European journal of medical research
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Randomized Controlled Trial Comparative Study Clinical Trial
Hemofiltration does not influence early S-100B serum levels in septic shock patients receiving stress doses of hydrocortisone or placebo.
The prognosis in patients with hyperdynamic septic shock correlates with the presence and the severity of septic encephalopathy. However, the neurological evaluation is considerably influenced by the use of analgesia sedation during mechanical ventilation. An early concentration peak of the neuroprotein S-100B in serum reflects both cellular damage at an increased permeability of the blood-brain-barrier and a delayed renal elimination. Thus, the objective of this study was to analyze the effect of continuous veno-venous hemofiltration (CVVH) on early S-100B serum levels in septic shock patients, who were treated with either stress doses of hydrocortisone or placebo. ⋯ Early S-100B serum levels in septic shock patients receiving either stress doses of hydrocortisone or placebo were not influenced by CVVH. For the first time, we observed a similar extent of S-100B serum increase in CVVH patients, who had significantly higher S-100B serum values compared to those without CVVH, as reported for out-of-hospital cardiac arrest or severe traumatic brain injury. Hypercortisolemia induced by the infusion of stress doses of hydrocortisone did not significantly reduce early S-100B serum concentrations with time.
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The aim of this study was to perform a realistic visualization of the auditory and vestibular system using volume data sets from high-resolution computed tomography (HR-CT) and high-resolution magnetic resonance imaging (HR-MRI). - In 10 patients with conductive and/or sensorineural hearing loss, vertigo and tinnitus, HR-CT and HR-MRI of the petrous bone were performed consecutively. CT was performed with a 16-slice computed tomography scanner using a high spatial resolution. MRI was performed with a 3.0 Tesla scanner using a three-dimensional-constructive interference in steady state (3D-CISS) gradient-echo, and T2-weighted, unenhanced and gadolinium (GD)-enhanced T1-weighted turbo spin-echo sequences. ⋯ Finally, both shaded-surface rendered models were superimposed semi-automatically using a commercial available software program to visualize the auditory and vestibular system. - The representation of the middle and inner ear structures with image fusion of HR-CT and HR-MRI takes advantage of both the high bony contrast of HR-CT and the high soft tissue contrast discrimination and sensitivity to fluids of HR-MRI, as well as the high spatial resolution of both modalities. In comparison to the fused axial CT/MRI, the images of 3D CT/MRI fusion facilitates a clear representation and better spatial orientation. - The middle and inner ear consists of bony structures, soft tissue structures and fluid-filled spaces. For this reason, the image fusion of volume data sets from HR-CT and HR-MRI allowed an optimized and realistic visualization of the auditory and vestibular system.