ABSTRACT
Immunoparalysis and apoptosis of T cells are serious problems for the evolution of septic patients. We aimed to relate changes in the number of αß and γδ T cells during hospital stay to the poor evolution of sepsis. In this prospective study, we recruited a total of 92 septic patients from the Emergency and Intensive Care Departments of two Hospitals, according to the latest criteria for the definition and management of sepsis. According to the severity of the septic process, there was a progressive decrease in T cells, being much more intense in γδ T cells. This decrease recovered in surviving patients, but CD3+CD56+ γδ T cells continued to decreased during hospital stay in non-surviving patients. Apoptosis increased in sepsis. Cell death of CD3+CD56+ γδ T cells progressively increased according to the severity of sepsis, especially in non-surviving patients.
Subject(s)
Sepsis , Shock, Septic , Apoptosis , CD3 Complex/immunology , CD56 Antigen/immunology , Hospitals , Humans , Lymphocyte Count , Prospective Studies , Receptors, Antigen, T-Cell, gamma-delta/metabolismABSTRACT
Introducción. La sintomatología referida como sensación de inestabilidad es muy habitual en pacientes que han sufrido un latigazo cervical. Se trata de un grupo de pacientes en el que habitualmente las pruebas de diagnóstico complementario no ofrecen hallazgos de interés. Pretendemos encontrar hallazgos comunes a la población con latigazo cervical que nos permitan diferenciarla de la sana. Material y métodos. Estudiamos una muestra de 30 pacientes que sufrieron un latigazo cervical en 2004 (7 hombres y 23 mujeres, con edades entre 20 y 72 años). Todos cumplimentaron dos escalas de valoración (Tinetti y Berg) y un estudio de posturografía con plataforma dinamométrica. Comparamos los datos obtenidos en la posturografía con población sana. Resultados. Se han encontrado diferencias significativas en la mayor parte de las pruebas analizadas, sobre todo en la valoración global (23,735). Las pruebas de Romberg con gomaespuma fueron las más sensibles para diferenciar ambas poblaciones (6,966 y 14,258). En las escalas de valoración utilizadas los datos fueron idénticos a la población sana. Los índices sensoriales también se vieron alterados, sobre todo el somatosensorial (21,075) y el vestibular (17,905). Los pacientes con latigazo cervical utilizaron de forma predominante la estrategia de cadera o medio-lateral (56,994) para compensar su inestabilidad. Conclusión. El análisis de los parámetros cinéticos de las pruebas de equilibrio y marcha, a diferencia de las escalas de valoración, permite diferenciar la población con latigazo cervical de la sana. Las pruebas más sensibles son las de Romberg con gomaespuma (ojos abiertos y cerrados)
Introduction. The symptomatology explained as sensation of instability is very usual in patients who have suffered a whiplash injury. In this type of patients the complementary tests of diagnosis do not usually offer findings of interest. With this work we aim to look for common findings to the population suffering whiplash injury so as to differentiate them from the healthy population. Methodology. A sample of 30 patients who suffered a whiplash injury in 2004 (7 men and 23 women, with ages between 20 and 72 years) was studied. All of them filled out the evaluation scales of Tinetti and Berg and performed a study based on gait and balance analysis with a dynamometric platform. Their results were compared to the data of healthy population. Results. Significant differences in most of the tests have been found, especially in the global evaluation (23.735). Romberg tests with foam were the most sensitive to differentiate both populations (6.966 and 14.258). The results obtained from the evaluation scales showed no differences between both groups. The sensorial indexes were also altered, above all, somatosensorial (21.075) and vestibular (17.905). Patients with whiplash injury predominantly used the hip or middle-lateral strategy (56.994) to compensate their instability. Conclusion. The analysis of the kinetic parameters obtained from the tests of balance and gait, unlike the evaluation scales, makes it possible to differentiate the population with whiplash injury from the healthy one. The most suitable tests are those of Romberg with foam (open and closed eyes)
Subject(s)
Male , Female , Adult , Aged , Middle Aged , Humans , Whiplash Injuries/physiopathology , Kinesics , Gait/physiology , Posture/physiology , Disability Evaluation , Whiplash Injuries/rehabilitationABSTRACT
In patients with severe heart failure due to acute myocardial infarction (AMI) breathing with PEEP can be of additional therapeutic value. This study was designed to assess the effects of CPAP through face mask with 15 cm H2O on left ventricular performance in AMI patients, using equilibrium radionuclide angiocardiography (ERA). In response to lung inflation, high levels of PEEP have been shown to decrease heart rate and stroke volume. The sum of the TPF pathological prolongation and the Mean-FR reduction suggests a decrease in the left ventricular compliance determined by the restriction imposed by the positive pressure. The global systolic performance is preserved.
