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31.
Elena Bignami Elena Frati Roberta Meroni Marco Simonini Ambra Licia Di Prima Paolo Manunta Alberto Zangrillo 《Annals of cardiac anaesthesia》2015,18(1):39-44
Background:
NGAL is one of the most promising AKI biomarkers in cardiac surgery. However, the best timing to dose it and the reference values are still matter of discussion.Aim of the Study:
We performed a uNGAL perioperative time course, to better understand its perioperative kinetics and its role in AKI diagnosis.Setting of the Study:
San Raffaele University Hospital, cardiac surgery department.Material and Methods:
We enrolled in this prospective observational study 19 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Based on preoperative characteristics, they were divided in low-risk and high-risk patients. uNGAL measurements were collected at pre-defined times before, during, and up to 24 hours after surgery.Statistical Analysis:
Data were analysed by use of SAS 1999-2001 program or IBM SPSS Statistics.Results:
In low-risk patients, uNGAL had the highest value immediately after general anesthesia induction (basal dosage: uNGAL: 12.20ng×ml-1, IQR 14.00). It later decreased significantly (3.40 ng×ml-1, IQR 4.80; P = 0.006) during CPB, and finally return to its original value 24 hours after surgery. In high-risk patients, uNGAL increased immediately after surgery; it had the highest value on ICU arrival (38,20 ng×ml-1; IQR 133,10) and remained high for several hours. A difference in uNGAL levels between the two groups was already observed at the end of surgery, but it became statistically significant on ICU arrival (P = 0.002).Conclusion:
This study helps to better understand the different kinetics of this new biomarker in low-risk and high-risk cardiac patients. 相似文献32.
Background
REM sleep behavior disorder (RBD) is parasomnia characterized by dream enactment and enabled by disruption of physiological muscle atonia during REM sleep. Over the past few years, diagnostic criteria and the methods used to confirm diagnosis have been updated.Objective
In this review article, the current knowledge regarding RBD diagnosis and treatment is presented.Methods
A selective literature search was carried out.Results and discussion
Although several RBD screening questionnaires have been developed, diagnosis can only be definitely confirmed on the basis of polysomnography. New methods for scoring electromyography (EMG) activity during REM sleep have been proposed during recent years and cutoff values have been established. The latest cutoff values for scoring EMG activity during REM sleep are included in the International Classification of Sleep Disorders (ICSD). The cutoff of 27?% muscle activity during REM sleep suggested by the Sleep Innsbruck Barcelona (SINBAR) group was also included in the third edition of the ICSD. The best-researched treatments for RBD are clonazepam and melatonin.33.
B. Annibale G. Capurso F. Baccini E. Lahner G. DAmbra E. Di Giulio G. Delle Fave 《Digestive and liver disease》2003,35(11):784-787
BACKGROUND: The usefulness of small bowel investigation in iron deficiency anaemia (IDA) patients is controversial. AIM: To evaluate the presence of small bowel lesions likely to cause IDA in patients with unexplained IDA after negative gastroscopy with biopsies and colonoscopy (CS). METHODS: A total of 117 outpatients, referred for unexplained IDA, underwent gastroscopy with biopsies and colonscopy. In 17 (14.5%) patients, endoscopic/histological investigations were negative. Of these patients, 13 underwent small bowel follow-through (SBFT) and if necessary to confirm the diagnosis, further gastrointestinal (GI) investigations. RESULTS: Small bowel lesions likely to cause IDA were found in five (38%) patients. Four of these lesions were detected by SBFT, two of them were malignant. These findings, confirmed at surgery and ileoscopy (IS), led to the final diagnoses ofjejunal and ileal adenocarcinoma, idiopathic ileal ulcers and ileal Crohn's disease. In one case, after negative SBFT, jejunal angiodysplasia was detected by video capsule endoscopy (VCE). Faecal occult blood test (FOBT) was positive in four (31%) patients, all of whom presented lesions likely to cause IDA, detected in three cases by SBFT and in one case by VCE. CONCLUSIONS: This study shows the importance of investigating the small bowel in IDA patients after negative upper and lower GI endoscopy, particularly if FOBT is positive. 相似文献
34.
Scaling root planing (SRP) has been proven efficacious as the traditional treatment approach for chronic periodontitis. However,
important limitations such as difficult access in deep pockets, grooves, and furcations have led to the development of new
therapeutic strategies. The erbium-doped:yttrium-aluminium-garnet (Er:YAG) laser is one of the most promising laser types
for periodontal therapy. Its efficacy in radicular debris removal and root smoothing has been proven in vitro. However, the
clinical effectiveness of the Er:YAG laser remains controversial. The aim of the present systematic review was to systemically
assess the scientific evidence for the effectiveness of Er:YAG laser compared to SRP in the treatment of chronic periodontitis.
Electronic database searches of MEDLINE, Cochrane Controlled Clinical Trial Register, Cochrane Database of Systematic Reviews,
Database of Abstracts of Reviews of Effects, CINAHL, Science Direct, ISI Web of Science, and SCOPUS were performed, as well
as hand-searching of relevant journals through December 23, 2010. Quality assessment was made according to the CONSORT guidelines.
The systematic review was performed according to the QUOROM statement and Cochrane Collaboration recommendations. Meta-analyses
of the clinical attachment level gain, probing depth reduction, and changes in gingival recession were performed using weighted
mean differences for continuous data with 95% confidence intervals, nested in a random effect model. No statistically significant
differences were found in any of the investigated clinical parameters among the five random controlled trials (RCTs) entered
into the study, indicating that there was no evidence of effectiveness. However, significant heterogeneity, a high risk of
bias in three of the five included studies, and methodological shortcomings indicate that the results should be considered
with caution. Future long-term, well-designed RCTs are needed to assess the scientific evidence of Er:YAG laser efficacy as
an alternative treatment strategy to SRP. 相似文献
35.
A Pozzi 《Kidney international》2012,82(5):507-509
Transforming growth factor-β (TGF-β) and phosphatidylinositol-3-kinase (PI3?K) isoforms contribute to glomerular disease. Finer and colleagues define a temporal and selective role for the p110γ catalytic isoform of PI3?K, normally expressed by hematopoietic cells, and TGF-β in adriamycin-mediated glomerular injury. Early ectopic upregulation of p110γ by podocytes drives initial injury and proteinuria, whereas late upregulation of TGF-β drives fibrogenesis. Thus, proteinuria and renal fibrogenesis involve distinct signaling activated by p110γ and TGF-β, respectively. 相似文献
36.
Pierfrancesco Bonfante Luigi D’Ambra Stefano Berti Emilio Falco Massimo Vittorio Cristoni Romolo Briglia 《World journal of gastrointestinal surgery》2012,4(12):289-295
AIM: To verify the clinical results of the endoscopic stenting procedure for colorectal obstructions followed by laparoscopic colorectal resection with “one stage anastomosis”.METHODS: From March 2003 to March 2009 in our surgical department, 48 patients underwent endoscopic stenting for colorectal occlusive lesion: 30 males (62.5%) and 18 females (37.5%) with an age range from 40 years to 92 years (median age 69.5). All patients enrolled in our study were diagnosed with an intestinal obstruction originating from the colorectal tract without bowel perforation signs. Obstruction was primitive colorectal cancer in 45 cases (93.7%) and benign anastomotic stricture in 3 cases (6.3%).RESULTS: Surgical resection was totally laparoscopic in 69% of cases (24 patients) while 17% (6 patients) of cases were video-assisted due to the local extension of cancer with infiltrations of surrounding structures (urinary bladder in 2 cases, ileus and iliac vessels in the others). In 14% of cases (5 patients), resection was performed by open surgery due to the high American Society of Anesthesiologists score and the elderly age of patients (median age of 89 years). We performed a terminal stomy in only 7 patients out of 35, 6 colostomies and one ileostomy (in a total colectomy). In the other 28 cases (80%), we performed bowel anastomosis at the same time as resection, employing a temporary ileostomy only in 5 cases.CONCLUSION: Colorectal stenting transforms an emergency operation in to an elective operation performable in a totally laparoscopic manner, limiting the confection of colostomy with its correlated complications. 相似文献
37.
Maria C. Susini Paola Guglielmelli Ambra Spolverini Flavia Biamonte Carmela Mannarelli Giovanni Barosi Katerina Zoi Andreas Reiter Andrew Duncombe Francisco Cervantes Mario Cazzola Nick Cross Alessandro M. Vannucchi the Associazione Italiana per la Ricerca sul Cancro Gruppo Italiano Malattie Mieloproliferative Investigators 《British journal of haematology》2013,162(3):424-427
This study prospectively compared the effect of secondary prophylaxis to episodic treatment on target joint (TJ) range of motion (ROM), number of joint haemorrhages and new TJ development in patients with moderate or severe haemophilia. Two‐hundred and eighty‐six males, 17% in prophylaxis, 83% in episodic treatment group, participating in the Centers for Disease Control and Prevention's Universal Data Collection project, fulfilled inclusion criteria: age >2 years at enrolment, free of TJs at enrolment, developed at least one TJ after enrolment, and received either prophylaxis or episodic treatment continuously for two follow‐up visits after TJ development. The outcomes of interest – percentage change in TJ ROM, number of joint haemorrhages and new TJ development, were modelled using multivariate linear, Poisson and logistic regression techniques respectively. Individuals who received secondary prophylaxis in comparison to episodic treatment were younger at TJ development (P < 0·01); there was no difference in the decrease in TJ ROM between the two groups (P = 0·9). Factors significantly associated with a higher rate of haemarthroses included episodic treatment, severe haemophilia, age >5 years at TJ development, obesity and inhibitor negative status. Secondary prophylaxis significantly decreased haemarthroses but was not associated with a significant improvement in TJ ROM or with new TJ development. 相似文献
38.
The authors present a patient with hypertrichosis lanuginosa acquisita without associated malignancy. 相似文献
39.
40.
Potenza L Vallerini D Barozzi P Riva G Forghieri F Zanetti E Quadrelli C Candoni A Maertens J Rossi G Morselli M Codeluppi M Paolini A Maccaferri M Del Giovane C D'Amico R Rumpianesi F Pecorari M Cavalleri F Marasca R Narni F Luppi M 《Blood》2011,118(20):5416-5419
Mucorales-specific T cells were investigated in 28 hematologic patients during the course of their treatment. Three developed proven invasive mucormycosis (IM), 17 had infections of known origin but other than IM, and 8 never had fever during the period of observation. Mucorales-specific T cells could be detected only in patients with IM, both at diagnosis and throughout the entire course of the IM, but neither before nor for long after resolution of the infection. Such T cells predominantly produced IL-4, IFN-γ, IL-10, and to a lesser extent IL-17 and belonged to either CD4(+) or CD8(+) subsets. The specific T cells that produced IFN-γ were able to directly induce damage to Mucorales hyphae. None of the 25 patients without IM had Mucorales-specific T cells. Specific T cells contribute to human immune responses against fungi of the order Mucorales and could be evaluated as a surrogate diagnostic marker of IM. 相似文献