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  • 1
    ISSN: 1432-1238
    Keywords: Cardiac output ; Modified Fick method ; Assumed RQ-value ; Carbon dioxide elimination ; Thermodilution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared a modified Fick method for measuring cardiac output against the thermodilution method in 11 critically-ill patients on mechanical ventilation. Oxygen consumption $$(\dot VO_2 )$$ was calculated indirectly, by measuring the carbon dioxide elimination $$(\dot VCO_2 )$$ during steady state and by assuming an average respiratory quotient of 0.9. For a total of 129 measurements, the mean difference in cardiac output between both methods was 0.03±1.3 l/min (95% confidence interval, −0.19 to 0.25 l/min,p=0.7) standard deviation, with the largest differences being measured in the low cardiac output range (〈5 l/min). No statistically significant difference was found between the cardiac output values obtained with either method. These data showed a good correlation between the two methods and suggest that the modified Fick method may be useful in determining cardiac output in seriously ill patients on mechanical ventilation not requiring pulmonary arterial catheterisation, or where facilities for undertaking metabolic measurements are not available.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1831
    Keywords: Key words  CD28 ; Cell adhesion molecules ; Cell activation markers ; Serum prognostic markers ; Human immunodeficiency virus type 1
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   CD28 is a transmembrane glycoprotein that provides T cells with an essential co-stimulatory signal during antigen presentation. Using flow cytometry, we document here an expansion of CD28– T cells in HIV infection. Whereas the percentage of CD4+CD28+ T cells among total lymphocytes was decreased, a small increase of the percentage of CD4+CD28– T cells was observed. In the CD8+ subset, there was a marked expansion of CD8+CD28– T cells. An increased percentage of CD8+ T cells positive for HLA-DR was found in both CD28+ and CD28– cells. Results were similar for CD38 expression. HIV infection was also distinguished by a shift from LFA-1lowCD28low to LFA-1highCD28high and LFA-1high-CD28neg expression pattern on CD8+ T cells. Negative correlations were found between percentage and absolute number of CD8+CD28+ T cells and several serum parameters usually associated with poor prognosis (IgA, IgE, β2-microglobulin and HIV-1 p24 antigen). Thus, HIV infection is characterized by a marked expansion of CD28– T cells with an abnormal expression of activation markers and cell adhesion molecules. In addition, CD8+CD28+, but not CD8+CD28– or total CD8+ T cell numbers, correlated with the levels of established serological markers of disease severity or progression and may, therefore, have predictive value.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1615-6692
    Keywords: Schlüsselwörter Event recorder ; Synkopen ; Herzrhythmusstörungen ; Monitoring ; Langzeitregistrierung ; Key Words Event recorder ; Syncope ; Arrhythmia ; Rhythm disturbances ; Monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Rarely and transient occurring arrhythmia, palpitation, dizziness, syncopes and chest pain frequently cause symptoms and complaints to patients with congenital cardiac defects. The reliable identification of their pathogenesis is often difficult. The study presented here demonstrates the impact of an event recorder for enlightening sporadically occurring complaints and symptoms. Fifty patients (age between 11 and 70 years, median 27 years) were examined with an event recorder (King of Hearts Express®, Instromedix, Hillsboro, USA). The patients were referred to an outpatient clinic for congenital cardiac defects in order to clarify unexplained arrhythmia, palpitations, dizziness, or syncope. Included were patients above 10 years of age. Previous cardiac studies (including ECG, exercise-ECG, Holter-Monitoring) were non-diagnostic in all. Altogether 227 ECGs had been recorded. 95% of them were of diagnostic quality. The event recorder afforded ambulatory monitoring and the median duration of monitoring was 22.5 days. The average number of registered events was 4.5±3.8. In 24% of the patients (n=12) diagnostic and/or therapeutical consequences resulted: electrophysiological examination (n=5), drug treatment (n=4) and pacemaker implantation (n=3). The event recorder is an important and highly effective tool in diagnosing sporadical transient symptoms and complaints, especially arrhythmias.
    Notes: Zusammenfassung Selten oder intermittierend auftretende Herzrhythmusstörungen verursachen bei Patienten mit angeborenen Herzfehlern häufig Symptome und Beschwerden wie Palpitationen, Schwindel, Synkopen und thorakale/kardiale Missempfindungen, deren Pathogenese oft nur schwer zu klären ist. In der vorliegenden Studie wird untersucht, welche Informationen ein Event-Rekorder bei der Abklärung sporadisch auftretender Beschwerden und Symptome liefern kann. Insgesamt wurden 50 Patienten (Alter zwischen elf und 70 Jahren, Median 27 Jahre), die sich zur Abklärung intermittierender Herzrhythmusstörungen, Palpitationen, Schwindel oder Präsynkopen in einer Ambulanz für angeborene Herzfehler vorstellten, mit einem Event-Rekorder (King of Hearts Express®, Instromedix, Hillsboro, USA) untersucht. Eingeschlossen wurden Patienten, die älter als zehn Jahre waren und bei denen mit vorausgegangenen Untersuchungen (inklusive EKG, Ergometrie und Holter-Monitoring) keine ausreichende Klärung erzielt werden konnte. Die durchschnittliche Tragedauer des Event-Rekorders betrug 28,0 Tage (Median 22,5 Tage). Die mittlere Anzahl registrierter Ereignisse lag bei 4,5±3,8. Insgesamt wurden 227 EKG registriert. 95% davon waren von ausreichender technischer Qualität. Diagnostische oder therapeutische Konsequenzen resultierten bei 24% (n=12) der Patienten: elektrophysiologische Untersuchung (n=5), medikamentöse Einstellung (n=4), Schrittmacherimplantation (n=3). Schlussfolgernd kann man feststellen, dass sich der Event-Rekorder zur Abklärung sporadisch auftretender kardialer Ereignisse oder Symptome gut eignet. Seinen besonderen Stellenwert erhält er beim Nachweis bzw. Ausschluss von selten auftretenden Herzrhythmusstörungen bei symptomatischen Patienten.
    Type of Medium: Electronic Resource
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