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  • 1
    ISSN: 1432-1238
    Keywords: Key words Acquired ATIII deficiency ; ATIII replacement therapy ; Septic shock
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. Methods: 120 patients admitted to the ICU with an ATIII concentration 〈 70 % were randomized to receive ATIII (total dose 24 000 units) or placebo treatment for 5 days; 56 patients had septic shock. Results: ATIII concentrations in the treated group remained constant throughout the treatment period (range 97–102 %). The Kaplan- Meier analysis showed no difference in overall survival between the two groups: 50 and 46 % for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1 % increase in the ATIII plasma concentration at baseline. Conclusions: The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1590-3478
    Keywords: Reye syndrome ; influenza B virus ; Coxsackievirus A5 ; mixed infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo studiato da un punto di vista clinico e virologico un caso di sindrome di Reye verificatosi in una bambina di 16 mesi pochi giorni dopo un episodio di influenza. La diagnosi di sindrome di Reye è stata posta sulla base di dati clinici e di laboratorio. Le indagini virologiche sono state condotte su campioni di feci, tampone faringeo, liquor e su una coppia di sieri. Dal liquor è stato isolato un virus coxsackie A5. Nella coppia di sieri è stata stata evidenziata una sieroconversione verso la variante del virus influenzale di tipo B in circolazione nella regione a quell'epoca e verso il ceppo di virus coxsackie A5 isolato. L'isolamento dal SNC del virus coxsackie A5 e la dimostrazione di una concomitante infezione da virus influenzale B nel caso da noi studiato depongono a favore dell'ipotesi che una infezione virale mista possa scatenare la sindrome di Reye.
    Notes: Abstract A 16 month old girl developed Reye syndrome a few days after an episode of influenza. The diagnosis of RS was made on clinical and laboratory data. Virological examinations were done on specimens of stools, throat swab, spinal fluid and two samples of serum. A coxsackievirus A5 was isolated from the spinal fluid. A seroconversion was found against the variant of influenza type B virus circulating in our region at that time and the isolated coxsackie A5 strain. The involvement in the CNS of coxsackie A5 and the demonstration of a simultaneous infection with influenza B virus supports the hypothesis that a mixed viral infection could trigger the Reye syndrome.
    Type of Medium: Electronic Resource
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