Critical care medicine
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Critical care medicine · Jan 2002
Case ReportsLate diagnosis of ornithine transcarbamylase defect in three related female patients: polymorphic presentations.
To describe three female patients of one family with different phenotypes of the same mutation of the ornithine transcarbamylase gene. X-linked inherited ornithine transcarbamylase deficiency is the most frequent urea cycle disorder. Many of the hemizygous males die during the neonatal period. Women, who are mostly healthy carriers, can also develop symptomatic hyperammonemia. ⋯ Diagnosis of urea cycle disorder should be considered in any patient with unexplained neurologic and psychiatric disorders with selective anorexia, even in adulthood. Unexplained coma with cerebral edema and respiratory alkalosis requires urgent measurement of ammonemia and metabolic work-up.
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Critical care medicine · Jan 2002
Overexpression of Bcl-2 in the intestinal epithelium improves survival in septic mice.
The aim of this study was to determine whether decreasing intestinal epithelial apoptosis in sepsis would alter mortality rates. The roles of the antiapoptotic protein Bcl-2 and the "executioner" protease caspase-3 in sepsis-induced gut cell death also were evaluated. ⋯ Decreasing intestinal epithelial cell death via overexpression of Bcl-2 improves survival in septic mice. The gut may play a central role in the pathophysiology of sepsis.
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Critical care medicine · Jan 2002
Anti-ovine interleukin-1beta monoclonal antibody immunotherapy in an ovine model of gram-negative septic shock.
To investigate the efficacy of an anti-ovine interleukin-1beta monoclonal antibody to ameliorate pathophysiological derangements and improve survival in an ovine model of gram-negative septic shock. ⋯ Adjunctive therapy with anti-ovine interleukin-1beta monoclonal antibody in ovine gram-negative septic shock was associated with improved hemodynamic performance. However, the beneficial effects were incomplete and survival was not significantly improved.
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Critical care medicine · Jan 2002
Randomized Controlled Trial Multicenter Study Clinical TrialRandomized, placebo-controlled trial of lisofylline for early treatment of acute lung injury and acute respiratory distress syndrome.
To determine whether the administration of lisofylline (1-[5R-hydroxyhexyl]-3,7-dimethylxanthine) would decrease mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). ⋯ In this study, there was no evidence that lisofylline had beneficial effects in the treatment of established ALI/ARDS.
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Critical care medicine · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialRandomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs. 7 days.
To determine whether extended use (7 days) would affect the efficiency on heat and water preservation of a hydrophobic condenser humidifier as well as the rate of ventilation-acquired pneumonia, compared with 1 day of use. ⋯ Changing the studied hydrophobic HME after 7 days did not affect efficiency, increase resistance, or altered bacterial colonization. The frequency rate of ventilation-acquired pneumonia was also unchanged. Use of HMEs for > 24 hrs and up to 7 days is safe.