Clin Lab
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Continuous renal replacement therapy (CRRT) is a standard therapy in critically ill patients suffering from acute kidney injury (AKI). Extracorporeal circulation and exposure to foreign surfaces during CRRT may induce disturbances in hemostasis, particularly in platelet function. The present study described the hemostatic changes associated with CRRT and aimed to identify the independent predictors of premature clotting of the circuit. ⋯ The results of the present study indicate that CRRT may lead to impaired primary hemostasis as shown by a decrease in ex vivo arachidonic acid-induced platelet aggregation. Moreover, viscoelastic measure indicate a fibrinogen-associated trend of increasing clot firmness during the study period. Further studies are needed to analyze whether these findings are of hemostatic relevance.
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Recently, an increasing interest has been extended to the secretory products of fat tissue adipokines and their role in the course of acute pancreatitis (AP). The study aimed to evaluate the levels of adiponectin (ADP), adipocyte fatty acid binding protein (A-FABP), fibroblast growth factor (FGF 21), and selected proinflammatory markers during the early stage of acute pancreatitis. The parameters were measured for identification of the patients with the high risk of severe AP. ⋯ Elevated levels of CRP and IL-6 in subjects with severe form of AP on day 4 indicate a diagnostic utility of both parameters in the disease severity prediction. Increased FGF 21 at admission compared to day 4 suggests its potential role as an immediate response gene during pancreatic injury. The dynamics of FGF 21 and A-FABP levels probably reflect the improvement of clinical condition in the early stage of AP.
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The phosphoinositide 3 kinase (PI3K)/AKT/mammalian target of the rapamycin (mTOR) pathway is a complicated intracellular pathway which leads to cell growth and tumor proliferation and plays a significant role in breast cancer. Multiple compounds targeting this pathway are being evaluated in clinical trials. NVP-BEZ235, a novel and orally available dual PI3K/mTOR inhibitor, showed great antitumor effect and provided a therapy strategy in breast cancer. ⋯ This study provides a novel treatment strategy that PI3K/AKT/mTOR pathway inhibitors in combination with autophagy inhibitors lead to further apoptosis in breast cancer cells.
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Review Meta Analysis
Could Blood Neutrophil Gelatinase-Associated Lipocalin (NGAL) be a Diagnostic Marker for Acute Kidney Injury in Neonates? A Systemic Review and Meta-Analysis.
Blood neutrophil gelatinase-associated lipocalin (NGAL) has been shown to be helpful for acute kidney injury (AKI) in pediatric patients and adults. Whether this is true in neonates remains unclear. ⋯ Blood NGAL could be used as diagnostic marker for AKI in neonates.
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Controlled Clinical Trial
C-terminal agrin fragment (CAF) reflects renal function in patients suffering from severe sepsis or septic shock.
One of the main causes of acute kidney injury (AKI) in patients treated on an intensive care unit (ICU) is sepsis. The identification of new biomarkers indicating the early development and future course of AKI are of utmost medical interest. The C-terminal agrin fragment (CAF) is measurable in blood serum and might reflect kidney function. Therefore, this study evaluates CAF in patients presenting to an internal ICU with severe sepsis or septic shock. Serum levels of CAF are correlated with biomarkers of kidney function, markers of systemic inflammation, and the presence of AKI and renal replacement therapy (RRT). ⋯ In patients suffering from severe sepsis and septic shock, serum levels of CAF were significantly associated with kidney function and RRT and were not influenced by severe septic conditions.