S100B was elevated at admission and discharge in schizophrenic patients compared with control subjects, whereas there were no significant differences for neuron-specific enolase. Treatment had no impact on either S100B or neuron-specific enolase. A systematic, quantitative meta-analysis
of all published studies involving 380 patients and 358 control subjects revealed elevated serum S100B in schizophrenia without any effect of antipsychotic treatment. Results suggest that increases of serum S100B are related to active secretion of S100B by astrocytes in combination with blood-brain barrier dysfunction in schizophrenia. (C) 2008 Elsevier Ireland Ltd. All fights reserved.”
“BACKGROUND
In some studies, tight glycemic control with insulin improved outcomes in Entinostat concentration adults undergoing cardiac surgery, but these benefits are unproven in critically ill children at risk for hyperinsulinemic hypoglycemia. We tested the hypothesis that tight glycemic
control reduces morbidity after pediatric cardiac surgery.
METHODS
In this two-center, prospective, randomized trial, we enrolled 980 children, 0 to 36 months of age, undergoing surgery with cardiopulmonary bypass. Patients were randomly assigned to either tight glycemic control (with the use of an insulin-dosing algorithm targeting a blood glucose level of 80 to 110 mg per deciliter [4.4 to 6.1 mmol per liter]) or standard care in the cardiac intensive care unit (ICU). Continuous glucose monitoring was used to guide the frequency of blood glucose measurement and to detect impending hypoglycemia. The primary outcome was the rate of health 8-Bromo-cAMP molecular weight care-associated infections in the cardiac ICU. Secondary outcomes included mortality, length of stay, organ failure, and hypoglycemia.
RESULTS
A total of 444 of the 490 children Cobimetinib chemical structure assigned to tight glycemic control (91%) received insulin versus 9 of 490 children assigned to standard care (2%). Although normoglycemia was achieved earlier with tight glycemic control than
with standard care (6 hours vs. 16 hours, P<0.001) and was maintained for a greater proportion of the critical illness period (50% vs. 33%, P<0.001), tight glycemic control was not associated with a significantly decreased rate of health care-associated infections (8.6 vs. 9.9 per 1000 patient-days, P=0.67). Secondary outcomes did not differ significantly between groups, and tight glycemic control did not benefit high-risk subgroups. Only 3% of the patients assigned to tight glycemic control had severe hypoglycemia (blood glucose <40 mg per deciliter [2.2 mmol per liter]).
CONCLUSIONS
Tight glycemic control can be achieved with a low hypoglycemia rate after cardiac surgery in children, but it does not significantly change the infection rate, mortality, length of stay, or measures of organ failure, as compared with standard care.