Cir Cir
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Multicenter Study Clinical Trial
[Cosyntropin test in severe active tuberculosis].
Frequency of adrenal insufficiency in patients with tuberculosis varies from 0 to 58%; however, all published series excluded severely ill patients. Our objective was to investigate adrenal insufficiency with the low-dose cosyntropin test in patients with severe active tuberculosis. ⋯ Adrenal insufficiency is frequent in severe active tuberculosis. The efficacy and security of supplemental steroid treatment in severe active tuberculosis should be established by a randomized clinical trial.
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Review Case Reports
[Malignant neoplasm in burn scar: Marjolin's ulcer. Report of two cases and review of the literature].
Marjolin's ulcer forms part of a group of neoplasms that originate in a burn scar, a phenomenon associated with superficial tissue trauma. The frequency of Marjolin's ulcer is low and represents between 2 and 5% of all squamous cell carcinomas of the skin. This condition is found three times more frequently in men than in women and is thought to be more aggressive than conventional squamous cell carcinoma of the skin. ⋯ Marjolin's ulcer usually occurs in old burn sites that were not skin grafted and were left to heal secondarily. Although it is believed that there is a latency period of 25-40 years after burn injury before the occurrence of malignancy, this may occur in a period as short as 3 months. Recurrence after radical surgery is 14.7%. Nonetheless, because of the aggressive behavior of this type of cancer, appropriate radical treatment allows an adequate control of the disease. Early grafting of the burn site can prevent the formation a malignant neoplasm. This condition should be suspected in a non-healing chronic ulcer on a burn scar.
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Comparative Study
[Exogenous nitric oxide donor in the liver inflammatory and hemodynamic response after hemorrhagic shock].
Hemorrhagic shock (HS) results in oxidative stress to cells and in the induction of the inflammatory response, with an increased expression of a number of proinflammatory mediators and cytokines. We tested the ability of the nitric oxide (NO) donor sodium nitroprusside (NP) to reduce tissue injury in a rodent model of uncontrolled hemorrhagic shock. ⋯ These data suggest that excess NO mediates hemorrhage-induced liver injury, and that the suppression of NO with NP may reduce the pathological consequences of severe hemorrhage, possibly by scavenging superoxide (O(2)(-)), thus limiting the production of more aggressive radicals.