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  • 1
    Electronic Resource
    Electronic Resource
    Kinetics and characteristics of an acute phase response following cardiac arrest (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1386-1394 
    Details
    ISSN: 1432-1238
    Keywords: Key words Hypoxia ; Ischemia ; Acute phase proteins ; Cardiac arrest ; Infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inflammation and hypoxia are frequently associated, but their interaction is poorly understood. In vitro studies have shown that hypoxia stimulates the genes of acute phase proteins (APP) and cytokines known to induce APP. We decided to determine kinetics and potential determinants of an acute phase response after cardiac arrest and to assess whether isolated moderate hypoxia can induce APP in humans in vivo. Design: Prospective, observational study in patients and human experiment. Setting: Tertiary care university hospital. Patients and participants: 22 patients after primarily successful cardiopulmonary resuscitation (CPR) and 7 healthy volunteers. Interventions: None in patients; exposure of volunteers to simulated altitude (460 torr/6 h). Results: Following CPR, type-1 APP (C-reactive protein, α1-acidglycoprotein, serum amyloid A) and type-2 APP (haptoglobin, α1-antitrypsin) increased consistently within 1–2 days and the ’negative' APP transferrin was downregulated. This APP response occurred irrespective of the cause of arrest, the estimated time of anoxia, clinical course or patient outcome and was not different in patients with and without infectious complications. Exposure of healthy volunteers to less severe but more prolonged hypoxia did not induce APP, although a time dependent increase of serum erythropoietin (EPO) was measurable under these conditions, indicating the activation of oxygen dependent gene expression. Conclusions: (i) A marked acute phase response occurs regularly after cardiac arrest, but within the complexity of this situation the severity of hypoxia is not a predominant determinant of this response. (ii) Despite in vitro evidence for similarities in the oxygen dependent regulation of APP and EPO production, the oxygen sensitivity of these proteins in vivo is different. (iii) Measurements of APP are not revealing regarding infectious complications in the early phase after CPR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051086
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Das Schmidt-Syndrom mit koexistentem Diabetes mellitus (1998)
    Springer
    Intensivmedizin und Notfallmedizin 35 (1998), S. 332-336 
    Details
    ISSN: 1435-1420
    Keywords: Key words Schmidt's syndrome ; Addison disease ; Addisonian crisis ; Diabetes mellitus type I (IDDM) ; Autoimmune thyreoiditis ; Autoimmune polyglandular syndrome (APS) ; Schlüsselwörter Schmidt-Syndrom ; Morbus Addison ; Addison-Krise ; Diabetes mellitus Typ I (IDDM) ; Autoimmunthyreoiditis ; Auto-immunes Polyglanduläres Syndrom (APS)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Zusammentreffen von Nebennierenrinden- und Schilddrüseninsuffizienz wird in der Literatur als Schmidt-Syndrom bezeichnet. Bei 2/3 dieser Patienten findet man einen koexistenten Diabetes mellitus Typ I. Da in der Gruppe der Diabetiker das Auftreten von pluriglandulären Erkrankungen beschrieben ist, sollte ein Krankheitsprozeß mit auffälliger Adynamie, Erbrechen, Bauchschmerzen, Exiskkose und Hypotonie auch an das gleichzeitige Vorliegen eines M. Addison denken lassen. Zusätzlich ist das frühzeitige Erkennen einer beginnenden Addison-Krise sehr wichtig, da trotz Intensivmedizin dieses Krankheitsbild mit einer hohen Letalität behaftet ist.
    Notes: Summary The coexistance of thyroid- and adrenocortical insufficiency is known as Schmidt's syndrome. In two-thirds of these patients you find also diabetes mellitus. In the group of diabetic patients one sees pluriglandular endocrine dysfunction more often than in non-diabetic patients. Therefore, one should be aware of a coexisting Addision's disease in diabetic patients who are complaining of tireness, weakness, vomiting, abdominal pain, and circulatory disturbances. It is very important to detect this combination as early as possible, because the lethality of an Addisionian crisis is still high.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050156
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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