RESUMEN
Microalbuminuria seems to be a reflection of increased vascular permeability caused by systemic inflammatory response, and is likely to be a predictor of mortality, sepsis and other outcomes of severe burn patients. We investigated the impact of microalbuminuria on the prognosis of patients with severe burns. This is a prospective study on severe burn patients (above 20%) admitted in the first 24 hours after burns to the Motahari Burn Hospital. Patients' microalbuminuria was measured at admission and 48 hours later, and its relationship with patient prognosis (sepsis, renal failure, death, inhalation injury and systemic inflammatory response syndrome) was analyzed. We concluded that microalbuminuria at admission in patients with severe burns was directly related to inhalation injury (P = 0.018), ARDS during hospitalization (P = 0.001) and length of hospital stay (P = 0.025). Moreover, microalbuminuria at 48 hours after admission had a direct connection with patient death (P = 0.001), sepsis (P = 0.001), renal failure (P = 0.001) and SIRS (P = 0.001). Microalbuminuria is a simple, noninvasive, fast and affordable test to predict sepsis, mortality, renal failure, systemic inflammatory response and a finding associated with inhalation injury in severe burn patients, making it a fast prognostic predictor that helps to improve the management of these patients.
Une microalbuminurie semble traduire l'augmentation de perméabilité capillaire due à une réaction inflammatoire systémique et pourrait être un paramètre pronostic de mortalité, sepsis et autres évolutions des patients gravement brûlés. Nous avons étudié la relation entre microalbuminurie et devenir des patients sévèrement brûlés. Il s'agit d'une étude conduite chez des patients brûlés sur plus de 20% de SCT admis dans le CTB Motahari dans les 24 h suivant l'accident. La microalbuminurie a été mesurée à l'entrée et à h48 et son association avec une inhalation de fumée ainsi qu'avec le devenir du patient (sepsis, insuffisance rénale, décès, réponse inflammatoire systémique) a été analysée. La microalbuminurie à l'entrée est associée avec l'inhalation de fumées (p=0,018), la survenue d'un SDRA (p=0,001) et la durée d'hospitalisation (p=0,025). La microalbuminurie à h48 est associée au décès (p= 0,001), au sepsis (p= 0,001), à l'insuffisance rénale (p= 0,001) et au SIRS (p= 0,001). La microalbuminurie est un marqueur simple, rapide et abordable, fortement corrélé au sepsis, à la mortalité, à l'insuffisance rénale, au SIRS, fréquemment associé à une inhalation de fumées. Ceci en fait un marqueur pronostic rapide pouvant aider à améliorer la prise en charge de ces patients.
RESUMEN
An integrated circuit for real-time wireless monitoring of neurochemical activity in the nervous system is described. The chip is capable of conducting measurements in both fast-scan cyclic voltammetry (FSCV) and amperometry modes for a wide input current range. The chip architecture employs a second-order DeltaSigma modulator (DeltaSigmaM) and a frequency-shift-keyed transmitter operating near 433 MHz. It is fabricated using the AMI 0.5-mum double-poly triple-metal n-well CMOS process, and requires only one off-chip component for operation. A measured current resolution of 12 pA at a sampling rate of 100 Hz and 132 pA at a sampling rate of 10 kHz is achieved in amperometry and 300-V/s FSCV modes, respectively, for any input current in the range of plusmn430 nA. The modulator core and the transmitter draw 22 and 400 muA from a 2.6-V power supply, respectively. The chip has been externally interfaced with a carbon-fiber microelectrode implanted acutely in the caudate-putamen of an anesthetized rat, and, for the first time, extracellular levels of dopamine elicited by electrical stimulation of the medial forebrain bundle have been successfully recorded wirelessly using 300-V/s FSCV.
