Medicina
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Review Comparative Study
[The new aspects of treatment of severe sepsis and septic shock].
The mortality rate of infection-induced organ dysfunction or hypoperfusion abnormalities due to severe sepsis and septic shock remains unacceptably high. The adequacy and speed of treatment administered in the first hours after syndrome develops influence outcome. Initial resuscitation, appropriate antimicrobial treatment, selection of optimal control methods, properties of fluid therapy, use of vasopressors and inotropic therapy, proper corticosteroid administration, value of the use of recombinant human activated protein C, and glucose control are the most important points newly evaluated for severe and septic shock management.
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To determine the colonization rate of Staphylococcus aureus in burn wounds and to assess the variation in the resistance of Staphylococcus aureus strains to antibiotics. ⋯ Staphylococcus aureus was the most prevalent pathogen isolated from burn wounds. On the first day of hospitalization Staphylococcus aureus isolates were obtained from 25.3% of patients; 12.5% of patients with burn wounds had methicillin-resistant Staphylococcus aureus at the end of the first week of hospitalization and 66% of patients--after two weeks and later. The resistance of methicillin-susceptible Staphylococcus aureus to gentamicin, tobramycin, and clindamycin decreased. The resistance of methicillin-resistant Staphylococcus aureus to clindamycin decreased and to ciprofloxacin--increased.
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To evaluate the relationship among risk factors for metabolic syndrome such as high body mass index, abdominal obesity, waist circumference, waist/hip ratio. ⋯ Statistically significant correlation between abdominal obesity, waist/hip ratio, waist circumference and body mass index was observed. Abdominal obesity is the mostly frequent indicator of metabolic syndrome.
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Photosensitive skin reactions occur when human skin reacts to ultraviolet radiation or visible light abnormally. The forms of photosensitivity are phototoxicity and photoallergy. ⋯ In order to avoid photosensitive reactions it is essential to determine the photosensitizing properties of such substances before drugs are introduced in therapy or products made available on the market. The article reviews the mechanisms of photosensitization, explains the most important differences between phototoxic and photoallergic reactions, summarizes the most common photosensitizers, and presents the clinical features and diagnostic procedures of phototoxic and photoallergic reactions.
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Review Comparative Study
QT dispersion and heart rate variability in sudden death risk stratification in patients with ischemic heart disease.
The aim of the article is to review the literature data about the significance and problems of the QT dispersion and heart rate variability in sudden death risk stratification in patients with coronary heart disease. QT dispersion is defined as the difference between the longest and the shortest QT intervals as measured in the 12-lead electrocardiogram. A direct relationship between the prolongation of QT dispersion and myocardial ischemia has been reported by several authors. ⋯ Heart rate variability representing a relationship between the autonomic nervous system and cardiovascular mortality, including sudden cardiac death, is one of the most promising markers. The predictive value of heart rate variability is independent of other factors established for postinfarction risk stratification, such as depressed left ventricular ejection fraction, increased ventricular ectopic activity, and presence of late potentials. For prediction of all-cause mortality, the value of heart rate variability is similar to that of left ventricular ejection fraction, but heart rate variability is superior to left ventricular ejection fraction in predicting arrhythmic events (sudden cardiac death and ventricular tachycardia).