RESUMO
In this review, we present information about a heterogeneity of monocyte subsets based on their unique functional and phenotypic properties. Here we also discuss the search of an optimal technique for the isolation of monocyte subsets as well as the origin of monocyte subsets and their role in inflammation.
Assuntos
Monócitos/imunologia , Animais , Humanos , Inflamação/imunologia , Inflamação/patologia , Monócitos/patologiaRESUMO
The paper presents an algorithm of cardio complex classification as part of processing the data of continuous cardiac monitoring. R-wave detection concurrently with cardio complex sorting is discussed. The core of this approach is the use of prior information about. cardio complex forms, segmental structure, and degree of kindness. Results of the sorting algorithm testing are provided.
Assuntos
Medicina Aeroespacial , Sistema Cardiovascular/fisiopatologia , Monitorização Fisiológica/métodos , Algoritmos , Humanos , Modelos Teóricos , Voo EspacialRESUMO
UNLABELLED: Current diagnosis of acute kidney injury (AKI) is one of the most pressing problems in the newborn in critical condition. OBJECTIVE: To determine the diagnostic value of indicators of renal blood flow as a marker of acute kidney injury in critically ill newborns. MATERIALS AND METHODS: The study included 40 infants in critical condition. A clinical assessment of severity of the condition during admission was carried out with Neonatal Multiple Organ Dysfunction Score (NEOMOD) and Neonatal Therapeutic Intervention Scoring System (NTISS). All patients underwent evaluation of clinical and instrumental parameters, including ultrasound of the renal vessels, renal vascular resistance index and speed performance. CONCLUSIONS: 1) biochemical markers used in routine clinical practice were not sufficiently informative for the diagnosis of AKI. 2) For a more accurate assessment of the risk of AKI using serum creatinine, GFR calculation and evaluation on a scale RIFLE it is should be focused on performance standards, appropriate for gestational age and birth weight. 3) Evaluation of blood flow at a particular index in the resistance of the main renal arteries had the greatest predictive value and had a relatively high sensitivity and specificity for the diagnosis of AKI.
Assuntos
Injúria Renal Aguda/diagnóstico , Doenças do Prematuro/diagnóstico , Circulação Renal/fisiologia , Injúria Renal Aguda/sangue , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/urina , Estado Terminal , Diagnóstico Precoce , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/sangue , Doenças do Prematuro/fisiopatologia , Doenças do Prematuro/urina , Testes de Função Renal , Sensibilidade e EspecificidadeRESUMO
The immune system dramatically contributes to the pathogenesis of cancer. An integral estimation of immune system state is considered to be perspective as a prognostic criterion for cancer. We hypothesize that the integral characteristic, uniting numerous parameters of immune response to tumor and presenting the state of the immune system of a cancer patient, may be of prognostic significance. The aim of this work was to verify this hypothesis. MATERIALS AND METHODS: We have evaluated 17 parameters cha-racterizing key innate and adaptive arms of immune system in 146 patients with primary diagnosed local breast cancer (BC) before cancer treatment. Using the original integrative approach of NovoSpark Corporation (Canada), we have presented the state of the immune system by a single visual image for each patient. RESULTS: We classified all BC patients in two groups: with favorable and unfavorable immune system states according to our previous data demonstrating dramatic differences of the visual images of immune system states in patients with good or poor disease outcomes. Then, we have examined the relationship between integral characteristic of the immune system state and the clinical outcome. The 3-year disease-free survival (DFS) of BC patients with favorable immune system state was more than 96.0% vs 65.4% in patients with unfavorable status (p = 0.00006). Univariate Cox proportional hazards regression analysis showed that the integral characteristic of immune system state assessed prior to cancer treatment as unfavorable, was predictive of the poorer DFS (HR = 15.70 [2.15-114.90], p = 0.0007). CONCLUSION: The integral characteristic of the immune system state is a significant prognostic factor in BC patients. The BC patients with favorable integral immune system state can be considered as a target group for immunotherapeutic approach.
Assuntos
Neoplasias da Mama/imunologia , Neoplasias da Mama/mortalidade , Sistema Imunitário/imunologia , Adulto , Biomarcadores , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Progressão da Doença , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Avaliação de Resultados da Assistência ao Paciente , Prognóstico , Análise de Sobrevida , Carga TumoralRESUMO
The purpose of the case study was substantiation of a differential intensive care in abdominal sepsis with respect to its clinical-and-pathogenetic variations. Retro- and prospective clinical-and-biochemical parameters were investigated in 60 patients with disseminated peritonitis and abdominal sepsis. The patients were shared between 3 groups with respect to their clinical-and-laboratory findings. Clinical-and-pathogenetic types were defined for the clinical course of abdominal sepsis (AS). It was found as necessary to add enteral detoxication to the combined intensive care scheme in type 1 AS. A single-stage intravenous perftoran infusion plus enteral detoxication are required in type 2 AS. And in type 3 AS, the therapeutic scheme should be expanded through intravenous infusion of perftoran with subsequent enteral detoxication.
Assuntos
Cavidade Abdominal , Cuidados Críticos/métodos , Peritonite/terapia , Sepse/terapia , Cavidade Abdominal/microbiologia , Feminino , Humanos , Masculino , Peritonite/diagnóstico , Peritonite/metabolismo , Estudos Retrospectivos , Sepse/diagnóstico , Sepse/metabolismoRESUMO
Hypercytokinemia plays a key role in the pathogenesis of systemic inflammatory response syndrome (SIRS). Monocytes are the main source of cytokines in the early inflammatory phase. Simultaneous stimulation of toll-like receptors (TLRs) and triggering receptor expressed on myeloid cells (TREM-1) activating receptor on monocytes results in the amplification of the inflammatory signal and multiple increase in proinflammatory cytokine production. The dynamics of those receptors expression on monocyte surface of patients with uncomplicated SIRS course followed coronary artery bypass surgery (CABG) was studied. The increase in TLR2 and TREM-1 expression on the first day after CABG induces proinflammatory and amplification potentials of monocytes in that period. The decrease in TLR2 surface expression on the seventh day compared to the preoperative values can be regarded as a mechanism limiting inflammatory response. The highest level of TLR2, TLR4, and TREM-1 surface expression was observed in CD14(hi)CD16(+) monocyte subpopulation, confirming its proinflammatory profile.
RESUMO
Cell-activating receptor TREM-1 (triggering receptor expressed on myeloid cells 1) regulates congenital immune response and contributes to systemic inflammatory response syndrome (SIRS) development. It is able to multiply cytokine production while stimulated together with the main receptors of the congenital immune system. The purpose of the paper is to study the potential use of soluble TREM-1 (sTREM-1) as a marker of intensive SIRS and a criterion for postoperative complications prediction following on-pump coronary artery bypass surgery (CABG). Results show that early postoperative sTREM-1 concentrations demonstrate their potential prognostic value regarding SIRS-associated complications.
RESUMO
The aim of this study was to evaluate on-line performance of a real-time digital imaging system based on amorphous silicon technology and to compare it with conventional film-screen equipment. The digital detecting imager consists of (1) a converter, which transforms the energy of the incident X rays into light; (2) a real-time digital detecting system, capable of producing as many as 10 pictures per second using a large-area pixel matrix (20 x 20 cm2) based on solid-state amorphous silicon sensor technology with a pitch of 400 microns; and (3) appropriate computer tools for control, real-time image treatment, data representation, and off-line analysis. Different phantoms were used for qualitative comparison with the conventional film-screen technique, with images obtained with both systems at the normal dose (used as a reference), as well as with dose reduction by a factor of 10 to 100. Basic image quality parameters evaluated showed that the response of the detector is linear in a wide range of entrance air kerma; the dynamic range is higher compared with the conventional film-screen combination; the spatial resolution is 1.25 lp per millimeter, as expected from the pixel size; and good image quality is ensured at doses substantially lower than for the film-screen technique. The flat-panel X-ray imager based on amorphous silicon technology implemented in standard radiographic equipment permits acquisition of real-time images in radiology (as many as 10 images per second) of diagnostic quality with a marked reduction of dose (as much as 100 times) and better contrast compared with the standard film technique. Preliminary results obtained with a 100-micron pitch imager based on the same technology show better quality but a less substantial dose reduction. Applications in craniofacial surgery look promising.