EA Levels Research Articles

Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study.

A novel assay for endotoxin, based on the ability of antigen-antibody complexes to prime neutrophils for an augmented respiratory burst response, was studied in a cohort study of 857 patients admitted to an intensive-care unit (ICU). On the day of ICU admission, 57.2% of patients had either intermediate (>or=0.40 endotoxin activity [EA] units) or high (>or=0.60 units) EA levels. Gram-negative infection was present in 1.4% of patients with low EA levels, 4.9% with intermediate levels, and 6.9% with high levels; EA had a sensitivity of 85.3% and a specificity of 44.0% for the diagnosis of gram-negative infection. Rates of severe sepsis were 4.9%, 9.2%, and 13.2%, and ICU mortality was 10.9%, 13.2%, and 16.8% for patients with low, intermediate, and high EA levels, respectively. Stepwise logistic regression analysis showed that elevated Acute Physiology and Chronic Health Evaluation II score, gram-negative infection, and emergency admission status were independent predictors of EA.

Administration of C1 inhibitor reduces neutrophil activation in patients with sepsis.

Forty patients with severe sepsis or septic shock recently received C1 inhibitor. In the present study we studied the effect of C1 inhibitor therapy on circulating elastase-alpha(1)-antitrypsin complex (EA) and lactoferrin (LF) levels in these patients to gain further insight about agonists involved in the activation of neutrophils in human sepsis. Elevated levels of EA and LF were found in 65 and 85% of the septic patients, respectively. Patients with elevated EA levels had higher organ dysfunction scores, higher levels of cytokines, and higher levels of complement activation products than patients with normal EA levels. C1 inhibitor therapy reduced EA as well as complement activation and IL-8 release in the patients with elevated EA on admission. We conclude that neutrophil activation in human sepsis correlates with the severity of organ dysfunction and involves complement and interleukin-8 as agonists. The effect of C1 inhibitor therapy on neutrophils may provide an explanation for the beneficial, although mild, effects of this treatment on organ dysfunction in sepsis.

Salivary cortisol levels in children adopted from romanian orphanages.

Six and a half years after adoption. 6- to 12-year-old children reared in Romanian orphanages for more than 8 months in their first years of life (RO. n = 18) had higher cortisol levels over the daytime hours than did early adopted (EA, < or = 4 months of age, n = 15) and Canadian born (CB, n = 27) children. The effect was marked, with 22% of the RO children exhibiting cortisol levels averaged over the day that exceeded the mean plus 2 SD of the EA and CB levels. Furthermore, the longer beyond 8 months that the RO children remained institutionalized the higher their cortisol levels. Cortisol levels for EA children did not differ in any respect from those of CB comparison children. This latter finding reduces but does not eliminate concerns that the results could be due to prenatal effects or birth family characteristics associated with orphanage placement. Neither age at cortisol sampling nor low IQ measured earlier appeared to explain the findings. Because the conditions in Romanian orphanages at the time these children were adopted were characterized by multiple risk factors, including gross privation of basic needs and exposure to infectious agents, the factor(s) that produced the increase in cortisol production cannot be determined. Nor could we determine whether these results reflected effects on the limbic-hypothalamic-pituitary-adrenal axis directly or were mediated by differences in parent-child interactions or family stress occasion by behavioral problems associated with prolonged orphanage care in this sample.

Regulation of Insulin-Like Growth Factor-1 Expression in Vascular Endothelial Cells by the Inflammatory Cytokine Interleukin-1

Insulin-like growth factor-1 (IGF-1) has important roles in vascular physiology and pathologies such as atherosclerosis. However, the factors that control expression of this growth factor in human vascular cells are largely unknown. In this study the effects of the inflammatory cytokine interleukin-1 (IL-1) on IGF-1 mRNA and peptide synthesis was examined in human endothelial cells. Cultured human umbilical vein endothelial (HUVE) cells were challenged with interleukin-1 and IGF-1 Ea and Eb mRNA levels were determined by nuclease protection assays and reverse transcription/polymerase chain reaction. IL-1 caused a dramatic increase in IGF-1 Ea mRNA in HUVE cells. Transcript levels peaked between 2 and 4 h of IL-1 treatment and declined over the subsequent 4 h. Consistent with its effect on mRNA, the inflammatory cytokine causes a 3-fold stimulation in production of IGF-1 peptide from endothelial cells. These results demonstrate increased IGF-1 mRNA and peptide in vascular endothelial cells stimulated with IL-1. This suggests that under conditions of local inflammation at the vessel wall the direct action of IL-1 on endothelium can lead to induction of IGF-1 which could promote the intimal hyperplasia often seen in these circumstances.

Late Quaternary relative sea‐level changes and the role of glaciation upon continental shelves

ABSTRACTSea levels of the past 20 kyr are largely determined by the response of the Earth to the last ice age. Consequently, sea‐level indicators are an important source of information about the interaction between cryosphere and hydrosphere and the solid Earth. Based on the material presented at a recent European Science Foundation conference, the present paper pin‐points some of the topics currently under discussion with respect to sea‐level evidence found on continental shelves. These topics include possible effects of erosion and changes in palaeotidal ranges on indicators of former relative sea levels as well as the problems involved in the determination of palaeo‐water depth in addition to former sea levels. More evidence is being gathered for substantial small‐scale patterns in the sea‐level changes at or nearby to the former ice margins. These patterns are not reproduced by the available geophysical models, which reconcile on first‐order level only the large‐scale pattern.

Experimental method dependent Zeeman relaxation of nontunnelling methyl groups

The nonexponentiality in the Zeeman spin-lattice relaxation of nontunnelling methyl groups is shown to be closely related to the fact that the relaxation depends on the experimental method. Experimental results on CF3COOAg demonstrate that the half-amplitude times by the saturation- tau -90 degrees method can be, provided the saturating 90 degrees pulses are properly spaced, twice as long as those by the 180 degrees - tau -90 degrees method for the magnetic field perpendicular to the fluorine plane above the temperature of the T1 minimum. The exponentiality of the relaxation below the T1 minimum temperature, independent of the crystal orientation, implies that the intergroup induced transitions are able to equalize the populations of the degenerate Ea and Eb levels in a time much shorter than any of the time constants describing the Zeeman relaxation. The value 25 kJ mol-1 is obtained for the activation energy of the CF3 group reorientations. Experiments on polycrystalline acetone show a similar but somewhat smaller dependence on the experimental method.