Przegla̧d lekarski
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The pulmonary endothelium synthesizes many bioactive compounds and their activation or injury may cause release these substances into the blood. We determined the influence of trauma severity for endothelium activation/injury by measurement of specific endothelial cell markers--soluble E-selectin (sES) and von Willebrand factor antigen (vWF:Ag). Thirty six severely traumatized patients were stratified according to an Injury Severity Score (ISS). ⋯ Significant correlation between plasma vWF:Ag and serum sES concentration was also observed (Rs = 0.501, p < 0.001). In conclusion, severe trauma patients manifest endothelial cell activation/injury. Plasma vWF:Ag concentration seems to be an important, early marker of trauma severity, while serum sE-selectin level may serve as prognostic factor in immediate postinjury period course.
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Shortening the time between the onset of pain and start of the efficacious treatment is an important mean to lower case-fatality in myocardial infarction (MI). The goal of this publication was to assess: 1) current time between the onset of pain and: a) calling medical service by the patient b) first examination by a doctor, and c) first administration of intravenous treatment, 2) reasons of the delay in calling medical service by the patient, 3) whether patients with a diagnosis of ischaemic heart disease (IHD) prior to hospitalization were instructed how to behave in case of chest pain, and 4) whether instructing how to behave in case of chest pain was related with a time between the onset of pain and calling medical service by the patient. Studied group were 515 patients hospitalised in 6 in-patient clinics of cardiology with MI or unstable angina (UA) or hospitalised for first PTCA or CABG, 427 (83%) agreed to participate, out of whom 184 had MI or UA including 110 patients having typical chest pain. ⋯ Patients who earlier received instruction had four times higher chance to call medical service within the first hour after the onset of pain (Odds Ratio = 4.11, 95% confidence interval 1.13-15.0). Only half of all patients hospitalised due to acute episode of IHD or for revascularization procedures received intensive instructions from a doctor. Adopting a detailed instruction on how to behave in case of chest pain as a standard procedure for patients with IHD may be an important mean to lower case-fatality in MI.