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Prognostic value of heat shock protein (HSP) levels in patients with severe trauma and in critically ill patients

dc.contributor.advisorLaušević, Željko
dc.contributor.otherBogojević, Desanka
dc.contributor.otherStefanović, Dejan
dc.contributor.otherStefanović, Branislav
dc.contributor.otherGrigorov, Ilijana
dc.creatorVuković, Goran M.
dc.date.accessioned2016-01-05T12:05:32Z
dc.date.available2016-01-05T12:05:32Z
dc.date.available2020-07-03T08:52:58Z
dc.date.issued2012-11-28
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=248
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/2346
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:5521/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=43577871
dc.description.abstractCilj: Cilj rada je bio da utvrdimo da li postoje razlike u vrednosti serumskog HSP između teško traumatizovanih i zdravih kao i između kritično obolelih i zdravih. Takođe ispitivana je prediktivna sposobnost HSP u odnosu na ishod lečenja. Metod: Praćeni su pacijenti primljeni na hirurgiju kao teško traumatizovani i kritično oboleli. Kontrolnu grupu su činili zdravi ispitanici. Kriterijum ulaska u studiju, za teško traumatizovane pacijente je bila vrednost ISS veća od 18 a kao kriterijum za kritično obolele vrednost LOD i SOFA skora veći od 5. Mi smo u studiji imali 40 ispitanika sa teškom traumom, 40 ispitanika koji su kritično oboleli i 10 zdravih ispitanika. Svim ispitanicima su određivane vrednosti HSP odmah na prijemu, zatim trećeg dana, kao i sedmog dana. Vrednosti su bile iskazane u arbitrarnim jedinicama (AU). Prediktivnu sposobnost HSP smo analizirali pomoću ROC kriva. Rezultati: Analizirajući srednje vrednosti HSP 70 u grupi ispitanika sa teškom traumom po danima, konstatovali smo statistički značajne razlike između grupe umrlih u odnosu na grupu izlečenih. Srednje vrednosti u grupi umrlih po danima su bile značajno više i iznosile su za prvi dan 398,32, za treći 456,74 i za sedmi dan 532,77. Analizom srednjih vrednosti HSP 60 u grupi ispitanika sa teškom traumom po danima, zaključili smo da postoji statistički značajna razlika izmedju srednjih vrednosti HSP 60 u grupi umrlih u odnosu na grupu izlečenih. Srednje vrednosti u grupi umrlih po danima su bile značajno više i iznosile su za prvi dan 330,93, za treći 378,93 i za sedmi dan 462,37. U grupi kritično obolelih srednje vrednosti HSP 70 po danima su statistički značajno različite izmedju grupe umrlih u odnosu na grupu izlečenih. Srednje vrednosti u grupi umrlih po danima su bile značajno više i iznosile su za prvi dan 265,47, za treći 459,59 i za sedmi dan 695,65. Analiza srednjih vrednosti HSP 60 po danima kod kritično obolelih su značajno različite izmedju grupe umrlih u odnosu na grupu izlečenih i srednje vrednosti HSP 60 u grupi umrlih su iznosile za prvi dan 478,34, za treći 679,35 i za sedmi dan čak 1035,32. Zaključak: Kada govorimo o teškoj traumi, HSP 60 je dominantan u predikciji ishoda već od prvog dana i pokazuje visoku prediktivnu sposobnost dok je HSP 70 dominantan sedmog dana, iako smo i za ostala merenja za oba HSP konstatovali prediktivne sposobnosti sa statističkim značajnostima. Kada govorimo o ispitanicima koji su kritično oboleli, HSP 70 i HSP 60 su podjednako dominantni u smislu prediktivne sposobnosti i to za merenja vršena sedmog dana sa nešta slabijim rezultatima za merenja od trećeg dana, dok za merenja prvog dana nepokazuju prediktivnu sposobnost i statističku značajnost...sr
dc.description.abstractObjective: The objective was to determine whether there are differences in serum heat shock protein (HSP) values between severely traumatized and healthy, as well as between critically ill and healthy subjects. Predictive value of HSP for treatment outcomes was investigated as well. Methods: Patients admitted at surgery department as severely traumatized and critically ill were monitored. Healthy subjects served as control group. Inclusion criteria for severely traumatized patients was Injury severity score (ISS) higher than 18, and for critically ill the inclusion criteria was LOD and SOFA score higher than 5. In total 40 patients with severe trauma, 40 critically ill and 10 healthy subjects were included in the study. Values of HSP were measured to all subjects immediately after admittance, the third and seventh day after admittance. Values were quoted in arbitrary units (AU). Predictive value of HSP was assessed using ROC curve. Results: Analysis in the group of patients with severe trauma showed significant difference in mean HSP 70 between patients who died and those who were successfully treated. In the group of patients who died mean levels were significantly higher in each measurement, and were 398.32 on the first day, 456.74 on the third, and 532.77 on the seventh day of stay. Analysis showed that average levels of HSP 60 in patients with severe trauma were significantly different in group of those who dies compared with those that were successfully treated. Values were significantly higher in patients who died and average values were 330.93, 378.93 and 462.37, on the first, third and seventh day of stay, respectively. Average level of HSP 70 critically ill patients were significantly different between those who died and those who were successfully treated. Average levels in those who died were significantly higher and were 265.47, 459.59 and 695.65, on the first, third and seventh day respectively. Analysis showed that average values of HSP 60 were significantly higher in patients who died compared to those who were successfully treated. Average values in critically ill patients who died were 478.34, on the first day, 679.35 on third and 1035.32 on the seventh day. Conclusion: In cases of severe trauma, HSP 60 is the most useful in predicting the outcome since the first day, and has high predictive value, whereas HSP 70 is the most useful on the seventh day, although both HSP 60 and HSP 70 were useful in predicting outcomes in third and seventh day. In critically ill patients, HSP 60 and HSP 70 are equally useful as outcome predictors, and are strongest predictors on the seventh day, with somewhat weaker results on third day. The values on the first day are not significant predictors of outcomes...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subjectHSPsr
dc.subjectHSPen
dc.subjectbiomarkerisr
dc.subjectteška traumasr
dc.subjectkritično obolelisr
dc.subjectsepsasr
dc.subjectskoring sistemisr
dc.subjectprediktivna sposobnostsr
dc.subjectbiomarkersen
dc.subjectsevere traumaen
dc.subjectcritically illen
dc.subjectsepsisen
dc.subjectscoring systemsen
dc.subjectpredictive valueen
dc.titlePrognostički značaj vrednosti proteina toplotnog stresa (HSP) kod teško traumatizovanih i kritično obolelih pacijenatasr
dc.titlePrognostic value of heat shock protein (HSP) levels in patients with severe trauma and in critically ill patientsen
dc.typedoctoralThesis
dc.rights.licenseBY-NC-ND
dcterms.abstractЛаушевић, Жељко; Стефановић, Дејан; Богојевић, Десанка; Стефановић, Бранислав; Григоров, Илијана; Вуковић, Горан М.; Прогностички значај вредности протеина топлотног стреса (ХСП) код тешко трауматизованих и критично оболелих пацијената; Прогностички значај вредности протеина топлотног стреса (ХСП) код тешко трауматизованих и критично оболелих пацијената;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10774/Disertacija.pdf


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