Annals of clinical and laboratory science
-
Ann. Clin. Lab. Sci. · Jan 2008
Influence of Nrf2 genotype on pulmonary NF-kappaB activity and inflammatory response after traumatic brain injury.
Inflammatory response plays an important role in the pathogenesis of acute lung injury (ALI) after traumatic brain injury (TBI). Nuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcription factor that plays a crucial role in cytoprotection against inflammation. The present study explored the influence of Nrf2 genotype on the production of cytokines and on activation of transcription factors in a murine TBI model. ⋯ Nrf2 (-/-) mice were shown to have a greater increase in the lung wet/dry weight ratio compared to their wild-type Nrf2 (+/+) counterparts after TBI. This exacerbation of lung injury in Nrf2 (-/-) mice was associated with increased levels of TNF-alpha, IL-1beta, IL-6, ICAM-1, and their mediator, NF-kappaB. The results suggest that Nrf2 plays an important protective role in attenuating the pulmonary inflammatory response and NF-kappaB activation after TBI.
-
Ann. Clin. Lab. Sci. · Jan 2008
Non-anion gap acidosis in asthma: clinical and laboratory features and outcomes for hospitalized patients.
Metabolic acidosis secondary to lactic acidosis may occur in acute, severe asthma and its presence suggests that respiratory muscle fatigue and tissue hypoxia play a major part in the pathogenesis. Non-anion gap metabolic acidosis (NAG acidosis) has also been reported in acute asthma but its impact on the clinical outcome has not been evaluated. The objective of this study was to evaluate the prevalence of NAG acidosis, characterize the laboratory findings, and determine its impact on clinical outcomes. ⋯ NAG acidosis was associated with a statistically significant (p = 0.028) risk of requirement for mechanical ventilation necessitating admission to the Medical Intensive Care Unit (MICU); the odds ratio for intubation for NAG acidosis compared to other groups was 3.92. No difference, however, was detected in overall length of stay (LOS) in hospital for patients with NAG acidosis vs the other groups. NAG metabolic acidosis in acute asthma may be more prevalent than expected and may be associated with more frequent need for mechanical ventilation and admission to an intensive care unit.
-
Ann. Clin. Lab. Sci. · Jan 2008
Progesterone administration modulates TLRs/NF-kappaB signaling pathway in rat brain after cortical contusion.
This study investigated whether progesterone administration modulates toll-like receptors (TLRs) and the nuclear factor-kappa B (NF-kappaB) signaling pathway in the injured rat brain following traumatic brain injury (TBI). Right parietal cortical contusion was made by a weight-dropping method. Male rats were given 0 or 16 mg/kg injections of progesterone at postinjury hr 1 and 6 and on days 1, 2, 3, 4, and 5. ⋯ Administration of progesterone following TBI down-regulates the cortical levels of these agents related to the TLRs/NF-kappaB signaling pathway. After progesterone administration, apoptotic TUNEL-positive cells in the injured brain were significantly decreased. In summary, post-TBI progesterone administration attenuates the TLRs/NF-kappaB signaling pathway in injured rat brain, and this may be a mechanism whereby progesterone improves the outcome following TBI.
-
Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsCase report: spontaneous splenic rupture during acute parasitemia of Babesia microti.
Babesia is a malaria-like protozoan parasite spread by Ixodes ticks primarily from the white-footed deer mouse to humans. Typically it causes subclinical disease, but occasionally causes acute febrile disease with hepatosplenomegaly. We report a case of spontaneous splenic rupture of a 56-yr-old man with acute Babesia microti infection.
-
Ann. Clin. Lab. Sci. · Jan 2007
Clostridium difficile infection in an urban medical center: five-year analysis of infection rates among adult admissions and association with the use of proton pump inhibitors.
C. difficile-associated diarrhea (CDAD) has become a major cause of morbidity in hospitalized patients. In this study of five-year (2001-2005, inclusive) trends of incidence of CDAD among adults in an inner-city medical center, the overall annual incidence increased from 5.08 to 8.42 cases/10(3) admissions (p = 0.0005). Age distribution remained fairly constant for 2001-2004 but decreased significantly in 2005 (p = 0.005); no significant change was observed for gender. ⋯ After controlling for the effect of antibiotic use, PPI either pre- or during admission was associated with CDAD (odds ratio, OR (adjusted) = 2.75, 95% CI = 1.68 to 4.52; p = 0.0001); the association with H2A was not significant (OR (adjusted) = 0.95, 95% CI = 0.39 to 2.34; p = 0.9153). If only first-time use during hospital stay is considered, PPI were also strongly associated with CDAD (OR (adjusted) = 1.88, 95% CI: 1.07 to 3.31; p = 0.0283) and H2A were not associated with CDAD (OR (adjusted) = 0.73, 95%CI: 0.26 to 2.06; p = 0.5520). These data suggest that the widespread prescription of PPI for stress ulcer prophylaxis in acute care facilities may contribute to the increased incidence of CDAD.