Medical science monitor : international medical journal of experimental and clinical research
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The activation of various cytokines, e.g. TNFalpha, IL-1 and/or IL-6, may play an important role in the pathogenesis of renal vasculitis and lupus nephritis (LN). The systemic effect of these cytokines may be modulated by their circulating soluble receptors. The plasma levels of cytokine receptors may thus also be markers of the activation of these cytokines. ⋯ While increased plasma levels of TNFalpha may be a nonspecific marker of the activity of ANCA-positive renal vasculitis and LN, plasma levels of sTNF-RII are also increased in patients with ANCA-positive renal vasculitis in remission. Increased plasma levels of sTNF-RII may inhibit the systemic effects of TNFalpha, but may also prolong the half-life of its active form. Plasma levels of sIL-6R are increased both in ANCA-A and in LN, but their increase is much less pronounced than that of sTNF-RII and cannot effectively block the systemic effects of IL-6.
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The aim of the study was to compare autopsy findings with antemortem findings in children who died in a pediatric intensive care unit. ⋯ Our findings support the importance of autopsy assessment in the pediatric intensive care setup. We believe that postmortem examination is also essential for improving the quality of pediatric patient care.
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Continuous determination of cardiac output (CO) by transpulmonary thermodilution calibrated pulse-contour analysis is gaining clinicical acceptance. However there is doubt, whether this method is reliable in hemodynamic instable patients. We compared pulse-contour analysis to thermodilution in patients with profound changes of CO. ⋯ CO measurement by arterial pulse-contour analysis is reliable even in patients with profound changes of CO or during hemodynamic instability.
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The purpose of the present study was to evaluate the influence of infiltration anesthesia of the projected line of incision in the skin of head on the hemodynamic response of the circulatory system, and the essential dose of opioids in 100 patients who underwent craniotomy. ⋯ Infiltration anesthesia of the projected line of skin incision in the head enabled maintenance of stability in the circulatory system and lower doses of opioids administered before commencing surgery.
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Cardiac troponins are sensitive and specific markers for the detection of minor myocardial injury. However, they have been rarely used to monitor myocardial injury after coronary stenting. The purpose of the study was to measure cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels after apparently successful percutaneous transluminal coronary angioplasty (PTCA) with or without coronary stenting and to compare their results with serum creatine kinase (CK) and its isoform, creatine kinase-MB (CKMB). ⋯ In conclusion, cTnI was a very sensitive marker in detecting minor myocardial injury after coronary angioplasty with or without stenting. The frequency of increased serum levels of cardiac troponins was higher in patients undergoing stent implantation than in those treated with angioplasty alone but did not reach significance. Side branch occlusion may have accounted for some, but not all, periprocedural minor myocardial injury in the stent group.