Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2021
Plasma MMP-9 and TIMP-1 levels on ICU admission are associated with 30-day survival.
Matrix metalloproteinases (MMPs) are involved in systemic inflammatory responses and organ failure. The aim of this study was to evaluate early circulating plasma levels of MMP‑2, MMP‑9 and their inhibitors TIMP‑1 and TIMP‑2 and their prognostic significance in critically ill patients on admission to the intensive care unit (ICU). ⋯ The MMP‑9 and TIMP‑1 levels are significantly elevated in acute critical care settings with increased short-term mortality risk, especially in patients with underlying heart disease. These findings support the value of MMPs and TIMPs as prognostic markers and potential therapeutic targets in conditions leading to systemic inflammation and acute organ failure.
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Wien. Klin. Wochenschr. · Feb 2021
Observational StudyVitamin D assessment in perioperative medicine and critical care : A prospective observational pilot study.
There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. ⋯ The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate.
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Wien. Klin. Wochenschr. · Feb 2021
Combination value of biomarkers in discriminating adult onset still's disease and sepsis.
Lymphocyte and plateletcrit (PCT) as proportions of routine complete blood count tests, have been studied as simple biomarkers for inflammatory diseases. The aim of our study was to investigate whether blood routine parameters, especially platelet parameters could be a useful tool to distinguish Adult onset Still's disease (AOSD) from sepsis. ⋯ Thus we suggest that lymphocyte, PCT may be a useful tool to make a distinction between AOSD and sepsis, as supplementary biomarkers to ferritin.
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Wien. Klin. Wochenschr. · Feb 2021
Impact of hemodialysis on liver stiffness measured with real-time two-dimensional shear wave elastography.
The impact of hemodialysis on liver stiffness is still unclear. The aim of the study was to assess liver fibrosis by real-time two-dimensional shear wave elastography (RT 2D-SWE) and to quantify the influence of net fluid withdrawal on liver stiffness during one hemodialysis session. The second aim was to investigate the influence of systolic blood pressure and time spent on dialysis (in years) on liver stiffness measurements. ⋯ In this study 27 patients with mean age 69.4 ± 14.75 years were included. Mean net fluid withdrawal volume per session was 2874.07 ± 778.35 ml. Mean pre-HD and post-HD liver stiffness measurements were 8.15 kPa (95% confidence interval, CI 7.61-8.68) and 6.70 kPa (95% CI 6.10-7.30 kPa), respectively. Mean liver stiffness reduction was 1.448 ± 1.14 kPa. The amount of fluid removed correlated with the decline in liver stiffness values after HD (ρ = 0.523, P = 0.003). There was a positive but statistically not significant correlation between time spent in HD and liver stiffness (ρ = 0.151, P = 0.623) CONCLUSION: Liver stiffness significantly declined after one session of HD. The change in liver stiffness was strongly correlated with the amount of net fluid withdrawal. Random liver stiffness measurements (LSM) by RT 2D-SWE does not precisely show the degree of fibrosis, Furthermore, it is presumed that postdialysis liver stiffness values likely reflect the real degree of liver fibrosis.
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Wien. Klin. Wochenschr. · Feb 2021
Determinants of the intercept and slope of glomerular filtration rate in recipients of a live donor kidney transplant.
Donor kidney function is considered a critical determinant of allograft survival after live donor (LD) kidney transplantation, but its independent impact on the evolution of graft function is less well defined. The objective of this study was to dissect the relative contribution of LD kidney function to baseline estimated glomerular filtration rate (eGFR) of recipients and its decline. ⋯ Donor-related characteristics, most prominently the function of donated kidneys and LD age, were predictive of eGFR at baseline. The ABMR was identified as the cardinal cause of progressive deterioration of allograft function.