Revue médicale suisse
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Vitamin D deficiency , defined by a 25-OH vitamin D3 plasma level < 30 ng/ml, is highly prevalent in the population. Several observational studies have suggested that such a deficiency increases the risk of hypertension development. Vitamin D seems to have an inhibitory effect on renin secretion and might by this mechanism exert an antihypertensive effect. Recent randomized trials have failed however to demonstrate a blood pressure lowering effect of vitamin D supplementation.
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Revue médicale suisse · Jan 2011
[Pediatrics. Fecal calprotectin in children: use and interpretation].
Fecal calprotectin is a small protein released mainly by neutrophils. It is recognized as a reliable, easy and non-invasive biomarker of gastro-intestinal inflammation. ⋯ It is not a specific marker of IBD but is increased in other situations of gastro-intestinal inflammation. In patients with IBD, fecal calprotectin is used to monitor treatment response.
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Revue médicale suisse · Dec 2010
Review[Pathophysiological mechanisms of organ dysfunction in sepsis].
Sepsis is defined as the systemic inflammatory response to an infection. The occurrence of organ dysfunction increases the severity of sepsis. ⋯ Although septic organ dysfunction has long been considered as the end result of chaotic, uncontrolled and deregulated inflammatory cascades, it might instead represent an adaptive response to avoid the occurrence of irreversible tissue damage and end-organ injury. In this article, we review the major mechanisms involved in organ dysfunction during sepsis, and also present the concept of organ dysfunction as an adaptive response to the septic process.
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Revue médicale suisse · Dec 2010
[Pre- and intra-hospital over-resuscitation in burns: frequent and deleterious].
Major burns are characterized by an initial capillary leak which requires fluid resuscitation for hemodynamic stabilisation. While under-resuscitation was the major cause of death until the 80ies, over-resuscitation has become an important source of complications: abdominal compartment syndrome, escharotomies, impaired gas exchange and prolonged mechanical ventilation and hospital stay. ⋯ The first alerts were published under the form of case reports of increased mortality due to abdominal compartment syndrome and respiratory failure. The paper analyses the causes of this fluid creep, and the ways to prevent it, which includes rationing prehospital fluid delivery, avoiding early colloids and permissive hypovolemia.