Comparison of procalcitonin and CrP in the postoperative course after lung decortication.

Objective: The objective of this prospective study was to compare the clinical value of procalcitonin (PCT) and C-reactive protein (CrP) plasma concentrations in their postoperative course after decortication.

Methods: Twenty-two patients requiring surgery for pleural empyema were chosen for this prospective study. Routine blood samples including CrP and PCT plasma concentrations were taken before the operation and on the 1st, 2nd, 3rd, and 7th postoperative day.

Local application of basic fibroblast growth factor increases the risk of local infection after trauma: an in-vitro and in-vivo study in rats.

Introduction: Local application of growth factors to stimulate wound and fracture healing is attracting increasing interest. We studied the effect of local application of a potent angiogenic growth factor, basic fibroblast growth factor (bFGF), on resistance to local infection after soft tissue trauma.

Methods: For in-vitro and in-vivo experiments, we used recombinant human bFGF.

Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study.

Background: The epidemiology of liver disease in patients admitted to emergency rooms is largely unknown. The current study aimed to measure the prevalence of viral hepatitis B and C infection and pathological laboratory values of liver disease in such a population, and to study factors associated with these measurements.

Methods: Cross-sectional study in patients admitted to the emergency room of a university hospital.

Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood.

Background: The Roche CARDIAC proBNP point-of-care (POC) test is the first test intended for the quantitative determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) in whole blood as an aid in the diagnosis of suspected congestive heart failure, in the monitoring of patients with compensated left-ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes.

Methods: A multicentre evaluation was carried out to assess the analytical performance of the POC NT-proBNP test at seven different sites.

Results: The majority of all coefficients of variation (CVs) obtained for within-series imprecision using native blood samples was below 10% for both 52 samples measured ten times and for 674 samples measured in duplicate.

Effect on infection resistance of a local antiseptic and antibiotic coating on osteosynthesis implants: an in vitro and in vivo study.

The purpose of this study was to acquire information about the effect of an antibacterial and biodegradable poly-L-lactide (PLLA) coated titanium plate osteosynthesis on local infection resistance. For our in vitro and in vivo experiments, we used six-hole AO DC minifragment titanium plates. The implants were coated with biodegradable, semiamorphous PLLA (coating about 30 microm thick).

[Influence of local application of basic fibroblast growth factor on resistance to local infection after standardized closed soft tissue trauma. An experimental study in rats].

The aim of the study was to obtain information on the importance/influence of local application of an angiogenic potent growth factor (bFGF) on local infection resistance after soft tissue trauma.A paired comparison of infection rates was carried out on Sprague-Dawley rats after standardized, closed soft tissue trauma and local, percutaneous bacterial inoculation of different concentrations (2 x 10(4)-2 x 10(7)), whereby the lower leg was treated with 1, 10, and 100 ng bFGF (n=16 each) and without bFGF (n=16). Statistical evaluation of the differences between the infection rates of both groups was performed using the two-sided Fisher's exact test ( p<0.

[Does surgical approach have an effect on the development of local infection? Animal experiment comparison of conventional open vs. minimally invasive bone plate osteosynthesis (MIPO)].

With a standardised model we investigated the influence of two different surgical approaches to the rabbit tibia for plate osteosynthesis on resistance to local infection after postoperative inoculation of graduated concentrations of staphylococcus aureus at the implant. The infection rate for the minimally invasive plate osteosynthesis with insertion of the implant in closed, soft tissue tunneling technique was 25% (3/12 animals; ID50 = 6.2 x 10(6) CFU) and for the conventional open approach 38% (5/13 animals; ID50 = 2 x 10(6) CFU).

Prognostic role of brain natriuretic peptide in acute pulmonary embolism.

Background: Rapid, noninvasive, and accurate prognostic assessment with an inexpensive cardiac biomarker is an appealing approach for patients with acute pulmonary embolism (PE).

Methods And Results: We measured at the time of admission the plasma level of plasma brain natriuretic peptide (BNP) to determine its utility in prognosticating the clinical course of 73 consecutive patients with acute PE. We used a prespecified BNP cut-off level (<90 pg/mL) for the prediction of the absence of a major adverse cardiovascular event, defined as any of the following: death, cardiopulmonary resuscitation, mechanical ventilation, or use of pressors, thrombolysis, catheter fragmentation, or surgical embolectomy.

Low pro-brain natriuretic peptide levels predict benign clinical outcome in acute pulmonary embolism.

Background: The role of pro-brain natriuretic peptide (proBNP) for the prediction of clinical outcome has not been examined in patients with acute pulmonary embolism (PE).

Methods And Results: ProBNP levels were measured in 73 patients with acute PE within 4 hours of admission. Adverse clinical outcome was defined as in-hospital death or the need for at least 1 of the following: cardiopulmonary resuscitation, mechanical ventilation, pressors, thrombolysis, catheter fragmentation, or surgical embolectomy.

B-type natriuretic peptide for diagnosis and treatment of congestive heart failure.

Background: Prognostic classification of congestive heart failure (CHF) is difficult and only possible with the help of additional diagnostic tools. B-type natriuretic peptide (BNP) has been used as a diagnostic and prognostic marker for patients (pts) with CHF. In this study, the clinical value of BNP for stratification and treatment of pts with CHF was evaluated.

Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats.

Purpose: The etiology of local posttraumatic infection in the locomotor system depends on the amount, virulence and pathogenicity of the inoculated microorganisms and the local/systemic host damage due to the type and extent of the accident or iatrogenic trauma. The relative effect of these factors remains unclear. In particular, it is still unclear today whether--in presence of microorganisms--soft tissue damage and its pathophysiological consequences lead to infection after soft tissue trauma, or whether the bacterial contamination is the primarily cause for posttraumatic infection.

PC-Fix and local infection resistance--influence of implant design on postoperative infection development, clinical and experimental results.

Bacterial infection is still one of the main complications after internal fixation of fractures. The design of implants influences local infection resistance. To reduce the development of infections around implants after internal fixation, the vitality of the bone should be preserved to optimize cellular and humoral host defence mechanisms.

Polylactide implants and bacterial contamination: an animal study.

Although bioresorbable aliphatic polyesters derived from lactic acid are now used clinically as sutures, bone-fracture fixation devices and sustained-release drug-delivery systems, very little is known about their behavior in the infected environment. The aim of the present study was to compare the resistance to infection of two polylactide implants with different degradation characteristics, and to evaluate the influence of a bacterial challenge on their mechanical and physicochemical properties. Various quantities of a beta-haemolyzing strain of Staphylococus aureus (V 8189-94) were inoculated into the medullary cavity of rabbit tibiae, and an extruded polylactide rod composed of either P(L)LA (Poly(L-Lactide)) or P(L/DL)LA (Poly(L/DL-Lactide)) was then inserted.

Ischaemia/reperfusion contributes to colonic injury following experimental aortic surgery.

Objectives: ischaemia of the colon is an important complication of abdominal aortic aneurysm (AAA) repair. The aim of this animal study was to investigate the effect of sequential ischaemia and reperfusion on sigmoid mucosal pO2 and its association with local ET-1 release.

Material And Methods: twelve pigs underwent colonic ischaemia followed by complete reperfusion.

Antioxidant and thyroid hormone status in selenium-deficient phenylketonuric and hyperphenylalaninemic patients.

Background: Subjects consuming protein-restricted diets, such as patients with phenylketonuria (PKU) or milder hyperphenylalaninemias (HPAs) are at risk of selenium deficiency. Selenium is a cofactor of the antioxidant enzyme glutathione peroxidase and of the thyroid hormone converting enzyme thyroxine deiodinase.

Objective: Our goal was to investigate the effects of low plasma selenium on antioxidant and thyroid hormone status.

Role of procalcitonin and granulocyte colony stimulating factor in the early prediction of infected necrosis in severe acute pancreatitis.

Background: Infected pancreatic necrosis (IPN) is the main cause of death in patients with severe acute pancreatitis. Therefore an early prediction of IPN is of utmost importance.

Aim: Analysis of new blood variables as potential early predictors to differentiate between IPN and sterile pancreatic necrosis (SPN).

Influence of the design for fixation implants on local infection: experimental study of dynamic compression plates versus point contact fixators in rabbits.

Objectives: Comparison of infection resistance after local bacterial challenge associated with two different designs for fixation implants: the conventional dynamic compression plate (DCP) and the point contact fixator (PC-Fix).

Design: Randomized, prospective study in experimental animals. Grouped sequential experimental procedure.

Troponin-I for prediction of early postoperative course after pediatric cardiac surgery.

Objectives: It was the aim of the study to test the prognostic value of cardiac troponin-I (cTnI) concerning the early postoperative course after pediatric cardiac surgery.

Background: Cardiac troponin-I is a very specific and sensitive marker of myocardial damage in adults and children. As perioperative myocardial damage may be a significant factor of postoperative cardiac performance, serial cTnI values were analyzed in children undergoing open heart surgery.

Susceptibility to local infection in biological internal fixation. Experimental study of open vs minimally invasive plate osteosynthesis in rabbits.

Resistance to local infection after fracture fixation with plate osteosynthesis may be influenced by the implantation technique. It is known that the extent of the surgical approach to the bone can compromise the local defence capacity. We have investigated susceptibility to infection after a local bacterial challenge in rabbit tibiae using either the open surgical approach for 'biological' internal fixation of standard 2.

Comparison of troponin-I and troponin-T after pediatric cardiovascular operation.

Background: Although the diagnostic value of troponin-T in childhood is documented, little is known about the significance of troponin-I. It was the aim of this study to compare the diagnostic value of troponin-I and troponin-T in children and newborns to assess the perioperative potential myocardial damage.

Methods: Forty-eight children, mean, 51+/-54 months (mean value +/-1 standard deviation) (range, 1 day to 204 months) undergoing cardiac operation were prospectively enrolled in the present study.

Assessment of troponin-T for detection of clinical cardiac rejection.

Non-invasive detection of cardiac rejection still remains a challenge after heart transplantation. We assessed troponin-T as a new serum marker to diagnose cardiac rejection. Twenty-five heart transplant patients (Berne) were monitored prospectively for up to 2 years, and compared to 89 retrospectively assessed patients (Stanford).

[Experimental reconstruction of the sheep orbit with biodegradable implants].

In a complex animal model in sheep, polydioxanone (PDS) and polylactic membranes were used for the reconstruction of large orbital-wall defects. In a long-term experiment over 1 year, polylactic implants alone showed the best performance as compared with combinations involving autogenous bone grafts and titanium miniplate fixation. As soon as these polylactic implants are approved for human surgery, they will be used to solve the still challenging problem of anatomical reconstruction of large comminuted fractures of more than one orbital wall.

[Experimental reconstruction of sheep orbits using biodegradable implants].

In a complex animal model in sheep, polydioxanone (PDS(®)) and polylactic membranes were used for the reconstruction of large orbital-wall defects. In a long-term experiment over 1 year, polylactic implants alone showed the best performance as compared with combinations involving autogenous bone grafts and titanium miniplate fixation. As soon as these polylactic implants are approved for human surgery, they will be used to solve the still challenging problem of anatomical reconstruction of large comminuted fractures of more than one orbital wall.