Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Sep 2002
Review[The role of monocytes/macrophages and their cytokines in the development of immunosuppression after severe injury].
Despite new generations of antibiotics and great improvement in the fields of rescue and modern intensive care medicine, sepsis remains one of the most frequent causes of complications and death in severely injured patients. Shock, bacterial colonization, invasive methods of treatment and immune mechanisms are reported to be responsible for the increased susceptibility of patients to sepsis after trauma. Posttraumatic immune abnormalities consist of two mechanistic entities: inappropriately hyperactive inflammatory processes and profound depression of cell-mediated immune function. ⋯ Phagocytosis, oxidative burst activity and cytokine secretion are impaired in macrophages early after traumatic injury. However, a widely accepted clinical treatment for post-injury immunosuppression does not currently exist. As our understanding of the pathogenesis of injury-induced immunosuppression progresses, our treatment approaches will likely improve.
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Pol. Merkur. Lekarski · Sep 2002
Review[Disorders of thermoregulatory mechanisms of the organism and their metabolic consequences. Part I. Hypothermia].
The maintenance of thermal equilibrium depends on the normal functioning of numerous body systems and their appropriate interaction with the environment. Man has a complicated neural and neuroendocrine control system that is designed to maintain a constant core temperature despite changes in environmental temperature or level of activity. Heat exchange is a bidirectional process involving the transfer of heat between an object and its environment. ⋯ The hypothalamus is the central control centre that ensures thermal homeostasis. Although many schemes exist for the classification of hypothermia, from the clinical point of view it is recommended to consider any temperature below 35 degrees C significant. Accurate temperature measurement and core temperature monitoring are essential for diagnosing hypothermia.