RESUMO
CONTEXT: There is a huge burden of patients with acute febrile illness (AFI) during the post-monsoon season in India. It is very important to have a functioning triage system, whereby patients with high likelihood of developing a severe illness are referred to higher levels of care. AIM: The objective of this study was to identify the alarm signs which would help in triaging of those patients with AFI without any specific diagnosis. METHODS: This was a retrospective review of records, whereby clinical and laboratory parameters of patients with AFI admitted in our tertiary care center between July 2016 and October 2016 were reviewed. STATISTICAL ANALYSIS USED: Appropriate tests of significance were applied using SPSS 21(Chicago, IL, USA) to find statistically significant differences between those who required mechanical ventilation, intensive care, ionotropic support, or higher intravenous antibiotics and those who recovered with minimal supportive care. RESULTS: Presence of comorbidities, dyspnea, altered sensorium, features of myocarditis, hypotension, leukocytosis (>11,000/µL), and acute kidney injury were significantly associated with requirement of higher levels of care, while presence of arthralgia, serositis, and leucopenia indicated a higher likelihood of recovery with minimal support. CONCLUSION: This article highlights the possibility of identification of simple alarm signs in patients with AFI which would indicate the need for higher levels of care.
RESUMO
A novel series of TGX-221 analogues was prepared and tested for their potency against the p110α, p110ß, and p110δ isoforms of the PI3K enzyme, and in two cellular assays. The biological results were interpreted in terms of a p110ß comparative model, in order to account for their selectivity towards this isoform. A CH2NH type linker is proposed to allow binding into the specificity pocket proposed to accommodate the high p110ß-selectivity of TGX-221, although there was limited steric tolerance for substituents on the pendant ring with the 2-position most favourable for substitution.
Assuntos
Antineoplásicos/farmacologia , Morfolinas/farmacologia , Inibidores de Fosfoinositídeo-3 Quinase , Inibidores de Proteínas Quinases/farmacologia , Subunidades Proteicas/antagonistas & inibidores , Pirimidinonas/farmacologia , Antineoplásicos/síntese química , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Classe Ia de Fosfatidilinositol 3-Quinase/química , Classe Ia de Fosfatidilinositol 3-Quinase/metabolismo , Humanos , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Morfolinas/síntese química , Inibidores de Proteínas Quinases/síntese química , Subunidades Proteicas/química , Subunidades Proteicas/metabolismo , Pirimidinonas/síntese química , Relação Estrutura-AtividadeRESUMO
OBJECTIVE: To establish the normal lipoprotein profile in the population and identify the early warning signs of coronary heart disease (CHD). DESIGN: Random blood sampling of healthy adults and patients with symptomatic CHD including that complicated with acute myocardial infarction. METHODS: Plasma lipids, lipoproteins, lipid peroxidation, antioxidant enzymes and scavengers, red-cell membrane lipids and glycoproteins were assayed. RESULTS AND CONCLUSION: The normal levels of plasma lipids and lipoproteins were established. Levels of plasma free fatty acids, fibrinogen, white blood cell counts, echinocytes, red-cell membrane lipids and protein-bound carbohydrate components are significantly higher in healthy subjects with coronary risk index above 4.5 than they are in normal individuals. Antioxidant defences appear to be the distinguishing factor, remaining higher in normal individuals and thus keeping lipid peroxidation under control. In symptomatic CHD, antioxidant defences are significantly lowered.
