All cases of bacteremia caused solely by Escherichia coli in 1977-1979, 1987-1989, and 1993-1994 in a Finnish university hospital were reviewed retrospectively to determine the clinical manifestations, the outcome, and the prognostic factors. In 332 episodes, mortality during the month after the first positive blood culture was 17%. This figure diminished during the study period from 23% in the 1970s to 9% in the 1990s (p = 0.028). Mortality was lowest among patients treated with a combination of antibiotics, 7% versus 18% among those treated otherwise (p = 0.034). The use of acetaminophen increased during the study period from 18 to 55%. Mortality among patients who received acetaminophen within a period < 24 h to 48 h of the first positive blood culture was 10% versus 22% among others (p = 0.002). Logistic regression analysis showed six factors predictive of a fatal outcome: pneumonia, no known focus, shock, CNS disorder, thromboembolism, and rapidly fatal underlying disease. Appropriate antibiotic therapy predicted survival. In the analysis, replacement of appropriate antibiotic therapy by acetaminophen revealed that this drug was significantly associated with survival.
Acute intestinal infections are widespread and hold the second place among infectious diseases, giving way solely to respiratory diseases. In this regard, much attention has been paid to examining acute intestinal infections, including immunopathogenetic mechanisms. And since proinflammatory and antiinflammatory cytokines play an important role in development of inflammatory reactions affecting disease severity and outcome, it becomes reasonable to study polymorphism of genes governing production of related molecules. Thus, the aim of our study was to examine the polymorphism in the IL-1β Т31С and IL-2 T330G genes; such mutations were characterized by nucleotide replacement affecting the gene promoters, which influenced production rate and level of the relevant cytokines. There were enrolled 108 patients with acute intestinal infections comprising main group as well as 94 apparently healthy subjects in the control group. Genomic DNA was isolated from the whole blood leukocytes by using a DNA-express-blood reagent, followed by conducting amplification reaction with two pairs of allele-specific primers. The polymorphism in the IL-1β, IL-2 genes was determined by PCR with primers purchased from Litech LLC (St. Petersburg). Data processing was carried out by using the statistical Statistica 6 suite software. While assessing the carriage rate of IL-1β T31C gene polymorphic markers by using the multiplicative inheritance model in both groups, the prevalence of the normal T allele and, respectively of the —31TT and —31TC genotypes with OR = 1.83 and an interval of 1.04—3.22 (χ2 = 6.35, p = 0.04, df = 2) was found, which allowed us to identify a relationship between the carriage of IL-1β в gene heterozygous variant and potentially elevated risk of AII. Regarding the IL-2 T330G gene, it was found that pathological G alleles was more markedly abundant in patients with acute intestinal infections compared to control group. Analyzing diverse IL-2 T330G carriage rate in patients with acute intestinal infections revealed that carriers of the TG heterozygous variant predominated — 56.48% (χ2 = 17.75, F = 0.000031), whereas pathological genotype GG was found in 13.89% (χ2 = 12.31, F = 0.000663, p < 0.05), with high probability of the relationship between carriage of these genotypes and a risk of disease development (OR — 3.63 [1.97—6.68] and OR — 6.91 [2.12—22.59]). Hence, the carriage of polymorphic variants of the IL-1β T31C and IL-2 T330G genes was associated with elevated risk of developing AII in case of infection with pathogenic microorganisms.
ГБОУ ВПО «Читинская государственная медицинская академия», г. Чита, РоссияРезюме. Под наблюдением находилось 20 больных (12 женщин и 8 мужчин) с эритематозно-бул-лезной формой средней степени тяжести и 20 больных (10 мужчин и 10 женщин) с эритематозной формой средней степени тяжести рожи в возрасте 45-55 лет. У всех больных диагностировано пер-вичное заболевание с локализацией воспалительного процесса на нижних конечностях. Больные го-спитализированы в течение 1-3-х суток с начала клинических проявлений болезни. Лабораторные исследования у всех пациентов проведены на 3 и 12 сутки с момента проявления симптомов рожи. Контрольная группа представлена 55 здоровыми лицами обоего пола в возрасте 45-55 лет. Всем боль-ным проводилась стандартная терапия, включающая антибиотики, десенсибилизирующие и дезин-токсикационные препараты.У больных с разными формами рожи проводилось определение показателя лимфоцитарно-тром-боцитарной адгезии (ЛТА). Установлено, что показатель ЛТА резко снижался уже в начале заболева-ния, несмотря на то, что существенных изменений в содержании абсолютного числа лимфоцитов по сравнению со здоровыми в эти сроки не выявлено. Одновременно уменьшалась степень адгезии. На 12 сутки лечения показатель ЛТА поднялся у больных, существенных изменений в содержании аб-солютного числа лимфоцитов по сравнению со здоровыми в эти сроки не выявлено. Степень адгезии также увеличивалась. При роже снижается способность лимфоцитов адгезировать на своей поверх-ности тромбоциты. Динамика параметров ЛТА -показатель оценки эффективности проводимого лечения. 672000, Россия, г. Чита, ул. Горького, 39а.
Актуальность. Несмотря на всестороннее изучение патогенеза первичной открытоугольной глаукомы (ПОУГ), механизмы возникновения заболевания до конца не изучены. В настоящее время определена роль аквапоринов в регуляции внутриглазного давления. Были обнаружены мутации, усиливающие и снижающие функции аквапорина 4, описано влияние различных генетических вариантов аквапоринов на величину внутриглазного давления. Цель исследования. Исследовать частоту встречаемости вариантов полиморфизма rs2075575 (C/Т) гена аквапорина 4 у больных ПОУГ. Материалы и методы. В исследовании приняли участие 101 пациент с ПОУГ и 80 здоровых людей (контрольная группа). Возраст исследуемых колебался от 45 до 87 лет. Средний возраст составил 66 лет. Критерием включения в основную группу служил диагноз ПОУГ развитой, далеко зашедшей и терминальной стадий. Критериями включения в контрольную группу служили возраст старше 60 лет, отсутствие глаукомы и выраженной соматической патологии. ДНК выделяли из буккального эпителия. Полиморфизм гена аквапорина 4 rs2075575 определяли методом полимеразной цепной реакции. Результаты. Установлено, что распределение генотипов у пациентов с ПОУГ отличается от группы здоровых лиц. Обнаружено, что генотип СС среди больных глаукомой встречается в 1,8 раза чаще, чем в контрольной группе. Наоборот, генотип СТ выявляется в 1,5 раза чаще в контрольной группе. Отношение шансов (OR) для генотипа СС равно 2,48 (95% CI 1,30-4,74). У генотипа СТ выявляется протекторная роль, OR =0,52 (95% CI 0,28-0,97). Частота встречаемости генотипа ТТ в исследуемых группах не различается. Выводы. Полиморфный вариант rs2075575 (C/Т) гена аквапорина 4 вносит вклад в риск развития ПОУГ в исследованной выборке. Background. Despite a comprehensive study of the pathogenesis of the disease, the mechanisms of primary open-angle glaucoma are not completely clear. Currently, the role of aquaporins in the regulation of intraocular pressure has been determined. Mutations were discovered that enhance and decrease the functions of aquaporin 4. The effect of various genetic variants of aquaporins on the value of intraocular pressure is described. The aim of research. To investigate the variability of the polymorphism of aquaporin 4 rs2075575 (C / T) in patients with glaucoma. Materials and methods. 101 persons with primary open-angle glaucoma and 80 persons without glaucoma (the control group) were examined. The age of the subjects ranged from 45 to 87 years. The average age was 66 years. The criterion for inclusion in the main group was the diagnosis of primary open-angle glaucoma of a developed, distant and terminal stage. The criteria for inclusion in the control group were age over 60 years, the absence of glaucoma, the absence of pronounced somatic pathology. DNAs were extracted from buccal epithelium. The polymerase chain reaction (PCR) method was used to determine the polymorphism of the aquaporin gene 4 rs2075575. Results. There was a significant difference in the distribution of genotypes in the study and control groups. СС genotype among patients with glaucoma occurs 1.8 times more often than in the control group. CT genotype, on the contrary, is 1.5 times more often in the control group. The odds ratio (OR) for this genotype is 2.48 (95% CI 1.30 - 4.74). The CT genotype reveals a protective role, OR = 0.52 (95% CI 0.28 - 0.97). The genotype of TT in the studied groups is slightly different in frequency of occurrence. Conclusion. The frequencies of gene polymorphisms of aquaporin 4 rs2075575 (C/Т) in patients with primary open-angle glaucoma and healthy were diverse. The likelihood of developing primary open-angle glaucoma is increased in carriers of the СС genotype. Genotype CT play a protective role for primary open-angle glaucoma.
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