Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Oct 2001
Review[Sepsis--continual pathogenetic, diagnostic and therapeutic problem].
Sepsis is defined as systemic inflammatory response syndrome (SIRS) caused by infection. Massive activation of humoral and cellular mechanisms of host defense is present and can lead to a multiple organ dysfunction syndrome. Sepsis is good example, that inflammation binds with considerable energetic and metabolic effort of organism i.e. demand for oxygen, protein and microelements. ⋯ Precious advice in selection of antibiotic were given. Advantage penicillins and karbapenems over cephalosporins result from binding to PBP 2 or 1, considerably smaller release of free endotoxin and smaller induction Jarish-Heixhaimer's reaction. The side effect stimulates inflammation and deepens SIRS by release toxins and increase of TNF-alpha.
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In modern anaesthesiology drug interactions are inevitable. The interactions between anaesthetic drugs are well known for anaesthesiologists and even purposely used to obtain optimal anaesthetic effects. ⋯ In this survey the most common interactions between anaesthetics and popular groups of drugs were discussed. The knowledge of drug interactions is very important and useful for the practice of anaesthesia.
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Pol. Merkur. Lekarski · Jun 2000
Review[Disturbances of the neurohumoral regulation in patients in critical illness and post-resuscitation period].
Cardiac arrest (CA) is an extreme stressful situation accompanied by impairment of hypotalamichypophyseal axis resulting from many reasons, specially when cardio-pulmonary resuscitation (CPR) has been delayed or prolonged. The author compares dysfunction of the neurohormonal system, including the release of hypophyseal and adrenal hormones, atrial natriuretic hormone and endothelin in patients in critical illness as well as in those after cardiac arrest. Associated consequences for the maintenance of homeostasis in postresuscitation period have also presented.
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Pol. Merkur. Lekarski · Jan 2000
Review[The role of cytokines and reactive oxygen species in the pathogenesis of sepsis].
The role of cytokines and reactive oxygen species (ROS) in multiple and not fully explained pathogenesis of sepsis was presented. Close attention was paid to the contribution of inflammatory cytokines (TNF-alpha, IL-1, IL-6, IL-8) to the enhanced phagocyte-derived oxidative metabolism and the activation of respiratory burst. The pleiotropic interaction of these and the other cytokines creating so-called cytokine network was described, among other things in order to express the phagocytic and endothelial receptors. ⋯ The key role of ROS generated by the activated phagocytes during sepsis has been outlined; it is proposed that the hypermetabolic response to sepsis results from enhanced ROS generation and so-called oxidant stress is a consequence of the imbalance between their generation and detoxification. The consequences of the action of oxygen free radicals resulting in lipid peroxidation followed by host auto-injury were also described. At the end a possibility of immunotherapy of sepsis connected with the application of pentoxifylline (PTXF) as TNF-alpha inhibitor was recommended to take into consideration.