Plasma IL-8 is a diagnostic parameter of early-onset bacterial infection (EOBI) in neonates but has a short half-life. The detergent-lysed whole-blood (DLWB) IL-8 consists of both extracellular and cell-bound IL-8. The objective of this study was to investigate kinetics of plasma and DLWB IL-8 in healthy newborns and those with suspected EOBI and to test the hypothesis that determination of DLWB IL-8 results in higher sensitivity for EOBI detection. Sixty-one neonates with clinical and serologic signs of EOBI composed the study group; 188 neonates with risk factors but without EOBI served as control subjects. IL-8 concentrations were determined in plasma and DLWB. In the control group, DLWB IL-8 concentrations were 280-fold higher (9599 pg/mL; SD 4433) up to 24 h post partum than corresponding plasma levels (34.2 pg/mL; SD 18.1). The sensitivity of DLWB versus plasma IL-8 for EOBI was 0.97 versus 0.71 after 6 h and 0.70 versus 0.32 after 24 h. Corresponding values for specificity were 0.95 versus 0.90 after 6 h and 0.92 versus 0.99 after 24 h. After 24 h, the negative predictive value for DLWB versus plasma IL-8 was 0.80 versus 0.66. DLWB IL-8 showed a higher sensitivity for EOBI within 6 h after first clinical suspicion than plasma IL-8. It also remained elevated longer. Our results suggest that DLWB IL-8 results in a higher sensitivity for EOBI. Abbreviations CRP, C-reactive protein DLWB, detergent-lysed whole blood EOBI, early-onset bacterial infection I/T ratio, immature to total neutrophil ratio NPV, negative predictive value PPV, positive predictive value ROC, receiver operator characteristics Neonates are susceptible to infections (1). The differential diagnosis of early-onset bacterial infection (EOBI) therefore must always be present for the neonatologist, regardless of how minor, unexpected, or discrete the clinical symptoms. EOBI is usually defined as occurring up to 72 h after birth (2) and is associated with a high morbidity and mortality risk (1). The nonspecific clinical signs as well as the currently established biochemical and hematologic parameters have their diagnostic limitations (3,4) [reviewed in (5,6)].Plasma IL-8 is an appreciated, highly predictive, and easily accessible chemokine to detect EOBI (7). IL-8 secretion is not limited to infections (8 -10), yet it occurs within 1-3 h of endotoxin challenge (11). As with most cytokines, its plasma half-life is short (Ͻ4 h) (12,13). Circulating IL-8, which can be detected in plasma or serum via immunoassay, is immediately bound to two distinct high-affinity IL-8 receptors that are abundantly present on neutrophils before internalization and degradation (14,15). Therefore, plasma IL-8 reflects only a small portion of the total IL-8 blood pool, because the majority is cell associated (16 -18).Cell association is enhanced by chemokine binding, non-IL-8 -specific receptors. These have been identified on various cell types (19), including the Duffy antigen-related chemokine receptors (16), presented on erythrocytes. Duffy antigenrelated chemokine-li...
Bei Patienten mit Posttraumatischen Belastungsstörungen (PTB) und zusätzlicher komplexer Thematik erfolgt in Deutschland im stationären Setting überwiegend eine Stabilisierung. Angenommen wird dabei, dass die erfolgreich Stabilisierten in einer ambulanten Folgetherapie mit einem traumakonfrontativen Verfahren behandelt werden. Die hier vorliegende Arbeit hat zwei Ziele: Erstens soll eine quantitative Literaturübersicht zum Thema Stabilisierung und Konfrontation bei komplex Traumatisierten gegeben werden. Hier zeigte sich, dass Stabilisierung überwiegend kleine bis mittlere Effekte erzielt und dass kognitiv-verhaltenstherapeutische Interventionen insgesamt erfolgreicher erscheinen. Zweitens soll die Inanspruchnahme von Folgebehandlungen nach stationärer Stabilisierung erfasst werden. Dazu wurden 147 sexuell traumatisierte Frauen, die eine stationäre, vorwiegend stabilisierende integrative Behandlung erhielten, nachuntersucht. Während sich die allgemeine psychische Belastung am Ende des stationären Aufenthalts stark verbesserte, zeigten sich nur kleine bis mittlere Effekte im Bereich der posttraumatischen Symptomatik. Nur ein geringer Teil der Stichprobe erhielt eine Traumakonfrontation in den vier Jahren nach der stationären Behandlung. Daraus und aus der Literaturübersicht kann abgeleitet werden, dass das stationäre Setting für Traumabearbeitung genutzt werden sollte.
Introduction The extent of tumor resection is a significant predictor of survival in highgrade gliomas. In recent years, several authors showed the benefit of intraoperative ultrasound partially matched with magnetic resonance imaging (MRI). The aim of this study was to find out if intraoperative neuronavigation in combination with intraoperative ultrasound has any impact on the complete resection of gliomas. A comparison between the ultrasound-controlled resection of brain tumors and operations controlled by navigated ultrasound was performed. Materials and Methods A total of 92 patients (54 men and 39 women) with a mean age of 53.2 years underwent 93 operations over a period of 4 years (2007)(2008)(2009)(2010). They harbored a tumor with suspicion of glioma; 32 of them had undergone previous surgery, and additional chemotherapy, and 29 of them had undergone irradiation. Overall, 49 operations were performed with navigated ultrasound (group A) and 44 with nonnavigated ultrasound (group B). A standardized early postoperative MRI was performed . Complete or gross total resection (GTR) was defined by a resection of 95% of the tumor. Skin incision and craniotomy were planned after registration of the neuronavigation system. The ultrasound system was used systematically before and after opening the dura, and during and at the end of resection. Results GTR could be achieved in 28 of 49 cases in group A and in 23 of 44 cases in group B. In group A, sensitivity and specificity of tumor remnants detected by ultrasound were higher than in group B. Concerning recurrent gliomas, the sensitivity of ultrasound visualizing tumor remnants was lower than in primary tumors. In case of preoperatively planned GTR, in both groups (navigated and non-navigated ultrasound) similar tumor remnant sizes were postoperatively detected by MRI. In nine cases the removal was incomplete because of eloquently located tumors. There was no significant difference between navigated and not-navigated ultrasound concerning GTR (p > 0.05).
These results show that further research on DET as a treatment for PTSD is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.