RESUMO
BACKGROUND: The favorable effect of mild therapeutic hypothermia (MTH) on neurologic status as well as on overall survival was shown in several trials; however, MTH is not readily implemented in daily routine. OBJECTIVE: We examined the effect of the implementation of MTH on neurologic outcome and overall survival in an emergency care hospital. STUDY DESIGN AND METHODS: The data of 68 patients between 09/2010 and 11/2011 who received MTH for 24 h at 33 °C after cardiopulmonary resuscitation (CPR) were compared with prospectively collected data from 180 patients before introduction of MTH (2001-2006). Survival and neurological status at discharge were determined using the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). RESULTS: MTH raised the percentage of patients with a CPC score of 1 or 2 from 70 % to 85 %. Furthermore, survival increased from 47/180 (26 %) between 01/2000 and 01/2006 to 27/68 (40 %) between 09/2010 and 11/2011. DISCUSSION: Implementation of MTH leads to improved neurological status and overall survival after CPR.
Assuntos
Reanimação Cardiopulmonar/mortalidade , Reanimação Cardiopulmonar/métodos , Hipotermia Induzida/mortalidade , Hipotermia Induzida/métodos , Terapia Combinada , Alemanha , Escala de Resultado de Glasgow , Mortalidade Hospitalar , Humanos , Estudos Prospectivos , Taxa de SobrevidaRESUMO
Eukaryotic protein synthesis initiation factor 4E (eIF-4E) was labeled in situ with [32P]orthophosphate in cultured HeLa cells and rabbit reticulocytes and purified by affinity chromatography. Tryptic digestion yielded one labeled peptide which contained predominantly serine and lysine. After treatment of the protein with citraconic anhydride to block epsilon-amino groups of lysyl residues, tryptic digestion yielded a labeled peptide whose composition was consistent with the structure Trp-Ala-Leu-Trp-Phe-Phe-Lys-Asn-Asp-Lys-Ser(P)-Lys-Thr-Trp-Gln-Ala-Asn-L eu-Arg, one of the arginyl peptides predicted from the human eIF-4E cDNA sequence. The only serine in this peptide is located at position 53 of eIF-4E. Thus, it is concluded that eIF-4E contains a single site of phosphorylation for an endogenous protein kinase, which is Ser-53 in the human eIF-4E sequence.