Expression of IL-7Ralpha(high) discriminates between activated CD25(+)CD45RO(+) CD4(+) T cells (IL-7Ralpha(high) and FoxP3 negative) and regulatory T cells (IL-7Ralpha(low) and FoxP3 positive). The IL-7Ralpha(high)CD25(+)CD45RO(+)CD4(+)FoxP3(-) T-cell population has been shown to be expanded in blood and tissue in patients after kidney transplantation and to contain alloreactive T-cells (activated T cells).In the present study, we have analysed the distribution of the IL-7Ralpha(high)CD25(+)CD45RO(+)CD4(+)FoxP3(-) T-cells in blood of 53 patients after liver transplantation. The IL-7Ralpha(high)CD25(+)CD45RO(+)CD4(+)FoxP3(-) T-cell population was significantly expanded (p<0.0001) href="http://ziber20.uv.ro/">more ...
Significance of arterial hypotension after resuscitation from cardiac arrest.
OBJECTIVE: Expert guidelines advocate hemodynamic optimization after return of spontaneous circulation (ROSC) from cardiac arrest despite a lack of empirical data on prevalence of post-ROSC hemodynamic abnormalities and their relationship with outcome. Our objective was to determine whether post-ROSC arterial hypotension predicts outcome among postcardiac arrest patients who survive to intensive care unit admission. DESIGN: Cohort study utilizing the Project IMPACT database (intensive care unit admissions from 120 U.S. hospitals) from 2001-2005. SETTING: One hundred twenty intensive care units. PATIENTS: Inclusion criteria were: 1) age > or =18 yrs; 2) nontrauma; and 3) received cardiopulmonary resuscitation before intensive care unit arrival. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Subjects were divided into two groups: 1) Hypotension Present--one or more documented systolic blood pressure <90> or =90 mm Hg. The primary outcome was in-hospital mortality. The secondary outcome was functional status at hospital discharge among survivors. A total of 8736 subjects met the inclusion criteria. Overall mortality was 50%. Post-ROSC hypotension was present in 47% and was associated with significantly higher rates of mortality (65% vs. 37%) and diminished discharge functional status among survivors (49% vs. 38%), p < .001 for both. On multivariable analysis, post-ROSC hypotension had an odds ratio for death of 2.7 (95% confidence interval, 2.5-3.0). CONCLUSIONS: Half of postcardiac arrest patients who survive to intensive care unit admission die in the hospital. Post-ROSC hypotension is common, is a predictor of in-hospital death, and is associated with diminished functional status among survivors. These associations indicate that arterial hypotension after ROSC may represent a potentially treatable target to improve outcomes from cardiac arrest.
Plasma lipid profile in pregnant women with HIV receiving nevirapine.
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanita, Viale Regina Elena 299, 00161 Rome, Italy. marco.floridia@iss.it
Limited information is currently available on the metabolic profile of nevirapine in pregnancy. We used data from a national observational study to evaluate plasma lipid profile in pregnant women receiving nevirapine. Lipid values were collected during routine clinical visits. Midpregnancy (second trimester) lipid values were analyzed according to use of nevirapine, calculating differences and 95% confidence intervals (CI) between women taking and not taking this drug. In order to adjust for possible confounders, multivariable models were constructed using as dependent variables levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG) levels and TC/HDL-C ratio, and as independent variables age, body weight, previous treatment history, CD4 count, and presence of any antiretroviral therapy, use or nonuse of protease inhibitors, stavudine, and nevirapine at the time of blood sampling. Overall, 375 women had available data for analysis. Pregnant women on nevirapine, compared to women not taking this drug, had in univariate analyses higher levels of HDL-C (difference: +13.0mg/dL [95%CI 7.4-18.6], p < p =" 0.06).">
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