Diagnostic and Prognostic Value of IL-10, FABP2 and LPS Levels in HCC Patients.

Hepatocellular carcinoma (HCC) still lacks valuable diagnostic and prognostic tools. This study aimed to investigate the potential diagnostic and prognostic value of baseline interleukin (IL)-10, fatty acid-binding protein 2 (FABP2) and lipopolysaccharide (LPS) levels in patients with HCC. Serum levels of IL-10, FABP2 and LPS in 47 newly diagnosed HCC patients and 50 healthy individuals were estimated and compared.

Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.

Previous studies indicate supplemental vitamin C improves microcirculation and reduces glycocalyx shedding in septic animals. Our randomized, double-blind, placebo-controlled trial aimed to investigate whether a high dose of intravenous ascorbic acid (AA) might improve microcirculation and affect glycocalyx in septic patients. In our study, 23 septic patients were supplemented with a high dose (50 mg/kg every 6 h) of intravenous AA or placebo for 96 h.

Links between Endothelial Glycocalyx Changes and Microcirculatory Parameters in Septic Patients.

The glycocalyx is an endothelial surface layer that is essential for maintaining microvascular homeostasis. Impaired integrity of the endothelial glycocalyx may be directly related to the development of microvascular dysfunction. To explore this hypothesis, we conducted a prospective observational study on adult patients diagnosed with sepsis.

Ocular microvascular changes in patients with sepsis: a prospective observational study.

Background: The aim of the study was to detect differences in the conjunctival microcirculation between septic patients and healthy subjects and to evaluate the course of conjunctival and retinal microvasculature in survivors and non-survivors over a 24-h period of time.

Methods: This single-center prospective observational study was performed in mixed ICU in a tertiary teaching hospital. We included patients with sepsis or septic shock within the first 24 h after ICU admission.

A case report and literature review: previously excluded tuberculosis masked by amiodarone induced lung injury.

Background: Amiodarone is an antiarrhythmic drug which is used to treat and prevent several dysrhythmias. This includes ventricular tachycardia and fibrillation, wide complex tachycardia, as well as atrial fibrillation (AF) and paroxysmal supraventricular tachycardia. Amiodarone may prove to be the agent of choice where the patient is hemodynamically unstable and unsuitable for direct current (DC) cardioversion.

Fatal outcome of late-onset angiotensin-converting enzyme inhibitor induced angioedema: A case report.

Rationale: Angiotensin-converting enzyme (ACE) inhibitors are one of the most used medication among patients with arterial hypertension. In most cases, ACE inhibitors caused side effects are mild; however, from 0.1% to 0.

Alterations of conjunctival glycocalyx and microcirculation in non-septic critically ill patients.

As of now the relationship between glycocalyx degradation and microcirculatory perfusion abnormalities in non-septic critical ill patients is unclear. In addition, conjunctival sidestream dark field-imaging for the purpose of glycocalyx thickness estimation has never been performed. We aimed to investigate whether changes in glycocalyx thickness in non-septic patients are associated with microcirculatory alterations in conjunctival and sublingual mucosa.

Cisplatin-induced sudden cardiac death with hemodynamic collapse: a severe adverse drug reaction: Case report.

Rationale: Cisplatin is responsible for a significant percentage of adverse drug reactions (ADRs) in oncology setting. A great proportion of cisplatin-induced severe adverse events are difficult to foresee, and giving premedication does not always prevent the occurrence of such events.

Patient Concerns: A 53-year-old woman with progressive T4 N0 M0 stage IV pleural mesothelioma experienced cardiac arrest with hemodynamic collapse after cisplatin and pemetrexed chemotherapy administration.

Ultrafiltration rate is an important determinant of microcirculatory alterations during chronic renal replacement therapy.

Background: Hemodialysis (HD) with ultrafiltration (UF) in chronic renal replacement therapy is associated with hemodynamic instability, morbidity and mortality. Sublingual Sidestream Dark Field (SDF) imaging during HD revealed reductions in microcirculatory blood flow (MFI). This study aims to determine underlying mechanisms.

Conjunctival microcirculatory blood flow is altered but not abolished in brain dead patients: a prospective observational study.

Background: The conjunctival microcirculation has potential as a window to cerebral perfusion due to related blood supply, close anatomical proximity and easy accessibility for microcirculatory imaging technique, such as sidestream dark field (SDF) imaging. Our study aims to evaluate conjunctival and sublingual microcirculation in brain dead patients and to compare it with healthy volunteers in two diametrically opposed conditions: full stop versus normal arterial blood supply to the brain.

Methods: In a prospective observational study we analyzed conjunctival and sublingual microcirculation using SDF imaging in brain dead patients after reaching systemic hemodynamic targets to optimize perfusion of donor organs, and in healthy volunteers.

Microcirculatory blood flow as a tool to select ICU patients eligible for fluid therapy.

Purpose: The aim of this study is to assess the incidence of sublingual microcirculatory flow alterations, according to a predefined arbitrary cutoff value, in patients with "clinical signs of impaired organ perfusion". Secondary endpoints were the changes in microvascular flow index (MFI), "clinical signs of impaired organ perfusion", and stroke volume (SV) after fluid administration, and the differences between groups.

Methods: Prospective, single-center, observational study in a 22-bed mixed intensive care unit (ICU).

Microvascular distribution in the ocular conjunctiva and digestive tract in an experimental setting.

Unlabelled: Recently improved microcirculatory imaging techniques, such as orthogonal polarization spectral (OPS) and its technical successor sidestream dark field (SDF) imaging, in handheld devices have allowed a direct observation of the microcirculation at the bedside. Usually a cut-off of 20 µm in diameter is used to differentiate small vessels (mainly capillaries) from large vessels (mainly venules) during this technique. We hypothesized that it was possible to measure the small vessels with a considerably smaller inner diameter.

Early course of microcirculatory perfusion in eye and digestive tract during hypodynamic sepsis.

Introduction: The aim of the study was to evaluate and compare the microcirculatory perfusion during experimental sepsis in different potentially available parts of the body, such as sublingual mucosa, conjunctiva of the eye, and mucosa of jejunum and rectum.

Methods: Pigs were randomly assigned to sepsis (n = 9) and sham (n = 4) groups. The sepsis group received a fixed dose of live Escherichia coli infusion over a 1-hour period (1.

Hospitalized adult patients with 2009 pandemic influenza A (H1N1) in Kaunas, Lithuania.

Unlabelled: The objective of this study was to identify case characteristics and clinical course of the disease in patients hospitalized with 2009 pandemic influenza A (H1N1) infection during the first wave of the pandemic and to identify risk factors associated with the complicated course of illness.

Material And Methods: A retrospective study of adult cases of the laboratory-confirmed 2009 pandemic influenza A (H1N1) virus admitted to three hospitals in Kaunas between November 1, 2009, and March 15, 2010, was carried out. The main outcome measures were clinical characteristics, risk factors for complicated disease, treatment, and clinical course of the disease.

Microcirculatory changes during open label magnesium sulphate infusion in patients with severe sepsis and septic shock.

Background: Microcirculatory alterations play a pivotal role in sepsis and persist despite correction of systemic hemodynamic parameters. Therefore it seems tempting to test specific pro-microcirculatory strategies, including vasodilators, to attenuate impaired organ perfusion. As opposed to nitric oxide donors, magnesium has both endothelium-dependent and non-endothelium-dependent vasodilatory pathways.

New insights for adult cardiopulmonary resuscitation. Up-coming resuscitation guidelines 2010.

Despite advances in cardiac arrest care, the overall survival to hospital discharge remains poor. The objective of this paper was to review the innovations in cardiopulmonary resuscitation that could influence survival or change our understanding about cardiopulmonary resuscitation. We have performed a search in the MEDLINE and the Cochrane databases for randomized controlled trials, meta-analyses, expert reviews from December 2005 to March 2010 using the terms cardiac arrest, basic life support, and advanced life support.

[Epileptic seizures in critically ill patients].

THE AIM OF THIS ARTICLE: To review the causes, clinical signs, pathophysiology, consequences, and treatment of seizures and status epilepticus in critically ill patients. Only 25% of people, who have seizures and status epilepticus, have epilepsy as well. In the intensive care settings, seizures and status epilepticus are a common neurologic complication, which is attributable to primary neurologic pathology (stroke, hemorrhage, tumor, central nervous system infection, head trauma) or secondary to critical illness (anoxic brain damage, intoxications, metabolic abnormalities) and clinical management.

The dependence of successful resuscitation on electrocardiographically documented cardiac rhythm in case of out-of-hospital cardiac arrest.

Objective: To determine the influence of electrocardiographically documented cardiac rhythm during sudden cardiac arrest on successful resuscitation among out-of-hospital deaths in Kaunas city.

Material And Methods: An observational prospective study was conducted between 1 January, 2005, and 30 December, 2005, in Kaunas city with a population of 360,627 inhabitants. In this period, all cases of cardiac arrest were analyzed according to the guidelines of the Utstein consensus conference.

Changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct-related artery with and without stent implantation.

Objective: To show differences in the changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct related artery with and without stent implantation and to assess the value of QRS score in the follow-up period.

Material And Methods: A total of 248 consecutive patients were divided into these groups: early angioplasty (24 hours) angioplasty without stents (n=114) or with stents (n=14). The changes in QRS score and echocardiographic left ventricular ejection fraction during the hospital and 3-month follow-up periods were compared between the groups.

Prediction of improvement in left ventricular function during a 1-year follow-up after acute myocardial infarction by the degree of acute resolution of electrocardiographic changes.

Background And Purpose: Reperfusion therapy results in better left ventricle (LV) function in cases of successful myocardial reperfusion; however, insufficient reperfusion or reocclusion of the infarct-related artery is associated with LV dysfunction. This study was proposed to determine whether the rate of ECG stage dynamics, after mechanical, thrombolytic, or spontaneous recanalization, is a predictor of improvement in LV function.

Methods: Twenty-seven consecutive patients, observed for 1 year, were divided into group A (11, change rate of > or =2 ECG stages per 2 days), group B (13, no rapid change), and cases with reocclusion (3).

[New guidelines for resuscitation in adults].

Five years after the last issue of the guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, in 2005 American Heart Association and European Resuscitation Council published new guidelines. In this review, basic life support (BLS) technique, indications for use of an automated external defibrillator (AED), recognition of sudden cardiac arrest, and management of choking (foreign-body airway obstruction) are presented according to the "Resuscitation Guidelines 2005."

[Physiological aspects of cardiopulmonary resuscitation in adults].

This article reviews the physiology of cardiopulmonary resuscitation (CPR), monitoring and new devices for generating blood flow during CPR. Two controversial mechanisms of blood flow during chest compressions are described: the thoracic pump mechanism and cardiac pump mechanism. Also, new physiological aspects of blood flow, physiology of ventilation and gas transport during CPR are overviewed.

[The new aspects of treatment of severe sepsis and septic shock].

The mortality rate of infection-induced organ dysfunction or hypoperfusion abnormalities due to severe sepsis and septic shock remains unacceptably high. The adequacy and speed of treatment administered in the first hours after syndrome develops influence outcome. Initial resuscitation, appropriate antimicrobial treatment, selection of optimal control methods, properties of fluid therapy, use of vasopressors and inotropic therapy, proper corticosteroid administration, value of the use of recombinant human activated protein C, and glucose control are the most important points newly evaluated for severe and septic shock management.

[Successful treatment with continuous infusion of coagulation factor concentrates in severe hemophilia A complicated with mixed trauma, crush syndrome and acute renal failure].

Treatment method of hemophilia with continuous infusion of clotting factor concentrates is not widespread. We report our experience with the use of continuous infusion of factor VIII in patient with mixed trauma, crush syndrome and acute renal failure. Patient was successfully treated with fasciotomy of left upper arm and forearm, 6 procedures of hemodialysis, 34.

Implementation of the patient education about cardiovascular risk factors into a daily routine of the Cardiology Unit of the hospital.

Background: Cardiovascular disease remains the leading cause of death in developed countries. Main modifiable cardiovascular risk factors are smoking, hypertension and dyslipidemia. We sought to introduce the patient education about these risk factors into a daily routine of the Cardiology Unit of the hospital.