Use of drug-eluting versus bare-metal stents in ST-segment elevation myocardial infarction.

The development of drug-eluting stents (DES) is one of the critical milestones in the advances of interventional cardiology. However, clinical stent thrombosis still poses a serious potential complication. In acute ST-segment elevation myocardial infarction (STEMI), acute total vessel occlusion has a larger thrombus burden, and the use of DES in this particular setting raises safety concerns.

Troponin increases in the critically injured patient: mechanical trauma or physiologic stress?

Background: Serum troponin (Tn) is a sensitive and specific marker of myocardial injury. Tn increase after injury is usually attributed to mechanical chest trauma, but this relationship remains unproven. We sought to examine the etiologic factors and prognostic significance of increased Tn levels in a widely screened trauma population.

Diagnosis of acid-base derangements and mortality prediction in the trauma intensive care unit: the physiochemical approach.

Background: Conventional measures such as anion gap and base deficit can be inadequate for defining and managing complex acid-base derangements. Physiochemical analysis is an alternative approach based on the principles of electroneutrality and conservation of mass, and may be more accurate for defining the presence and type of acidosis and unmeasured anions.

Methods: We retrospectively analyzed 2,152 sets of laboratory data from 427 trauma patients admitted to the intensive care unit.

Differential effects of tumor necrosis factor-alpha on proliferation, cell surface antigen expression, and cytokine interactions in malignant gliomas.

Tumor necrosis factor-alpha (TNF-alpha), a cytokine produced by astrocytes in vivo and in vitro, was tested for its effects on two malignant astrocytoma cell lines (A-172, U-87). Both lines were immunoreactive for glial fibrillary acidic protein, vimentin, Class I antigens, and interleukin-6. The lines differed in their expression of Class II and intercellular adhesion molecule-1 (ICAM-1) antigenic determinants: A-172 cells were negative for both Class II and ICAM-1 antigens, while U-87 cells were intensely positive for Class II and weakly positive for ICAM-1.

Delayed cerebrospinal fluid sterilization in infants with Hemophilus influenzae type b meningitis.

Cerebrospinal fluid (CSF) sterilization after greater than 24 h of intravenous antibiotic therapy (delayed CSF sterilization) was noted in two infants treated with ceftizoxime and ceftazidime for bacterial meningitis. A case-control study was conducted of children between 6 w and 6 y of age treated between 1975 and 1985 at one institution for bacterial meningitis to determine risk factors for delayed CSF sterilization. Hemophilus influenzae type b was isolated from all children (n = 5) with delayed CSF sterilization, compared with only 78% of all children in the study (n = 83).