1,721,002 research outputs found
Sepsis and AKI in ICU Patients: the role of Plasma Biomarkers
Full text linkSepsis is a primary cause of morbidity and mortality in intensive care unit (ICU) and critically ill patients. Gram-negative bacteria are implicated in 50-60% of cases of sepsis in ICU and endotoxin is considered to play an important role in the pathogenesis of septic shock.
Sepsis is also a contributing factor in more than 20% of cases of acute kidney injury (AKI) in ICU patients, with cases severe enough to require renal replacement therapy. AKI occurs in 35-65% of ICU admissions and most studies show a threefold to fivefold increase in the risk of death among patients with AKI compared to patients without AKI.
Given the higher mortality rate of ICU patients with sepsis and AKI, we decided to investigate the possible correlation between serum biochemical markers of organ damage, such as Neutrophil Gelatinase-Associated Lipocalin (NGAL), Advanced Oxidation Protein Products (AOPP) and Brain Natriuretic Peptide (BNP) and endotoxin activity in ICU septic patients. Moreover, comparisons of the levels of these biomarkers were made between septic and non septic patients, septic patients with or without AKI and between patients who developed AKI with or without sepsis.
Ninety-eight consecutive adult patients admitted to ICU of San Bortolo Hospital, Vicenza, Italy, between October 2008 and August 2010, were enrolled in this study. Patients were divided in two groups depending on the presence of sepsis, defined as Systemic Inflammatory Response Syndrome (SIRS) associated with an infectious process. Fifty-six patients had sepsis, while forty-two patients were non septic. Among septic patients, twenty-four subjects developed AKI, defined by RIFLE criteria, while thirty-two did not. AKI occurred in fourteen patients without sepsis as well.
A significant correlation (p=0.02) was found only between endotoxin activity and BNP levels of septic patients. The levels of NGAL, BNP and AOPP were significantly higher among septic patients compared with non septic subjects (p<0.001). Among septic patients, subjects who developed AKI showed significant higher levels of NGAL and AOPP (p=0.0425), and BNP (p=0.0327). Among patients who developed AKI, a significant difference was found only in terms of AOPP levels between septic and non septic patients.
The correlation between endotoxin activity and BNP in septic patients and the increase in the levels of NGAL, BNP and AOPP in case of sepsis and AKI, in particular if they are associated, indicate a multiorgan involvement in these two conditions. Their evaluation can allow clinicians to individualize earlier patients at higher risk of morbidity and mortality.La sepsi è una delle cause principali di morbidità e mortalità nei pazienti critici in Terapia Intensiva. I batteri Gram-negativi sono implicati nel 50-60% dei casi di sepsi in Terapia Intensiva e l’endotossina svolge un ruolo importante nella patogenesi dello shock settico.
La sepsi è anche un fattore che contribuisce in oltre il 20% dei casi al danno renale acuto nei pazienti in terapia intensiva, e in alcuni casi vi è la necessità di una terapia renale sostitutiva. L’insufficienza renale acuta (IRA) si verifica nel 35-65% dei ricoveri in Terapia Intensiva e la maggior parte degli studi mostrano un aumento di cinque volte sul rischio di morte tra i pazienti con danno renale acuto rispetto ai pazienti senza IRA.
Dato il tasso di mortalità più elevato di pazienti in Terapia Intensiva con sepsi e IRA, si è indagato nei pazienti settici della Terapia Intensiva sulla possibile correlazione tra i biomarcatori di danno d'organo (NGAL, AOPP e BNP) e l'attività dell’endotossina. Inoltre, il confronto dei livelli di questi marcatori sono stati analizzati tra i pazienti settici e non settici, pazienti settici con o senza IRA e tra i pazienti che hanno sviluppato danno renale acuto, con o senza sepsi.
Novantotto pazienti adulti ricoverati in Terapia Intensiva dell'Ospedale di San Bortolo, Vicenza, Italia, tra ottobre 2008 e agosto 2010, sono stati arruolati in questo studio. I pazienti sono stati divisi in due gruppi a seconda della presenza di sepsi, definita come Sindrome da Risposta Infiammatoria Sistemica (SIRS) associata a un processo infettivo. Cinquantasei pazienti presentavano sepsi, mentre 42 pazienti non presentavano sepsi. Tra i pazienti settici, 24 soggetti hanno sviluppato IRA, definita dai criteri RIFLE, mentre 32 non hanno IRA. Una correlazione significativa tra l’attività di endotossina e i biomarcatori è stata trovata solo con i livelli di BNP dei pazienti settici (p=0,02). I livelli di NGAL, BNP e AOPP erano significativamente più alti tra i pazienti settici rispetto ai soggetti non settici (p<0,001). Tra i pazienti settici, i soggetti che hanno sviluppato IRA hanno mostrato livelli più alti di NGAL e AOPP (p=0,0425), e BNP (p=0,0327).
La correlazione tra l'attività dell’endotossina e i livelli di BNP nei pazienti settici, e l'aumento dei livelli di NGAL, BNP e AOPP in caso di sepsi e IRA, in particolare se sono associati, indicano un coinvolgimento multiorgano in queste condizioni. La loro valutazione può permettere ai medici di individuare prima i pazienti a maggior rischio di morbidità e mortalità
Cardiorenal syndrome type 1: A defective regulation of monocyte apoptosis induced by proinflammatory and proapoptotic factors
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Cytotoxic effects of p-cresol in renal epithelial tubular cells
Full text linkBACKGROUND:
The uremic syndrome is characterized by a deterioration of kidney function due to the accumulation of uremic toxins. Currently, 100 different uremic toxins have been identified. Uremic toxins are particularly difficult to remove by conventional dialysis treatments and are the major causes of mortality in patients with chronic kidney disease (CKD). p-Cresol is a well-known uremic toxin which accumulates in uremic serum. Our aim was to evaluate the in vitro effect of p-cresol on apoptosis and necrosis in renal tubular cells (RTCs) to better understand the pathophysiological effect of this toxin on the kidney.
METHODS:
We studied apoptosis and necrosis in RTCs, which were incubated for 24 h with increasing concentrations of p-cresol. A DNA ladder was noted in treated cells as a qualitative marker of the apoptotic process. Furthermore, we performed quantitative analysis of cell viability using a flow cytometer and assessed caspase-3 activity.
RESULTS:
Incubation with p-cresol for 24 h resulted in a significant reduction in RTC viability. DNA isolated from RTCs incubated with increasing p-cresol concentrations for 24 h showed a 'ladder' pattern of apoptosis at p-cresol concentrations of 10, 5 and 2.5 mg/l. However, we did not observe any significant changes in apoptosis levels detected by annexin V and caspase-3 compared with untreated cells. Cytofluorimetric analysis of necrosis highlighted significantly higher cell death rates in RTCs incubated with the higher p-cresol concentrations (range 40-10 mg/l) compared with other concentrations (5-2.5 mg/l) and untreated cells (p < 0.05). Necrosis induction was stronger at higher p-cresol concentrations.
CONCLUSION:
It is necessary to develop new therapeutic and dialytic strategies to manage p-cresol concentrations in CKD
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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