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131.
Aim
To compare the value of Procalcitonin (PCT) as a marker of surgical site infection to other inflammatory markers, including C-Reactive Protein (CRP), White Cell Count (WCC) and Erythrocyte Sedimentation Rate (ESR) in patients undergoing a number of spinal procedures. This study also aims to describe the biokinetic profile of the above-named markers in patients developing surgical site infection and those remaining infection-free post-operatively.Methods
200 patients undergoing four routine elective spinal procedures were included for analysis. All patients had blood specimens taken at baseline, day 1, 2, 3, 4 and 5 post-operatively for analysis of PCT, CRP, ESR and WCC levels. All patients were monitored for early surgical site infection. Patients with other sources of infection in the early postoperative period were excluded.Results
Procalcitonin was the most sensitive and specific marker for the detection of surgical site infection in the immediate post-operative period with sensitivity and specificity of 100% and 95.2% respectively. Although Procalcitonin is an inflammatory marker, extent of surgical physiological insult did not alter its biokinetics as opposed to the other inflammatory markers making it a valuable marker of infection.Conclusion
Procalcitonin was found to be superior to the other inflammatory markers investigated in this study as a marker for early surgical site infection in patients undergoing spinal surgery. 相似文献132.
Pierachille Santus Angelo Corsico Paolo Solidoro Fulvio Braido Fabiano Di Marco 《COPD》2014,11(6):705-717
The large surface area for gas exchange makes the respiratory system particularly susceptible to oxidative stress-mediated injury. Both endogenous and exogenous pro-oxidants (e.g. cigarette smoke) trigger activation of leukocytes and host defenses. These mechanisms interact in a “multilevel cycle” responsible for the control of the oxidant/antioxidant homeostasis. Several studies have demonstrated the presence of increased oxidative stress and decreased antioxidants (e.g. reduced glutathione [GSH]) in subjects with chronic obstructive pulmonary disease (COPD), but the contribution of oxidative stress to the pathophysiology of COPD is generally only minimally discussed. The aim of this review was to provide a comprehensive overview of the role of oxidative stress in the pathogenesis of respiratory diseases, particularly COPD, and to examine the available clinical and experimental evidence on the use of the antioxidant N-acetylcysteine (NAC), a precursor of GSH, as an adjunct to standard therapy for the treatment of COPD. The proposed concept of “multilevel cycle” helps understand the relationship between respiratory diseases and oxidative stress, thus clarifying the rationale for using NAC in COPD. Until recently, antioxidant drugs such as NAC have been regarded only as mucolytic agents. Nevertheless, several clinical trials indicate that NAC may reduce the rate of COPD exacerbations and improve small airways function. The most plausible explanation for the beneficial effects observed in patients with COPD treated with NAC lies in the mucolytic and antioxidant effects of this drug. Modulation of bronchial inflammation by NAC may further account for these favorable clinical results. 相似文献
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Gabriele Cipriani MD Marcella Vedovello MD Angelo Nuti MD Andrea di Fiorino MD 《Psychiatry and clinical neurosciences》2012,66(6):467-473
Jealousy is a complex emotion that most people have experienced at some time in life; pathological jealousy refers primarily to an irrational state. Othello syndrome is a psychotic disorder characterized by delusion of infidelity or jealousy; it often occurs in the context of medical, psychiatric or neurological disorders. At least 30% of cases in the literature show a neurological basis for their delusion of infidelity, although its biological basis is not fully understood. The purpose of this paper is to examine the phenomenon of pathological jealousy in people with dementia. We searched the electronic databases for original research and review articles on Othello syndrome in demented patients using the search terms ‘Othello syndrome, morbid jealousy, pathological jealousy, delusional disorders, dementia’. Convictions about the partner's infidelities may form the content of psychopathological phenomena, such as delusions. Delusional jealousy is a frequent problem in dementia. Coexistent delusions and hallucinations are frequent. The violence in demented patients suffering from this syndrome is well documented and forensic aspects are highlighted. There are no systematic researches about the clinical characteristics of Othello syndrome in persons suffering from dementia, but only case reports and it is not possible to differentiate or compare differences of delusional jealousy across the various type of dementia or distinguish the syndrome in demented patients from the syndrome in other psychiatric disorders. Frontal lobe dysfunction may be called into question in delineating the cause of the delusional jealousy seen in Othello syndrome. 相似文献
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Fabio Rodi Emmanouil Theodorakis Georgios Touloupakis Angelo Ventura 《中华创伤杂志(英文版)》2016,19(3):156-159
Purpose: The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients.
Methods: Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C (AO classification system), were included. Patients have been followed up for a minimum of 12
months. We assessed callus formation, radiological results, clinical outcome (according to the Constant Shoulder Score System) and complications. Any difference in the clinical recovery among the 2 types of fracture pattern (B and C) was investigated.
Results: The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12
months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the B and C fracture patterns (p > 0.05). We noticed an overall of 5 complications (9.8%). There was no need to revision any of the implants.
Conclusion: Anatomic reduction and proper plate positioning are essential for minimizing implantrelated complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a good clinical recovery with a low rate of complications. 相似文献
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