The bioimpedance spectroscopy as useful tool for measuring the fluid excess and fluid management in severe polytrauma patients.

Although the fluid therapy plays a fundamental role in the management of polytrauma patients (PP), a tool which could determine it appropriately is still lacking. The aim of this study was to evaluate the application of a bioimpedance spectroscopy (BIS) for body fluids volume and distribution monitoring in these patients. This prospective, observational study was performed on 25 severe PP and 25 healthy subjects. The body fluids composition was repeatedly assessed using BIS between days 3 to 11 of intensive care unit stay while the impact of fluid intake and balance was evaluated. Fluid intake correlated significantly with fluid excess (FE) in edemas, and their values were significantly higher in comparison with the control group. FE was strongly associated with cumulative fluid balance (p<0.0001; r=0.719). Furthermore, this parameter was associated with the entire duration of mechanical ventilation (p=0.001, r=0.791) independently of injury severity score. In conclusion, BIS measured FE could be useful in PP who already achieved negative fluid balance in prevention the risk of repeated hypovolemia through inappropriate fluid restriction. What is more, measured FE has a certain prognostic value. Further studies are required to confirm BIS as a potential instrument for the improvement of PP outcome.

Pulse check as a tool to raise awareness of atrial fibrillation in pharmacies in the Czech Republic - a pilot project.

OBJECTIVE: The aim of the study was to raise the awareness of atrial fibrillation (AF) and the importance of pulse check in Czech pharmacies as well as to point out further possibilities of developing consulting activities in pharmacies. METHOD: Our project was performed as part of a worldwide campaign during three weeks: Heart Rhythm Week (06/2017) and Atrial Fibrillation Awareness Week (11/2017, 11/2018). Pharmacies actively providing indi-vidual counselling offered manual pulse check to patients aged  40 years without chronic anticoagulant therapy. Whenever high risk of AF was observed, patients were referred to a physician for further evaluation. RESULTS: Pharmacists undertook pulse checks in 187 patients (mean age 59.0 ± 12.3 years; 70.6% women) in 14 participating pharmacies. The most common symptoms were fatigue (42.2%) and palpitations (20.9%), however, 40.6% of patients were asymptomatic. The mean heart rate was 73.2 ± 11.3 beats per minute (min. 51; max. 135) and irregular pulse was observed in 4.3% patients. The average CHA2DS2-VASc score was 2.0 ± 1.3. Eight (4.3%) patients were referred to a physician and in 5 patients (2.7%) the arrhythmia was diagnosed. CONCLUSION: Czech pharmacies have successfully adopted this campaign, are interested in continuity of the project and may thus contribute to raise awareness of AF.

Comet assay and its use for evaluating oxidative DNA damage in some pathological states.

The comet assay, or single-cell gel electrophoresis (SCGE), is a sensitive, rapid, relatively simple and inexpensive method for detecting DNA strand breaks in individual cells. It is used in a broad variety of applications and as a tool to investigate DNA damage and repair. The sensitivity and specificity of the assay are greatly enhanced if the DNA incubated with an enzyme, which recognizes a specific kind of DNA damage. This damage induced by oxidative stress plays a pivotal role in many diseases and in aging. This article is a critical review of the possible application of the comet assay in some pathological states in clinical practice. Most of the studies relate to evaluating the response of an organism to chemotherapy or radiotherapy with statistically significant evidence of DNA damage in patients. Other useful applications have been demonstrated for patients with heart or neurodegenerative diseases. Only a few studies have been published on the use of this method in critically ill patients, although its use would be appropriate. There are also other scenarios where the comet assay could prove to be very useful in the future, such as in predicting the likelihood of certain pathological conditions.

Perinatal immunoglobulin levels in premature and small-for-date infants.

In 100 low-birth-weight newborns divided into a group of prematures with adequate birth weight and a group of antenatal hypotrophics, the immunoglobulins in cord serum and in serum at 5 days were determined. The results are expressed in International Units/ml. A significant increase of IgM as compared with cord blood after 5 days of life was found in both groups. In prenatal hypotrophics insignificantly higher levels of IgM were detected both in cord and in 5-day blood. It could be supposed that the dystrophisation of some small-for-date newborns could result from intrauterine infection.