Effect of volume replacement during combined experimental hemorrhagic shock and traumatic brain injury in prostanoids, brain pathology and pupil status / Efeito da reposição volêmica durante o choque hemorrágico combinado com traumatismo craniencefálico sobre prostanóides, patologia cerebral e status pupilar

Traumatic brain injury (TBI) is the main cause of trauma-related deaths. Systemic hypotension and intracranial hypertension causes cerebral ischemia by altering metabolism of prostanoids. We describe prostanoid, pupilar and pathological response during resuscitation with hypertonic saline solution (HSS) in TBI. Method Fifteen dogs were randomized in three groups according to resuscitation after TBI (control group; lactated Ringer’s (LR) group and HSS group), with measurement of thromboxane, prostaglandin, macroscopic and microscopic pathological evaluation and pupil evaluation.Result Concentration of prostaglandin is greater in the cerebral venous blood than in plasma and the opposite happens with concentration of thromboxane. Pathology revealed edema in groups with the exception of group treated with HSS.Discussion and conclusion There is a balance between the concentrations of prostaglandin and thromboxane. HSS prevented the formation of cerebral edema macroscopically detectable. Pupillary reversal occurred earlier in HSS group than in LR group.

O traumatismo cranioencefálico (TCE) é a principal causa de morte relacionada ao trauma. O choque hemorrágico e hipertensão intracraniana causam isquemia cerebral alterando o metabolismo de prostanóides. Neste estudo, relatamos o comportamento dos prostanóides, resposta pupilar e patologia durante a reposição volêmica com solução salina hipertônica (SSH) no TCE. Método Quinze cachorros foram randomizados em três grupos (controle, grupo de Ringer lactato e grupo de SSH) e foram avaliados tromboxane, prostaglandina, avaliação patológica macroscópica e microscópica e status pupilar.Resultado A concentração de prostaglandina é maior no sangue cerebral em comparação ao plasma, e o inverso ocorre com o tromboxane. A patologia revelou edema em todos os grupos, com exceção do grupo tratado com SSH.Discussão e conclusão Existe um equilíbrio entre concentrações cerebrais e plasmáticas de prostaglandina e tromboxane. A SSH protegeu o cérebro da formação de edema pós traumático.

Thromboxane in complicated and uncomplicated hypertension

This work comprised 77 hypertensive patients as well as 14 healthy normotensive age matched subjects as a control group. They were categorized into uncomplicated hypertension [group I], hypertension complicated by coronary artery disease [group II], and hypertension complicated by acute cerebral infarction [group III]. They were submitted to full clinical assessment, ECG, abdominal sonography, routine laboratory investigations, plasma renin activity, plasma thromboxane B2 and 6-keto-prostaglandin F1 alpha. Echocardiography and CT brain scan were done whenever indicated. 6-keto-prostaglandin F1 alpha level was significantly reduced in group I, while thromboxane B2 level showed no difference, however, the ratio TXB2/6.K.PGF1 alpha was significantly higher when compared with controls. In hypertensive patients complicated by coronary artery disease [group II] while both thromboxane B2 and 6-keto-prostaglandin F1 alpha levels showed no significant difference compared with either controls or group I, the ratio TXB2/6.K.PGF1 was significantly higher. In hypertensive patients complicated by cerebral infarction [group III] both thromboxane B2 level and the ratio TXB2/6.K.PGF1 alpha level were significantly higher when compared with either controls, group I or group II patients. However, 6.K.PGF1 alpha showed no significant difference when compared with these groups. In the three studied groups both TXB2 and 6.K.PGF1 alpha were positively correlated with either systolic, diastolic or mean blood pressure. Also, TXB2 and 6.K.PGF1 alpha levels were positively correlated to each other. In this study, the plasma renin activity showed no significant difference between the controls and any of the three studied groups

Calcium and prostaglandins in blood and uterine muscle in normal and abnormal uterine actions

Uterine activity integral [UAI] together with plasma and uterine muscle calcium ions, PGF2 alpha and PGE2 were estimated in 32 primigravidae of those admitted to the Department of Obstetrics and Gynecology of El-Menia University Hospital and delivered by cesarean section. Seven women showed normal uterine action, 15 showed hypotonic uterine action, and 10 showed hypertonic uterine action. The study showed that PGE2 alpha and calcium ions levels increased in blood and uterine muscle during labor, especially in the hypertonic state and decreased in the hypotonic contractions, whereas, PGE2 showed no significant changes. These changes could incriminate PGF2 alpha and calcium ions in the pathogenesis of these abnormal uterine actions