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Second Hour (second + hour)
Selected AbstractsB-type natriuretic peptide as an indicator of right ventricular dysfunction in acute pulmonary embolism,INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2008T. Yardan Summary Objective:, B-type natriuretic peptide (BNP) is a neurohormone secreted from cardiac ventricles in response to ventricular strain. The aim of present study was to evaluate the role of BNP in the diagnosis of the right ventricular (RV) dysfunction in acute pulmonary embolism (PE). Methods:, BNP levels were measured in patients with acute PE as diagnosed by high probability lung scan or positive spiral computed tomography. All patients underwent standard echocardiography and blood tests during the second hour of the diagnosis. Results:, Forty patients diagnosed as acute PE (mean age, 60.4 ± 13.2 years; 62.5% women) were enrolled in this study. Patients with RV dysfunction had significantly higher BNP levels than patients without RV dysfunction (426 ± 299.42 pg/ml vs. 39.09 ± 25.22 pg/ml, p < 0.001). BNP-discriminated patients with or without RV dysfunction (area under the receiver operating characteristic curve, 0.943; 95% CI, 0.863,1.022). BNP > 90 pg/ml was associated with a risk ratio of 165 (95% CI, 13.7,1987.2) for the diagnosis of RV dysfunction. There was a significant correlation between RV end-diastolic diameter and BNP (r = 0.89, p < 0.001). Sixteen patients (40%) were diagnosed as having low-risk PE, 19 patients (47.5%) with submassive PE and five patients (12.5%) with massive PE. The mean BNP was 39.09 ± 25.2, 378.4 ± 288.4 and 609.2 ± 279.2 pg/ml in each group respectively. Conclusion:, Measurement of BNP levels may be a useful approach in diagnosis of RV dysfunction in patients with acute PE. The possibility of RV dysfunction in patients with plasma BNP levels > 90 pg/ml should be strongly considered. [source] QTc interval and QTc dispersion during haemodiafiltrationNEPHROLOGY, Issue 6 2004FULVIO FLOCCARI SUMMARY: Background and Aim: Our aim was to evaluate QTc interval and QTc dispersion in 27 end-stage renal disease (ESRD) patients undergoing Acetate Free Biofiltration (AFB) in order to ascertain any correlations between the electrrocardiographic (ECG) parameters, serum Na+, K+, Ca++, Mg++ and intraerythrocytic Mg++ (Mg++e) concentrations. All measures were made at t0 (session beginning), t1 (first hour), t2 (second hour), t3 (third hour), and t4 (session end). Results: Blood pressure, heart rate, bodyweight and total ultrafiltration in the three dialysis sessions were constant. A significant progressive increase occurred in serum Ca++ during the sessions, while there was a significant diminution in serum K+. The pattern for Mg++ concentrations in serum and erythrocytes differed: in serum it decreased, whereas Mg++e increased. At t4, the QTc interval was reduced to a significant extent with respect to the baseline value. QTc dispersion significantly increased at t1 without there being significant variations at other times with respect to t0. At t2, t3 and t4, values promptly returned to baseline levels. QTc had a negative correlation with serum Ca++ levels at t4. In contrast, an inverse correlation was found between QTc dispersion and serum K+ at t1. No other correlations could be found between any other electrolytes, QTc interval or QTc dispersion. Conclusion: In conclusion, the decrease observed in the QTc interval at the end of an AFB session was inversely related to serum Ca++ concentrations. Moreover, an increase in QTc dispersion occurred during the first hour of the session, and was negatively correlated with serum K+. [source] Cyclosporine drug monitoring with C0 and C2 concentrations in children with stable renal allograft functionPEDIATRIC TRANSPLANTATION, Issue 2 2006Mukaddes Kalyoncu Abstract:, Cyclosporin A (CsA) has a narrow therapeutic window and necessitates monitoring of blood concentration. We aimed to evaluate trough (C0) and second hour (C2) level after ingestion of drug monitoring in renal allograft recipients. In this retrospective study, 12 children eight boys and four girls; mean age at transplantation 14.6 ± 3.7 yr (ranges: 7.0,19.0), mean age post-transtplant 17.8 ± 4.9 yr (ranges: 9.0,24.0) who were transplanted >6 months were enrolled in this evaluation. Ten were recipients of a living related donor and two deceased donor grafts. While six children were receiving CsA, steroids and azathioprine, the other six received CsA, steroids and mycophenolate mofetil. Clinical course, blood pressure, renal and liver function tests were recorded. Mean C0 and C2 were 96.2 ± 59.5 and 504 ± 305.4 ng/mL respectively. Mean serum creatinine level was 1.2 ± 0.45 mg/dL and mean creatinine clearance (CrCl) was 89.2 ± 36.8 mL/min/1.73 m2. There was a correlation between serum creatinine level, CsA dose and C2 levels,whereas,there was no correlation between age, blood pressure, CrCl and C2 levels. However, no correlation was found between C0 levels and any of the above parameters. In conclusion, our data suggest that C2 levels are correlated better with dose and serum creatinine level. [source] Regional anaesthesia elastomeric pump performance after a single use and subsequent refill: a laboratory studyANAESTHESIA, Issue 7 2009C. R. K. Grant Summary Ambulatory local anaesthetic delivery systems are often limited by a short effective duration of infusion. Prolonging nerve blockade by substituting a new pump as recommended by the manufacturers, represents a substantial consumable item cost ($US300,500). We therefore evaluated the flow delivery performance of 31 single model elastomeric devices (all with a 2 ml.h,1 background and 5 ml every hour bolus capability) that had been filled, used in clinical practice and then refilled in the laboratory. For the second infusion, there was a pattern of over-infusion (< 10 ml.h,1) in the first hour; however, all pumps depreciated to < 150% of predicted by the second hour. The subsequent performance of all pumps was not only within safe limits, but also predominantly within the range (background infusion ± 15%, bolus +10/,20%) specified by the manufacturer for primary infusion. We conclude that this elastomeric regional anaesthesia pump design performs satisfactorily after having been refilled following a single previous use. [source] Cytokine response of electrolytic ablation in an ex vivo perfused liver modelANZ JOURNAL OF SURGERY, Issue 7-8 2010Gianpiero Gravante Abstract Background:, The inflammatory response following hepatic ablation depends on different factors including the method used, the duration and intensity of the treatment and the presence or absence of ischemia. Debate continues about the use of different modalities and whether some aspects of the response may be advantageous by releasing immunological active substances. Little data have been published concerning the cytokine response elicited by hepatic electrolytic ablation (EA). Study of an ex vivo liver model could allow for the evaluation of this response without the influence of confounding systemic factors. Methods:, Livers explanted from 11 pigs were perfused extracorporeally with normothermic autologous blood. Four of them underwent EA after 1 h of reperfusion. Serum samples were obtained up to 6 h after the reperfusion and assayed for IL-1,, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IFN-,, TNF-,. Results:, Significant changes in the control group were observed for IL-6 after the second hour and IL-8 after the first hour compared with baseline levels (P < 0.001). In the EA group, IL-6 and IL-12 were raised after the second hour and IL-8 and IL-10 after the first hour (P < 0.001). The comparison between groups showed significant differences for IL-2, IL-4 (decreased in the EA group compared with controls), IL-10 and TNF-, (EA group increased compared with controls; P < 0.001). Conclusions:, The ex vivo perfused liver model demonstrated changes in levels of IL-2, IL-4, IL-10 and TNF-, following hepatic EA. [source] | ||||||||||