Comparative effects of macro-sized aluminum oxide and aluminum oxide nanoparticles on erythrocyte hemolysis: influence of cell source, temperature and size

Al2O3 is the most abundantly produced nanomaterial and has been used in diverse fields, including the medical, military and industrial sectors. As there are concerns about the health effects of nanoparticles, it is important to understand how they interact with cells, and specifically with red blood cells. The hemolysis induced by three commercial nano-sized aluminum oxide particles (nanopowder 13 nm, nanopowder <50 nm and nanowire 2-6 nm × 200-400 nm) was compared to aluminum oxide and has been studied on erythrocytes from humans, rats and rabbits, in order to elucidate the mechanism of action and the influence of size and shape on hemolytic behavior. The concentrations inducing 50% hemolysis (HC50) were calculated for each compound studied. The most hemolytic aluminum oxide particles were of nanopowder 13, followed by nanowire and nanopowder 50. The addition of albumin to PBS induced a protective effect on hemolysis in all the nano-forms of Al2O3, but not on Al2O3. The drop in HC50 correlated to a decrease in nanomaterial size, which was induced by a reduction of aggregation Aluminum oxide nanoparticles are less hemolytic than other oxide nanoparticles, and behave differently depending on the size and shape of the nanoparticles. The hemolytic behavior of aluminum oxide nanoparticles differs from that of aluminum oxide.

Comparative effects of macro-sized aluminum oxide and aluminum oxide nanoparticles on erythrocyte hemolysis: influence of cell source, temperature and size

Al2O3 is the most abundantly produced nanomaterial and has been used in diverse fields, including the medical, military and industrial sectors. As there are concerns about the health effects of nanoparticles, it is important to understand how they interact with cells, and specifically with red blood cells. The hemolysis induced by three commercial nano-sized aluminum oxide particles (nanopowder 13 nm, nanopowder <50 nm and nanowire 2-6 nm × 200-400 nm) was compared to aluminum oxide and has been studied on erythrocytes from humans, rats and rabbits, in order to elucidate the mechanism of action and the influence of size and shape on hemolytic behavior. The concentrations inducing 50% hemolysis (HC50) were calculated for each compound studied. The most hemolytic aluminum oxide particles were of nanopowder 13, followed by nanowire and nanopowder 50. The addition of albumin to PBS induced a protective effect on hemolysis in all the nano-forms of Al2O3, but not on Al2O3. The drop in HC50 correlated to a decrease in nanomaterial size, which was induced by a reduction of aggregation Aluminum oxide nanoparticles are less hemolytic than other oxide nanoparticles, and behave differently depending on the size and shape of the nanoparticles. The hemolytic behavior of aluminum oxide nanoparticles differs from that of aluminum oxide.

Avaliação de índices dopplerfluxométricos da veia cava inferior e do ducto venoso em fetos submetidos à transfusão intravascular

OBJETIVO: avaliar os efeitos da transfusão intravascular nos índices dopplerfluxométricos do ducto venoso e da veia cava inferior (SV/CA) e relacionar essas alterações com o nível de hemoglobina pré-transfusão intravascular. MÉTODOS: trata-se de estudo transversal prospectivo. Foram realizadas 62 transfusões intravasculares em 27 fetos de gestações complicadas por isoimunização materno-fetal. Os 62 casos foram divididos em dois grupos: (A) fetos com níveis de hemoglobina pré-transfusão £10 g/dL, (B) fetos com níveis de hemoglobina pré-transfusão >10 g/dL. Os índices SV/CA e CA/SV foram medidos usando Doppler colorido 6 horas antes e 12 horas após a transfusão. Compararam-se os valores dos índices antes e após as transfusões em todos os 62 casos, e após a transfusão em cada grupo. O teste de Wilcoxon foi usado para comparação. Os resultados foram considerados estatisticamente significativos quando p<0,05. RESULTADOS: quando estudamos todo o grupo (62 casos), não encontramos diferença significativa no índice CA/SV antes e após a transfusão (p=0,775). No entanto, o índice SV/CA apresentou aumento significativo após a transfusão (p=0,004). Nos fetos com níveis de hemoglobina pré-transfusão £10 g/dL não foi observada diferença significativa nos valores de ambos os índices SV/CA e CA/SV, com p=0,061 e p=0,345, respectivamente. Após a transfusão intravascular houve aumento significativo do índice CA/SV em fetos com níveis de hemoglobina pré-transfusão >10 g/dL (p=0,049), mas o índice SV/CA não se alterou nesse grupo (p=0,086). CONCLUSÕES: o estudo por dopplervelocimetria venosa pode ser útil para a compreensão dos ajustes hemodinâmicos fetais após a transfusão intravascular. O aumento no índice SV/CA sem alteração no índice CA/SV após a transfusão em fetos anêmicos pode ser mecanismo compensatório importante em resposta ao aumento do volume intravascular. O aumento do índice CA/SV em fetos com hemoglobina pré-transfusão <10 g/dL sugere um estado de hipervolemia fetal.

Is there correlation between the turbulent eddies size and mechanical hemolysis ?

Hemolytic profile of an artificial device chronically implanted in the cardiovascular system may represent the difference between the success and failure in its long-term performance. Last decades have witnessed efforts on the development of methods capable of predicting red blood cell damage in artificial organs. However, all of them have had limited success to predict hemolysis. The primary cause of this problem is that such models do not take into consideration structures of turbulent flow. The present paper demonstrates that microscopic measurable occurrences of the turbulent flow may be linked to red blood cell trauma. This study suggests that if the smallest turbulent eddies dimension is under 10 m m hemolysis is not dependent on the exposure time and the red blood cells damage depends only on the dissipation of the turbulent energy in the erythrocyte membrane. The analysis reported here opens the possibility of mapping the flow field in artificial assist devices based on the smallest eddy length scales. This is a promising new trend and should be considered in the designing requirements of the next generations of artificial organs.

Extracellular matrix molecules as targets for brown spider venom toxins

Loxoscelism, the term used to describe lesions and clinical manifestations induced by brown spider's venom (Loxosceles genus), has attracted much attention over the last years. Brown spider bites have been reported to cause a local and acute inflammatory reaction that may evolve to dermonecrosis (a hallmark of envenomation) and hemorrhage at the bite site, besides systemic manifestations such as thrombocytopenia, disseminated intravascular coagulation, hemolysis, and renal failure. The molecular mechanisms by which Loxosceles venoms induce injury are currently under investigation. In this review, we focused on the latest reports describing the biological and physiopathological aspects of loxoscelism, with reference mainly to the proteases recently described as metalloproteases and serine proteases, as well as on the proteolytic effects triggered by L. intermedia venom upon extracellular matrix constituents such as fibronectin, fibrinogen, entactin and heparan sulfate proteoglycan, besides the disruptive activity of the venom on Engelbreth-Holm-Swarm basement membranes. Degradation of these extracellular matrix molecules and the observed disruption of basement membranes could be related to deleterious activities of the venom such as loss of vessel and glomerular integrity and spreading of the venom toxins to underlying tissues.

An experimental model of hemolysis-induced acute pancreatitis

The literature indicates that acute pancreatitis is a complication of massive hemolysis with a prevalence of about 20%. We describe an experimental model of hemolysis-induced acute pancreatitis. Hemolytic anemia was induced in rats by a single ip injection of 60 mg/kg of 20 mg/ml acetylphenylhydrazine (APH) in 20% (v/v) ethanol on the first experimental day (day 0). One hundred and fifty Wistar albino rats weighing 180-200 g were divided into three groups of 50 animals each: groups 1, 2 and 3 were injected ip with APH, 20% ethanol, and physiological saline, respectively. Ten rats from each group were sacrificed on study days 1, 2, 3, 4 and 5. Serum amylase, lipase levels and pancreatic tissue tumor necrosis factor-alpha (TNF-alpha) and platelet-activating factor (PAF) contents were determined and a histological examination of the pancreas was performed. No hemolysis or pancreatitis was observed in any of the rats in groups 2 and 3. In group 1, massive hemolysis was observed in 35 (70%) of 50 rats, moderate hemolysis in seven (14%), and no hemolysis in eight (16%). Thirty-three of 35 (94.2%) rats with massive hemolysis had hyperamylasemia, and 29 of these rats (82.8%) had histologically proven pancreatitis. The most severe pancreatitis occurred on day 3, as demonstrated by histology. Tissue TNF-alpha and PAF levels were statistically higher in group 1 than in groups 2 and 3. Acute massive hemolysis induced acute pancreatitis, as indicated by histology, in almost 80% of cases. Hemolysis may induce acute pancreatitis by triggering the release of proinflammatory and immunoregulatory cytokines.

Oxidation of the albumin thiol to sulfenic acid and its implications in the intravascular compartment

Human serum albumin (HSA) is the most abundant protein in the intravascular compartment. It possesses a single thiol, Cys34, which constitutes ~80% of the total thiols in plasma. This thiol is able to scavenge plasma oxidants. A central intermediate in this potential antioxidant activity of human serum albumin is sulfenic acid (HSA-SOH). Work from our laboratories has demonstrated the formation of a relatively stable sulfenic acid in albumin through complementary spectrophotometric and mass spectrometric approaches. Recently, we have been able to obtain quantitative data that allowed us to measure the rate constants of sulfenic acid reactions with molecules of analytical and biological interest. Kinetic considerations led us to conclude that the most likely fate for sulfenic acid formed in the plasma environment is the reaction with low molecular weight thiols to form mixed disulfides, a reversible modification that is actually observed in ~25% of circulating albumin. Another possible fate for sulfenic acid is further oxidation to sulfinic and sulfonic acids. These irreversible modifications are also detected in the circulation. Oxidized forms of albumin are increased in different pathophysiological conditions and sulfenic acid lies in a mechanistic junction, relating oxidizing species to final thiol oxidation products.

Effects of different general anesthetics on serum hemolysis and hepatic and muscular glycogenolysis in rats

Anesthetics can affect the structure and biological function of tissues and systems differentially. The aim of the present study was to compare three injectable anesthetics generally used in experiments with animals in terms of the degree of hemolysis and glycogenolysis occurring after profound anesthesia. Twenty-four male Wistar rats (330-440 g) were divided into three groups (N = 8): chloral hydrate (CH), ketamine + xylazine (KX), Zoletil 50® (zolazepam and tiletamine) + xylazine (ZTX). After deep anesthesia, total blood was collected. The liver and white (WG) and red gastrocnemius (RG) muscles were also immediately removed. The degree of serum hemolysis was quantified on the basis of hemoglobin concentration (g/L). Hepatic and muscular glycogen concentrations (mmol/kg wet tissue) were quantified by the phenol-sulfuric method. The CH and KX groups exhibited serum hemolysis (4.0 ± 2.2 and 1.9 ± 0.9 g/L, respectively; P < 0.05) compared to the ZTX group, which presented none. Only KX induced elevated glycogenolysis (mmol/kg wet tissue) in the liver (86.9 ± 63.2) and in WG (18.7 ± 9.0) and RG (15.2 ± 7.2; P < 0.05). The CH and ZTX groups exhibited no glycogenolysis in the liver (164.4 ± 41.1 and 176.8 ± 54.4, respectively), WG (28.8 ± 4.4, 32.0 ± 6.5, respectively) or RG (29.0 ± 4.9; 25.3 ± 8.6, respectively). Our data indicate that ZTX seems to be an appropriate general anesthetic for studies that seek to simultaneously quantify the concentration of glycogen and serum biochemical markers without interferences. ZTX is reasonably priced, found easily at veterinary markets, quickly induces deep anesthesia, and presents a low mortality rate.

Exogenous normal lymph alleviates microcirculation disturbances and abnormal hemorheological properties in rats with disseminated intravascular coagulation

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500.

Use of intravascular ultrasonography for the characterization of coronary artery disease in patients with chronic kidney disease

INTRODUCTION: Chronic kidney disease patients present a very high cardiovascular mortality. Nevertheless, a comparative description of lesion characteristics, using intravascular ultrasound in dialysis patients, has not yet been reported. The objective of the present study was to analyze the plaque morphology through intravascular ultrasound in comparison to their counterparts with normal renal function. METHODS: Patients were screened for coronary artery disease, and the coronary angiography was performed when indicated. Plaque morphology was evaluated by ultrasound, and findings were compared to a group of patients with coronary artery disease, who presented normal renal function, it carefully matched for all Framingham risk factors and lesion location at the coronary artery tree. RESULTS: One hundred and thirty-nine patients from a single center of hemodialysis were screened for the study. Patients with coronary lesions confirmed at the angiography presented lower hemoglobin (10.8 ± 1.5 versus 12.0 ± 19; p < 0.046) levels and higher levels of low-density lipoprotein (110.6 ± 25.8 versus 75.5 ± 43.1; p < 0.004), when compared to the ones without coronary artery disease. The ultrasound revealed greater proximal reference diameter (4.1 ± 0.6 versus 3.7 ± 0.5; p < 0.007), smaller crossed sectional area (4.2±1.6 versus 5.2 ± 1.8; p < 0.02), and the calcification was located in a deeper arterial layer (69 versus 9%; p < 0.004) in patients with chronic kidney disease when compared to the Control Group. CONCLUSION: Lesions of the patients with chronic kidney disease presented a larger proximal diameter and intense calcification in the deeper layer of the vessel, which suggest a greater positive remodeling effect in response to a more aggressive atherosclerotic process in the medial section of the artery.

Pharmacometrics of neuromuscular blocking agents in anesthetized patients and animals : impact of dose and intravascular mixing phase

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Complicaciones de la preeclampsia severa y su relación con variables demográficas y obstétricas

Introducción: La preeclampsia severa es una de las principales patologías que afectan a las mujeres embarazadas, sus complicaciones tienen un alto impacto en la salud del binomio madre-hijo. Materiales y métodos: Se realizo una serie de casos, durante un periodo de 1 año se revisaron las historias clínicas de las pacientes que ingresaron a la unidad de cuidado intensivo obstétrico de la Clínica Orquídeas, con diagnóstico de preeclampsia severa. Se describieron los datos demográficos y las complicaciones. Se realizó análisis univariado con las variables de interés y se calcularon diferencias significativas por medio del test exacto de Fisher. Resultados: Se registraron 196 pacientes con preeclampsia severa en el periodo de estudio. Las complicaciones mas frecuentes fueron síndrome HELLP (30,6%), insuficiencia renal aguda (16,3%) y edema pulmonar (10,2%); el ingreso de las pacientes con preeclampsia severa a la UCIO en embarazo aumenta el riesgo de sufrir complicaciones. El síndrome de HELLP se presento con mayor frecuencia en pacientes que realizaron 6 o mas controles prenatales (p=0.066). Discusión: Los resultados evidencian una prevalencia de preeclampsia severa mayor que la observada por otros autores, probablemente por ser una UCI exclusivamente obstétrica. Las complicaciones mas frecuentes son concordantes con otros estudios publicados. El mayor riesgo de complicaciones asociadas en pacientes que ingresan embarazadas a la UCIO podría estar en relación a la severidad de la patología. Se requieren estudios analíticos para establecer asociaciones entre cada una de las complicaciones y sus factores condicionantes.

Caso sospechoso de envenenamiento por araña reclusa (loxosceles) y revisión de la literatura

El Loxoscelismo en una enfermedad causada por la picadura de una araña del género Loxosceles, que se puede manifestar con compromiso cutáneo y/o sistémico e incluso llevar a la muerte. La distribución geográfica de la araña es mundial, con mayor incidencia en países como Perú, Chile y Brasil, y en algunos lugares de Norte América. En Colombia, se ha identificado este tipo de arácnido, sin embargo no se ha reportado ningún caso, se cree que probablemente exista subregistro. El cuadro clínico puede ir desde pacientes asintomáticos hasta dermonecrosis severa, con gran riesgo de secuelas e incapacidad funcional. Cuando hay compromiso sistémico, cursa con falla renal, hemólisis, coagulación intravascular diseminada y alto riesgo de muerte. El diagnóstico es clínico y epidemiológico, pues no hay pruebas serológicas confirmatorias disponibles. A pesar de que se han descrito múltiples opciones terapéuticas, no hay un consenso que permita hacer recomendaciones, por la escasa evidencia científica que existe al respecto. Este artículo presenta el caso de un varón de 11 años, con antecedente de picadura por animal desconocido, con evolución clínica sugestiva de loxoscelismo cutáneo y sistémico, que recibió manejo con suero antiarácnido, oxígeno hiperbárico, inhibidor de polimorfonucleares y reconstrucción quirúrgica. Se revisa la literatura y la situación de la enfermedad en Colombia, con el fin de llamar la atención sobre una enfermedad poco conocida y favorecer la sospecha diagnóstica y el enfoque adecuado.

Inhibitory Effect of Gallic Acid and Its Esters on 2,2 '-Azobis(2-amidinopropane)hydrochloride (AAPH)-Induced Hemolysis and Depletion of Intracellular Glutathione in Erythrocytes

The protective effect of gallic acid and its esters, methyl, propyl, and lauryl gallate, against 2,2'-azobis(2-amidinopropane)hydrochloride (AAPH)-induced hemolysis and depletion of intracellular glutathione (GSH) in erythrocytes was studied. The inhibition of hemolysis was dose-dependent, and the esters were significantly more effective than gallic acid. Gallic acid and its esters were compared with regard to their reactivity to free radicals, using the DPPH and AAPH/pyranine free-cell assays, and no significant difference was obtained. Gallic acid and its esters not only failed to inhibit the depletion of intracellular GSH in erythrocytes induced by AAPH but exacerbated it. Similarly, the oxidation of GSH by AAPH or horseradish peroxidase/H(2)O(2) in cell-free systems was exacerbated by gallic acid or gallates. This property could be involved in the recent findings on proapoptotic and pro-oxidant activities of gallates in tumor cells. We provide evidence that lipophilicity and not only radical scavenger potency is an important factor regarding the efficiency of antihemolytic substances.

Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos

JUSTIFICATIVA E OBJETIVOS: A ropivacaína foi introduzida na prática clínica há pouco mais de dez anos, associando-se a baixo risco de complicações do sistema nervoso central e cardiovascular. O objetivo destes relatos é apresentar um caso de parada cardíaca e outro de toxicidade neurológica, após injeção intravascular acidental da ropivacaína, durante a realização de anestesias peridurais. RELATO DOS CASOS: Trata-se de duas pacientes submetidas a cirurgias plásticas estéticas sob anestesia peridural torácica com ropivacaína a 0,5%. Durante a realização da técnica, uma delas apresentou parada cardíaca em assistolia e a outra, toxicidade neurológica. Prontamente atendidas, ambas apresentaram rápida recuperação, tendo sido possível a realização dos respectivos atos cirúrgicos. CONCLUSÕES: O reconhecimento e o tratamento rápidos da injeção intravascular acidental, bem como as características farmacológicas da ropivacaína foram decisivos, em ambos os casos, na boa recuperação das pacientes.