In 39 patients with acute meningococcal infections, the plasma concentrations of tumor necrosis factor-alpha (TNF) and its soluble receptors (sRs) TNFsR-p55 and TNFsR-p75 were measured from admission till recovery. At admission, patients with shock had significantly higher TNF, TNFsR-p55, and TNFsR-p75 values than patients without shock. In addition, during the first 24 hours, patients with shock had higher TNFsR-p75 to TNFsR-p55 ratios, indicating that in shock the increase of TNFsR-p75 exceeds that of TNFsR-p55. TNF measured more than 12 hours after admission failed to differentiate between shock and nonshock because TNF concentrations normalized within 12-24 hours. However, because concentrations of TNFsRs remained elevated for 5-6 days, at that time plasma TNFsRs still differentiated between shock and nonshock. Plasma exchange or whole blood exchange (PEBE), performed in 20 patients with shock, accelerated the decrease of plasma TNFsRs. However, because of a rebound after each PEBE session, the overall half-lives of both TNFsRs were not affected by PEBE.
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http://dx.doi.org/10.1086/513933 | DOI Listing |
Crit Care Sci
January 2025
Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile - Santiago, Chile.
Background: ANDROMEDA-SHOCK 2 is an international, multicenter, randomized controlled trial comparing hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock to standard care resuscitation to test the hypothesis that the former is associated with lower morbidity and mortality in terms of hierarchal analysis of outcomes.
Objective: To report the statistical plan for the ANDROMEDA--SHOCK 2 randomized clinical trial.
Methods: We briefly describe the trial design, patients, methods of randomization, interventions, outcomes, and sample size.
JAMA Netw Open
January 2025
Department of Medicine, University of California, San Francisco.
Importance: Multiple organ dysfunction (MOD) is a leading cause of in-hospital child mortality. For survivors, posthospitalization health care resource use and costs are unknown.
Objective: To evaluate longitudinal health care resource use and costs after hospitalization with MOD in infants (aged <1 year) and children (aged 1-18 years).
Int Urol Nephrol
January 2025
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.
Purpose: Urinary cytokine changes may serve as biomarkers to assess treatment outcomes for interstitial cystitis/bladder pain syndrome (IC/BPS). This study analyzed the changes in urinary cytokines following various bladder therapies and explored their clinical significance in therapeutic mechanisms.
Methods: A total of 122 patients with IC/BPS treated with platelet-rich plasma (PRP), botulinum toxin-A (BoTN-A), hyaluronic acid (HA), or low-energy shock wave (LESW) were evaluated.
mBio
January 2025
Department of Microbiology, Genetics, & Immunology, Michigan State University, East Lansing, Michigan, USA.
The emergence and global spread of carbapenem-resistant complex species present a pressing public health challenge. Carbapenem-resistant spp. cause a wide variety of infections, including septic shock fatalities in newborns and immunocompromised adults.
View Article and Find Full Text PDFUrologia
January 2025
Department of Urology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India.
Introduction: Extracorporeal shock wave lithotripsy (ESWL) causes trauma to the renal parenchyma. Due to the kidney injury, free radicals are generated, and an inflammatory process develops. Inflammatory markers like interleukin's (IL), C-reactive protein (CRP), and procalcitonin (PCT) are released into the circulation.
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