutrophils and monocytes, resulting in an elevated risk of tissue damage by the uncontrolled production of reactive oxygen species. Contradictory observations reported in previous studies may in part be the result of different methods used to determine hydrogen peroxide production.</p