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  • 1
    ISSN: 1432-1238
    Keywords: Key words Hemofiltration ; Systemic inflammatory response syndrome ; Tumor necrosis factor α ; Interleukin-6 ; Clearance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To test the hypothesis that continuous hemofiltration increases interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) clearances and results in decreased cytokine plasma concentrations independent of renal function in patients with early SIRS. Design: Prospective, controlled, randomized study. Setting: Intensive care units at a university hospital. Patients: 28 consecutive patients who fulfilled the criteria of the systemic inflammatory response syndrome (SIRS). Interventions: Patients with SIRS were randomly assigned to either a hemofiltration or a control group irrespective of renal function. In patients of the hemofiltration group an isovolemic hemofiltration was initiated directly after the diagnosis of SIRS and maintained for at least 48 h. Measurements and results: A significant (p 〈 0.001) increase in total IL-6 clearance (hemofiltrate + urine), but not in TNFα clearance, was observed with hemofiltration. However, the plasma concentrations of both cytokines remained unchanged. Hemodynamic variables did not change significantly. Conclusions: Continuous hemofiltration increases IL-6 plasma clearance but not TNFα clearance. However, hemofiltration failed to decrease plasma concentrations of TNFα and IL-6 and, therefore, cannot be used effectively for cytokine elimination in SIRS. Accordingly, beneficial effects occasionally reported with hemofiltration are unlikely to be expected due to elimination of IL-6 or TNFα.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter MRT ; Kinder ; Tumor ; Abdomen ; Differentialdiagnose ; Key words MRI ; Pediatric ; Tumor ; Abdomen ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To evaluate the potential of MRI in determining benign and premalignant abdominal tumors in childhood. Methods: MR images of 93 children with 69 malignant and 24 benign abdominal tumors were analyzed retrospectively without and with knowledge of clinical findings. Based on the final diagnosis, MR findings were surveyed with regard to the correct differential diagnosis and to the differentiation between benign and malignant masses. Results: Analysis of MRI alone revealed relatively low sensitivity of 67% for diagnosis of a benign tumor. The main reason was unspecific morphologic criteria leading to the false-negative diagnosis of a malignant tumor. Together with clinical and laboratory findings, sensitivity could be increased to 92%. The main criterion for differentiation of malignant tumors turned to be out the origin of tumor. Benign tumors could be best differentiated by their internal structure. Conclusion: When considering clinical findings in pediatric abdominal tumors, MRI represents a valuable modality for differential diagnosis.
    Notes: Zusammenfassung Zielsetzung: Ziel der Arbeit ist die Bestimmung der Wertigkeit der MRT für die Unterscheidung benigner und prämaligner abdomineller Tumoren im Kindesalter. Methode: Bei 93 Kindern mit 69 malignen und 24 benignen abdominellen Raumforderungen wurden die MRT-Bilder retrospektiv ohne und mit Kenntnis der klinischen Befunde analysiert. Anhand der endgültigen Diagnose wurde die Aussagekraft der MRT in Bezug auf die korrekte Artdiagnose und die Unterscheidung zwischen benignen und malignen Tumoren überprüft. Ergebnisse: Bei der alleinigen MRT-Analyse wurde für die Diagnose „benigner Tumor” eine relativ niedrige Sensitivität von 67% erzielt. Die Hauptursache hierfür waren unspezifische morphologische Unterscheidungskriterien, die zur falsch-negativen Diagnose eines Malignoms führten. Zusammen mit den klinischen Befunden konnte die Sensitivität auf 92% angehoben werden. Als Hauptkriterium für die korrekte Artdiagnose zeigte sich bei den Malignomen die Organzugehörigkeit und bei den benignen Tumoren die Binnenstruktur. Schlußfolgerung: Im Rahmen der integrierten Diagnostik liefert die MRT einen wertvollen Beitrag zur Differentialdiagnostik kindlicher abdomineller Tumoren.
    Type of Medium: Electronic Resource
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