Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Comparative Study
[The SOFA score in evaluating septic illnesses. Correlations with the MOD and APACHE II score].
The SOFA score, a new system for patients with sepsis-related diseases, was introduced in 1994 by the "Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine." The purpose of this study was to compare the new SOFA score with the APACHE II and MOD scores. The data on 874 patients from a surgical intensive care unit in an university hospital were analyzed using commercially available software (SPSS for Windows, Version 7.5.2 and MS Excel '97). ⋯ The ROC analyses of the APACHE II, the MOD and the SOFA scores were comparable (area under the curve: APACHE II 0.73, MOD 0.77, SOFA 0.71). In conclusion, the SOFA score is reliable and might be useful in the daily routine of an intensive care unit.
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Interfragmentary movement and size of the fracture gap influence fracture healing. Limited movements promote callus formation and may result in increased mechanical stability. Although larger movements still promote callus formation, the bony consolidation of the fracture is hampered. ⋯ Therefore, having in mind a minimally invasive surgical approach, one should strive for good reduction of the fracture ends and flexible yet stable osteosynthesis. Dynamization of the fracture by enabling axial movement will close the fracture gap, stimulate tissue differentiation and possibly accelerate the healing process. External mechanical stimulation, however, has not been shown to effectively enhance the healing process under flexible fixation or in load-bearing patients.
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[Does liberation of interleukin-12 correlate with the clinical course of polytraumatized patients?].
Interleukin-12-p70 (IL-12-p70) is a potent immunoregulatory cytokine composed of a heavy chain (p40) and a light chain (p35). Contradicting results have been reported with regard to leukocyte release and systemic concentration of IL-12 after polytrauma. ⋯ After major injuries there is no overall suppression of IL-12 formation. Patients with normal or elevated IL-12 levels belong mainly to the survivors, whereas patients with decreased IL-12 levels are at high risk of succumbing to multi-organ failure.