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111.
ABSTRACT: INTRODUCTION: The Endotoxin Activity Assay (EAA) is a useful test to risk stratify patients with severe sepsis and assess for Gram negative infection. However, the significance of intermediate levels of EAA (0.4-0.59) at the bedside has not been well elucidated. The purpose of this study was to interpret intermediate EAA levels in clinical practice. METHODS: This retrospective observational study included all adult patients with suspected sepsis admitted to our medico-surgical intensive care unit (ICU) in whom EAA was measured from July 2008 to September 2011. Data collected included EAA, white blood cell (WBC) count and differential, C-reactive protein (CRP), procalcitonin (PCT) and bacterial cultures. Data were analyzed by comparative statistics. RESULTS: Two hundred and ten patients were studied. Ninety two (43%) patients had culture documented gram negative infection. Patients with Gram-negative organisms in cultures had significantly higher EAA levels (0.47, IQR 0.27) than those without any Gram-negative organisms in cultures (0.34, IQR 0.22) (p < 0.0001). For patients with intermediate EAA levels (0.40 to 0.59), PCT levels and presence of left shift of WBC significantly differed between patients with Gram negative organisms in their blood or other cultures and those who had no organisms in any of the cultures (4.9 versus 1.7 ng/mL, p < 0.05; 57.9 versus 18.9%, p < 0.0004, respectively). CONCLUSIONS: We confirm that high levels of EAA in our cohort of patients with suspected sepsis are strongly associated with gram negative infection. In those patients with intermediate elevation in EAA levels, use of PCT and WBC differential can provide additional diagnostic value to clinicians at the bedside. 相似文献
112.
Impact of the Charlson comorbidity index and prognostic nutritional index on prognosis in patients with early gastric cancer after endoscopic submucosal dissection
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![点击此处可从《Digestive endoscopy》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Naoto Iwai Osamu Dohi Yuji Naito Yutaka Inada Akifumi Fukui Shun Takayama Kazuyuki Ogita Kei Terasaki Takahiro Nakano Tomohiro Ueda Tetsuya Okayama Naohisa Yoshida Kazuhiro Katada Kazuhiro Kamada Kazuhiko Uchiyama Takeshi Ishikawa Osamu Handa Tomohisa Takagi Hideyuki Konishi Nobuaki Yagi Yoshito Itoh 《Digestive endoscopy》2018,30(5):616-623
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Hiroyasu Uzui Akira Nakano Yasuhiko Mitsuke Toru Geshi Junji Sakata Katsuhiko Sarazawa Tetsuji Morishita Takehiko Satou Kentarou Ishida Jong‐Dae Lee 《Journal of diabetes investigation.》2011,2(2):148-153
Aims/Introduction: Although the improvement of postprandial hyperglycemia by an alpha‐glucosidase inhibitor (α‐GI) has been associated with a risk reduction of cardiovascular events, the relationship between postprandial hyperglycemia and arterial stiffness has not been well understood. We therefore examined whether ameliorating the postprandial state by α‐GI leads to an improvement in arterial stiffness. Materials and Methods: A total of 22 patients with type 2 diabetes mellitus were treated with acarbose. Cardio‐ankle vascular index (CAVI) as the arterial stiffness was measured by using a VaSera CAVI instrument before and 12 months after acarbose treatment. Serum high‐sensitivity C‐reactive protein (hs‐CRP), pentraxin‐3 (PTX3) and matrix metalloproteinase (MMP) ‐2, ‐9 were measured at the same time points. Furthermore, circulating peripheral blood mononuclear cells were examined for the frequencies of CD14 positive cells expressing membrane type‐1 MMP (MT1‐MMP) at the single cell level using flow cytometry. Results: After acarbose treatment, postprandial glucose and glycosylated hemoglobin (HbA1c) were significantly decreased. Serum levels of hs‐CRP, PTX3, MMP‐2 and MMP‐9 were significantly decreased. CAVI showed a significant reduction, although the changes were not significant in blood pressure and heart rate. MT1‐MMP expression was significantly decreased by acarbose treatment. In multivariate analysis, improvement of blood glucose, decrease of PTX3 levels and MT1‐MMP expression were independent predictors of beneficial change in CAVI. Conclusions: The present study showed that the beneficial effects of acarbose on arterial stiffness are mediated by an improvement of postprandial hyperglycemia and vascular remodeling markers. In conclusion, acarbose treatment might reduce the risk of cardiovascular diseases by altering the arterial stiffness in postprandial hyperglycemic status. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00079.x , 2010) 相似文献
114.
Kohei Horimoto Junji Kato Yasuyuki Sumikawa Tokimasa Hida Takafumi Kamiya Sayuri Sato Hitomi Takahashi Masahide Sawada Toshiharu Yamashita Hisashi Uhara 《The Journal of dermatology》2018,45(4):487-490
We examined dermoscopic features of three cases of extraocular sebaceous carcinoma and reviewed the literatures. The yellowish structures, polymorphous vessels and ulceration were common findings in our cases and all cases of the previous reports. The appearance of whitish‐pink areas has not been described previously. Our results suggested that the combination of four dermoscopic features, whitish‐pink areas, yellowish structures, polymorphous vessels and ulceration might be distinctive in extraocular sebaceous carcinoma. 相似文献
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Propensity score‐matched study of laparoscopic and open surgery for colorectal cancer in rural hospitals
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![点击此处可从《Journal of gastroenterology and hepatology》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Toshihiro Nakao Mitsuo Shimada Kozo Yoshikawa Jun Higashijima Takuya Tokunaga Masaaki Nishi Chie Takasu Hideya Kashihara Ichio Suzuka Takashi Nishizaki Hiroshi Okitsu Toshiyuki Yagi Hidenori Miyake Murato Miura Mitsutoshi Fukuyama Daisuke Wada Yoshiaki Bando 《Journal of gastroenterology and hepatology》2016,31(10):1700-1704