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Allo-HSCT is associated with life-threatening complications. Therefore, a considerable number of patients require admission to a PICU. We evaluated the incidence and outcome of PICU admissions after allo-HSCT in children, along with the potential factors influencing PICU survival. A retrospective chart review of 668 children who underwent first allo-HSCT in the Department of Pediatric Hematology/Oncology and BMT in Wrocław during years 2005-2017, particularly focusing on patients admitted to the PICU within 1-year post-HSCT. Fifty-eight (8.7%) patients required 64 admissions to the PICU. Twenty-four (41.5%) were discharged, and 34 (58.6%) patients died. Among the discharged patients, 6-month survival was 66.7%. Compared with survivors, death cases were more likely to have required MV (31/34; 91.2% vs. 16/24; 66.7% P = .049), received more aggressive cardiac support (17/34; 50% vs. 2/24; 8.3% P = .002), and had a lower ANC on the last day of their PICU stay (P = .004). Five patients were successfully treated with NIV and survived longer than 6 months post-discharge. The intensity of cardiac support and ANC on the last day of PICU treatment was independent factors influencing PICU survival. Children admitted to the PICU after allo-HSCT have a high mortality rate. Mainly those who needed a more aggressive approach and had a lower ANC on the last day of treatment had a greater risk of death. While requiring MV is associated with decreased PICU survival, early implementation of NIV might be considered., (© 2020 Wiley Periodicals LLC.)

Background: Monitoring of biochemical markers of inflammation in acute mediastinitis (AM) can be useful in the modification of treatment. This study was a retrospective evaluation of selected biochemical parameters with negative impact on the prognosis in surgically treated patients., Material/methods: There were 44 consecutive patients treated surgically due to AM of differentiated etiology. Selected biochemical markers (WBC, RBC, HGB, HCT, PLT, CRP, PCT, ionogram, protein and albumins) were assessed before surgery and on the 3rd day after surgery. ANOVA was applied to find factors influencing observations. Numerical data [laboratory parameters] were compared by means of medians., Results: The overall hospital mortality rate was 31.82%. In the group of dead patients, there were observed statistically significant lower mean preoperative values of RBC [p=0.0090], HGB [p=0.0286], HCT [p=0.0354], protein [p= 0.0037], albumins [p=0.0003] and sodium [p<0.0001] and elevated values of CRP [P=0.0107] and PCT p<0.0001]. High level of inflammatory markers on day 3 after surgery was found to increase the risk of death - for WBC (by 67%), for CRP (by 88%) and for PCT (by 100%)., Conclusions: Poor prognosis was more frequent in patients with preoperative high levels of CRP, PCT, anemia, hypoproteinemia and hyponatremia. The risk of death increases significantly if in the immediate postoperative period no distinct decrease in WBC count and of the CRP and PCT level is observed. In such a situation the patients should be qualified earlier for broadened diagnostic workup and for reoperation.

Unlabelled: The aim of the study was to evaluate the range of chronic inflammation in patients after second or subsequent myocardial infarction, and to compare it with its range in patients after first MI., Material and Methods: C-reactive protein measurement clinical value was examined by high sensitivity CRP method (hsCRP) and compared to clinical value of other heart attack risk factors: total cholesterol (TC) and cholesterol in HDL fraction (HDL-C), triglycerides (TG) and fibrinogen (FBG). The research included 120 patients in two investigated groups: Z2--30 patients undergoing secondary prevention after second (subsequent) heart attack, and Z1--30 patients with first myocardial infarction. There were two reference groups: KOR--30 people undergoing planned coronarography and K--30 healthy individuals. Groups Z2, Z1 and KOR patients were treated with PCI (percutaneous coronary intervention)., Results: HsCRP medians for group Z2 (2.65 mg/I) and groups Z, (2.25 mg/) and KOR (2.35 mg/l) were significantly higher than in group K (1.10 mg/dl)., Conclusions: Highest clinical value of hsCRP in coronary attack prediction was confirmed. Relative area under ROC curve (AUC) was highest in group 2, higher than in group Z1 (0.778 and 0.711, respectively). In patients undergoing secondary prevention, group Z2, hsCRP measurement showed higher clinical value in subsequ ent myocardial infarction prediction than in first one. In groups Z2 and Z1, HDL-C measurement also shows high diagnostic value for coronary risk assessment. AUC are 0.875 and 0.782, respectively. However, in treatment with statins, high AUC values do not necessarily reflect myocardial infarction risk.

Unlabelled: Significant progress in diagnosis and treatment of heart attack led European Society of Cardiology (ESC) and American College of Cardiology (ACC) to develop in 2007 a document on contemporary criteria for diagnosis of fresh myocardial infarction. In the case of percutaneous coronary intervention (PCI) in patients with initially normal serum concentrations of biomarkers troponin increase above the 99th percentile upper limit of the reference points to the occurrence of myocardial necrosis dislodgement. Conventionally assumed that the increased levels of biomarkers of value in excess of 3 x 99th percentile upper reference requires identification of MI in conjunction with PCI., The Aim of the Study: To evaluate the dynamic of troponin concentrations and C-reactive protein in patients with the second or subsequent myocardial infarction undergoing percutaneous coronary intervention (PCI) and comparing the results obtained with the results obtained in patients with first myocardial infarction, in patients undergoing elective coronary angiography and the healthy control group., Material and Methods: The study involved a total of 120 patients who entered in four groups: study group Z2 and three comparative groups: Z1, the NRA and C. Z2 study group consisted of patients admitted to hospital because of second or subsequent myocardial infarction. Z1 group consisted of patients with first myocardial infarction. Patients groups Z2 and Z1 underwent PCI. The group included people the NRA people with a history of previous myocardial infarction, who underwent elective coronary angiography and after noting the time of surgery of coronary arteries was performed in one PCI slot. Control group C consisted of healthy, free from recognized risk factors for heart attack, in which there were no previous episodes of acute heart. Patients groups Z2 and NRA received statins and ASA before hospitalization. The material in patients with suspected myocardial infarction (study group Z2 and Z1 and in the group NRA represented the blood clot, taken on at the time of notification to the patient to the hospital, between 6 and 9 h, in 16 h, 24 and 48 h hospitalization. In the control group C blood samples were taken at one time. In plasma the concentrations of cardiac troponin I (cTnl), and serum CRP., Results: The dynamics of median concentrations of cTnl for the test group Z2 and control group Z1 are comparable. Median concentrations are very close to each other (with the exception of point 1) in any of the measuring points, there was no statistically significant differences. Between 6 and 9 time of infarction in group Z1 median concentrations were significantly higher than in Z2. Significant differences were found between the Z1 and Z2 group and the NRA in all. measuring points, at the time of admission, between 6 and 9 time, the 16th, 24th and 48 time of onset of stroke (point 0, p = 0.027, points 1, 2, 3, and 4 p = 0.0000). The reference group of people from the NRA who previously underwent selective coronary heart attack and surgery PCI, 7 patients were observed a slight increase in troponin I concentrations (usually between the 9th and 24th h hospitalisation), not exceeding three times the value of the decision, which permits the exclusion of myocardial. Median concentrations of CRP in 16 h, 24 and 48 h MI showed significant differences between the group and the NRA Z2 (section 2, p = 0.001, section 3 and 4--p < 0.001) and between the group and the NRA Z1 (section 2, p = 0.028, section 3 and 4--p < 0.001). Median values in the group Z2 versus Z1 showed similar dynamics in the time points 0, 1, 2 and 3. Higher median values in the fourth time point were observed in the group Z2. Median CRP at the time of admission to hospital was the highest in the group Z2 (2.65 mg/l), and reference groups Z1 and NRA was 2.25 mg/l and 2.35 mg/l. Median CRP in the groups Z2, Z1 and CRV were significantly higher against the group C (1.20 mg/l). In group C the lowest percentage observed in the results of CRP >3 mg/l (indicating the risk of ACS) of 16.7%. In the other groups this proportion was 30-40% and was highest in the group Z2., Conclusions: The concentration of cardiac troponin I in the first hours of the course of myocardial infarction (between 6 and 9 h) in patients who have made a second heart attack tends to lower its growth levels compared to people with first MI. It can be assumed that the myocardial inflammatory response to repeated defense system reduces the area of necrosis and less ejection from the troponin myocardial cells. In patients who underwent myocardial infarction in the past and were subjected to selective coronary angiography, and its treatment by PCI, troponin I, did not exceed three times the 99th percentile of the healthy population, suggesting that the proper emergency procedures cardiac surgeons performing PCI.

Objective: We examined whether an acute phase reaction could occur in children with lymphocytic meningitis of homogeneous etiology (parotitis epidemic from the Paramyxoviridae family), a sign of which would be an increase in concentrations of acute phase proteins (APP's) in cerebrospinal fluid (CSF) and/or in blood serum. We also tested the usefulness of the determination of selected APP's concentrations in CSF and serum in diagnosis and monitoring of the course of the disease, provided that an increase in concentrations of selected APP's were discernible., Methods: Cases were 78 children with lymphocytic meningitis as a complication of parotitis epidemic. Controls were 30 healthy children (control group K1) and 19 children hospitalized with suspected meningitis (control group K2). The following APP's presence in CSF and serum were tested: C-reactive protein (CRP), alpha-2-haptoglobin (HPT), alpha-1-antitripsin (AAT) and alpha-1-acid glycoprotein (AAG), alpha-2-ceruloplasmin (CER) and alpha-2-macroglobulin (AMG). The results were compared and analyzed., Results: The results of the research show a significant increase in all APP's determined, except for CRP and AAG, in children with parotidal meningitis., Conclusions: Determination of CRP concentration either in CSF or in serum is not useful in diagnosis of parotidal meningitis and in differentiation of lymphocytic and bacterial forms of the disease.