239 research outputs found
ProteĂna C-reativa nĂŁo Ă© um marcador Ăștil de infecção em unidade de terapia intensiva cirĂșrgica
CONTEXT AND OBJECTIVE: C-reactive protein (CRP) is commonly used as a marker for inflammatory states and for early identification of infection. This study aimed to investigate CRP as a marker for infection in patients with postoperative septic shock. DESIGN AND SETTING: Prospective, single-center study, developed in a surgical intensive care unit at Hospital das ClĂnicas, Faculdade de Medicina da Universidade de SĂŁo Paulo. METHODS: This study evaluated 54 patients in the postoperative period, of whom 29 had septic shock (SS group) and 25 had systemic inflammatory response syndrome (SIRS group). All of the patients were monitored over a seven-day period using the Sequential Organ Failure Assessment (SOFA) score and daily CRP and lactate measurements. RESULTS: The daily CRP measurements did not differ between the groups. There was no correlation between CRP and lactate levels and the SOFA score in the groups. We observed that the plasma CRP concentrations were high in almost all of the patients. The patients presented an inflammatory state postoperatively in response to surgical aggression. This could explain the elevated CRP measurements, regardless of whether the patient was infected or not. CONCLUSIONS: This study did not show any correlation between CRP and infection among patients with SIRS and septic shock during the early postoperative period.CONTEXTO E OBJETIVO: A proteĂna C reativa (PCR) Ă© muito usada como marcador de estados inflamatĂłrios e na identificação precoce de infecção. Este estudo teve como proposta investigar a PCR como marcadora de infecção em pacientes em choque sĂ©ptico no perĂodo pĂłs-operatĂłrio. TIPO DE ESTUDO E LOCAL: Estudo prospectivo, monocĂȘntrico, desenvolvido numa unidade de terapia intensiva pĂłs-operatĂłria do Hospital das ClĂnicas da Faculdade de Medicina da Universidade de SĂŁo Paulo. MĂTODOS: Foram avaliados 54 pacientes no pĂłs-operatĂłrio, sendo 29 deles com choque sĂ©ptico (grupo SS) e 25 com sĂndrome da resposta inflamatĂłria sistĂȘmica (grupo SI). Todos os pacientes foram acompanhados durante sete dias pelo escore SOFA (Sequential Organ Failure Assessment) e com dosagens diĂĄrias de PCR e lactato. RESULTADOS: As dosagens de PCR nĂŁo diferiram entre os grupos. NĂŁo foi observada correlação entre dosagem de PCR e lactato ou escore SOFA nos grupos estudados. Observamos que as concentraçÔes plasmĂĄticas de PCR estavam elevadas em quase todos os pacientes avaliados. Os pacientes no pĂłs-operatĂłrio apresentam estado inflamatĂłrio em resposta Ă agressĂŁo cirĂșrgica, sendo este fato capaz de explicar as dosagens de PCR elevadas, independentemente de o paciente estar ou nĂŁo infectado. CONCLUSĂES: Este estudo nĂŁo evidenciou correlação entre PCR e infecção nos pacientes com sĂndrome da resposta inflamatĂłria sistĂȘmica e choque sĂ©ptico no perĂodo pĂłs-operatĂłrio precoce
C-reactive protein is not a useful indicator for infection in surgical intensive care units
Wean Earlier and Automatically with New technology (the WEAN study): a protocol of a multicentre, pilot randomized controlled trial
<p>Abstract</p> <p>Background</p> <p>Weaning is the process during which mechanical ventilation is withdrawn and the work of breathing is transferred from the ventilator back to the patient. Prolonged weaning is associated with development of ventilator-related complications and longer stays in the Intensive Care Unit (ICU). Computerized or Automated Weaning is a novel weaning strategy that continuously measures and adapts ventilator support (by frequently measuring and averaging three breathing parameters) and automatically conducts Spontaneous Breathing Trials to ascertain whether patients can resume autonomous breathing. Automated Weaning holds promise as a strategy to reduce the time spent on the ventilator, decrease ICU length of stay, and improve clinically important outcomes.</p> <p>Methods/Design</p> <p>A pilot weaning randomized controlled trial (RCT) is underway in the ICUs of 8 Canadian hospitals. We will randomize 90 critically ill adults requiring invasive ventilation for at least 24 hours and identified at an early stage of the weaning process to either Automated Weaning (SmartCareâą) or Protocolized Weaning. The results of a National Weaning Survey informed the design of the Protocolized Weaning arm. Both weaning protocols are operationalized in Pressure Support mode, include opportunities for Spontaneous Breathing Trials, and share a common sedation protocol, oxygen titration parameters, and extubation and reintubation criteria. The primary outcome of the WEAN study is to evaluate compliance with the proposed weaning and sedation protocols. A key secondary outcome of the pilot RCT is to evaluate clinician acceptance of the weaning and sedation protocols. Prior to initiating the WEAN Study, we conducted a run-in phase, involving two patients per centre (randomizing the first participant to either weaning strategy and assigning the second patient to the alternate strategy) to ensure that participating centres could implement the weaning and sedation protocols and complete the detailed case report forms.</p> <p>Discussion</p> <p>Mechanical ventilation studies are difficult to implement; requiring protocols to be operationalized continuously and entailing detailed daily data collection. As the first multicentre weaning RCT in Canada, the WEAN Study seeks to determine the feasibility of conducting a large scale future weaning trial and to establish a collaborative network of ICU clinicians dedicated to advancing the science of weaning.</p> <p>Trial Registration Number</p> <p>ISRCTN43760151</p
Quark helicity distributions in the nucleon for up, down, and strange quarks from semi--inclusive deep--inelastic scattering
Polarized deep--inelastic scattering data on longitudinally polarized
hydrogen and deuterium targets have been used to determine double spin
asymmetries of cross sections. Inclusive and semi--inclusive asymmetries for
the production of positive and negative pions from hydrogen were obtained in a
re--analysis of previously published data. Inclusive and semi--inclusive
asymmetries for the production of negative and positive pions and kaons were
measured on a polarized deuterium target. The separate helicity densities for
the up and down quarks and the anti--up, anti--down, and strange sea quarks
were computed from these asymmetries in a ``leading order'' QCD analysis. The
polarization of the up--quark is positive and that of the down--quark is
negative. All extracted sea quark polarizations are consistent with zero, and
the light quark sea helicity densities are flavor symmetric within the
experimental uncertainties. First and second moments of the extracted quark
helicity densities in the measured range are consistent with fits of inclusive
data
Exclusive Leptoproduction of rho^0 Mesons from Hydrogen at Intermediate Virtual Photon Energies
Measurements of the cross section for exclusive virtual-photoproduction of
rho^0 mesons from hydrogen are reported. The data were collected by the HERMES
experiment using 27.5 GeV positrons incident on a hydrogen gas target in the
HERA storage ring. The invariant mass W of the photon-nucleon system ranges
from 4.0 to 6.0 GeV, while the negative squared four-momentum Q^2 of the
virtual photon varies from 0.7 to 5.0 GeV^2. The present data together with
most of the previous data at W > 4 GeV are well described by a model that
infers the W-dependence of the cross section from the dependence on the Bjorken
scaling variable x of the unpolarized structure function for deep-inelastic
scattering. In addition, a model calculation based on Off-Forward Parton
Distributions gives a fairly good account of the longitudinal component of the
rho^0 production cross section for Q^2 > 2 GeV^2.Comment: 10 pages, 6 embedded figures, LaTeX for SVJour(epj) document class.
Revisions: curves added to Fig. 1, several clarifications added to tex
Evidence for a narrow |S|=1 baryon state at a mass of 1528 MeV in quasi-real photoproduction
Evidence for a narrow baryon state is found in quasi-real photoproduction on
a deuterium target through the decay channel p K^0_S --> p pi^+ pi^-. A peak is
observed in the p K^0_S invariant mass spectrum at 1528 +/- 2.6 (stat) +/-2.1
(syst) MeV. Depending on the background model,the naive statistical
significance of the peak is 4--6 standard deviations and its width may be
somewhat larger than the experimental resolution of sigma=4.3 -- 6.2 MeV. This
state may be interpreted as the predicted S=+1 exotic Theta^{+}(uuddbar(s))
pentaquark baryon. No signal for an hypothetical Theta^{++} baryon was observed
in the pK^+ invariant mass distribution. The absence of such a signal indicates
that an isotensor Theta is excluded and an isovector Theta is unlikely.Comment: 8 pages, 4 figure
Search for a Technicolor omega_T Particle in Events with a Photon and a b-quark Jet at CDF
If the Technicolor omega_T particle exists, a likely decay mode is omega_T ->
gamma pi_T, followed by pi_T -> bb-bar, yielding the signature gamma bb-bar. We
have searched 85 pb^-1 of data collected by the CDF experiment at the Fermilab
Tevatron for events with a photon and two jets, where one of the jets must
contain a secondary vertex implying the presence of a b quark. We find no
excess of events above standard model expectations. We express the result of an
exclusion region in the M_omega_T - M_pi_T mass plane.Comment: 14 pages, 2 figures. Available from the CDF server (PS with figs):
http://www-cdf.fnal.gov/physics/pub98/cdf4674_omega_t_prl_4.ps
FERMILAB-PUB-98/321-
Search for ZZ and ZW Production in ppbar Collisions at sqrt(s) = 1.96 TeV
We present a search for ZZ and ZW vector boson pair production in ppbar
collisions at sqrt(s) = 1.96 TeV using the leptonic decay channels ZZ --> ll nu
nu, ZZ --> l l l' l' and ZW --> l l l' nu. In a data sample corresponding to an
integrated luminosity of 194 pb-1 collected with the Collider Detector at
Fermilab, 3 candidate events are found with an expected background of 1.0 +/-
0.2 events. We set a 95% confidence level upper limit of 15.2 pb on the cross
section for ZZ plus ZW production, compared to the standard model prediction of
5.0 +/- 0.4 pb.Comment: 7 pages, 2 figures. This version is accepted for publication by Phys.
Rev. D Rapid Communication
Measurement of the Cross Section for Prompt Diphoton Production in p-pbar Collisions at sqrt(s) = 1.96 TeV
We report a measurement of the rate of prompt diphoton production in
collisions at using a data sample of 207
pb collected with the upgraded Collider Detector at Fermilab (CDF II).
The background from non-prompt sources is determined using a statistical method
based on differences in the electromagnetic showers. The cross section is
measured as a function of the diphoton mass, the transverse momentum of the
diphoton system, and the azimuthal angle between the two photons and is found
to be consistent with perturbative QCD predictions.Comment: 7 pages, 3 figures,revtex4. Version accepted by PRL, but with cross
section tables i
Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector
The inclusive and dijet production cross-sections have been measured for jets
containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass
energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The
measurements use data corresponding to an integrated luminosity of 34 pb^-1.
The b-jets are identified using either a lifetime-based method, where secondary
decay vertices of b-hadrons in jets are reconstructed using information from
the tracking detectors, or a muon-based method where the presence of a muon is
used to identify semileptonic decays of b-hadrons inside jets. The inclusive
b-jet cross-section is measured as a function of transverse momentum in the
range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet
cross-section is measured as a function of the dijet invariant mass in the
range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets
and the angular variable chi in two dijet mass regions. The results are
compared with next-to-leading-order QCD predictions. Good agreement is observed
between the measured cross-sections and the predictions obtained using POWHEG +
Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet
cross-section. However, it does not reproduce the measured inclusive
cross-section well, particularly for central b-jets with large transverse
momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final
version published in European Physical Journal
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