Infection
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In this prospective study the Glasgow Coma Scale (GCS) score was evaluated in 107 critically ill infectious disease (ID) patients admitted to the Intensive Care Unit (ICU) during a 1-year period. Patients were separated into two groups: those affected by central nervous system (CNS) infections and those affected by infections other than of the CNS. ⋯ Univariate logistic regression analysis confirmed a significant relationship between the first ICU day GCS score and the subsequent ICU mortality in the group of patients with CNS infections (r = 0.3152, p = 0.0015) but not in the group with infections not affecting the CNS (r = 0.0919, p = 0.1106). Our preliminary results suggest that the prognostic value of the GCS score is valid only in patients with CNS infections but not in other ID patients.
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Two different receptors exist for tumor necrosis factor-alpha (TNF-alpha), designated as p55 (TNF-RI) and p75 (TNF-RII). Soluble (= s) forms of TNF-Rs are secreted after proteolytic cleavage and block the effects of TNF-alpha. sTNF-RI, sTNF-RII and the soluble interleukin 2 receptor (sIL-2R) were determined by ELISA in serum samples of HIV-infected children and adolescents. Twelve children with vertical HIV infection (mean age +/- SD, 5.9 +/- 3.8 years) and 17 horizontally infected patients (16.1 +/- 7.3 years) were classified according to the revised CDC criteria. ⋯ There were no differences in soluble receptor levels between vertical or horizontal transmission. Surprisingly, no significant differences for sTNF-RI, sTNF-RII and sIL-2R occurred when 19 patients in stage CDC I were compared to ten patients in stages II or III. The clearly elevated sTNF-RII levels in patients with horizontal and vertical HIV infection indicate the activation of the monocyte/macrophage system in both groups.