Outcomes of mechanical ventilation in COVID-19 pregnant patients.

BACKGROUND: Pregnancy poses a risk factor for respiratory infections due to hormonal changes, reduced tolerance to hypoxia, immunodeficiency, and increased susceptibility towards viral infections. Pregnant women might develop a broad spectrum of clinical conditions associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, from asymptomatic to potentially life-threatening complications. Critical respiratory failure associated with the progression of viral pneumonia is the most severe complication of the coronavirus disease (COVID-19). In some cases, it may require intubation and invasive mechanical ventilation. CASE SERIES: In this case series, we evaluated the outcomes and clinical features of eight critically ill pregnant patients requiring invasive mechanical ventilation during treatment. The most commonly observed symptoms were fever at admission to the hospital, cough, difficulty breathing, and fatigue. Less frequently observed were sore throat and loss of smell and taste. All patients had anemia, and hypertension was the second most common comorbidity in pregnancy. Pregnant patients with lethal outcomes were older than those who recovered. They had higher body mass index values, more symptoms at admission, and higher C-reactive protein values and ferritin levels. Acute Respiratory Distress Syndrome (ARDS) was diagnosed in five cases, and none of these patients survived. CONCLUSION: Obesity, maternal age, and diagnosis of ARDS were most commonly observed in our group of patients with lethal outcomes. Preventive measurements, counseling, and enlightenment of potential risk factors, such as obesity, advanced maternal age, and pregnancy-related comorbidities, should be the cornerstones in crises such as COVID-19 when medical care and resources are limited or restricted. HIPPOKRATIA 2022, 26 (1):32-37.

[Second hemorrhage in patients with splenic injuries]. / Dvovremensko krvarenje kod bolesnika sa povredom slezine.

Although the diagnosis of spleen injuries is not a considerable clinical problem today, subsequent ruptures of this organ may occur in a smaller number of patients (2-5% of total proportion of spleen injuries) following the so-called "free interval". Such injuries are most commonly explained by present hematoma localized in the central spleen, which becomes larger in time, and eventually causes its rupture. This form of lesion may be found both in isolated blunt abdominal injuries and in associated injuries. When it is the question of delayed hemorrhage, our results as well as data obtained from foreign literature, suggest three basic rise factors of the etiology of this type of injury. These are as follows: a) spleen injuries in severe trauma or polytrauma, b) older patients (over 65 years of age), and c) in cases when more than a single blood unit had to be administered for the initial hemodynamic stabilization of a patient. Delayed hemorrhage, which is occult in polytraumatized patients since it is frequently "disguised" by severity of clinical picture and traumatic shock, may subsequently cause sudden fall of hemogram and hemodynamic parameter values, and if immediate surgery is not performed, it may lead to heavy bleeding and lethal outcome of the patient.

2S albumin from buckwheat (Fagopyrum esculentum moench) seeds.

Sucrose density gradient centrifugation showed that approximately 30% of total buckwheat proteins migrated with a 2S sedimentation coefficient. The main part of that fraction, polypeptides in the range of molecular mass from 8 to 16 kDa, were water soluble and represented albumins. SDS-PAGE analysis in nonreducing and reducing conditions showed that these polypeptides were not linked by disulfide bonds. The albumins make 25% of total salt soluble proteins, but that content is dramatically reduced under S-deficiency conditions. Determination of amino acid composition showed high methionine (9.2%) and lysine (5.6%) contents. That characteristic offers the possibility of transfer of the genes for individual albumin polypeptides to legumes and cereals limited in those essential amino acids to improve their nutritional quality.

Contribution to the biophysics of the lethal effects of electric field on microorganisms.

The proposed model assumes that the criteria leading to the lethal breakdown of microorganisms suspended in a continuous medium depend on two parameters: (a) the applied electric field must exceed the critical field of membrane to create holes and (b) the Joule energy (deposited in the membrane) must exceed the minimum value beyond which the cell can not recover. The first parameter initiates (reversible) breakdown and the second one, the completion of the (irreversible) electrical breakdown leading to death of the cell. The number of cells surviving the electric field treatment is related to statistical distribution of cell size. Comparison between theory and the experimental results of Kinosita and Tsong (1977); Hülsheger et al. (1980, 1981, 1983); Rosemberg and Korenstein (1990) and others is given.