Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Oct 2002
Case Reports[Pyoderma gangrenosum--positive effect of cyclosporin A therapy ].
Although pyoderma gangrenosum is a disorder known since over 70 years, it still remains a diagnostic and therapeutic problem. We describe three subjects with pyoderma gangrenosum; two were females, one was male, one case was associated with colitis ulcerosa, two were without any related disorders. Histopathologic examinations supported the diagnosis in all cases. ⋯ Cyclosporin A introduced in the dose of 5 mg/kg/d resulted in dramatic response and complete remission. Serum CyA levels, biochemical parameters of liver and kidney function, blood pressure were monitored during the therapy. No adverse events due to Cyclosporin A were observed.
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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.
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Pol. Merkur. Lekarski · Jul 2002
Comparative Study[Comparison of the early results of coronary artery bypass grafting in women and men].
Aim of the study was comparing the early results of coronary artery bypass grafting (CABG) in women (W) and in men (M). This study comprises 1640 consecutive patients (1390 male and 250 female) at the age from 29 to 78 years (mean 57.2 +/- 8.9 years) operated on between January 1995 and June 2001 because of coronary artery disease. At least one myocardial infarction in history was noted in 156 W (62.4%) and 848 M (61.0%) (NS). ⋯ Female patients are at higher mortality risk of coronary artery bypass grafting. Efficacy of IABP in the treatment of LCOS is lower in W. Infectious complications are more frequent in females.
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Nitric oxide (NO) is highly active molecule playing a key role in physiological as well as pathological processes in the organism. Asthmatic patients show an increased expression of inducible nitric oxide synthase (iNOS) in airway epithelial cells and an increased level of NO in exhaled air. ⋯ The role of excessively produced NO in the pathogenesis of asthma is under active investigation. Determination of airway production of NO may be an important biomarker of inflammation for monitoring anti-inflammatory therapy.