No abstract

This study is the first to demonstrate both the presence of circulating miRNAs in lymph and the alteration of specific miRNAs in AP. Furthermore, these miRNAs alter in rat and human AP plasma and have potential to be explored as novel biomarkers of pancreatitis.

Limited data are available on the electrocardiogram and ambulatory electrocardiogram recording (Holter) in children infected with the human immunodeficiency virus type 1 (HIV-1). The purpose of this study was to estimate the prevalence and cumulative incidence of rhythm and conduction abnormalities in HIV-1-infected children. Electrocardiograms and Holter monitoring studies were performed annually on 205 HIV-1-infected children enrolled after 28 days of life (group I), 93 HIV-1-infected infants enrolled during pregnancy or during the first 28 days of life (group IIa), and 463 HIV-1-uninfected infants enrolled during pregnancy or during the first 28 days of life (group IIb). The 5-year cumulative incidence in the group I children of second-degree atrioventricular block or supraventricular or ventricular tachycardia was 13.4%, and the 5-year incidence was higher for the older infected group I children (16.8% for children > or =4 years old at first study and 11.4% for children <4 years, p = 0.04). The mean corrected QT interval was also longer for the older infected group I children (p = 0.002) and prolonged in the HIV-1-infected compared to the HIV-1-uninfected group II children (p = 0.02). None of the children had atrial fibrillation or flutter. Arrhythmias are uncommon in children infected with HIV-1 and in children of HIV-1-infected mothers and the arrhythmias identified tend to be benign. Therefore, routine Holter monitoring does not appear to be indicated in asymptomatic children.

Grade 1C)'. It assumes equal risk for a lumbar plexus block when compared with an upper limb plexus block and does not consider the potential benefits of ultrasound in mitigating vascular injury.In the absence of robust evidence, it is our assertion that, by identifying current practice across the country, confidence can be gained that we are operating in a way similar to our colleagues. Thus, it allows the application of the Bolam principle. For upper limb blocks, the authors recommend:(i) ultrasound-guided technique in patients with altered coagulation; (ii) INR ,2.5 (88% concordance); (iii) platelet count ≥50 000 (65% concordance); (iv) concomitant use of clopidogrel is not necessarily a contraindication (50% concordance); (v) a national audit project similar to the Royal College of Anaesthetists' third national audit project, identifying major complications of central neuraxial blockade, would be of benefit.

The lavage of the peritoneal cavity in patients with severe acute pancreatitis does not appear to confer a clinical benefit. Whether lavage of the pancreatic bed after necrosectomy is beneficial has yet to be determined.