The American journal of the medical sciences
-
Review Meta Analysis
The role of TNF-α 308G>A polymorphism in the risk for ischemic stroke.
Stroke is a common health problem; however, its pathogenesis is not clear. Several studies have examined the association of -308G>A promoter polymorphism in the tumor necrosis factor-α gene (TNF-α) with ischemic stroke susceptibility. However, the results of these studies are inconsistent and the sample sizes of most of the studies were small. Thus, a meta-analysis was conducted to provide a more robust estimate of the effect of the TNF-α 308G>A polymorphism on the risk for ischemic stroke. ⋯ This study suggests that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke, whereas it is a protective factor for ischemic stroke in Asians and the adult population. However, in the overall analysis and in Caucasians, a significant association was not found.
-
Oxidative stress has been implicated in the pathogenesis of cardiovascular disorders, including atherosclerosis. In pharmacological doses, niacin (vitamin B3) was proven to reduce total cholesterol, triglyceride, very-low-density lipoprotein, and low-density lipoprotein levels, and to increase high-density lipoprotein (HDL) levels. The aim of this study was to evaluate the effect of niacin treatment in patients with low levels of HDL cholesterol (HDL-C; <40 mg%) on their lipid profile and oxidative stress status. ⋯ Although serum CRP levels were not affected by niacin treatment, a correlation between CRP and HDL levels was obtained when computing the results. Niacin treatment in hypercholesterolemic patients with low HDL levels caused a significant decrease in their oxidative stress status. These results indicate an additional beneficial effect of niacin beyond its ability to affect the lipid profile.
-
Chronic obstructive pulmonary disease (COPD) causes a high rate of morbidity worldwide and predicting a bacterial cause of an exacerbation of COPD is difficult. ⋯ In adult patients with symptoms of AECOPD, an elevated serum CRP level of >19.6 mg/L indicates bacterial exacerbation. In patients with AECOPD with mucoid sputum, an elevated CRP level of >15.21 mg/L indicates bacterial infection, which may be a useful clinical marker for therapy of this disease.
-
The relative effectiveness of anticoagulation strategies during continuous renal replacement therapy (CRRT) may vary according to the clinical circumstances. In this study, the case of a 46-year-old man who developed fungal mediastinitis with the pathogen Scedosporium prolificans after coronary bypass surgery is reported. Numerous debridements and multiple antifungal agents were not effective in this patient. ⋯ Argatroban anticoagulation was started without further ECC clotting, and the patient recovered from both acute kidney injury and septic shock, despite continued miltefosine administration. Sepsis may contribute to recurrent ECC clotting. Argatroban, a direct thrombin inhibitor, had a disproportionate effectiveness to maintain ECC patency in this patient.