Articles: cations.
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Mafenide acetate is used in some burn wounds for its ability to penetrate eschar but requires frequent uncomfortable dressing changes for its application. The authors hypothesize that hydrofiber dressings will hold mafenide acetate solution for an extended period of time and maintain antimicrobial activity longer than traditional gauze, thus possibly obviating the need for frequent dressing changes. Four experimental arms included: 1) hydrofiber, stored on a dry well plate as control, 2) gauze saturated with 2.5% mafenide acetate, stored on nonsterile porcine skin, 3) hydrofiber saturated with mafenide acetate, stored on dry well plate, and 4) hydrofiber saturated with mafenide acetate, stored on nonsterile porcine skin. ⋯ Gauze saturated with mafenide acetate did not reliably demonstrate antimicrobial activity beyond 0 hours. Hydrofiber saturated with mafenide acetate, whether stored on a dry well plate or nonsterile porcine skin, consistently possessed sustained antimicrobial activity as demonstrated by zones of inhibition greater than 2 mm to both S. aureus and P. aeruginosa. Mafenide acetate-soaked hydrofiber dressings stay moist and maintain antimicrobial activity against S. aureus and P. aeruginosa for at least 72 hours without repeated soaks.
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Receptor for advanced glycation end products (RAGE) and its cleavage fragment soluble RAGE (sRAGE) are opposite players in inflammation. Enhanced monocytic RAGE expression and decreased plasma sRAGE levels are associated with higher mortality in infarction-related cardiogenic shock. Active matrix metalloproteinase-9 (MMP-9) has been implied in RAGE ectodomain cleavage and subsequently sRAGE shedding in vitro. We investigated MMP-9 activity in myocardial infarction-induced cardiogenic shock with regard to RAGE/sRAGE regulation. ⋯ Serum MMP-9 activity is increased in acute myocardial infarction, but markedly suppressed in cardiogenic shock. Maintaining MMP-9 activity could be a therapeutic target to limit RAGE-induced deleterious inflammation in cardiogenic shock.
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To explore the role of pancreatic ductal adenocarcinoma (PDAC) size on surgical and survival outcomes. ⋯ Among the tumors measured, 21.5% were <20 mm and 78.5% >20 mm. Larger tumors were associated with higher Ca19.9, T3-T4 and N1, higher grade, perineural invasion, R1 resections, more positive lymph nodes, and higher lymph node ratios (P < 0.05). Tumours <20 mm showed a better prognosis (33 vs 23 months; P < 0.01), but worse surgical results with higher pancreatic fistula (21.1% vs 14.6%; P < 0.01) and mortality rates (1.5% vs 0.3%; P = 0.04). PDAC size was associated with worse prognosis (hazard ratio 1.26, P = 0.02), together with Ca19.9, grading, and N1. When measured at imaging, tumor size was underestimated (median 23 vs 30 mm; P < 0.01) and did not influence prognosis CONCLUSIONS:: PDAC size >20 mm, measured at gross pathology, correlates with surgical outcomes and is an independent predictor of poor prognosis. Given that imaging underestimates size by about 20%, perhaps tumors that measure >20 mm at imaging should be considered for neoadjuvant treatment regardless of resectability.
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Randomized Controlled Trial
Randomized clinical trial of landiolol hydrochloride for the prevention of atrial fibrillation and postoperative complications after oesophagectomy for cancer.
Atrial fibrillation is common after oesophageal surgery. The aim of this study was to evaluate whether landiolol hydrochloride was effective and safe in the prevention of atrial fibrillation after oesophagectomy, and to see whether a reduction in incidence of atrial fibrillation would reduce other postoperative complications. ⋯ Landiolol was effective and safe in preventing atrial fibrillation after oesophagectomy. Registration number: UMIN000010648 (http://www.umin.ac.jp/ctr/).