Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Feb 2002
Review[Gastrointestinal tract dysfunction in critical illness].
Until relatively recently, the gastrointestinal (GI) tract was considered a dormant, metabolically and immunologically inactive organ in critically illnesses. However, the GI tract provides a number of crucial functions that, in fact, may influence morbidity and mortality of many critically ill patients. Its large absorptive area provides a site for nutrient digestion and utilization and serves as an important barrier preventing the systemic absorption of intraluminal microbes and its toxic products. ⋯ The gut dysfunction occurs frequently and early in the intensive care patients. Abnormal colonization, impaired intestinal epithelial barrier function and bacterial translocation represent the key components of gut failure implicating in the pathogenesis of sepsis and multiorgan dysfunction. This review summarizes recent insights into the role of the gut in critically ill patients with particular focus on 1) the basis of "gut-origin hypothesis", 2) pathophysiology of gut dysfunction, 3) monitoring of intestinal function, and 4) protective measures and novel therapeutic strategies.
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Casopís lékar̆ů c̆eských · Jan 2002
Editorial Historical Article[140 years' of the Casopis Lekaru Ceskych (Journal of Czech Physicians)].
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Ethylene glycol is a common substance in various antifreeze preparations. Intoxication is caused by ingestion either as a suicide attempt or by an accident. The clinical course of intoxication is always severe, however, immediate launching of proper treatment can reverse the poor prognosis. ⋯ Organ manifestations. 3. Acute renal failure. The case report of 46-year-old man admitted after ingestion of ethylene glycol in suicidal attempt summarises the essential principles of therapy--monitoring of vital functions, administration of ethanol solution as an antidote and hemodialysis to remove toxic components.
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Casopís lékar̆ů c̆eských · Jul 2000
[Hematologic and cytogenetic response to treatment in patients with chronic myeloid leukemia].
The Interferon alpha therapy increases the number of cytogenetic responses in patients with chronic myeloic leukaemia. The addition of cytarabine can reduce the number of Ph positive metaphases. The achievement of cytogenetic response is connected with longer survival of patients with chronic myeloic leukaemia. The aim of the study was the evaluation of the achievement of hematologic and cytogenetic response as well as adverse effects of the treatment in chronic myeloic leukaemia patients. ⋯ Based on the published date, that show a better survival of patients with the achieved cytogenetic response as well as the higher number of cytogenetic responses in the group of interferon plus cytarabine therapy from our observation, we believe, that combined therapy should be suitable as a front-line therapy of chronic myeloic leukaemia patients.
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Casopís lékar̆ů c̆eských · May 2000
Review[Immunoablation and hematopoietic stem cell transplantation in the treatment of multiple sclerosis].
High dose chemotherapy with autologous hematopoietic cell support is a standard approach in the management of selected hematological malignancies. Autoimmune diseases which do not respond to conventional immunosuppression might benefit from high dose immunoablative chemotherapy. The transplantation of hematopoietic cells is necessary after the high dose chemotherapy to restore bone marrow function. ⋯ Experience with preclinical studies on murine experimental allergic encephalomyelitis (EAE), as well as the course of MS following bone marrow transplantation for coincidental malignancy in humans formed the basis of the first clinical studies involving high dose chemotherapy and autologous hematopoietic support. Results of the first studies confirm that the method is feasible in patients with MS, and that the effect is very promising. Nonetheless, more consistent results vis a vis the therapeutic effect should emanate from upcoming studies.