Serum levels of interleukin-6 (II-6), interleukin-18 (II-18) and c-reactive protein (CRP) in patients with type-2 diabetes and acute coronary syndrome without ST-Segment elevation

Background. Atherosclerosis is an inflammatory disease, and serum levels of inflammatory markers such as interleukin 6 (IL-6), interleukin 18 (IL-18) and C-reactive protein (CRP) are used to evaluate patients with coronary artery disease. In patients with type-2 diabetes, atherosclerosis is related to a larger number of events such as myocardial infarction and death, when compared with patients without diabetes. Objective: To evaluate the inflammatory response in patients with diabetes and acute events of coronary instability. Methods: Two groups of patients were primarily selected. The first group was comprised of diabetic outpatients with stable angina (D-CCS) and presence of coronary artery disease on coronary angiography (n =36). The second group was comprised of diabetic patients seen in the emergency room with acute coronary syndrome (D-ACS) without ST-segment elevation (n=38). Non-diabetic patients with ACS (n=22) and CCS (n = 16) comprised the control group. Serum levels of CRP IL-6 and IL-18 were determined using nephelometry (CRP) and ELISA (IL-6 and IL-18) techniques. Results: Higher serum IL-6 levels were found in diabetic or non-diabetic patients with ACS than in the group with CCS. On the other hand, diabetic patients with ACS had higher CRP levels in comparison with the other groups. Serum IL-18 levels were not significantly different among the patients studied. Conclusion: our findings suggest a more intense inflammatory activity in patients with coronary instability This inflammatory activity, as measured by CRP seems to be even more intense in diabetic patients. (Arq Bras Cardiol 2008;90(2):86-90).902949

Preoperative B-type natriuretic peptide, and not the inflammation status, predicts an adverse outcome for patients undergoing heart surgery

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objectives: B-type natriuretic peptide (BNP) and inflammatory markers are implicated in the pathophysiology of both ischemic cardiomyopathy and complications after cardiac surgery with cardiopulmonary bypass (CPB). The purpose of this study was to assess preoperative and postoperative levels of BNP, interleukin-6 (IL-6), interleukin-8 (IL-8), P-selectin, intercellular adhesion molecule (ICAM), C-reactive protein (CRP) in patients undergoing cardiac surgery with CPB and investigate their variation and ability to correlate with immediate outcome. Methods: Plasma levels of these markers were measured preoperatively, 6 and 24 h after CBP in 62 patients. Main endpoints were requirements for intra-aortic balloon pump, intensive care unit (ICU) stay longer than five days, ventilator dependence >24 h, requirement for dobutamine, hospital stay >10 days, clinical complications (infection, myocardial infarction, renal failure, stroke and ventricular arrhythmias) and in-hospital mortality. Results: Preoperative BNP levels correlate with longer ICU stay (P=0.003), longer ventilator use (P=0.018) and duration of dobutamine use (P190 pg/ml as predictor of ICU >5 days and BNP levels >20.5 pg/ml correlated with dobutamine use, with areas under the curve of 0.712 and 0.842, respectively. Preoperative levels of ICAM-1 were associated with in-hospital mortality (P=0.042). In the postoperative period, was found association between CRP, IL-6 and P-selectin with ventilation duration (P=0.013, P=0.006, P<0.001, respectively) and P-selectin with ICU stay (P=0.009). Conclusions: BNP correlates with clinical endpoints more than inflammatory markers and can be used as a predictor of early outcome after heart surgery. (C) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.125778783Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2002/08301-5

Perfil clínico-epidemiológico dos pacientes portadores de paracoccidioidomicose no Serviço de Estomatologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul Clinical-epidemiologic profile of paracoccidioidomycosis at the Stomatology Department of São Lucas Hospital, Pontificia Universidade Católica of Rio Grande do Sul

No presente estudo, são descritas as características clínicas e epidemiológicas de 61 casos de paracoccidioidomicose, atendidos no Serviço de Estomatologia do Hospital São Lucas da PUCRS, no período de junho de 1976 a junho de 2004. O Rio Grande do Sul é considerado uma região endêmica da doença devido às condições eco-epidemiológicas para o desenvolvimento do fungo. Observou-se que a doença ocorreu em 58 (95%) homens e 3 (5%) mulheres, predominando a faixa etária de 40 a 59 anos (70,5%), e a profissão vinculada à agricultura em 27 (44,3%) pacientes. O hábito de fumar foi prevalente em 52 (85,3%) pacientes da amostra e muitos eram, também, etilistas. Todos os casos apresentavam manifestações estomatológicas, sendo que as lesões orais ocorreram predominantemente com aspecto ulcerado e moriforme, observadas em vários sítios anatômicos. As evidências radiográficas de lesões pulmonares estavam presentes em 32 (65,3%) radiografias avaliadas.<br>The aim of the article was to describe clinical and epidemiological features of 61 oral paracoccidioidomycosis cases from the Stomatology Department of São Lucas Hospital, analyzed from July 1976 to June 2004. The State of Rio Grande do Sul is an endemic region due to ecoepidemiologic conditions, that are favorable for the development of the yeast. Men are the most affected gender, with 58 (95%) affected compared to 3 (5%) women. Ii is most prevalent (70.5%) between 40 and 59 years of age. Agricultural labor was the most common occupation with 27/61 (44.3%) patients. Tobacco smoking was prevalent in 52 (85.3%) of the sample, and alcoholism was a frequent finding. All the patients showed stomatologic manifestations, with ulcers and mulberry-like stomatitis the most prevalent, these oral lesions were also observed in many anatomical sites. Alterations were present in 32 (65.3%) of the pulmonary radiographs