The clinical investigator最新文献_第8页

Elevation of intracranial pressure in acute AIDS-related cryptococcal meningitis. 急性艾滋病相关隐球菌性脑膜炎的颅内压升高。

The clinical investigator Pub Date : 1994-12-01 DOI: 10.1007/BF00577748

R Malessa, M Krams, U Hengge, C Weiller, V Reinhardt, L Volbracht, F Rauhut, N H Brockmeyer

{"title":"Elevation of intracranial pressure in acute AIDS-related cryptococcal meningitis.","authors":"R Malessa, M Krams, U Hengge, C Weiller, V Reinhardt, L Volbracht, F Rauhut, N H Brockmeyer","doi":"10.1007/BF00577748","DOIUrl":"https://doi.org/10.1007/BF00577748","url":null,"abstract":"Prior to the AIDS-era, elevation of intracranial pressure was known to be a typical complication of cryptococcal meningitis associated with an increased risk of early death. In AIDS-patients, however, the prevalence and clinical significance of this complication are as yet unclear. We analysed clinical features and courses, CSF findings, serological results and neuroimaging scans in acute cryptococcal meningitis in eight patients with AIDS. Five showed symptoms and signs compatible with raised intracranial pressure, which was life-threatening in one and the most probable cause of death in another. Serial monitoring of intracranial pressure together with repeated CSF analysis revealed that severe intracranial pressure elevation in AIDS related cryptococcal meningitis can occur in spite of effective antimycotic treatment, does not depend on an increased CSF/serum osmolality ratio or CSF overproduction and can be associated with normal cranial computed tomography and magnetic resonance imaging findings. Our data support the hypothesis that CSF reabsorption failure plays the crucial role in the pathophysiological mechanism. External lumbar drainage may be of benefit in selected cases of acute AIDS related cryptococcal meningitis with persisting life threatening elevation in intracranial pressure and normal computed tomogram.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00577748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18712684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Volumes and Na+/H+ antiporter activity of lymphocytes in patients with congestive heart failure. 充血性心力衰竭患者淋巴细胞体积和Na+/H+抗转运蛋白活性的变化。

The clinical investigator Pub Date : 1994-12-01 DOI: 10.1007/BF00577741

M Christ, V Klauss, W Pliml, K Theisen, M Wehling

{"title":"Volumes and Na+/H+ antiporter activity of lymphocytes in patients with congestive heart failure.","authors":"M Christ, V Klauss, W Pliml, K Theisen, M Wehling","doi":"10.1007/BF00577741","DOIUrl":"https://doi.org/10.1007/BF00577741","url":null,"abstract":"Previous studies in patients with congestive heart failure (CHF) treated with diuretics and/or digoxin have shown abnormalities of cellular volume and electrolytes in biopsies of skeletal muscle. These abnormalities seem to play an important role with regard to the dysregulation of peripheral vascular resistance and characteristic clinical features of CHF, for example, muscular weakness. This study assessed the effect of angiotension-converting enzyme (ACE) inhibitor therapy on cell volume and cell volume regulation in patients with CHF. Cell diameters of human mononuclear leukocytes (HML) were determined electronically by a Coulter Counter. Cell diameters for 19 patients with decreased left ventricular ejection fraction (determined via levocardiography) on therapy with ACE inhibitors (group 1) were compared to those of HML from patients on diuretics alone (group 2, n = 16). The activity of the Na+/H+ antiporter was determined by cell swelling in isotonic propionate. The control group consisted of 20 normal, age- and sex-matched volunteers. HML diameters were significantly increased from 7.16 +/- 0.07 in normals to 7.24 +/- 0.08 microns (group 1; P < 0.01) and 7.23 +/- 0.11 microns (group 2; P < 0.05), indicating an abnormal regulation of cell volume. There were no statistically significant correlations between the individual ejection fraction or digoxin therapy and average cell diameters. In both patient groups ethylisopropylamiloride-sensitive swelling rates were normal compared to the control group indicating a normal activity of the Na+/H+ antiporter. In conclusion, increased cell sizes reflect a structural change in HML rather than a rapidly reversible functional abnormality which was not affected different by ACE inhibition and diuretic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00577741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18715736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Cyclosporine A enhances total cell calcium independent of Na-K-ATPase in vascular smooth muscle cells. 环孢素A提高血管平滑肌细胞不依赖na - k - atp酶的细胞总钙。

The clinical investigator Pub Date : 1994-12-01 DOI: 10.1007/BF00577742

D Bokemeyer, U Friedrichs, A Bäcker, H J Kramer, H Meyer-Lehnert

{"title":"Cyclosporine A enhances total cell calcium independent of Na-K-ATPase in vascular smooth muscle cells.","authors":"D Bokemeyer, U Friedrichs, A Bäcker, H J Kramer, H Meyer-Lehnert","doi":"10.1007/BF00577742","DOIUrl":"https://doi.org/10.1007/BF00577742","url":null,"abstract":"The effect of cyclosporine A in enhancing vasconstrictor-induced calcium (Ca2+) mobilization in vascular smooth muscle cells may contribute to important side effects in cyclosporine therapy such as hypertension and nephrotoxicity. As we have previously shown, cyclosporine A stimulates transmembrane Ca2+ influx. Since Ca2+ efflux was not affected by cyclosporine A, we concluded that cyclosporine augments angiotensin II induced Ca2+ mobilization in vascular smooth muscle cells by an increased amount of Ca2+ in angiotensin II sensitive intracellular Ca2+ stores. The present study was therefore designed to examine the effect of cyclosporine A on cellular calcium content and on membrane calcium transport mechanisms. An important mechanism of Ca2+ extrusion from the cell is the Na-Ca exchanger. Its activity is closely related with that of the Na-K-ATPase. By increasing cellular sodium concentration the blockade of Na-K-ATPase would in turn activate cellular calcium uptake bx the Na-Ca exchanger. Therefore, we hypothesized that cyclosporine A might exert its effects in the same manner as a circulating Na-K-ATPase inhibitor. Total cell calcium was measured by atomic absorption and activity of Na-K-ATPase was estimated by an assay measuring phosphate production. Preincubation of the cells with cyclosporine (10 micrograms/ml) for 15 min increased total cell calcium from 31.4 +/- 5.0 to 46.5 +/- 5.3 nmol/mg protein (P < 0.05). Activity of Na-K-ATPase was not affected by cyclosporine A (3.9 +/- 0.2 vs. 4.3 +/- 0.2 mumol Pi h-1 mg-1 protein). Therefore, cyclosporine A induced Ca2+ influx is not mediated by an inhibition of the Na-K-ATPase.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00577742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18715737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

A case of pure red cell aplasia: follow-up on different immunosuppressive regimens. 纯红细胞发育不全1例:不同免疫抑制方案的随访。

The clinical investigator Pub Date : 1994-12-01 DOI: 10.1007/BF00577754

M Baldus, M Möller, H Walter, H Brass, W Queisser

{"title":"A case of pure red cell aplasia: follow-up on different immunosuppressive regimens.","authors":"M Baldus, M Möller, H Walter, H Brass, W Queisser","doi":"10.1007/BF00577754","DOIUrl":"https://doi.org/10.1007/BF00577754","url":null,"abstract":"A 66-year-old patient was admitted to our hospital in January 1992 for further evaluation of severe normocytic anemia. Hemoglobin (Hb) was 3.5 g/dl, reticulocyte count 1%. Bone marrow showed a nearly complete lack of red cell precursors, thus favoring the diagnosis of acquired pure red cell aplasia (PRCA). Immunosuppressive therapy with prednisolone was started but had to be supplemented with azathioprine because of a further rapid decrease in Hb to 3.7 g/dl after an initial transfusion of 6 U red blood cells. However, with this regimen a renewed decrease in Hb to 6.6 g/dl was noted, and further transfusions were required. Therefore therapy was switched to cyclosporine A (CyA) while tapering off prednisolone. Four months after the initial diagnosis a positive parvovirus B19 IgM antibody was found. After the failure of hematological remission with three immunosuppressive regimens a course of high-dose intravenous immunoglobulins (IVIG) was administered in July 1992. Six weeks after IVIG therapy a peak hemoglobin concentration of 12.3 g/dl was noted, and further transfusion was not required. CyA was tapered off in October 1992. One month later CyA was reinstituted because of a relapse of PRCA but was unsuccessful until January 1993. At this time immunosuppressive CyA therapy was discontinued because of a periodontal abscess. In February 1993 a second IVIG infusion was given, and a second remission of PRCA was noted, showing an increase in hemoglobin up to 14.5 g/dl by November 1993. At the last follow-up visit in February 1994 our patient was still in complete hematological remission.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00577754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18712636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Liposomal tretinoin for uncomplicated acne vulgaris. 脂质体维甲酸治疗单纯寻常性痤疮。

The clinical investigator Pub Date : 1994-12-01 DOI: 10.1007/BF00577761

M Schäfer-Korting, H C Korting, E Ponce-Pöschl

{"title":"Liposomal tretinoin for uncomplicated acne vulgaris.","authors":"M Schäfer-Korting, H C Korting, E Ponce-Pöschl","doi":"10.1007/BF00577761","DOIUrl":"https://doi.org/10.1007/BF00577761","url":null,"abstract":"Frequently occurring skin irritancy and flare-up reactions impede the use of topical tretinoin for acne vulgaris due to poor patient compliance. Liposome encapsulation improves penetration into the skin and local tolerability in animals. We investigated efficacy and local tolerability of liposomal tretinoin in man. In a double-blind study 20 patients with uncomplicated acne vulgaris received liposomal tretinoin (0.01%) on one side of the body and a commercial gel preparation with either 0.025% or 0.05% on the other once daily for 10 weeks. Comedones and papules/pustules were counted every 2 (-4) weeks. Then also redness, scaling, and burning were rated according to a four-point scale. Moreover, the patients noted skin irritancy in a diary on a daily base. With conventional tretinoin the gels were equally efficacious and equally well tolerated. Liposomal tretinoin also appeared equipotent to the reference gels. There may even have been a slightly more rapid clearing of comedones following the liposome preparation. With respect to skin irritancy, however, liposomal tretinoin was superior. As rated by the patients, liposome encapsulated tretinoin induced less burning (mean cumulative score 2.7 +/- 1.2) than the 0.025% gel (16.1 +/- 7.1) and the 0.05% gel (9.7 +/- 4.1) gel and less erythema (1.8 +/- 0.7) than the 0.025% gel (11.4 +/- 3.8; (P < 0.05). Liposomal tretinoin was also better tolerated according to the rating by the investigator. Liposomal encapsulation of tretinoin allows reduction of the concentration of the active agent without a decline in efficacy for acne vulgaris. Since local tolerability is thus increased, liposomal tretinoin should favor the acceptance of this treatment by the patient.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00577761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18713212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 72

Ectopic ACTH secretion due to a bronchopulmonary carcinoid localized by somatostatin receptor scintigraphy. 由生长抑素受体显像定位的支气管肺类癌引起的异位ACTH分泌。

The clinical investigator Pub Date : 1994-11-01 DOI: 10.1007/BF00190747

G Iser, M Pfohl, U Dörr, E M Weiss, F J Seif

{"title":"Ectopic ACTH secretion due to a bronchopulmonary carcinoid localized by somatostatin receptor scintigraphy.","authors":"G Iser, M Pfohl, U Dörr, E M Weiss, F J Seif","doi":"10.1007/BF00190747","DOIUrl":"https://doi.org/10.1007/BF00190747","url":null,"abstract":"We present the case of a 65-year-old woman with an adrenocorticotropic hormone (ACTH) secreting bronchopulmonary carcinoid. This patient showed the typical long history of Cushing's syndrome, including hypokaliemia, impaired glucose tolerance, high levels of ACTH and beta-endorphin, and coproduction of other peptides. At the onset of clinical symptoms in 1979 an adrenal adenoma was suspected, and left-sided adrenalectomy was performed. The symptoms soon recurred, and the diagnosis of ACTH-dependent Cushing's syndrome was made. As no ACTH-secreting tumor was found, the right adrenal was resected, and the patient was followed up regularly. Fourteen years later chest roentgenography and computed tomography revealed a para-aortic pulmonary lesion, which was suspicious for a bronchopulmonary carcinoid. ACTH and beta-endorphin were excessively, pancreatic polypeptide slightly elevated at that time. The final diagnosis was made using somatostatin receptor scintigraphy which confirmed the hormonal activity of the suspicious lesion; no additional focus was found. This method turned out to be not only a useful additional localization technique but also a promising tool for characterization and staging of a suspected ACTH-producing carcinoid. The tumor was resected curatively, and the diagnosis was confirmed histologically.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00190747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18891655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Prospective randomized clinical study in general surgery comparing a new low molecular weight heparin with unfractionated heparin in the prevention of thrombosis. 普外科前瞻性随机临床研究比较一种新型低分子量肝素与未分离肝素在预防血栓形成中的作用。

The clinical investigator Pub Date : 1994-11-01 DOI: 10.1007/BF00190751

J Limmer, D Ellbrück, H Müller, E Eisele, J Rist, F Schütze, H Beger, H Heimpel, E Seifried

{"title":"Prospective randomized clinical study in general surgery comparing a new low molecular weight heparin with unfractionated heparin in the prevention of thrombosis.","authors":"J Limmer, D Ellbrück, H Müller, E Eisele, J Rist, F Schütze, H Beger, H Heimpel, E Seifried","doi":"10.1007/BF00190751","DOIUrl":"https://doi.org/10.1007/BF00190751","url":null,"abstract":"A prospective, randomized, controlled clinical trial was performed comparing the antithrombotic efficacy of the low molecular weight heparin LMWH 21-23, (Braun) with an unfractionated heparin in elective general surgical patients over an observation period of 7 postoperative days. A total of 230 patients were admitted: 103 (group I) received low molecular weight heparin and 100 (group II) low-dose unfractionated heparin treatment given subcutaneously. In group I 41 patients (46%) were operated on for malignant disease and in group II 54 patients (54%). Due to the large amount of great abdominal procedures the intra- and perioperative application of hydroxyethyl starch was allowed for volume substitution. None of the patients died due to fatal pulmonary embolism. In group I four patients revealed positive 125I-labeled fibrinogen uptake (3.9%); two patients belonged to the hydroxyethyl starch subgroup. In group II five patients displayed a positive fibrinogen uptake (5%); two belonged to the hydroxyethyl starch subgroup. The results of the hemostaseological investigations (e.g., prothrombin time, activated partial thromboplastin time, thrombin clotting time, fibrinogen, antithrombin III, protein C, plasminogen, alpha 2-antiplasmin, tissue-type plasminogen activator, plasminogen activator inhibitor) revealed no statistically significant differences between groups I and II or their subgroups, although a tendency to prolonged clotting times was observed. The antifactor Xa activity values, however, displayed a statistically significant difference between the two groups (P < 0.05). The antifactor Xa activity measured up to 0.16 U/ml for the low molecular weight heparin (group I) and 0.05 U/ml for the unfractionated heparin (group II) in the postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00190751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18891659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Intravenous teicoplanin does not prevent Clostridium difficile associated diarrhea. 静脉注射替柯planin不能预防艰难梭菌相关性腹泻。

The clinical investigator Pub Date : 1994-11-01 DOI: 10.1007/BF00190753

C Wenisch, E Etzersdorfer, S Breyer, W Graninger

{"title":"Intravenous teicoplanin does not prevent Clostridium difficile associated diarrhea.","authors":"C Wenisch, E Etzersdorfer, S Breyer, W Graninger","doi":"10.1007/BF00190753","DOIUrl":"https://doi.org/10.1007/BF00190753","url":null,"abstract":"A 59-year-old man with the diagnosis of endocarditis of the mitral valve due to Streptococcus mitis was treated with penicillin G, gentamicin, and later with clindamycin as inpatient for 3 weeks. Thereafter outpatient therapy with parenteral teicoplanin 3 x per week was initiated. After 17 days of teicoplanin treatment he developed severe diarrhea, and stool samples were positive for Clostridium difficile toxin. In addition to the ongoing parenteral therapy with teicoplanin, oral teicoplanin was administered. On the third day of this regimen the diarrhea and other disabling symptoms subsided, and test results for C. difficile toxin became negative. Oral teicoplanin was continued for 10 days and cleared C. difficile effectively after treatment as assessed by consecutive stool cultures (until 60 days thereafter). The parenteral administration of teicoplanin could not prevent the onset of C. difficile associated diarrhea in this patient, who previously had been treated with clindamycin. Thus, the administration of parenteral teicoplanin does not seem to be a treatment option for C. difficile associated diarrhea in patients in which oral therapy is not possible.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00190753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18891661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Nicotine-induced gene expression of proenkephalin in bovine chromaffin cells. 尼古丁诱导的牛嗜铬细胞前脑啡肽基因表达。

The clinical investigator Pub Date : 1994-11-01 DOI: 10.1007/BF00190754

X Wang, B Bacher, V Höllt

{"title":"Nicotine-induced gene expression of proenkephalin in bovine chromaffin cells.","authors":"X Wang, B Bacher, V Höllt","doi":"10.1007/BF00190754","DOIUrl":"https://doi.org/10.1007/BF00190754","url":null,"abstract":"The induction of the proenkephalin gene by nicotine has been characterized in bovine adrenal medullary chromaffin cells. Nicotine (10 microM) caused an approximately fourfold increase in the proenkephalin mRNA levels within 24 h. The half-life of the proenkephalin mRNA in nicotine-stimulated cells was similar to that in control cells (about 13 h), indicating that nicotine does not affect mRNA stability but acts at the levels of proenkephalin gene transcription. This was also supported by experiments showing that the expression of a proenkephalin chloramphenicol acetyl transferase reporter gene (PENKCAT-153/+50) containing 153 nucleotides of upstream promoter sequences is increased (about twofold) by nicotine after transient transfection in the chromaffin cells. In addition, nicotine induced a marked elevation of the immediate early gene mRNAs c-fos, c-jun, and jun-B. Maximally increased levels for c-fos mRNA (about 100-fold) were obtained after 20 min. c-jun and jun-B were increased three- to fivefold 60 min after nicotine addition. The expression of PENKCAT-153/+53 and of a proenkephalin gene reporter plasmid which contains a dimer of the enkephalin cAMP responsive element 2 (ENKCRE-2) in front of a minimal promoter was increased by cotransfection of a c-fos expression plasmid, indicating that nicotine may induce the proenkephalin gene in chromaffin cells via c-Fos which binds to the ENKCRE-2 element.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00190754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18891662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Comparison of serum phospholipase A2, polymorphonuclear granulocyte elastase, C-reactive protein and serum amyloid A with the APACHE II score in the prognosis of multiple injured patients. 血清磷脂酶A2、多形核粒细胞弹性酶、c反应蛋白和血清淀粉样蛋白A与APACHE II评分在多发损伤患者预后中的比较

The clinical investigator Pub Date : 1994-11-01 DOI: 10.1007/BF00190738

R Ensenauer, M Püttmann, M Quintel, R Kattermann, J Aufenanger

{"title":"Comparison of serum phospholipase A2, polymorphonuclear granulocyte elastase, C-reactive protein and serum amyloid A with the APACHE II score in the prognosis of multiple injured patients.","authors":"R Ensenauer, M Püttmann, M Quintel, R Kattermann, J Aufenanger","doi":"10.1007/BF00190738","DOIUrl":"https://doi.org/10.1007/BF00190738","url":null,"abstract":"This prospective study of 35 multitraumatized intensive care unit patients requiring mechanical ventilation examined the relative utility of four biochemical parameters with a physiological scoring system for predicting lethal outcome. Levels of serum phospholipase A2 (PLA2), serum amyloid A (SAA), polymorphonuclear granulocyte elastase (PMN elastase), and C-reactive protein (CRP) were determined at short intervals during the patient's hospitalization. The first specimen was obtained at the time of admission, and subsequent specimens were drawn at 8 h intervals for the first 48 h and then twice daily until death or convalescence. Calculations of the APACHE II score used the most deranged variables during the first 24 h of admission to assess patient outcome. Additional calculations of the APACHE II score at the time of each blood draw served as an indicator of patient status. The results indicate that during the first 24 h after admission none of the four examined biochemical parameters gives reliable information about the outcome. The APACHE II score provided the earliest indicator of patient outcome (83% sensitivity, 65% specificity). PMN elastase provided useful information first at 32 h (83% sensitivity, 45% specificity) and better at 132 h (86% sensitivity, 86% specificity). CRP was of intermediate use in predicting outcome initially at 72 h (83% sensitivity, 50% specificity) and later at 132 h (86% sensitivity, 93% specificity). PLA2 and SAA were not useful as early indicators of lethal outcome.","PeriodicalId":22408,"journal":{"name":"The clinical investigator","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00190738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18892423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6