33 research outputs found
Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women
Obesity, the insulin resistance syndrome, and atherosclerosis are closely
linked and may all be determinants of an increased acute-phase response.
In this study, we examined the relationship of C-reactive protein (CRP)
with measures of obesity, variables of the insulin resistance syndrome,
and intima-media thickness of the common carotid arteries in 186 healthy,
middle-aged women selected from the general population. Associations were
assessed by regression analysis. CRP was strongly associated with body
mass index (BMI) and waist circumference. CRP was also associated with
other variables of the insulin resistance syndrome, including blood
pressure, insulin, high density lipoprotein cholesterol, triglycerides,
apolipoprotein A1 (inversely), plasminogen activator inhibitor-1 antigen,
and tissue-type plasminogen activator antigen. Associations between CRP
and the variables of the insulin resistance syndrome disappeared after
controlling for BMI but remained significant for plasminogen activator
inhibitor-1 antigen only. The association of CRP with common carotid
artery intima-media thickness was weak and limited to ever-smokers. BMI
explained 29.7% of the variance of CRP, whereas common carotid artery
intima-media thickness explained only 3.7%. The results of this
population-based study indicate that adiposity is strongly associated with
CRP in healthy, middle-aged women. In this population, BMI accounted for
the relationship between CRP and other variables of the insulin resistance
syndrome. Further studies should determine whether losing weight
ameliorates the inflammatory state
Induction of hypothermia in patients with various types of neurologic injury with use of large volumes of ice-cold intravenous fluid
An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient
OBJECTIVES:
To address the issues of Prevention and Management of Acute Renal Failure in the ICU Patient, using the format of an International Consensus Conference. METHODS AND
QUESTIONS:
Five main questions formulated by scientific advisors were addressed by experts during a 2-day symposium and a Jury summarized the available evidence: (1) Identification and definition of acute kidney insufficiency (AKI), this terminology being selected by the Jury; (2) Prevention of AKI during routine ICU Care; (3) Prevention in specific diseases, including liver failure, lung Injury, cardiac surgery, tumor lysis syndrome, rhabdomyolysis and elevated intraabdominal pressure; (4) Management of AKI, including nutrition, anticoagulation, and dialysate composition; (5) Impact of renal replacement therapy on mortality and recovery.
RESULTS AND CONCLUSIONS:
The Jury recommended the use of newly described definitions. AKI significantly contributes to the morbidity and mortality of critically ill patients, and adequate volume repletion is of major importance for its prevention, though correction of fluid deficit will not always prevent renal failure. Fluid resuscitation with crystalloids is effective and safe, and hyperoncotic solutions are not recommended because of their renal risk. Renal replacement therapy is a life-sustaining intervention that can provide a bridge to renal recovery; no method has proven to be superior, but careful management is essential for improving outcome