Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jul 2006
[N-terminal pro-brain natriuretic peptide (NT-proBNP) and ischemia modified albumin (IMA) in exercise induced ischemia in patients with stable coronary artery disease].
Preliminary data indicate that B type natriuretic peptides' levels may rise in exercise induced myocardial ischemia in patients with stable coronary artery disease. Such findings hint at a potential broader application of these markers reaching beyond its present use in chronic heart failure and acute coronary syndromes. Ischemia modified albumin (IMA) is a novel diagnostic marker in acute coronary syndromes as its value increases in states of myocardial ischemia and necrosis. The role of this marker in the assessment of exercise induced myocardial ischemia in stable coronary artery disease has not been extensively investigated and remains unknown. ⋯ Exercise induced myocardial ischemia has little influence on NT-proBNP increase. The test measuring it has therefore insufficient ability to detect exercise induced ischemia in stable coronary artery disease. In patients with stable coronary artery disease without severe impairment of left ventricular function the history of myocardial infarction is the main factor determining NT-proBNP increase during exercise. Changes in serum albumin concentration during exercise seem to exclude the use of IMA in the assessment of exercise induced myocardial ischemia.
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Pol. Arch. Med. Wewn. · Apr 2006
[Septic shock in patients with blood diseases. Analysis of clinical situation, treatment and outcome in sixty patients].
Septic shock is one of the major direct causes of death in patients in hematology departments. The aim of the study was to identify situations and factors associated with septic shock in patients with blood diseases. We analyzed the medical treatment of septic shock and its outcome, we based on data from clinical history. ⋯ The most important factors influencing survival in septic shock is patient's organ sufficiency and adequacy of applied antibiotics (early goal-directed antibiotic therapy)--in the same way the sensitivity of microorganisms to this treatment. The neutropenia didn't influence an outcome. The best results were achieved in patients whom combinations of three antibiotics were given: beta-lactam + aminoglicoside + glicopeptide antibiotic or carbapenem + glicopeptide antibiotic + fluorochinolon.