Wyniki wyszukiwania - Biblioteka Nauki

1

Evaluation of the activity of thermostable DNA polymerases in the presence of heme, as a key inhibitor in the real time PCR method in diagnostics of sepsis

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Gosiewski T. , Brzychczy-Włoch M. , Pietrzyk A. , Sroka A. , Bulanda M.

Acta Biochimica Polonica

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2013

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tom 60

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nr 4

603-606

EN

The study aim was evaluation of the usefulness of several thermostable DNA polymerases in real time PCR conducted in the presence of the heme. Our study had the advantage of testing several different polymerases, one of which proved to be the least sensitive to heme activity. We also found that there is no need of supplementing the reaction mixture with protective substances like BSA. Selection of the appropriate polymerase can increase the efficiency of the PCR reaction which is very important for diagnosis of sepsis and for other analyses performed on DNA template isolated from the blood.

2

Lactate / albumin ratio as prognostic tool for risk stratification in septic patients admitted to ICU

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Mourya V. , Gupta R. , Yadav A. , Yadav R.

Critical Care Innovations

|

2023

|

tom 6

|

nr 4

11-22

EN

INTRODUCTION: Sepsis stands as the primary cause behind intensive care unit (ICU) admissions. The most critical parameters in sepsis management have been shown to be early recognition. Management delays have been associated with increased mortality and morbidity The aim of this study is to study the lactate/albumin (L/A) ratio as prognostic tool for risk stratification in septic patients admitted to ICU. MATERIALS AND METHODS: This prospective observational study was conducted with100 patients. Admitted in ICU with sepsis and septic shock were studied. Serum lactate/albumin ratio was calculated at the time of admission. Apache 2 and SOFA score was calculated at admission. All patients received initial treatment according standard protocol. All patients were followed up till discharge. An adverse outcome in terms of in hospital mortality, length of ICU stays and inotropic support was used in this study. RESULTS: Lactate/albumin ratio >1.5(AUC 0.89) correctly predicted in-hospital mortality among 27% patients with sensitivity and specificity of 90% and 78.6% respectively (p value =0.001). Lactate/albumin ratio <1.50 (AUC 0.73) correctly predicted length of ICU stays <72 hours among 17% patients with sensitivity and specificity of 85% and 58.8% respectively (p value =0.001). Lactate/albumin ratio >1.50 (AUC 0.91) correctly predicted requiring inotropic support among 36% patients with sensitivity and specificity of 83.7% and 89.5% respectively (p value =0.001). CONCLUSIONS: We concluded that lactate/albumin ratio was a stronger parameter than lactate, albumin, APACHE score and SOFA alone in predicting mortality, length of ICU stay and requiring noradrenaline inotropic support among sepsis patients in the ICU.

3

Evaluating the effectiveness of antiseptic solution Decasan in treatment of necrotic soft tissue diseases

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Fuss J. , Palii V. , Voloboyeva A.

Polish Journal of Surgery

|

2016

|

tom 88(5)

233-237

EN

Sepsis is a severe generalised infection caused usually by pathogenic bacteria. It is often the cause of hospitalization and death in patients treated in intensive care and other hospital wards. Latest research brought to better understanding of patomechanisms, took place significant development of therapy heading to improvement of general patients condition treated as a basis and additionally supported by local therapy. The aim of the study was to evaluate the possibility of using the solution Decasan in the comprehensive treatment of patients necrosis of soft tissues. Material and methods. The study included 192 patients (W/M 103/89; average -aged 53.35 ± 5.36 years). According to the classification of septic states (Chicago, 1991), patients were divided into three groups: first – patients to the local form of the infection, the second – with Systemic Inflammatory Response Syndrome (SIRS), which lasted up to 72 hours and the third – patients with various forms of sepsis, SIRS in which lasted 72 hours. Results. As a result of our studies carried out in patients where the wound was made decontamination solution Decasanu, received: pain reduction, decrease tissue swelling, early debridement of the wound and the appearance in the wound granulation, to reduce delays wound healing. Proposed algorithms treatment of various forms of sepsis, pointed out the essential elements, ie.: a comprehensive approach to the treatment of infection by early surgical intervention, intensive supportive therapy (fluid resuscitation), antibiotic therapy directed to microorganisms that cause infections and topical antiseptics therapy (solution Decasanu). Conclusions. The preparation antiseptic Decasan can be safely used for disinfection of skin, mucous membranes and wounds in the foci of infections caused by bacteria, fungi and protozoa.

4

An Uncommon Course Of Acute Appendicitis With Sepsis – A Case Report

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Żyluk A. , Jagielski W.

Polish Journal of Surgery

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2015

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tom 87

|

nr 5

272-276

EN

Authors report a case of 54-years-old patient, who presented to the hospital due to three-day history of weakness, abdominal pain and diarrhea. His general shape was severe, abdomen was tender at palpation in hypogastrium, peritoneal signs were positive, and blood tests showed highly elevated markers of inflammation, including procalcitonin, what suggested the sepsis. Despite unclear clinical picture, the presence sepsis was an argument to give the patient surgery. Intraoperatively, perforated appendix was found, being in mass with the omentum and small bowel. An appendectomy was performed. Postoperative course was complicated by the wound infection, but recovery progressed quickly and patient was dismissed at 5 days after operation. In the discussion the authors referred to the similar cases reported in the literature, concluding that acute appendicitis can be a life threating event for – to date – healthy adult person. Although a tendency to treat conservatively an uncomplicated acute appendicitis and to delay operations is supported by scientific evidence, the cases may occur in which only prompt surgical intervention protects the patient from serious complications.

5

High mobility group B1 levels in sepsis and disseminated intravascular coagulation

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Eskici Z. M. , Açıkgöz Ş. , Pişkin N. , Mungan G. , Can M. , Güven B. , Köktürk F.

Acta Biochimica Polonica

|

2012

|

tom 59

|

nr 4

561-566

EN

Cytokines trigger coagulant and fibrinolytic systems in sepsis to result in Disseminated Intravascular Coagulation (DIC) that is an important complication and leads to disseminated hemorrhages and multi-organ failure. High Mobility Group B1 DNA Binding (HMGB1) protein is a cytokine taking part in systemic inflammatory response. The objective of this study was to investigate HMGB1 levels in groups of septic patients with and without DIC.Twenty-one septic patients without DIC and 12 septic patients with DIC from the Intensive Care Unit (ICU) were included in the study. In addition, 20 patients admitted to the ICU without sepsis or DIC and 20 healthy volunteers served as controls. Levels of HMGB1, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, protein C, protein S, anti-thrombin III (ATIII), platelet (thrombocyte) and leukocyte count were determined. Levels of fibrinogen, protein C, ATIII and platelet count were significantly lower and D-dimer was significantly higher in the group with sepsis plus DIC compared to the group with sepsis without DIC. Levels of HMGB1 were higher in the group with sepsis and DIC compared to the group with sepsis; however, the difference was not statistically significant and the levels of HGMB1 of both groups were significantly higher compared to ICU and healthy control groups. HMGB1 levels were not significantly different in survivor and non survivor patients. HMGB1 levels did not differ in lower respiratory tract infection (LRTI) and urinary tract infection (UTI) in regard to the etiology of sepsis.

6

The Impact of the Types of Microorganisms Isolated from Blood and Wounds on the Results of Treatment in Burn Patients with Sepsis

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Glik J. , Kawecki M. , Gaździk T. , Nowak M.

Polish Journal of Surgery

|

2012

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tom 84

|

nr 1

6-16

EN

Despite development of combustiology, infections continue to be the most important cause of death among patients with burns. Sepsis is the most severe clinical presentation of infection in patients after thermal injuries who require immediate treatment. Early diagnosis and proper treatment of sepsis are important in the clinical management that is often hampered for multiple reasons, e.g. impaired patient immunity, problems with microorganisms with multi-antibacterial drug resistance.The aim of the study was to assess effect of type of a microorganism isolated from blood and wound on results of treatment of sepsis in patients with burns.Material and methods. Effect of type of microorganisms isolated from blood and wound on the result of treatment of sepsis was studied in 338 patients hospitalized immediately after an injury in Centre for Burn Treatment in Siemianowice Śląskie in years 2003 - 2004 (at the age of 18 - 96 years, 66 women and 272 men). Clinical symptoms of generalized infection were found in all study subjects. The study group was divided into two subgroups: cured patients and patients who died of sepsis. The following parameters were assessed in both subgroups: type of microorganism isolated from blood, type of microorganism isolated from wound as well as occurrence of the same and different infections of blood and burn wound.Results. positive blood cultures were found in 165 patients (48.8%), 106 (64.2%) were cured, 59 (35.8%) died. The most commonly isolated microorganisms in cured patients were Gram(+) Staphylococcus epidermidis MRSE (19.81%) and Staphylococcus aureus MRSA (18.87%). Gram(-) intestinal rods were least commonly isolated from this group. The most commonly isolated microorganisms from blood of patients who were to die, included non-fermenting Gram(-) rods Acinetobacter baumannii (35.59%) and Pseudomonas aeruginosa (22.03%). Mixed bacterial flora was found in the blood of 22.03% patients. Among patients who were to die, the same microorganisms were found in the blood and in the wound in 32.2% of patients, while this rate was 17.92 in cured patients. The most commonly found bacteria in the blood and burn wound in the cured patients included Staphylococcus aureus MRSA (31.58%) and Staphylococcus aureus (21.05%). In the group of patients who were to die, the most common bacteria isolated simultaneously from the blood and burn wound included Acinetobacter baumannii (47.37%) and Pseudomonas aeruginosa (36.84%).Conclusions. 1. The patients with thermal injuries are at higher risk of death in the event of sepsis caused by Gram(-) bacteria versus Gram(+) bacteria. 2. Infection of blood and burn wound caused by the same bacteria Pseudomonas aeruginosa and Acinetobacter baumanni increases the risk of death due to sepsis in patients with burns following thermal injuries.

7

Trefoil factor 3 as a marker of intestinal cell damage during sepsis

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Žurek J. , Kýr M. , Vavřina M. , Fedora M.

Open Medicine

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2014

|

tom 10

|

nr 1

EN

Objective: Gastrointestinal dysfunction or gut failure frequently occurs in seriously ill patients and can be responsible for multi-organ failure. Trefoil factor 3 (TFF3) was characterized for its role in reconstitution of an epithelial barrier after mucosal injury in the jejunum. The aims of our study was an analysis of TFF3 levels dynamics in patients with sepsis and the correlation of TFF3 with severity of sepsis and mortality. Methods: Prospective observational study, a ten days evaluation period in children aged 0-19 years with systemic inflammatory response syndrome or septic state. Blood tests to determine levels of TFF3 were obtained as long as the patient met the criteria for systemic inflammatory response syndrome or sepsis. Results: Analysis of dynamics revealed steady levels of TFF3 during the 10 day period evaluated. TFF3 levels could not differentiate between various septic conditions in patients until a marked organ dysfunction developed. Higher Area Under Curve was noticed between control group and patients with sepsis. We could not make any strong conclusions based on mortality model. Conclusions: Levels of TFF3 are elevated in paediatric patients with sepsis through organ dysfunction.

8

Pro-Atrial Natriuretic Peptide (proANP) A New Prognostic Marker in Clinical Outcome of Critically Ill Patients

88%

Reith H. , Rauchschwalbe S.

Polish Journal of Surgery

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2007

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tom 79

|

nr 3

161-166

EN

The diagnosis of sepsis and the prediction of its outcome are important aims to tackle for this heterogeneous disease. There is a lack of biomarkers to aid in identification of risk groups, inclusion of patients in ongoing studies, and better differentiation of therapeutic strategies. Since the introduction of the prohormone procalcitonin (PCT), many studies have begun to focus on new prohormones.The aim of the study was to evaluate the prognostic value of pro-atrial natriuretic peptide (proANP) as a new marker of sepsis outcome.Material and methods. A cohort of 80 patients developing post-surgical sepsis was consecutively included into this study. Blood samples were obtained for analysis of proANP and determination the serum levels of sTNF-R1, TNF-α, IL-6, IL-8, IL-10, procalcitonin and neopterin. Cytokine levels were measured repeatedly until the patients discharge from the ICU.Results. 54/80 (67.5%) fulfilled the criteria for severe sepsis and 36/80 (45.0%) developed septic shock. Multiple organ failure occurred within 60/80 patients (75.0%); the overall mortality was 26/80 (32.5%). Concerning the diagnosis of sepsis, severe sepsis, or septic shock, there was no statistical difference in the proANP values. However, there was a statistical difference in the prediction of outcome in that 26 nonsurvivors had 803.5 (441.5/ 1095) pmol/L levels while the survivors level was 315.5 (187/ 594.5) pmol/L. In addition, there were no statistical significant differences between proANP and other cytokines.Conclusions. There was a significant correlation between proANP values and the outcome of critically ill patients. ProANP does not differentiate between clinical features like sepsis, severe sepsis or septic shock.

9

Prognostic value of using neutrophil-lymphocyte ratio in patients with burn injury for the diagnosis of sepsis and bacteraemia

88%

Fuss J. , Voloboyeva A. , Poliovyj V.

Polish Journal of Surgery

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2018

|

tom 90(5)

13-16

EN

Objective: Despite the progress in the treatment of burn injuries, the mortality rate among seriously ill patients still remains high nowadays. The main causes of fatal cases with extensive deep burns are generalized infectious complications, the major of which is sepsis. According to the authors, 25%–85% of those who died of burn injuries in later periods, died from sepsis. The frequency and severity of infectious complications in patients with burn injuries requires an accurate diagnosis of infection that will determine the tactics of therapeutic and surgical treatment of such patients (Di Lonardo A. et al., 1993). However, the clinical diagnosis of wound infection in patients with burn injuries is quite difficult. Materials and methods: The clinical material included 188 patients with burn injuries. The average age of those patients ranged from 20 to 59 years. Men - 98 (52.1%), women - 90 (47.9%). The survey was conducted from April 2014 to July 2016. Results: In our opinion, the strength of NLR (neutrophil-lymphocyte ratio) is the possibility of implementing this parameter simply by using already available biomarkers (neutrophil count and lymphocyte count). Therefore, this ratio is easy to integrate in clinical practice and cost effective. Conclusion: The application of NLR for the diagnosis of sepsis in patients with burn injuries is the option of choice, since its determination requires only a general blood test.

10

Evaluation of patients with candida infections in a tertiary care hospital’s general intensive care unit in Turkey.

88%

Ceylan İ. , Korkmaz H. A. , Karakoç E.

Critical Care Innovations

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2022

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tom 5

|

nr 2

1-10

EN

INTRODUCTION: : Studies indicate that approximately 90% of the patients followed in the ICU have Candida spp colonization. In this study we aimed to elucidate the epidemiology, characteristics, management and outcomes of patients with candidemia in the intensive care unit of a training and research hospital. MATERIAL AND METHODS: All patients over the age of 18 who were hospitalized in general intensive care unit more than 24 hours between 2013 and 2019 were included in the this retrospective study. RESULTS: A total of 43 critically ill patients with blood cultures positive for Candida spp. have been enrolled in this retrospective analysis. The duration of stay in the intensive care unit of the survivors was approximately 53 days, while the average length of stay in the intensive care unit of the non survivors was 16 days, and this difference was statistically significant (p<0.05), 89.7% of septic patients with candidemia died the intensive care unit. There was a statistically significant difference between the two groups in terms of platelets, urea and systolic blood pressure (p<0.05), the mean platelet and systolic blood pressure values of the surviving patients were higher than the deceased individuals, while the urea value was lower. The average fungal growth time of the surviving individuals was 17 days, while this period was 1 day in the non-survivor patients. CONCLUSIONS: The mortality rate was higher in patients with sepsis and concomittant candida infection at very soon days of ICU hospitalization. Early administration of empirical antifungal therapy with coverage of non-albicans should be considered for septic patients.

PL

WSTĘP: Badania wskazują, że około 90% pacjentów obserwowanych na OIOM ma kolonizację Candida spp. W tym badaniu mieliśmy na celu wyjaśnienie epidemiologii, charakterystyki, zarządzania i wyników pacjentów z kandydemią na oddziale intensywnej terapii szpitala szkoleniowo-badawczego. MATERIAŁ I METODY: Do tego retrospektywnego badania włączono wszystkich pacjentów powyżej 18 roku życia, którzy byli hospitalizowani na oddziale intensywnej terapii ogólnej dłużej niż 24 godziny w latach 2013-2019. WYNIKI: Łącznie 43 krytycznie chorych pacjentów z dodatnimi posiewami krwi na Candida spp. zostało włączonych do analizy retrospektywnej. Czas pobytu na oddziale intensywnej terapii dla ocalałych wynosił około 53 dni, podczas gdy średni czas pobytu na oddziale intensywnej terapii dla ocalałych wynosił 16 dni, a różnica ta była istotna statystycznie (p<0,05). 89,7% septycznych pacjentów z kandydemią zmarło na oddziale intensywnej terapii. Wykazano statystycznie istotną różnicę między obiema grupami w zakresie płytek krwi, mocznika i skurczowego ciśnienia krwi (p<0,05). Średnie wartości ciśnienia krwi u pacjentów, którzy przeżyli, były wyższe niż zmarłych, natomiast zawartość mocznika była niższa. Średni czas wzrostu grzybów osobników, które przeżyły wynosił 17 dni, podczas gdy u pacjentów, którzy nie przeżyli, okres ten wynosił 1 dzień. WNIOSKI: Śmiertelność była wyższa u pacjentów z sepsą i współistniejącym zakażeniem drożdżakami w bardzo krótkim czasie hospitalizacji na OIT. U pacjentów z posocznicą należy rozważyć wczesne zastosowanie empirycznego leczenia przeciwgrzybiczego, obejmującego także osoby nie zakażone.

11

Peroxisome proliferator-activated receptor gamma [PPARgamma] and sepsis

88%

Von Knethen A. , Soller M. , Brune B.

Archivum Immunologiae et Therapiae Experimentalis

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2007

|

tom 55

|

nr 1

12

Therapeutic approach to a child with acute respiratory distress syndrome: a report of two cases

75%

Nosal S. , Durdik P. , Luptakova A. , Sutovska M. , Nosal V. , Jesenak M. , Havlicekova Z. , Hamzik J. , Banovcin P.

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nr 6

43-51

13

Hypothermia effects on liver and kidney oxidative stress parameters in an experimental model of sepsis in rats

75%

Sidonia B. , Horatiu R. , Vlad L. , Francisc D. , Ciprian O. , Cosmin P. , Liviu O. , Sanda A.

Journal of Veterinary Research

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2020

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tom 64

|

nr 1

14

Lipopolisacharyd bakteryjny jako obiekt najnowszych badań nad endotoksemią

75%

Futoma-Kołoch B. , Godlewska U. , Pędlowski M.

Laboratorium - Przegląd Ogólnopolski

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2014

|

tom nr 7-8

37--41

PL

Lipopolisacharyd (LPS) jest antygenem powierzchniowym występującym u bakterii Gram-ujemnych. Działanie LPS na organizm ludzki często rozpatrywane jest w kontekście sepsy, którą cechuje nadmierna odpowiedź zapalna w odpowiedzi na obecność endotoksyny. Niniejsze opracowanie zawiera najnowsze informacje o wpływie LPS na przebieg reakcji z udziałem białek sygnałowych w komórkach odpornościowych oraz o aktualnie prowadzonych badaniach klinicznych, w których uwzględnia się działanie prozapalne LPS. Podano także przykłady pochodnych LPS, stosowanych jako składniki szczepionek przeciwbakteryjnych, a także przykłady leków zapewniających ochronę w endotoksemii.

EN

Lipopolysaccharide (LPS) is a surface antigen present in Gramnegative bacteria. LPS action on the human body is often considered in the context of sepsis, which is characterized by excessive inflammatory response in the presence of endotoxin. This study shows the latest information about the effects of LPS on the course of cellular reactions involving signaling proteins and the ongoing clinical trials, in which pro-inflammatory effects of the LPS is taking into account. Moreover, in this paper LPS derivatives are used as components of antibacterial vaccines, as well as drugs, which provide protection in endotoxemia are described.

15

Diagnostyka laboratoryjna sepsy

75%

Zielińska-Borkowska U. , Skirecki T.

Laboratorium Medyczne

|

2019

|

tom nr 1

34--39

PL

Sepsa to nieprawidłowa odpowiedź gospodarza na zakażenie wywołane przez patogeny. Dokładna i szybka diagnoza pozwala na wdrożenie szybkiej terapii. W pracy przedstawiono niektóre badania laboratoryjne wykonywane w podejrzeniu sepsy. Od 2016 roku zalecane jest oznaczanie mleczanów. Do badań włączono również poziom bilirubiny oraz kreatyniny, a raczej ich progresje w określaniu niewydolności wielonarządowej. Zaproponowano kilka nowych markerów do rozpoznawania sepsy, jak i wskaźników prognostycznych. Do chwili obecnej nie ma jednego laboratoryjnego testu pozwalającego na jego podstawie rozpoznać sepsę.

EN

Sepsis is the host response to microbial pathogens. An accurate and timely diagnosis of sepsis allows for prompt and appropriate treatment. This paper discusses selected laboratory tests that are carried out when sepsis is suspected. The 2016 sepsis consensus definitions include lactate concentrations. Also included in the 2016 definitions are the measurements of bilirubin and creatinine, or rather their progressions, in order to determine multisystem organ failure. Several new biomarkers have been proposed to diagnose sepsis or to predict mortality. So far there has been no single laboratory test that accurately diagnoses sepsis.

16

The effect of omeprazole on treatment outcomes in patients with severe traumatic brain injury and sepsis

75%

Oliynyk O.

Health Problems of Civilization

|

2021

|

tom 15

|

nr 2

EN

Background. The interrelation between omeprazole use and the possibility of developing nosocomial pneumonia, acute kidney damage and Clostridium difficile-induced diarrhea in patients with sepsis requires further study. Material and methods. 200 patients with severe craniocerebral injury that underwent surgery for the pathology and developed sepsis in the postoperative period were examined in a blind, randomized placebo-controlled research study. The patients were divided into two groups. Patients in Group 1, as part of their therapy regimen for sepsis, received a daily dose of 0.2 mg/kg omeprazole as an intravenous infusion; patients in Group 2 received placebo instead of omeprazole, in addition to a similar therapy regimen as Group 1. Results. Among patients receiving omeprazole, the number of concomitant ventilatorassociated pneumonia cases increased by 1.32 times, the number of acute kidney damage cases by 1.33 times and the number of cases of Clostridium difficile toxin secretion with feces by 1.75 times. Conclusions. The routine use of omeprazole in the management of patients with sepsis may worsen treatment results.

PL

Wprowadzenie. Kwestia korelacji stosowania omeprazolu z możliwym rozwojem szpitalnego zapalenia płuc, ostrego uszkodzenia nerek czy biegunki wywołanej przez Clostridium difficile u pacjentów z sepsą wymaga dalszych badań. Materiał i metody. W ślepym i randomizowanym badaniu kontrolowanym placebo przebadano 200 pacjentów z poważnymi obrażeniami czaszkowo-mózgowymi, którzy w wyniku tej patologii przeszli operację, i u których w okresie pooperacyjnym rozwinęła się sepsa. Zostali oni podzieleni na dwie grupy. Grupa 1 przyjmowała omeprazol w formie wlewu dożylnego w dziennej dawce 0,2 mg/kg jako część kompleksowego leczenia sepsy; grupa 2 przyjmowała placebo zamiast omeprazolu jako dodatek do głównej terapii, podobnej do tej stosowanej w przypadku grupy 1. Wyniki. Wśród pacjentów przyjmujących omeprazol liczba przypadków towarzyszącego respiratorowego zapalenia płuc wzrosła o 1,32 raza, ostrego uszkodzenia nerek – o 1,33 raza, a wydalenia toksyn Clostridium difficile w kale – o 1,75 raza. Wnioski. Rutynowe stosowanie omeprazolu w leczeniu pacjentów z sepsą może pogorszyć wyniki terapii.

17

Melatonin as an antioxidant: biochemical mechanisms and pathophysiological implications in humans.

75%

Reiter R. J. , Tan D.-x. , Mayo J. C. , Sainz R. M. , Leon J. , Czarnocki Z.

Acta Biochimica Polonica

|

2003

|

tom 50

|

nr 4

1129-1146

EN

This brief resume enumerates the multiple actions of melatonin as an antioxidant. This indoleamine is produced in the vertebrate pineal gland, the retina and possibly some other organs. Additionally, however, it is found in invertebrates, bacteria, unicellular organisms as well as in plants, all of which do not have a pineal gland. Melatonin's functions as an antioxidant include: a), direct free radical scavenging, b), stimulation of antioxidative enzymes, c), increasing the efficiency of mitochondrial oxidative phosphorylation and reducing electron leakage (thereby lowering free radical generation), and 3), augmenting the efficiency of other antioxidants. There may be other functions of melatonin, yet undiscovered, which enhance its ability to protect against molecular damage by oxygen and nitrogen-based toxic reactants. Numerous in vitro and in vivo studies have documented the ability of both physiological and pharmacological concentrations to melatonin to protect against free radical destruction. Furthermore, clinical tests utilizing melatonin have proven highly successful; because of the positive outcomes of these studies, melatonin's use in disease states and processes where free radical damage is involved should be increased.

18

Soluble selectin profiles associated with severe trauma

75%

Siemiatkowski A. , Rogowski F. , Wereszczynska-Siemiatkowska U. , Malinowska L. , Borkowski J.

Archivum Immunologiae et Therapiae Experimentalis

|

2001

|

tom 49

|

nr 4

19

Staphylococcal superantigens: do they play a role in sepsis?

75%

Holtfreter S. , Broker B. M.

Archivum Immunologiae et Therapiae Experimentalis

|

2005

|

tom 53

|

nr 1

20

Sepsa jako powikłanie drobnego zranienia

63%

Jurkiewicz B.

Pediatria i Medycyna Rodzinna

|

2010

|

tom 6

|

nr 4

324-327

EN

Sepsis is a severe generalised infection caused usually by pathogenic bacteria. Natural defence mechanisms are destroyed by bacterial toxin and systemic inflammatory response syndrome (SIRS) is developed. High virulence pathogens like meningococcus, pneumococcus, Haemophilus influenzae, Salmonella, Streptococcus, Staphylococcus (generally Staphylococcus aureus) are factors causing general infection. Other microorganisms causing SIRS are viruses, fungus, or parasites. Mechanisms developing sepsis are complex. Respiratory system, infection in abdominal cavity, encephalomyelitis, and urinary system infection are usually entry of septicaemia. Particular type of infection is sepsis developed after surgical procedure or invasive diagnostic investigation. Rare cause of fully symptomatic SIRS are small skin wounds causing damage of skin barrier and penetration of skin bacteria inside the organism. In propitious conditions i.e. decrease of immunity bacteria can spread via bloodstream, destroy vessel endothelium and provoke septic shock. The article presents two cases of sepsis induced by Staphylococcus aureus. No other deviation but small wounds were found in general state of those children. Early diagnostics and highly specialistic treatment carried out on Pediatric Surgery and Orthopedics Department resulted in complete recovery of presented patients.

PL

Sepsa jest to ciężkie uogólnione zakażenie, powstające najczęściej na skutek zakażenia bakteriami chorobotwórczymi. Toksyny bakteryjne uszkadzają naturalne mechanizmy obronne organizmu, wywołując uogólniony zespół odczynu zapalnego (SIRS). Do czynników wywołujących zakażenie należą bakterie chorobotwórcze o dużej zjadliwości, takie jak: meningokoki, pneumokoki, pałeczka hemofilna, salmonella, paciorkowce czy gronkowce (najczęściej Staphylococcus aureus). Innymi drobnoustrojami odpowiadającymi za wystąpienie zespołu SIRS mogą być wirusy, grzyby lub pasożyty. Mechanizm powstawania sepsy jest złożony. Wrotami zakażenia krwi najczęściej są układ oddechowy, infekcje w obrębie jamy brzusznej, zapalenie opon mózgowo-rdzeniowych i zakażenia układu moczowego. Szczególnym rodzajem zakażenia jest sepsa rozwijająca się po zabiegach operacyjnych lub inwazyjnych badaniach diagnostycznych. Rzadką przyczyną wystąpienia pełnoobjawowego zespołu SIRS mogą być drobne zranienia skóry powodujące uszkodzenie bariery skórnej i przeniknięcie do organizmu bakterii, które zwykle znajdują się na powierzchni skóry. W sprzyjających warunkach, na przykład zmniejszonej odporności, mogą one rozprzestrzenić się drogą krwionośną, uszkadzając śródbłonek naczyń, i w efekcie wywołać wstrząs septyczny. W pracy przedstawiono dwa przypadki sepsy wywołanej bakterią Staphyloccocus aureus u dzieci, u których stwierdzono jedynie drobne zranienia skóry bez żadnych innych odchyleń od stanu prawidłowego. Wczesna diagnostyka i wczesne wysokospecjalistyczne leczenie wprowadzone w Oddziale Chirurgii i Ortopedii Dziecięcej pozwoliło na opanowanie sepsy i doprowadziło do całkowitego wyleczenia dzieci.