Przegla̧d lekarski
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Cardiac surgery with cardiopulmonary bypass (CPB) in children with congenital heart disease induces neutrophil activation, degranulation and systemic inflammatory response. Matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-2 (MMP-2) are enzymes involved in degranulation and leukocyte extravasation. These are secreted as a pro-enzyme in response to several inflammatory mediators and are inhibited by tissue inhibitor of metalloproteinase-1 (TIMP-1) and tissue inhibitor of metalloproteinase-2 (TIMP-2). ⋯ These findings suggest that kinetics of MMPs concentrations in serum after cardiac surgery appear to depend on many factors. We demonstrated the link between CPB duration and the MMP-9 concentration. Future studies will determine whether inhibition of MMPs activity diminishes morbidity in children after cardiac surgery.
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Case Reports
[Severe nonfatal poisoning after intravenous abuse of transdermal fentanyl--a case report].
Fentanyl is a potent synthetic opioid with short-acting analgesic activity after intravenous or subcutaneous administration. The potency and lipid solubility of fentanyl make it suitable for delivery via the transdermal therapeutic system in the treatment of chronic pain. ⋯ The present case demonstrates the possibility of intravenous abuse of transdermal patches and the risk of severe intoxication. In the cases of suspected fentanyl overdose specific assays should be utilized for the detection of fentanyl because it may not be detected by the routine opiate screening procedure.
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Electrophysiological examinations still play an important role in initial diagnostics of neuromuscular disorders and monitoring of the disease progress or recovery process. ⋯ Electromyographic examination remains important diagnostic tool of neuromuscular disorders. In order to limit extension of differential diagnostics EMG should be performed in its early stage.