European journal of clinical investigation
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Eur. J. Clin. Invest. · May 2013
Soluble urokinase plasminogen activator receptor, C-reactive protein and triglyceride are associated with heart rate variability in non-diabetic Danes.
Heart rate variability (HRV) is associated with an increased risk of cardiovascular morbidity and mortality. HRV is in part a function of the activity of the autonomic nervous system and has been associated with low-grade inflammation. In patients with type 2 diabetes, HRV is decreased and is a predictor of poor outcome. As HRV and its determinants in non-diabetic individuals have not been studied properly, the aim of this observational study was to evaluate possible associations between HRV vs. impaired fasting glucose, insulin resistance, lipidaemia and markers of inflammation and immune activation in these individuals. ⋯ A low HRV is not related to prediabetes, that is, insulin resistance and impaired fasting glucose, but is related to the immune and inflammatory markers suPAR and CRP and plasma triglyceride.
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The relevance of mitochondrial dysfunction as to pathogenesis of multiple organ dysfunction and failure in sepsis is controversial. This focused review evaluates the evidence for impaired mitochondrial function in sepsis. ⋯ Mitochondrial function in sepsis is highly variable, organ specific and changes over the course of sepsis. Patients who will die from sepsis may be more affected than survivors. Nevertheless, the current data from mostly young and otherwise healthy animals does not support the view that mitochondrial dysfunction is the general denominator for multiple organ failure in severe sepsis and septic shock. Whether this is true if underlying comorbidities are present, especially in older patients, should be addressed in further studies.
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Coronary revascularization using percutaneous coronary intervention (PCI) is one of the major treatments for patients with stable coronary artery disease, with approximately 1.5 million patients undergoing PCI in the United States and Europe every year. An important neglected complication of PCI is contrast-induced acute kidney injury (CI-AKI). ⋯ Following PCI, CI-AKI is an overlooked complication which is associated with significant morbidity and mortality. In this article, we review the pathophysiology of CI-AKI in patients undergoing PCI and discuss the potential therapeutic options for preventing it.
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Eur. J. Clin. Invest. · May 2013
ReviewMechanisms of acute exacerbation of respiratory symptoms in chronic obstructive pulmonary disease.
Exacerbations of chronic obstructive respiratory disease (ECOPD) are acute events characterized by worsening of the patient's respiratory symptoms, particularly dyspnoea, leading to change in medical treatment and/or hospitalisation. AECOP are considered respiratory diseases, with reference to the respiratory nature of symptoms and to the involvement of airways and lung. Indeed respiratory infections and/or air pollution are the main causes of ECOPD. ⋯ Most concomitant chronic diseases share with COPD not only the underlying chronic inflammation of the target organs (i.e. lungs, myocardium, vessels, adipose tissue), but also clinical manifestations like fatigue and dyspnoea. For this reason, in patients with multi-morbidity (eg COPD with chronic heart failure and hypertension, etc), the exacerbation of respiratory symptoms may be particularly difficult to investigate, as it may be caused by exacerbation of COPD and/or ≥ comorbidity, (e.g. decompensated heart failure, arrhythmias, thromboembolisms) without necessarily involving the airways and lung. In these cases the term ECOPD is inappropriate and misleading.
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Eur. J. Clin. Invest. · May 2013
Genetic variation in C-reactive protein in ethnic Chinese population in Taiwan.
High-sensitivity C-reactive protein (hs-CRP) is a sensitive inflammatory marker suggested for cardiovascular risk stratification. This study aimed to assess the potential genetic determinants for serum hs-CRP levels in a cohort with well-controlled nondiabetic hypertension. ⋯ C-reactive protein genotype contributed limitedly to serum hs-CRP levels in subjects with well-controlled hypertension, suggesting the impacts of clinical rather than genetic determinants to serum hs-CRP levels for cardiovascular risk stratification in this intermediate-risk Taiwanese cohort.