Effect of a Low Molecular Weight Heparin Molecule,Dalteparin, on Cellular Apoptosis and Inflammatory Process in an Incisional Wound-Healing Model

Purpose In this study we aimed to test the effect of a low molecular weight heparin molecule, namely dalteparin, on the inflammation and cellular apoptosis in an incisional wound-healing model in rats. Methods Eighteen male Sprague–Dawley rats were randomly assigned to three groups (n = 6 for each group). Two full-thickness skin incisions were made over cervical and lumbar regions of all rats. Group 1 (sham group) received no treatment, group 2 (control group) received 0.01 ml/g saline subcutaneously 12 h two times daily from 0 to 10th postoperative day, and group 3 (dalteparin group): received 1 IU/g dalteparin subcutaneously two times daily from 0 to 10th postoperative day. A histological evaluation was done by light microscopy. Apoptosis was detected immunohistochemically by anti-poly (ADP-ribose) polymerase p85 fragment pAb. Results The early inflammatory response and related tissue edema were depressed on day 3 in the dalteparin group when compared with those in the other groups (P < 0.05). Fibroblast proliferation was also depressed on day 10 in the dalteparin group compared to the others (P < 0.05). Furthermore, increased apoptosis was detected in the dalteparin group both on day 3 and day 10. Conclusion Our results showed that dalteparin may adversely affect the incisional wound healing by suppressing the early inflammatory process and increasing cellular apoptosis; however, further studies are warranted to confirm the results.     

Evaluation of inhaler technique,adherence to therapy and their effect on disease control among children with asthma using metered dose or dry powder inhalers

Objective: To address the problems about correct use of inhaler devices, adherence to inhaler corticosteroid treatment and the effects of these problems on the control of asthma. Methods: Children with asthma were evaluated for the correct use of inhaler devices and adherence to therapy using a questionnaire. Effect of these on control of asthma was defined. Results: A hundred and seventy-one patients and/or their families were interviewed. The mean age was 8.29?±?4.65 years (1–19) and 62.6% were male. Metered dose inhaler (MDI) with spacer was used by 119 (69.5%) patients and 52 (30.5%) used dry powder inhalers (DPIs). The devices were used correctly by 68.1% of patients using MDI and 34.6% of patients using DPI (p?<?0.001). The most common improper step was “breathe in from the spacer 5–6 times or 10?s” for MDI (24.4%) and “exhale to residual volume” for DPI (51.9%). Frequency of correct use was higher in patients trained 3 times (p?<?0.001). Asthma was controlled more frequently among correct users (p?<?0.001). Partial or poor adherence was showed 22.8% of patients. Patients with mothers who had lower educational status had higher frequency of incorrect use of inhaler device (p?=?0.007). Conclusion: It was found that asthma control was better among correct users. Repetitive training about using devices may contribute improving inhaler technique. Especially children whose mothers had low education level and patients using DPI should be evaluated more carefully.     

Endoplasmic reticulum stress, redox, and a proinflammatory environment in athero-susceptible endothelium in vivo at sites of complex hemodynamic shear stress

Endothelial phenotype heterogeneity plays an important role in the susceptibility of arteries to atherosclerosis. Regions of blood flow disturbance correlate with the development of disease. Here, we briefly outline the association of endoplasmic reticulum stress with endothelium in regions of athero-susceptibility in vivo. It is an important example of susceptible cell phenotype that is likely linked to proinflammatory and oxidative stress pathways. The endothelium in such regions is chronically exposed to complex hemodynamic shear stresses that may be considered as a risk factor for atherosclerosis via these mechanisms.