To assess the diagnostic value of procalcitonin (PCT), interleukin (IL)-6, IL-8, and standard measurements in identifying critically ill patients with sepsis, we performed prospective measurements in 78 consecutive patients admitted with acute systemic inflammatory response syndrome (SIRS) and suspected infection. We estimated the relevance of the different parameters by using multivariable regression modeling, likelihood-ratio tests, and area under the receiver operating characteristic curves (AUC). The final diagnosis was SIRS in 18 patients, sepsis in 14, severe sepsis in 21, and septic shock in 25. PCT yielded the highest discriminative value, with an AUC of 0.92 (CI, 0.85 to 1.0), followed by IL-6 (0.75; CI, 0.63 to 0.87), and IL-8 (0.71; CI, 0.59 to 0.83; p < 0.001). At a cutoff of 1.1 ng/ml, PCT yielded a sensitivity of 97% and a specificity of 78% to differentiate patients with SIRS from those with sepsis-related conditions. Median PCT concentrations on admission (ng/ ml, range) were 0.6 (0 to 5.3) for SIRS; 3.5 (0.4 to 6.7) for sepsis; 6.2 (2.2 to 85) for severe sepsis; and 21.3 (1.2 to 654) for septic shock (p < 0.001). The addition of PCT to a model based solely on standard indicators improved the predictive power of detecting sepsis (likelihood ratio test; p = 0.001) and increased the AUC value for the routine value-based model from 0.77 (CI, 0.64 to 0.89) to 0.94 (CI, 0.89 to 0.99; p = 0.002). In contrast, no additive effect was seen for IL-6 (p = 0.56) or IL-8 (p = 0.14). Elevated PCT concentrations appear to be a promising indicator of sepsis in newly admitted, critically ill patients capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection.

The detection of spirochetes in 15 patients with clinically documented early disseminated LB has been analysed when using cultivation method of the plasma or the cerebrospinal fluid, electron microscopy, commercial Western blot and detecting the DNA of the pathogen in vitro cultures by PCR-RFLP. Spirochetes were isolated in eight blood and one cerebrospinal fluid culture samples. In seven cases (47%), previous serodiagnostic laboratory tests were negative. Borrelial DNA was detected by PCR in 67% patients (9 blood samples and 1 CSF sample). Using MseI restriction fragments of PCR products of the amplified rrf-rrl region, we identified Borrelia garinii (80%), one B. afzelii isolate and one B. burgdorferi s.s.

e29 tion of their immune system due to the HAART and therefore less exposition with therapeutic antibiotics.

will be observed. The difference between the frequencies under pre and post oscillate conditions depends on the stiffness of the object (Young's ratio). So, the consistency of material can be measured by monitoring the shift in the frequency. Using the tactile sensor system, the measurements were made. We measured skin consistency during surgery in aged (65+) patients with gastrectomy. The primary disease, procedures, operative time, antibiotics, ASA classification, preoperative skin treatment, comorbidity, smoking history, BMI, wound contamination, post operative hyperglycemia, postoperative albumin, postoperative delirium and length of hospital stay were recorded. In case with infection, type of wound infection and the day of diagnosis as infection were also recorded.Results: 39 patients had gastrectomy for gastric cancer and 7 patients suffered from wound infection. Age (75.6 with infection versus 73.7 without infection) and BMI (23.4 vs 21.7) indicated no statistical difference between with and without wound infection, as well as, skin consistency (503.8 vs 480.1). The operative time more than 180 minutes and NNIS risk index were only risk factors for infection. In patient with SSI, the length of hospital stay was longer than the patients without wound infection. Conclusion:The skin consistency did not associate with the wound infection. Long time procedure and higher risk index were only risk factors for wound infection in mature patients with gastrectomy.