Irish journal of medical science
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The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function. ⋯ The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.
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Sepsis is the most frequent cause of systemic inflammatory response syndrome (SIRS). Procalcitonin (PCT) and C-reactive protein (CRP) are well-known predictors of sepsis. Serum PCT levels are associated with blood culture positivity in patients with sepsis, but the magnitude of elevation of PCT and CRP levels at the onset of sepsis is unknown in Gram-negative (GN) bacteremia and in Gram-positive (GP) bacteremia. ⋯ Serum PCT levels are higher in GN sepsis than GP sepsis in 72 h. There are not differences in CRP. The separation of PCT and CRP phenomenon is helpful for early diagnosis of GP sepsis.
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The participation of inflammation in the progression of cancer for many years have been the subject of research. ⋯ In this article we present a brief history of the discovery mechanisms and potential links between acute and chronic inflammation and cancer.
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Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). ⋯ This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.
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Large loop excision of the transformation zone (LLETZ) is the most common form of treatment for cervical pre-cancer. The majority of procedures should be performed under local anaesthesia (LA) in an outpatient setting. ⋯ The use of GA for LLETZ rarely confers benefits in terms of diagnostic or therapeutic quality indicators. The categorisation we propose is a simple audit tool that could be adopted by all colposcopy units to reduce the rate of GA.