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  • Dexamethasone  (1)
  • Plasmatic blood clotting  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 14 (1988), S. 163-166 
    ISSN: 1432-1238
    Keywords: Dexamethasone ; Cortisol ; Head injury ; Pediatric
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective randomised study was performed on 25 children aged 1.4 to 15.8 years with severe head injury (Glasgow Coma Scale⪕7) to determine the clinical effectiveness and the impact on endogenous cortisol production of high-dose steroid therapy. Thirteen patients (group 1) received dexamethasone 1 mg/kg/day during the first 3 days and 12 (group 2) not. All patients were treated with a standardized regimen. Urinary free cortisol was measured by radioimmunoassay, and the clinical data were recorded at hourly intervals. Outcome was assessed 6 months later using the Glasgow Outcome Scale. We found a higher frequency of bacterial pneumonias in the dexamethasone-treated patients (7/13 versus 2/12). Group 1 showed a suppression of endogenous cortisol production from day 1 to day 6. In group 2, menu free cortisol was up to 5-fold higher than under basal conditions. The results in group 2 showed taht the endogenous steroid production reacts adequately to the stress of severe head injury. It probably is sufficient to elicit maximum glucocorticoid effects. There was no other statistically significant difference in the clinical and laboratory data between the two groups. We conclude that dexamethasone in high doses suppresses endogenous cortisol production up to 6 days and may increase the risk of bacterial infection without affecting the outcome or the clinical and laboratory data.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 57 (1979), S. 1305-1309 
    ISSN: 1432-1440
    Keywords: Arterial thrombogenesis ; Plasmatic blood clotting ; Thrombin ; Prothrombin ; Arterielle Thrombogenese ; plasmatische Gerinnung ; Thrombin ; Thrombozyten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Neben einer Darlegung der heutigen Auffassung der arteriellen Thrombogenese wird versucht, unter Einbezug neuer Erkenntnisse bezüglich Gefäßwand und Interaktion des plasmatischen Gerinnungssystems, ein Konzept für die Frühphase arterieller Thrombusbildung zu geben. Es bestehen Hinweise dafür, daß an der geschädigten Gefäßinnenseite thromboplastische Aktivität lokale Thrombinbildung bewirkt. Unter arteriellen Blutströmungsgeschwindigkeiten reagiert Thrombin mit Thrombocyten bis zur Thrombusbildung. Aus den noch z.T. hypothetischen Zusammenhängen ergibt sich vielleicht die Möglichkeit, neuartige spezifische Behandlungsmöglichkeiten zur Prophylaxe bzw. Therapie der arteriellen Thrombose zu entwickeln.
    Notes: Summary Apart from today's concept of arterial thrombogenesis, a mechanism of the early events in arterial thrombus formation is proposed, which also includes recent insight into the nature of the blood vessel wall and its interaction with the plasmatic blood clotting system. Observations have accumulated indicating that at the site of lesions of the interior vessel lining thromboplastic activity does appear to induce local thrombin formation. Under conditions of high arterial blood flow thrombin interacts with platelets culminating in the formation of a white thrombus. Based on these considerations, which in part may still be speculative, the possibility may evolve to develop a new highly specific prophylaxis and therapy of arterial thrombosis.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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