JAP Volume 7 Issue 1 News
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editor@japractice.com Big risk for little lungs
during which rapid airway and lung growth would normally occur, we hope to understand how the developing airway is particularly susceptible to cigarette smoke with the goal of developing interventions to prevent downstream problems such as asthma and bronchopulmonary dysplasia,” said Dr Vogel. The human foetal airway smooth muscle cells of deceased 18-to-
20-week human foetuses were exposed to various levels of cigarette smoke. Gel analysis was used to determine changes in caveolae and their proteins, cell proliferation and death. Changes in the level of calcium were examined using fluorescent Ca2+
sensitive dyes and
Foetuses and premature babies exposed to cigarette smoke are at a greater risk of developing childhood respiratory diseases, such as asthma. Research presented at the ANESTHESIOLOGY 2012 annual meeting revealed cigarette smoke adversely affects the developing human airway, especially in prematurity.
“Due to their highly immature lungs, premature babies often require high levels of additional oxygen in the neonatal intensive care unit, which can put these babies at higher risk for life-long problems with lung diseases,” said study author Elizabeth Vogel, M.D., Department of Anaesthesiology, Mayo Clinic, Rochester, Minn. Additional exposure to second-hand smoke in the home often
precipitates further respiratory problems and possible return trip(s) to the ICU. “By examining human foetal airway cells from gestational ages
Rise in sepsis mortality in pregnant women
Severity and death rates are increasing in pregnant and postpartum women with sepsis, and more than 30 percent of mothers who develop sepsis will experience some type of organ dysfunction. In the UK, maternal deaths related to sepsis are increasing, and
it is currently one of the leading causes of death in pregnant or postpartum women. “The importance of this research is that it helps define the
problem of sepsis during pregnancy,” said Melissa E. Bauer, D.O., University of Michigan, Department of Anaesthesiology. “The more we know about this disease, the more we will be able to do to help prevent, diagnose and treat it.” To determine the incidence, severity of the disease in those
affected, quantify how many deaths are related to sepsis, and determine risk factors for sepsis, the study used a database representing 44 million patients over 11 years. The results of the study, presented at the ANESTHESIOLOGY
2012 annual meeting, revealed: • The incidence of sepsis is approximately 1:3,300 during hospitalisation for childbirth
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• An estimated 1:10,000 deliverieswill be complicated by sepsis, leading to organ system dysfunction
• About 1:100,000will die fromsepsis during hospitalisation for childbirth
Identifying risk factors for sepsis is an important process to help guide physicians to more closely monitor those at an elevated risk. Certain conditions may be associated with an elevated risk for sepsis, including medical conditions such as chronic congestive heart failure, chronic liver disease, chronic kidney disease, lupus and HIV. All women, especially women with these conditions, should be educated about the signs of infection and precautions to take. “Pregnant patients are at a higher risk for infection than the general
population,” added Dr Bauer. “The most common infections that may be causing these severe infections are urinary tract infections, pneumonia and chorioamnionitis (infection of the membranes and amniotic fluid). As infection worsens, it could lead to sepsis.” Clinical signs of sepsis include low temperature, fever, rapid heart
rate, low blood pressure, rapid breathing rate, low oxygen level, changes in mental status and decreased urine output.
real-time microscopic imaging. Cells exposed to cigarette smoke had increased levels of calcium and caveolar proteins, similar to the effects of inflammation in asthma. Even low levels of cigarette smoke increased markers of cell proliferation, while higher smoke levels caused cell death. These results indicate that the detrimental effects of cigarette
smoke are caused, at least in part, by altered caveolar signaling in developing airway smooth muscle cells. Increased caveolar proteins, calcium and cell proliferation can make the airways thicker and more responsive to bronchoconstrictors, thus increasing airway contractility, making it more difficult for the baby to breathe. Such detrimental changes would be only more problematic in premature babies with an immature respiratory system and weak chest walls. The authors report that future studies will rely on a combination of human cell-based work and appropriate animal models to gain a better understanding of how cigarette smoke influences the developing airway.
Copyright © Igor Korionov – Fotolia
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