Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients

Introduction: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today’s critical care unit is also linked to its multiple pharmacological effects.

Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin.

Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale.     

Eucalyptol-based green extraction of brown alga Zonaria tournefortii

A green extraction method, based on the use of 1,8-cineole (eucalyptol) as biosolvent, has been developed to prepare crude extracts from the brown alga Zonaria tournefortii characterized by chemical composition, particularly dominated by phenolic compounds derived from phloroglucinol. The main advantage of the developed technique are the recovery of eucalyptol, based on multistep liquid-liquid extraction with distilled water, followed by centrifugation and elimination of the aqueous phase, and the complete recycling of biosolvent by steam distillation. A comparative study between the proposed green extract and the conventional extract, prepared by solvent maceration using the mixture CH₂Cl₂/MeOH (1/1:v/v), was performed in terms of qualitative and quantitative determination of several parameters as:(i) the total phenolic content determined by the Folin-Ciocalteu assay, (ii) the presence of phenols determined by high performance liquid chromatography (HPLC), and (iii) the antioxidant activity assessed by the DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging assay. In short, eucalyptol provides a safe and selective extraction of phenolic compounds from Zonaria tournefortii with no environmental side effects and a good recovery of the solvent.     

What Impact Does Venous Thromboembolism and Bleeding Have on Cancer Patients’ Quality of Life?

Background

Venous thromboembolism (VTE) is common in cancer patients and its treatment is associated with a high risk of recurrent VTE (rVTE) and bleeding.

Peripheral blood leukocyte telomere length is associated with age but not renal function: A cross-sectional follow-up study

Objectives

We aimed to evaluate the relationship between baseline renal function and changes in telomere length in Han Chinese.

Methods

The telomere restriction fragment (TRF) length of leukocytes in the peripheral blood was measured in healthy volunteers recruited in 2014. The estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine (Scr) and serum cystatin C (CysC)-eGFRcys and eGFRScr-cys through the Cockcroft-Gault formula (eGFRC-G) or the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI / eGFRCKD-EPI) equation. The correlation between telomere length changes over time and renal function was analyzed.

Results

Leukocyte TRF lengths were negatively correlated to age (r = -0.393, p < 0.001) and serum CysC (r = -0.180, p < 0.01), while positively associated with eGFRCKD-EPI, eGFRC-G, eGFRcys, and eGFRScr-cys (r = 0.182, 0.122, 0.290, and 0.254 respectively, p < 0.01). The 3-year change of telomere length was 46 bp/years. When adjusted for age, the associations between telomere length changes and baseline, subsequent TRF lengths, and serum CysC were no longer present. No association was observed between TRF length changes and renal function.

Conclusion

The rate of telomere length changes was affected by age and baseline telomere length. The telomere length changes might be important markers for aging.

     

A rapid diagnosis of anaerobic infection in the oro-maxillary region by gas-liquid chromatography

The relationship between volatile fatty acids (VFAs) in pus and infecting bacterial species was examined in order to establish a rapid identification system for anaerobic microorganisms in purulent inflammation in the oro-maxillary region. VFAs were detected by the direct injection of pus into gas-liquid chromatography (GLC). Bacterial examination was carried out by anaerobic culture using blood agar plates. The bacterial identification was carried out mainly according to the VPI manual. Analysis of the direct VFA patterns of each sample resulted in 5 groups. The following bacterial species were the main isolates in each group: Streptococcus intermedius in Group A, Peptostreptococcus micros in Group B, Fusobacterium nucleatum in Group C, Bacteroides gingivalis in Group D, and Peptostreptococcus anaerobius in Group E. The profile of VFAs produced in the PYG culture medium of the above isolated bacteria was compared with the direct VFA patterns. Agreement ratios between direct and PYG VFA patterns were as follows: Group A, 47.1%; Groups B and C, 45.0%; Group D, 87.5%; and Group E, 62.9%. The acetic acid concentration was more than 14 x 10(-4) meq/ml in Group B, the butyric acid concentration was more than 7 x 10(-4) meq/ml in Group C, and the iso-caproic acid concentration was more than 14 x 10(-4) meq/ml in Group E. In these cases, it was found that the agreement ratios between the direct and PYG FVA pattern were high. In Group D, irrespective of the concentration of iso-valeric acid detected, the agreement ratio was very high. The antibiotic susceptibility of the isolates was studied. Efficiency rates of ABPC, PIPC, CCL, CEZ, CMZ, SBT/CPZ, JM, CLDM, MINO and GM were relatively low and resistant rates were high for the gram-negative rods.     

Angiolipoma of the tongue: report of a case

Angiolipoma is a rare variety of lipoma in the maxillofacial region. Only eight cases have been documented so far. A case in which an angiolipoma occurred within the tongue of a 49-year-old man is described here. The difference from earlier cases occurring in the tongue is noted. Close follow-up has, as yet, revealed no recurrence.