912 resultados para RETROGRADE SINUS PERFUSION


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Ultrahigh-temperature (UHT) granulites of the central Highland Complex, Sri Lanka, underwent some of the highest known peak temperatures of crustal metamorphism. Zircon and monazite U-Pb systems in granulites near Kandy, the highest grade region (similar to 1050 degrees C; 0.9 GPa), preserve both a record of the timing of prograde and retrograde phases of UHT metamorphism and evidence for the ages of older protolith components. Zircon grains from a quartz-saturated granulite containing relics of the peak UHT assemblage have remnant detrital cores with dates of ca. 2.5-0.83 Ga. Date clusters of ca. 1.7 and 1.04-0.83 Ga record episodes of zircon growth in the source region of the protolith sediment. Two generations of overgrowths with contrasting Th/U record metamorphic zircon growth at 569 +/- 5 and 551 +/- 7 Ma, probably in the absence and presence of monazite, respectively. The age of coexisting metamorphic monazite (547 +/- 7 Ma) is indistinguishable from that of the younger, low-Th/U zircon overgrowths. Zircon from a quartz-undersaturated monazite-absent UHT granulite with a mainly retrograde assemblage is mostly metamorphic (551 +/- 5 Ma). The ca. 570 Ma zircon overgrowths in the quartz-saturated granulite probably record partial melting just before or at the metamorphic peak. The ca. 550 Ma zircon in both rocks, and the ca. 550 Ma monazite in the quartz-saturated sample, record post-peak isothermal decompression. A possible model for this pressure-temperature-time evolution is ultrahot collisional orogeny during the assembly of Gondwana, locally superheated by basaltic underplating, followed by fast extensional exhumation.

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BACKGROUND & AIMS: Prophylactic administration of interleukin (IL)-10 decreases the severity of experimental pancreatitis. Prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in humans is a unique model to study the potential role of IL-10 in this setting. METHODS: In a single-center, double-blind, randomized, placebo-controlled study, the effect of a single injection of 4 microg/kg (group 1) or 20 microg/kg (group 2) IL-10 was compared with that of placebo (group 0), all administered 30 minutes before therapeutic ERCP. The primary endpoint was the effect of IL-10 on serum levels of amylases and lipases measured 4, 24, and 48 hours after ERCP. The secondary objective was to evaluate changes in plasma cytokines (IL-6, IL-8, tumor necrosis factor) at the same time points and the incidence of acute pancreatitis in the 3 groups. Subjects undergoing a first therapeutic ERCP were eligible for inclusion. RESULTS: A total of 144 patients were included. Seven were excluded based on intention to treat (n = 1) or per protocol (n = 6). Forty-five, 48, and 44 patients remained in groups 0, 1, and 2, respectively. The 3 groups were comparable for age, sex, underlying disease, indication for treatment, type of treatment, and plasma levels of C-reactive protein (CRP), cytokines, and hydrolases at baseline. No significant difference was observed in CRP, cytokine, and hydrolase plasma levels after ERCP. Forty-three patients developed hyperhydrolasemia (18 in group 0, 14 in group 1, and 11 in group 2; P = 0.297), and 19 patients developed acute clinical pancreatitis (11 in group 0, 5 in group 1, 3 in group 2; P = 0.038). Two severe cases were observed in the placebo group. No mortality related to ERCP was observed. Logistic regression identified 3 independent risk factors for post-therapeutic ERCP pancreatitis: IL-10 administration (odds ratio [OR], 0.46; 95% confidence interval [95% CI], 0.22-0.96; P = 0.039), pancreatic sphincterotomy (OR, 5.04; 95% CI, 1.53-16.61; P = 0.008), and acinarization (OR, 8.19; 95% CI, 1.83-36.57; P = 0.006). CONCLUSIONS: A single intravenous dose of IL-10, given 30 minutes before the start of the procedure, independently reduces the incidence of post-therapeutic ERCP pancreatitis.

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BACKGROUND: The development of a microcomputer-based device permits quick, simple, and noninvasive quantification of the respiratory sinus arrhythmia (RSA) during quiet breathing. METHODS AND RESULTS: We prospectively and serially measured the radionuclide left ventricular ejection fraction and the RSA amplitude in 34 cancer patients receiving up to nine monthly bolus treatments with doxorubicin hydrochloride (60 mg/m2). Of the eight patients who ultimately developed symptomatic doxorubicin-induced congestive heart failure, seven (87.5%) demonstrated a significant decline in RSA amplitude; five of 26 subjects without clinical symptoms of cardiotoxicity (19.2%) showed a similar RSA amplitude decline. On average, significant RSA amplitude decline occurred 3 months before the last planned doxorubicin dose in patients destined to develop clinical congestive heart failure. CONCLUSION: Overall, RSA amplitude abnormality proved to be a more specific predictor of clinically significant congestive heart failure than did serial resting radionuclide ejection fractions.