Administration of anti-TNF antibody improves left ventricular function in septic shock patients; Results of a pilot study

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Fasciite nécrosante de la paroi abdominale post-césarienne

Necrotizing fasciitis (NF) is a rare infection (0,2 to 0,4/100,000 adults) of the dermis and hypodermis extending along muscular fascia1. The absence of pathognomonic symptoms makes its diagnosis difficult. Rapidly progressive, it is a life-threatening emergency whose prognosis is letal in 30 % of cases. Treatment of necrotizing fasciitis is mixed and involves aggressive surgical debridement and medical treatment with antibiotics and supportive agents. This article is presenting the case of a young woman who developed abdominal necrotizing fasciitis following a caesarean section. In forty-eight hours, the patient developed septic shock with an extensive and rapid destruction of her abdominal wall. After hysterectomy and multiple surgical debridements, evolution was favorable. After one month, a reconstruction of the abdominal wall could be performed.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Beneficial effects of prophylactic OKT3 in cadaver kidney transplantation: comparison with cyclosporin A in a single-center prospective randomized study.

Clinical TrialJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

Corticosteroids increase blood interleukin-10 levels during cardiopulmonary bypass in men

Background. Interleukin (IL)-10 is a potent antiinflammatory cytokine inhibiting the release of tumor necrosis factor-α (TNF-α) and IL-8 by activated macrophages and polymorphonuclear leukocytes. Cardiopulmonary bypass (CPB) represents a unique situation where an inflammatory reaction is predictably induced. The present study examined the influence of CPB on the release of TNF-α, IL-1β, IL-8, and IL-10 and also defined the effects of pretreatment with corticosteroids on the release of these cytokines. Methods. The study included 22 patients undergoing coronary artery bypass graft operations, including eight control patients and seven patients who received dexamethasone, and seven patients who received methylprednisolone 4 hours before the operation. Cytokines were measured with the enzyme-linked immunosorbent assay technique before treatment, before anesthesia induction, immediately before heparin administration, before aorta declamping, 10 minutes and 90 minutes after aorta declamping, and 4 hours after the end of CPB. Results. In the control patients the TNF-α levels and especially the IL-8 levels increased during CPB and reached their maximal levels 4 hours after CPB. IL-10 levels rose moderately and transiently, reaching peak values 90 minutes after aorta declamping. Notably, administration of corticosteroids prevented IL-8 release but increased IL-10 levels, which were tenfold higher than in the control group 90 minutes after aorta declamping (dexamethasone, 271 ± 128 pg/ml; methylprednisolone, 312 ± 213 pg/ml; control, 17 ± 12 pg/ml, p < 0.05). IL-1β was not detected in any group of patients. Conclusions. The present data indicate that IL-10 is released together with proinflammatory cytokines during and after CPB and that pretreatment with corticosteroids markedly enhances this release. The release of IL-10 may play an important role in the antiinflammatory effects of corticosteroids.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Cerebral venous thrombosis and procoagulant factors: A case study

Cerebral venous thrombosis is a polymorphic clinical entity for which diagnosis has become more frequent with the advent of neuroradiology. The superior sagittal and transverse sinuses are frequently involved, whereas cavernous sinus thrombosis is much less frequent. Inherited resistance to the anticoagulant action of activate protein C (APC resistance), antithrombin deficiency, protein C and S deficiencies, and hyperhomocysteinemia seem to represent major causes of thrombophilia when unusual thromboembolic events (ie, before the age of 45 years) are observed. The authors present the combined occurrence of protein C and protein S deficiencies in a 32-year-old woman, manifested by extensive cerebral venous thrombosis.SCOPUS: ar.jinfo:eu-repo/semantics/publishe