Diagnosis of anaphylactic shock caused by antibiotics]

A total of 277 cases with anaphylactic shock due to the use of various antibiotics were analyzed. Anaphylactic shock due to penicillin (38.2 per cent), streptomycin (19.8 per cent), combihation of streptomycin with penicillin (16.9 per cent) or bicillin (15.2 per cent) was most frequent. The causes of the diagnostic mistakes are shown and the clinical signs of the main typical form of the drug anaphylactic shock are descrifed. Four variants of atypical clinical picture of anaphylactic shock, i.e. hemodynamic (collaptoid), asphyctic, cerebral and abdominal were classified. Examples of diagnostic mistakes are presented. It was shown that the drug allergological anamnesis was not always considered in the therapeutic practice.     

Hemorrhagic infarct of the brain during cardiogenic shock]

The paper deals with the possible mechanism in the development of a hemorrhagic brain infarction during myocardial infarction, complicated by a cardiogenic shock of the III degree. The results of a postmortal study of the brain, its major arteries, as well as the vessels of the Willis circle, permit to assume that the mechanism of realization of this cerebral vascular complication is in a joint metabolic and microcirculatory disorders accompanying the shock. Besides, there is also a stenosing atherosclerotic process, with prevalent lesion of the intracranial part of the magistral arteries, supplying the brain.     

Modulation mechanism of IL-1 in hemorrhagic shock in relation to endotoxin]

Laser scanning cytometry (LSC), a newly developed technology, allowed simple detection of dead cells with morphological features of apoptosis for cells stained with only propidium iodide (PI). HeLa cells were treated with Adriamycin (ADM, 0.5 or 1.0 microgram/ml). A PI fluorescence value (representing DNA content) versus PI fluorescence peak (representing chromatin condensation) cytogram of LSC made it possible to segregate cells with high PI fluorescence peak from others in a cell population and concomitantly to analyze the relationship between the cells and the cell cycle. A fraction of the cells manifesting hypercondensation of chromatin was exclusively present in a cell population treated with ADM. Visual inspection of the cells defined in the cytogram revealed morphological features of apoptosis. LSC analysis facilitates monitoring effects of anticancer drugs on a cell population, because nuclear DNA staining with PI is simple and rapid.     

FMRFa and FMRFamide-like peptides (FaRPs) in the pathogenesis of shock]

The cardioactive FMRFa is found in the several animal tissues but the action mechanism and the physiological role of FMRFa and FaRPs is unknown. Authors discussed the hypothesis that FMRFa and FaRPs may act as endogenous sympatoadrenal system modulators; sometimes they can act as adrenaline-like hormones. Their physiological significance may be more clear by the pathological and hypobiotics conditions.     

Differences in the stimulation of NO synthesis during heat shock in genetically different rats]

OBJECTIVES: In certain younger patients with congestive heart failure (CHF), Doppler/echocardiography has identified a "restrictive" pattern of early diastolic ventricular filling characterized by very rapid early filling and a steep deceleration slope. We asked whether a similar restrictive pattern can be identified in very old patients with CHF, and if so, what are its clinical correlates and prognostic implications. DESIGN: Retrospective cohort with prospective follow-up. SETTING: Academic long-term care facility. PARTICIPANTS: Thirty-nine residents with clinical CHF (age 89 +/- 5 (SD) years) MEASUREMENTS: Transmitral Doppler flow, clinical characteristics, recurrent CHF episodes, hospitalizations, and mortality were measured. RESULTS: Fifteen (38%) of the subjects had restrictive filling patterns, characterized by a ratio of early to late flow (E/A) > 1.00 and 24 (62%) had nonrestrictive patterns. The restrictive pattern was associated with a longer duration of CHF, more angina, and higher rate of symptomatic recurrences of CHF. CONCLUSION: A restrictive diastolic filling pattern may represent a late stage in the evolution of congestive heart failure when left ventricular filling pressure is markedly increased. The treatment of CHF in older patients may need to account for different patterns of diastolic filling.     

Culture shock

Parasathi Teare argues that attempts to eradicate female circumcision are misguided. Instead, we should demand effective medical care for women in developing countries.     

Future shock

The authors studied activity of home nutricevtic concentrate of topinambur in patients with different clinical forms of insulin-dependent diabetes mellitus. Concentrate of topinambur promoted normal carbohydrate and lipid metabolism, increased ferrum level in serum, had immunomodulating activity. Nutricevtic was the most effective one in patients with not long duration of insulin-dependent diabetes mellitus.     

Cardiogenic shock

Cardiogenic shock (CS), defined as forward failure combined with systolic blood pressure < 90 mm Hg and reduced organ perfusion despite adequate volume loading, still has a grim prognosis with mortality rates of 80-100% if the causes are left untreated. The most frequent conditions underlying CS are acute myocardial infarction, acute and severe aortic or mitral incompetence, rapidly progressive dilatative cardiomyopathy and hypertrophic obstructive cardiomyopathy. Whereas correct conservative management by drugs and pacing may be life saving in the latter, the other conditions require early invasive management. Indications for cardiac surgery and circulatory assistance are given for mechanical complications leading to CS. In CS complicating myocardial infarction, comprehensive management with early invasive revascularization and intraaortic balloon pumping may result in improved survival compared with the disappointing outcome of medical treatment, including fibrinolysis. This strategy can be offered to the majority of infarct patients in CS, who are primarily admitted to hospitals not equipped for interventional cardiology or cardiac surgery. Between-hospital transfer of these patients for PTCA (or surgery) and advanced intensive care has been shown to be feasible and safe.     

Septic shock

Although our understanding of molecular events in septic shock is growing exponentially, bedside management has changed only incrementally over the last 20 years. In pediatric and adult patients alike, treatment continues to be largely supportive. Morbidity and mortality, though gradually improving, continue to be high. The major similarities, as well as the minor differences, between pediatric and adult septic shock are reviewed in this article, with an emphasis on current clinical practice and recent clinical investigations of novel therapies.     

Heat shock genes and the heat shock response in zebrafish embryos

Heat shock genes exhibit complex patterns of spatial and temporal regulation during embryonic development in a wide range of organisms. Our laboratory has initiated an analysis of heat shock protein gene expression in the zebrafish, a model system that is now utilized extensively for the examination of early embryonic development of vertebrates. We have cloned members of the zebrafish hsp47, hsp70, and hsp90 gene families and shown them to be closely related to their counterparts in higher vertebrates. Whole mount in situ hybridization and Northern blot analyses have revealed that these genes are regulated in distinct spatial, temporal, and stress-specific manners. Furthermore, the tissue-specific expression patterns of the hsp47 and hsp90 alpha genes correlate closely with the expression of genes encoding known chaperone targets of Hsp47 and Hsp90 in other systems. The data raise a number of interesting questions regarding the function and regulation of these heat shock genes in zebrafish embryos during normal development and following exposure to environmental stress.     

Pheochromocytoma mimicking septic shock

A tumour arising from chromaffin cells, the pheochromocytoma may be associated or present with hypotension and result in a lethal shock. The authors report a rare case of pheochromocytoma simulating septic shock. They review the mechanisms by which hypersecretion of catecholamines may cause shock. The detection of pheochromocytoma in its atypical presentation is essential for early diagnosis and the reduction of mortality related to this condition.     

Immediate shock deficit in fear conditioning: Effects of shock manipulations.

Pavlovian contextual fear conditioning occurs when an aversive unconditional stimulus (US), such as a footshock, is presented to a rat shortly after it is placed in an experimental context. Contextual fear conditioning does not occur when the shock is presented immediately upon placement of the rat in the novel chamber. In the present study, the authors report that increasing either the number of immediate shock sessions (Experiment 1) or the immediate shock duration (Experiment 2) did not reverse this deficit. However, immediate shock seems to sensitize subsequent context conditioning (Experiment 3). These findings suggest that the associative deficit produced by immediate shock is not related to the rat's ability to process the footshock US. (PsycINFO Database Record (c) 2010 APA, all rights reserved)