Prediction of hospital outcome in septic shock: a prospective comparison of tissue Doppler and cardiac biomarkers

Introduction  

Diastolic dysfunction as demonstrated by tissue Doppler imaging (TDI), particularly E/e' (peak early diastolic transmitral/peak early diastolic mitral annular velocity) is common in critical illness. In septic shock, the prognostic value of TDI is undefined. This study sought to evaluate and compare the prognostic significance of TDI and cardiac biomarkers (B-type natriuretic peptide (BNP); N-terminal proBNP (NTproBNP); troponin T (TnT)) in septic shock. The contribution of fluid management and diastolic dysfunction to elevation of BNP was also evaluated.     

Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and withoutHelicobacter pylori infection

Fasting antroduodenal motor activity was studied in 15 dyspeptic patients with chronic superficial antral gastritis andHelicobacter pylori infection (group A), 10 dyspeptic patients with chronic superficial antral gastritis withoutHelicobacter pylori infection (group B), and eight healthy control subjects (group C) by manometric recording of phases of the interdigestive migrating motor complex (MMC) prolonged over 240 min. A significantly lower incidence of activity fronts (phase III of MMC) starting from the antrum was observed in patients with gastritis andHelicobacter pylori infection vs patients without bacterial colonization (P=0.013) and in these latter vs control subjects (P=0.013). Likewise, the overall number of activity fronts was smaller in patients with gastritis than in healthy subjects (P=0.034). Symptomatic evaluation was performed in the two groups of dyspeptic patients, without detecting any differences in frequency and severity of complaints. Our results show a significant reduction in the occurrence of interdigestive antral phase III of MMC in chronic gastritis associated withHelicobacter pylori infection, suggesting a possible relationship between fasting motility and bacterial colonization.     

Occupational exposure to lead--granulometric distribution of airborne lead in relation to risk assessment.

The amount of airborne lead absorbed by the body during occupational exposure depends not only on lead concentration in workplace air, but also on the granulometric distribution of the aerosol. The Occupational Safety and Health Administration (OSHA) set the lead Permissible Exposure Limit (PEL) at 50 micrograms/m3 on the basis of Bernard's model and a number of assumptions, including assumption "C", which predicts that the first 12.5 micrograms/m3 are made up of fine particles (aerodynamic diameter < 1 micron) whereas the remaining 12.5 micrograms/m3 consist of particles > 1 micron. Occupational exposure to airborne lead at a concentration of 50 micrograms/m3 and a granulometric distribution calculated according to the above mentioned assumption, leads, in the model, to a mean blood level of 40 micrograms/dl. In the present study, we tested the validity of assumption "C" in the environmental air of a factory that manufactured crystal glassware containing 24% lead oxide. An 8-stage impactor was used to measure the particle size of airborne dust collected from personal and area samplings. Results indicate that, on the whole, assumption "C" cannot be considered valid in the work environment investigated in this study. As a result, lead absorption levels in exposed workers may be noticeably different from those predicted by the OSHA model. We therefore suggest that in order to make a correct evaluation of the risk of occupational exposure to lead, it is essential to integrate total airborne lead concentration with a measurement of the granulometric distribution of the aerosol.     

Rare digestive hemorrhage caused by diverticular pathology of the small intestine

The Authors report two cases of digestive hemorrhage secondary to diverticulosis of the small intestine. The incidence of this pathology in an overall population of 215 digestive hemorrhages was 0.9%. A clinical identity-kit is drawn of patients affected by jejunal diverticulosis, and the most important and characteristic anamnestic manifestations are defined. The most statistically significant complication is hemorrhage which was observed in 33% of cases. Clinical manifestations of hemorrhage are defined as variable and "bizarre", since they may appear as hematemesis, melena or enterorrhagia. The surgical procedure for radical definitive and prophylactic therapy is segmentary resection of the jejunum affected by pseudodiverticulosis.     

In vitro anti-inflammatory activities of blacklip abalone (Haliotis rubra) in RAW 264.7 macrophages

Abalone (Haliotis sp) has been used as a traditional functional food for many years by different cultures believing that consumption provides health benefits. We investigated the anti-inflammatory activity from blacklip abalone visceral waste. An extract was prepared from the viscera using digestion with the food grade proteases papain and bromelain followed by anion exchange chromatography (AEC). The anti-inflammatory potential of the extract and AEC fractions were investigated in comparison to a plant-derived positive control (quercetin) through the inhibition of lipopolysaccharide-stimulated nitric oxide production in RAW 264.7 monocytes. Significant anti-inflammatory activity was observed in response to the abalone extract and the unbound AEC material over a concentration (based on collagen) range of 12–96?µg/mL. Overall, results indicated that blacklip abalone extract has anti-inflammatory activity in vitro, warranting further investigation into the bioactive constituents that may be potential anti-inflammatory therapeutics.