Neutrophil gelatinase-associated lipocalin in dehydrated patients: a preliminary report

<p>Abstract</p> <p>Background</p> <p>Acute kidney injury has been recognized as a major contributor to end stage renal disease. Although neutrophil gelatinase-associated lipocalin (Ngal) has been reported as a promising biomarker for early detection of acute kidney injury, no study has yet examined its potential clinical impact in patients with normal renal function. The purpose of current study is to investigate possible difference in serum Ngal levels between dehydrated and control patients.</p> <p>Findings</p> <p>A total of twelve patients presented with symptoms of mild dehydration defined by history of diarrheas or vomiting and orthostatic (postural) hypotension and an age and sex matched group of twelve control patients were included. The two groups of patients did not seem to differ in basic clinical and laboratory parameters. Serum Ngal was higher in dehydrated patients when compared to control group (Ngal = 129.4 ± 25.7 ng/mL vs 60.6 ± 0.4 ng/mL, p = 0.02). Ngal was not correlated with age, hemoglobin, white blood cell count, red blood cell count, urea or creatinine.</p> <p>Conclusions</p> <p>The presence of elevated Ngal levels in dehydrated patients may suggest its role as a very sensitive biomarker in even minimal and "silent" prerenal kidney dysfunction</p

Le Cénomanien de la Vallée du Mondego (Portugal). Limite avec le Turonien. Evolution Ouest-Est, implications paléogéographiques

Three sections eastwards between Figueira-da-Foz and Coimbra define lithologie and faunistic composition of Upper Cenomanian of Beira littorale, exact age of Cenomanian transgression and stratigraphie boundary with Turonian layers. Very coastal features of Cenomanian near by Coimbra and more typically marine Figueira-da-Foz Cenomanian allow to set a paleoshoreline eastward from Coimbra and are inconsistent with theories of a direct communication with Celtiberic basin.Trois coupes échelonnées d'Ouest en Est entre Figueira-da-Foz et Coimbra précisent la composition lithologique et faunistique du Cénomanien supérieur de la Beira littorale, l'âge exact de la transgression cénomanienne et la limite avec le Turonien. Le caractère très margino-littoral du Cénomanien de Coimbra et celui plus franchement marin de Figueira-da-Foz, permettent de placer un paléorivage à l'Est de Coimbra et s'opposent ainsi à l'idée d'une communication directe avec un bassin Celtiherique.Lauverjat Jacques. Le Cénomanien de la Vallée du Mondego (Portugal). Limite avec le Turonien. Evolution Ouest-Est, implications paléogéographiques. In: Géologie Méditerranéenne. Tome 5, numéro 1, 1978. Colloque sur le Cénomanien (France – Europe Occidentale), Paris, 6-7 septembre 1976. pp. 109-114

La nappe de l'Albien dans le Bassin de Paris : de nouvelles idées pour de vieilles eaux

Raoult Y., Boulegue J., Lauverjat J., Violette S., De Marsily Gh., Levassor A. La nappe de l'Albien dans le Bassin de Paris : de nouvelles idées pour de vieilles eaux. In: Transferts dans les systèmes sédimentaires : de l'échelle du pore à celle du bassin. Réunion spécialisée SGF-TRABAS/CNRS, Paris 27-28 septembre 1999. Résumés. Strasbourg : Institut de Géologie – Université Louis-Pasteur, 1999. pp. 117-119. (Sciences Géologiques. Mémoire, 99

Is diabetes a risk factor for central venous access port-related bloodstream infection in oncological patients?

International audienceIt was a dogma that patients with diabetes mellitus (DM) are at increased risk of infection or death associated with an infection. However, in cancer patients, this has not been well investigated. The aim was to investigate whether diabetic patients with cancer are at high risk of central venous access port (CVAP)-related bloodstream infection (BSI), and to analyse mortality after CVAP-BSI. A total of 17 patients with type 1 DM (T1DM), 66 with type 2 DM (T2DM) and 307 non-diabetic patients were included. Each patient was followed up until the first late CVAP-BSI or for a maximum for 1 year in the absence of a CVAP-BSI. Fifty-three CVAP-BSIs occurred in 66,528 catheter-days. The cumulative incidence of CVAP-BSI was not higher in T1DM (5.9 %; p = 0.17) and T2DM (19.7 %; p = 0.70) compared with the non-diabetic patients (12.7 %). However, in patients with CVAP-BSI, the 1-month crude mortality rate was higher in DM patients (42.9 % vs. 15.4 %; p = 0.04), whereas the mortality in patients without CVAP-BSI was similar in both groups of patients (19.8 % vs. 17.1 %; p = 0.58). Of the 12 deaths that occurred within 1 month of CVAP-BSI, 16.66 % was attributable to CVAP-BSI. The predictive factor of 1-month mortality was DM (p = 0.04). Parenteral nutrition (PN) was independently associated with CVAP-BSI in diabetic patients (p = 0.001). In this study, diabetes did not increase the risk of CVAP-BSI, but mortality was higher in diabetic patients who had a CVAP-BSI. This suggests, in addition to medical treatment, CVAP should be withdrawn after infection onset

Vitamin C in Home Parenteral Nutrition: A Need for Monitoring

International audienceTo date, there are no recommendations about screening plasma vitamin C concentration and adjust its supplementation in patients on long-term home parenteral nutrition (HPN). The aim of this study was to evaluate vitamin C status and determine if a commercial multivitamin preparation (CMVP) containing 125 mg of vitamin C is sufficient in stable patients on HPN. All clinically stable patients receiving HPN or an intravenous fluid infusion at least two times per week for at least 6 months, hospitalized for nutritional assessment, were retrospectively included, for a total of 186 patients. We found that 29% of the patients had vitamin C insufficiency (i.e., \textless25 µmol/L). In univariate analysis, C-reactive protein (CRP) (p = 0.002) and intake of only 125 mg of vitamin C (p = 0.001) were negatively associated with vitamin C levels, and duration of follow-up in our referral center (p = 0.009) was positively associated with vitamin C levels. In multivariate analysis, only CRP (p = 0.001) and intake of 125 mg of vitamin C (p \textless 0.0001) were independently associated with low plasma vitamin C concentration. Patients receiving only CMVP with a low plasma vitamin C level significantly received personal compounded HPN (p = 0.008) and presented an inflammatory syndrome (p = 0.002). Vitamin C insufficiency is frequent in individuals undergoing home parenteral nutrition; therefore, there is a need to monitor plasma vitamin C levels, especially in patients on HPN with an inflammatory syndrome and only on CMVP