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New Findings What is the central question of this study? Is there a beneficial effect and what are the mechanisms of acute and multiple hyperbaric oxygenation (HBO2) exposures on the outcome of cerebral tissue injury induced by a transient middle cerebral artery occlusion model in diabetic female rats? Are 20-hydroxyeicosatetreanoic acid and epoxyeicosatrienoic acids involved?, What is the main finding and its importance? Equal reduction of cortical and total infarct size in rats treated with HBO2 and HET0016 (20-hydroxyeicosatetreanoic acid production inhibitor) and significant mRNA upregulation of epoxyeicosatrienoic acid-producing enzymes (Cyp2J3 and Cyp2C11) in treated groups suggest that HBO2 and HET0016 are highly effective stroke treatments and that cytochrome P450 metabolites are involved in this therapeutic effect., We evaluated the effects of acute and repetitive hyperbaric oxygenation (HBO2), 20-hydroxyeicosatetreanoic acid (20-HETE) inhibition by N-hydroxy- N′-(4-butyl-2methylphenyl)-formamidine (HET0016) and their combination on experimental stroke outcomes. Streptozotocin-induced type 1 diabetic Sprague-Dawley female rats ( n = 42; n = 7 per group), were subjected to 30 min of transient middle cerebral artery occlusion (t-MCAO)-reperfusion and divided into the following groups: (1) control group, without treatment; and groups exposed to: (2) HBO2; (3) multiple HBO2 (HBO2 immediately and second exposure 12 h after t-MCAO); (4) HET0016 pretreatment (1 mg kg−1, 3 days before t-MCAO) combined with HBO2 after t-MCAO; (5) HET0016 treatment (1 h before, during and for 6 h after t-MCAO); and (6) HET0016 treatment followed by HBO2 after t-MCAO. Messenger RNA expression of CYP2J3, CYP2C11, CYP4A1, endothelial nitric oxide synthase and epoxide hydrolase 2 was determined by real-time qPCR. Cortical infarct size and total infarct size were equally and significantly reduced in HBO2- and HET0016-treated rats. Combined treatment with HET0016 and HBO2 provided no significant additive effect compared with HET0016 treatment only. Messenger RNA of Cyp2J3 was significantly increased in all study groups, and mRNA of Cyp2C11 was significantly increased in the multiple HBO2 group and the HET0016 treatment followed by HBO2 group, compared with the control group. Expression of endothelial nitric oxide synthase was significantly increased after HBO2 treatments, and expression of epoxide hydrolase 2 was increased in all groups compared with the control group. In diabetic female Sprague-Dawley rats, HBO2 and HET0016 are highly effective stroke treatments, suggesting the involvement of cytochrome P450 metabolites and the NO pathway in this therapeutic effect. [ABSTRACT FROM AUTHOR]

Aim: To determine optimal duration of transient middle cerebral artery occlusion (t-MCAO) for a stroke model in female diabetic Sprague-Dawley (SD) rats. Methods: Streptozotocin-induced type-1 diabetic SD female rats (n= 25, 12 weeks old, five groups;n= 5 per group) were subjected to different duration of t-MCAO (20, 30, 45, 60 and 90 minutes) followed by reperfusion. A control group of rats without diabetes (n= 5) was subjected to 30 minutes of t-MCAO followed by reperfusion. Twenty-four hours after reperfusion, infarct volumes were evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Results: Intra-ischaemic reductions of regional cerebral blood flow (rCBF) were similar in all groups (68–75% of baseline values). Reperfusion was significantly impaired in the 90-minute ischaemia group (56–62% vs 80–125% in other groups). Twenty minutes of t-MCAO induced a small infarct (3 ± 5% of ischaemic hemisphere). Thirty minutes of ischaemia produced a significantly larger infarct (46 ± 6%). In the 45 and 60 minute groups, ischaemia infarct was 52 ± 5% and 59 ± 3% of the ischaemic hemisphere, respectively. Ischaemia of 90’ led to a massive stroke (89 ± 6% of ischaemic hemisphere encompassing the whole striatum (22 ± 3%) and almost the whole MCA irrigated cortex area (67 ± 6%)). Thirty minutes of t-MCAO did not produce stroke in the control group. Conclusion: The diabetic rat stroke model should be different from the non-diabetic, because female type-1 diabetic SD rats are highly sensitive to brain ischaemia and it is necessary to significantly shorten the duration of t-MCAO, optimally to 30 minutes. [ABSTRACT FROM AUTHOR]

Abstract: New adamantane–dipyrromethanes (AdD 1–4) were synthesized and their anion binding properties investigated. AdD 1–3 form 2:1 complexes with F− (AdD:F=2:1) characterized by high association constants, and 1:1 complexes with Cl−, Br−, and . The binding of Cl−, Br−, and by AdD 1–3 is 2–3 times stronger than for the reference compound, meso-phenyldipyrromethane (5). However, AdD 4 forms complexes with F− characterized by 1:1 and 1:2 stoichiometry (AdD:F=1:2). [Copyright &y& Elsevier]

Heart failure (HF) is a clinical state resulting in impaired cardiac function and structural changes of the heart muscle causing an insufficient oxygen-tissue supply and metabolically impairment. Our aim is to present and evaluate the implantation of left ventricular assist device (LVAD) from a nurse point of view. Congestive heart failure is one of the leading causes of morbidity and mortality in Europe. Left ventricular assist devices have revolutionized the treatment of end-stage heart failure. Its powerful therapeutic approach in acute and chronic heart failure is due to the fact that lowering of left ventricular volume by increasing left ventricular output increases organ perfusion, improves oxygen supply of organs by maintaining adequate minute volume.1 Every patient who is suffering from heart failure should be examined by a cardiologist to evaluate the stage of heart failure and decide about adequate treatment options. Treatment modalities as well as the prognosis depends on the stage of heart failure and clinical condition. Every patient goes through an extensive diagnostic process. The left ventricular assist device has two optional implant strategies, one considering LVAD as “bridge to transplant” or “bridge to recovery” and the second considering LVAD as long term therapy. When it is determined that the patient is suitable for LVAD implantation he and his family undergo a specific training for managing the implanted device. This training is consisted of education prior and after LVAD implantation. Prior implantation, education consists of informing the patient and his family about benefits and risks of cardiac device implantation as well as explaining what it means living with a heart pump, dependents on mechanical device, everyday issues and concerns, changes in the surface of the body, dealing with cables, portable pump-batteries, possible infections and alarms, changes in quality of life and self-responsibility. After surgery patients are transferred to intensive care unit where it is important to monitor hemodynamic and pump parameters as well as signs of skin infection at the cable surrounding. After implantation of LVAD, recovery seems to depend on patients acceptance of a new body device. For better outcomes, early self-care is being encouraged. The role of the nurse is to prepare the patient for discharge from the hospital by educating the patient about all consistent parts of the pump (control system, battery, battery charger, power supply module, driveline) and managing proper skin hygiene. Another unavoidable issue is the unceasing necessity of anticoagulant therapy (avoiding ischemic events) as well as regular coagulation and volume monitoring.2 Patients healthcare, after implantation of a cardiac assist device, is nowadays still a challenging venture. The advisory role of the nurse an individual approach and sensibility for noticing and preventing potential risks makes the nurse a link between the entire medical team, the patient and his family. [ABSTRACT FROM AUTHOR]

Aortal stenosis is quiet often valvular disease, especially in elderly people. The gold standard in medical treatment is surgical aortal valvular replacement.1 Although, people of advanced age and with multiple comorbidities often have high surgical risk. That is the main reason why TAVI procedure is developed as optimal treatment in that category of patients. TAVI is less invasive and have less perioperative risk than classical cardiosurgical procedure.2The role of medical nurse is very important in all aspects of medical care. The nurse has important role in coordination with multidisciplinary team before TAVI procedure and later in education of the patients and family members. Although TAVI procedure is less invasive, the postprocedural treatment is demanding and quiet complicated. It is very important to monitor hemodynamic status and taking into considerations all the comorbidities. Early mobilization and complications are important aspects in medical care. Whereas some patients have diastolic dysfunction and hypertrophic left ventricle it is important to follow adequate volume status and optimize cardiac output and systemic perfusion. Many of this patients have chronical renal impairment and optimal postprocedural hydration is demand as protection of acute renal injury. ECG monitoring and neurological status changes are also required. TAVI procedure is less invasive method in high grade symptomatic aortal stenosis after which patients are very soon mobile, the medical health care is quiet demanding and complicated. Because this is new medical approach in treatment, medical nurses should be adequately familiar with risks, advances and possible complications of this procedure. New researches will make much stronger roll of medical nurses in multidisciplinary team approach and give more quality in medical treatment of this patients. [ABSTRACT FROM AUTHOR]

In the structure of caesium chloride 2-( N-morpholinio)­ethane­sulfonate, Cs+·Cl−·C6H13NO4S, determined by X-ray diffraction analysis at 100 K, the caesium cation is coordinated by the chloride anion and six O atoms. [ABSTRACT FROM AUTHOR]

Introduction: Mechanical circulatory support is becoming a more common therapy for end-stage heart failure in intensive cardiac care unit, and currently there are several types of devices that can be used as bridge therapy to recovery phase or hearth transplantation. Extracorporeal membrane oxygenation (ECMO) replaces heart and lung function using extracorporeal blood flow and it can be used as mechanical support in cardio-circulatory or respiratory failure.1 In a patient on ECMO support there is a strong activation of inflammatory response in a short period of time, usually due to shock before the initiation of support, but also, due to long, non-physiological blood flow through the piping, rotational pump and the oxygenator, where there is higher possibility of development of infection. In this phase patients are hemodynamically unstable, dependent on vasoactive support and substitution of intravenous fluids with a raise in inflammatory markers seen in laboratory results. Adsorbers for extracorporeal blood purification (CytosorbTM) can absorb molecules ranging from 5 to 55 kDa, which is the size where cytokines and some metabolites such as bilirubin, bile acids and ammonium can be absorbed, and it can be used to control inflammatory response which eventually can damage blood vessel walls and lead to target organs damage. Case report: This case report will show a 38-year-old patient who was hospitalized in Department of Cardiac Intensive Care after deterioration of his primary condition (cardiomyopathy) with hemodynamic instability, which lead to placement of both left and right sided mechanical circulatory support with an adsorber. This led to a decrease of inflammatory markers with good clinical and microbiological response. Patients soon underwent heart transplantation without any major complications and fast recovery. Conclusion: Use of adsorber via ECMO machine or dialysis machine is a very complex procedure which needs responsible approach to intervention and the only guarantee of success lays in a multidisciplinary approach. [ABSTRACT FROM AUTHOR]