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1
Goodness, Kelly R. "Retrospective Evaluation of Malingering: A Validational Study of the R-SIRS and CT-SIRS." Thesis, University of North Texas, 1999. https://digital.library.unt.edu/ark:/67531/metadc278240/.
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Empirically based methods of detecting retrospective malingering (i.e., the false assertion or exaggeration of physical or psychological symptoms reportedly experienced during a prior time period) are needed given that retrospective evaluations are commonplace in forensic assessments. This study's main objective was to develop and validate a focused, standardized measure of retrospective malingering. This objective was addressed by revising the Structured Interview of Reported Symptoms (SIRS), an established measure of current feigning. The SIRS' strategies were retained and its items modified to produce two new SIRS versions: The Retrospective Structured Interview of Reported Symptoms (R-SIRS) and The Concurrent-Time Structured Interview of Reported Symptoms (CT-SIRS). Forensic inpatients were used to test the R-SIRS (n = 25) and CT-SIRS (n = 26) which both showed good internal consistency and interrater reliability. The overall effectiveness of the R-SIRS and the CT-SIRS in the classification of malingerers and genuine patients was established in this initial validation study. Moreover, their classification rates were similar to those obtained by the SIRS. Pending additional validation, these measures are expected to increase the quality of forensic evaluations by providing the first standardized methods of assessing retrospective malingering.
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Kern, Hartmut. "SIRS und Sepsis nach kardiochirurgischen Eingriffen." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2001. http://dx.doi.org/10.18452/13775.
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Systemische Inflammation (SIRS) und Sepsis sind bekannte postoperative Komplikationen nach kardiochirurgischen Eingriffen. Bei 77,1 % der untersuchten 3653 kardiochirurgischen Patienten bestanden am ersten postoperativen Tag definierte Symptome eines SIRS. Nur 20 % dieser Patienten entwickelten ein prolongiertes SIRS über mindestens die ersten 72 Stunden postoperativ und 4,4 % eine Sepsis im weiteren primären intensivmedizinischen Verlauf. Aus der Patientengruppe mit prolongiertem SIRS entwickelten immerhin 21,8 % eine Sepsis. Die 564 Patienten mit prolongiertem SIRS waren durch eine signifikant (p< 0,001) verlängerte Beatmungs- und Behandlungsdauer auf der Intensivstation (ICU), eine erhöhte Krankenhausliegedauer sowie eine um den Faktor 10 signifikant erhöhte ICU- und Krankenhausmortalität im Vergleich zu Patienten ohne prolongiertes SIRS gekennzeichnet. Die 135 Patienten mit einer Sepsis während ihrer primären postoperativen intensivstationären Behandlung hatten eine deutlich erhöhte intensivstationäre Mortalität von 40,7 % gegenüber 1,6 % bei Patienten ohne Sepsis. Die Patienten mit prolongiertem SIRS (15,4 % der Gesamtpopulation) benötigten insgesamt 52,9 % der Bettentage und 57,7 % der Gesamtkosten der intensiv-medizinischen Behandlung. Die septischen Patienten (3,7 %) verursachten alleine 24,6 % der intensivstationären Behandlungstage sowie 28,7 % der Gesamtkosten. Die fünf Variablen weibliches Geschlecht, das Auftreten definierter intraoperativer Komplikationen, ein APACHE II- Score > 17 bei Aufnahme auf der Intensivstation, der postoperative Bedarf von mehr als einem Inotropikum sowie das Vorhandensein von definierten, therapiebedürftigen metabolischen Störungen innerhalb der ersten 24 Stunden postoperativ diskriminierten in Bezug auf das Vorhandensein oder Nicht-Vorhandensein der Zielvariablen prolongiertes SIRS (> 3 Tage ) mehr als 88 % der Patienten richtig. Jeweils über 96 % der Patienten konnten durch die aus diesen Variablen entwickelten Regressionsgleichungen richtig zugeordnet werden bezüglich des Auftretens oder Nicht-Auftretens einer Sepsis bzw. eines letalen Ausgangs. Das intern validierten Modell für die Zielvariable prolongiertes SIRS (> 3 Tage) erreichte eine hohe Spezifität von über 97 % bei einer Sensitivität von 39 %. Die vorliegenden Regressionsgleichungen ermöglichen es somit, am Patientengut dieser Institution prospektiv Patienten mit erhöhtem Risiko auf ein prolongiertes SIRS bzw. eine Sepsis mit hoher Spezifität zu selektionieren.The development of a systemic inflammatory response syndrome (SIRS) and sepsis are well known complications after cardiac surgery. In the present study, 77.1 % of the 3653 cardiac surgical patients developed SIRS or SIRS-like symptoms on the first postoperative day. Only 20 % of these patients, however, showed a prolonged SIRS during the first 3 postoperative days. 4.4 % of all patients had septic complications during their stay on the intensive care unit (ICU). However, 21.8 % of the patients with prolonged SIRS developed sepsis. The identified 564 patients with prolonged SIRS showed a significantly (p < 0.001) increased duration of mechanical ventilation, ICU- and hospital treatment, respectively. Their ICU- and hospital mortality was tenfold higher than in patients without prolonged SIRS. The ICU-mortality of 135 septic patients was 40.7 % in contrast to 1.6 % in patients without sepsis. Patients with prolonged SIRS (15.4 % of the study population) accounted for 52.9 % of the bed days on ICU and for 57.7 % of the total costs. Septic patients (3.7 % of the study population) required 24.6 % of the bed days and 28.7 % of the total costs during their ICU-stay. The use of 5 variables including female gender, defined intraoperative complications, an APACHE II- Score of > 17 on ICU-admission, the use of more than one inotrope postoperatively, and the treatment of defined metabolical disorders identified 88 % of the patients with prolonged SIRS (> 3 days) correctly during the first 24 hours postoperativly. The resulting predictive models identified more than 96 % of the patients with sepsis or lethal outcome correctly. The internal validation of the predictive model for prolonged SIRS (> 3 days) demonstrated a specifity of 97 % and a sensitivity of 39 %. Therefore, the early identification of patients at risk for the development of prolonged SIRS or sepsis in our institution seems to be possible using multiple logistic regression of these predictive models.
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Henry, Courtney. "Population Based Model of Gonorrhea and Interventions Against Increased Antibiotic Resistance." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2784.
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Gonnorrhea is an infectious sexually transmitted disease (STD) caused by the bacterium Neisseria gonorrhoeae that commonly reproduces in the reproductive tract.The Centers of Disease Control and Prevention (CDC) estimate that more than 700,000 individuals in the U.S. contract new gonorrheal infections per year. During recent years, there has been a progressive global increase of drug-resistant strains of gonorrhea. Therefore, there exists the necessity for health organizations to encourage the monitoring, research and development of innovative treatment regimens. We have developed multiple mathematical models to explore the gonorrheal disease state. The first objective of model formulation was to fit the model to established disease and population data provided by the CDC and U.S. Census Bureau and then include the presence of antibiotic resistance in the model. Additionally, we discuss intervention methods to combat this resistance. The second objective of model formulation was to use parameter sensitivity to determine specific age groups to target in effort to alter disease dynamics.
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Hamacher, Lena. "Kardiales Troponin I bei Hunden mit systemischem Entzündungssyndrom (SIRS)." Diss., Ludwig-Maximilians-Universität München, 2015. http://nbn-resolving.de/urn:nbn:de:bvb:19-179998.
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Abstract:
Background: Myocardial injury can be detected by cardiac troponin I (cTnI) concentrations, which appears to be a predictor of short-term death in critically ill patients. It is unknown if the best prognostic indicator of short-term survival is cTnI measurement at admission or at later time points.
Hypothesis/Objectives: Measuring cTnI with a high-sensitivity (hs) test at different time points after admission may be a better short-term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).
Animals: Prospective, observational clinical study of 60 dogs with SIRS.
Methods: Cardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3 and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28-day mortality were assessed by receiver operating characteristic (ROC) curve analysis.
Results: Forty-one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; p = 0.004) and at the peak time point (median, 0.23 ng/mL; p = 0.01) compared to 19 non-survivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve (AUC) to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.
Conclusions: Increased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow-up measurement of cTnI concentration provides no additional prognostic information for short-term mortality.
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Mathisen, Martine. "Sykepleieres ivaretakelse av pasienter med mistenkt sepsis i et akuttmottak." Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2636.
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Slik det norske helsevesenet fungerer er oftest sykepleier tettest på pasienten over tid samt er den første til å møte pasienten ved ankomst i et akuttmottak. Det er sykepleier som triagerer pasienten ved ankomst og det er en sykepleier som gjør de primære undersøkelsene. Kunnskap om SIRS og sepsis er viktig å inneha for og kunne plukke opp tegnene i en tidlig fase og dermed kunne kommunisere funnene til ansvarlig lege slik at behandling kan igangsettes raskt. I tillegg må sykepleiere ha kunnskap om prioriteringen av de viktigste primære behandlingstiltakene som bør igangsettes hos pasienter med mistanke om sepsis. Kommunikasjon er også viktig opp mot pasienten for jevnlig å kunne vurdere pasientens tilstand og en eventuelt forverring. Om strukturerte metoder for bedømming ikke er tilstede hos ansvarlig sykepleier kan dette få store konsekvenser for pasienten ved at sepsis kan utvikle seg til alvorlig sepsis eller septisk sjokk som har høy mortalitet. Hensikten med studien var å undersøke sykepleieres ivaretakelse av pasienter med mistenkt sepsis i et akuttmottak. Metoden var kvantitativ og data ble samlet inn ved hjelp av en spørreundersøkelse på ett akuttmottak hvor 36 sykepleiere besvarte skjemaet. Den innsamlede dataen ble analysert ved hjelp av deskriptiv statistikk og presentert i prosentform i tabell, diagrammer og løpende tekst. Resultatet viste at en stor andel av sykepleierne hadde god kunnskap om evidensbasert forskning og benyttet denne så vel som i undersøkelsen som i behandlingen av pasienten med mistenkt sepsis. Det kom samtidig frem at så mange som ca. 30 prosent ikke var sikre på hva SIRS kriteriene er og hva som er definisjonen på sepsis. Åtti prosent var sikre på primære behandlingstiltak, mens 20 prosent var usikre. Dette viser at det er behov for forbedring. Videre viser undersøkelsen at 75 prosent mener at triage er et godt verktøy for å oppdage mistanke om sepsis i en tidlig fase. I all hovedsak viste undersøkelsen at det var oppfattet å være god kommunikasjonen både mellom sykepleier og lege samt mellom sykepleier og pasient. Konklusjonen var at det var en høy andel sykepleiere i avdelingen som har god kunnskap om evidensbasert forskning samt lokale og internasjonale retningslinjer for både ivaretakelse og behandling av pasienter med sepsis. Sykepleierne visste hvilke kriterier de skal se etter for å oppdage sepsis i en tidlig fase samt hvilke målinger og tiltak som burde gjøres for å unngå utviklingen av alvorlig sepsis og septisk sjokk. Det er allikevel fortsatt rom for forbedringspotensialet da det burde være tett opp mot 100 prosent som sitter inne med denne kunnskapen. Kommunikasjonen mellom sykepleier og lege ved behandling av pasienter med mistenkt sepsis viste seg å oppfattes som god, bortsett fra ved bruk av medisinsk team hvor det fremgikk at ikke alles roller var godt nok kjent. Når det gjelder kommunikasjonen mellom sykepleier og pasient ble denne oppfattet god fra sykepleiers side ved at de hadde tid til å formidle trygghet via verbal og/eller non-verbal kommunikasjon. Sykepleierne opplevde i stor grad at pasientene forsto informasjonen de ga om sepsis og aktuelle behandlingstiltak, men at legenes informasjon til pasienten ikke ble forstått like godt.The way the Norwegian healthcare system works most often a nurse is the one that work closest with the patient over time and they are the first to see the patients as they arrive at the emergency department. It´s a nurse that do a triage of the patient at arrival and it´s a nurse that perform the first survey. Knowledge of SIRS and sepsis is important to be able to catch the signs at an early stage and then be able to communicate the findings to a doctor so that the treatment can get started as quick as possible. The nurse must also have knowledge about how to prioritize which cause of treatment that should be started if they suspect sepsis in a patient. The communication with the patient is also important to be able to continuously assess the patient’s condition and a possible deterioration. If structured methods for assessment are not in place this might have huge consequences for the patient because sepsis can develop in to severe sepsis or septic shock, which have a high mortality rate. The aim of this study was to investigate nurses’ care for patients with suspected sepsis in an Emergency Department. The method used was quantitative and the data was collected by using a survey. The study was set in an emergency department where 36 nurses answered the survey. The collected data was analysed by using descriptive statistic and presented in a table, diagrams and text by using per cent. The result showed that a big share of the nurses had a wide knowledge in evidensebased research and used this in their survey and treatment of the patient with suspected sepsis. At the same time it showed that as many as about 30 per cent was not sure about what the SIRS criteria are nor what´s the correct definition of Sepsis. Eighty per cent was sure about what the primary treatment includes but 20 per cent was unsure. This show there is a need for improvement. Further on the survey shows that 75 per cent sees triage as a good way of detecting suspicion of sepsis at an early stage. All in all the survey showed that the communication was considered good both between nurse and doctor and nurse and patient. The conclusion was that a high share of the nurses at the emergency department had a wide knowledge about evidence based research as well as local and international guidelines for care and treatment of patients with suspected sepsis. The nurses had the accurate knowledge about which criteria’s to look for to be able to detect sepsis at an early stage as well as which measurements and measures that should be done to be able to avoid sepsis to develop in to severe sepsis or septic shock. Even so there is room for improvement as there should be close to a 100 per cent that hold this knowledge. The communication between nurse and doctor during the treatment of patient with suspected sepsis was understood as good except from when they where using what they call the medical team this because the roles in the team was not well known for everybody. The communication between nurse and patient was considered good from a nurse point of view because they felt like they had enough time to express safety to the patient by using verbal and/or non-verbal communication. The nurses mostly experienced that the patients understood the information they gave about sepsis and actual treatment but that the doctor’s information was not understood that well.
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Rodrigues, Luís Miguel Manita. "Coagulopathy in sepsis and the prognostic value of abnormal coagulation times." Master's thesis, Universidade de Évora, 2017. http://hdl.handle.net/10174/21771.
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Sepsis is a hard to define condition associated with the deleterious systemic inflammatory response syndrome (SIRS) which ultimately leads to the failure of multiple organs. The mediators released throughout this exaggerated inflammatory reaction activate coagulation pathways and generate a dysfunctional response that results in coagulopathy.
The present dissertation includes a literature review regarding the subject of sepsis and associated coagulopathy, along with a study that primarily aims to investigate the use of abnormal coagulation times as biological markers of coagulation dysfunction and as predictors of outcome in veterinary patients who are at risk of developing sepsis.
The results suggest that pairing coagulation time data with an organ failure scoring system may be advantageous in the prediction of outcome. Furthermore, critically ill patients should be given a five-day time frame following admission before euthanasia is considered, as most tend to survive their illnesses once they get past this period; RESUMO:
COAGULOPATIA NA SÉPSIS E O VALOR DE PROGNÓSTICO DE TEMPOS DE COAGULAÇÃO ALTERADOS
A sépsis é uma síndrome de difícil definição e que está associada à síndrome da resposta inflamatória sistémica (SIRS) que leva à falha de múltiplos órgãos. Os mediadores libertados durante esta reação inflamatória exagerada levam à ativação disfuncional da coagulação sanguínea, o que resulta em coagulopatia.
A presente dissertação inclui uma revisão bibliográfica sobre o tema da sépsis e a coagulopatia associada, bem como um estudo cujo objetivo primário é o de investigar a utilização de tempos de coagulação alterados, tanto como marcadores biológicos de disfunção da coagulação sanguínea bem como fatores de prognóstico em pacientes veterinários em risco de sépsis.
Os resultados do estudo realizado mostram vantagem em associar a avaliação dos tempos de coagulação com sistemas de pontuação de falha orgânica para a realização do prognóstico. Estes sugerem também que os pacientes críticos que ultrapassam os primeiros cinco dias após a sua admissão hospitalar tendem a sobreviver.
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Ferreira, André de Brito Cavaco. "Clínica e cirurgia de animais de companhia." Master's thesis, Universidade de Évora, 2017. http://hdl.handle.net/10174/22430.
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Este relatório foi elaborado no âmbito do estágio curricular efetuado no Hospital Veterinário Muralha de Évora, que decorreu entre 1 de Outubro de 2016 e 31 de Março de 2017 e encontra-se dividido em duas partes. A primeira parte aborda a casuística acompanhada durante o estágio. A segunda parte consiste numa revisão bibliográfica dirigida ao tema “Síndrome da Resposta Inflamatória Sistémica (systemic inflammatory response syndrome, SIRS), sepsis e Síndrome da Disfunção Múltipla de Órgãos (multiple organ dysfunction syndrome, MODS) em animais de companhia” seguida da apresentação de um caso clínico ilustrativo do tema. O SIRS, a sepsis e o MODS constituem síndromes graves, sendo o reconhecimento precoce destas condições essencial para uma evolução clínica favorável. Nestas síndromes, a abordagem ao paciente baseia-se, sobretudo, numa monitorização rigorosa e na terapêutica de suporte, que tem como objetivo principal a estabilização dos parâmetros cardiovasculares e, se presente, o controlo da infeção; Abstract: Small Animal Practice
This report was elaborated on the context of the traineeship at Hospital Veterinário Muralha de Évora from October 1st, 2016 to March 31st, 2017 and it is divided in two parts. The first part describes the casuistry followed during the traineeship. The second part consists of a literature review directed to the theme “SIRS, sepsis and MODS in companion animals”, followed by the presentation of a clinical case. SIRS, sepsis and MODS are serious syndromes and the early recognition of these conditions is essential for a favorable clinical course. The approach to these patients is mainly based on strict monitoring and supportive therapy, whose main goals are the stabilization of cardiovascular parameters and, if present, the control of infection.
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Coelho, Ana Maria de Mendonça. "Mecanismos de ação da solução salina hipertônica na pancreatite aguda experimental." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-07052010-170926/.
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INTRODUÇÃO: A pancreatite aguda (PA) grave é um processo inflamatório do pâncreas caracterizado por alterações hemodinâmicas e resposta inflamatória sistêmica com altos níveis de mortalidade. A ativação inapropriada intrapancreática das enzimas pancreáticas desempenha papel importante no desencadeamento dos mecanismos inflamatórios responsáveis pelas manifestações locais e sistêmicas da doença. Em trabalho anterior observamos redução significativa da mortalidade após administração de solução salina hipertônica em ratos, através de redução das alterações hemodinâmicas e da resposta inflamatória sistêmica, mas os efeitos da solução salina hipertônica na ativação das enzimas pancreáticas e na própria lesão pancreática não foram estudados. O objetivo deste estudo foi avaliar se o mecanismo de ação da solução salina hipertônica, reduzindo a gravidade da pancreatite aguda em ratos, ocorre devido à redução da intensidade da lesão pancreática e/ou à redução da resposta inflamatória sistêmica e seus efeitos. MÉTODOS: Foi utilizado um modelo experimental de pancreatite aguda grave através da injeção intraductal de taurocolato de sódio a 2,5%. Cento e quarenta e dois ratos Wistar machos foram divididos em quatro grupos: Controle (animais que não foram submetidos à indução da PA), Grupo ST (animais que não receberam tratamento após a indução da PA), Grupo SSF (animais que receberam 34ml/Kg de solução salina fisiológica de NaCl 0,9% por via endovenosa, 1 hora após a indução da PA) e grupo SSH (animais que receberam 4ml/Kg de solução salina hipertônica de NaCl 7,5% por via endovenosa, 1 hora após a indução da PA). Após 2, 12 e 24 horas da indução da PA os animais foram sacrificados e os materiais foram coletados para análise. Foram efetuadas a quantificação do volume de líquido ascítico e as determinações no líquido ascítico e no soro dos peptídeos liberados na ativação do tripsinogênio (TAP) e da atividade da amilase. No tecido pancreático foram realizadas as análises da peroxidação lipídica (MDA), da atividade da mieloperoxidase (MPO) e a análise histológica. Os níveis de citocinas (TNF-, IL-6 e IL-10) foram analisados no líquido ascítico, soro e tecido pancreático. RESULTADOS: Os níveis de TAP e amilase no líquido ascítico e soro, de MDA e MPO no tecido pancreático e a análise histológica mostraram resultados iguais nos três grupos de animais que foram submetidos a PA (ST, SSF e SSH). Observamos redução do volume de líquido ascítico e dos níveis de TNF- , IL-6 e IL-10 no líquido ascítico, soro e tecido pancreático nos animais nos quais foi administrada solução salina hipertônica (grupo SSH) quando comparados com os animais tratados com solução salina fisiológica (grupo SSF) e os animais sem tratamento (grupo ST) (p<0,05). CONCLUSÕES: A administração de solução salina hipertônica (NaCl 7,5%) na pancreatite aguda experimental foi capaz de reduzir a resposta inflamatória local e sistêmica, sem modificar contudo a intensidade das lesões pancreáticas.INTRODUCTION: Severe acute pancreatitis (AP) is characterized by hemodynamic alterations and systemic inflammatory response leading to a high mortality rate. In AP the inappropriate activation of pancreatic enzymes plays an important role in pancreas autodigestion and in the inflammatory mechanisms responsible for the systemic response of the disease. In a previous study, we have demonstrated that hypertonic saline solution infusion significantly reduced mortality in experimental AP through an improvement in the hemodynamic conditions and by an antiinflammatory response, but its effects on the pancreatic lesions were not evaluated. The aim of the present study was to evaluate if the hypertonic saline solution reduces mortality in AP through a local effect attenuating the pancreatic lesion and/or by reducing the systemic inflammatory response syndrome (SIRS). METHODS: An experimental model of severe AP by injection of 0.5ml of 2.5% sodium taurocholate into the pancreatic duct was utilized. A hundred and forty two male Wistar rats were divided into 4 groups: C (control, without AP), ST (no treated AP), SSF (animals received 34ml/kg of normal saline solution of NaCl 0.9% IV, 1 hour after AP), and SSH (animals received 4ml/Kg of hypertonic saline solution of NaCl 7.5% IV, 1 hour after AP). After 2, 12 and 24 hours of induction of AP volume of ascitic fluid, trypsinogen activation peptides (TAP) levels and amylase activity in ascitic fluid and serum were determined. Pancreatic lipid peroxidation (MDA), myeloperoxidase (MPO) activity, and pancreatic histology were analysed 2 and 24 hours after AP. TNF-, IL-6, and IL-10 levels in ascitic fluid, serum, and pancreatic tissue were also analyzed. RESULTS: There were no significant differences in TAP levels and amylase activity in the ascitic fluid and serum in animals of groups ST, SSF and SSH. No differences in pancreatic MPO, MDA and histological score were observed among these three groups with AP. In the SSH group it was observed a significant decrease in volume of ascitic fluid and inflammatory cytokines levels (TNF-, IL-6, and IL-10) in ascitic fluid, serum, and pancreatic tissue when compared to ST and SSF groups (p<0.05). CONCLUSIONS: These findings suggest that hypertonic saline solution decreases local and systemic inflammatory response in acute pancreatitis without changing the intensity of the pancreatic lesions.
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Norberg, Maria, and Lisa Ådin. "Vårdpersonalen i frontlinjen - identifiering och hantering av sepsis i ett tidigt skede inom akutsjukvården : En litteraturstudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-178711.
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Bakgrund: Sepsis erfordrar att tidiga behandlingsåtgärder initieras, annars riskerar patienten utstå svåra komplikationer som i värsta fall kan leda till döden. Då sjukdomstillståndet uttrycks genom diffusa symtom kan denna tidiga initiering av behandlingsåtgärder vara svår, vilket ställer höga krav på vårdpersonalens kunskap. Syfte: Att kartlägga vårdpersonalens kunskaper gällande definition, identifiering och hantering av sepsis i ett tidigt skede inom akutsjukvården. Metod: Litteraturstudie baserad på nio kvantitativa artiklar. Databassökningar genomfördes i CINAHL, PubMed, Scopus och Web of science. Artiklarna är kvalitetsgranskade och analyserade med Fribergs analysmodell och sammanställd i text samt i tabeller. Resultat: Kunskapsbrister redovisas. Professionerna med högre utbildningsnivå redovisar högre kunskapsnivåer. Lägst kunskapsnivåer redovisas gällande minskad kroppstemperatur, vätskeinfusion, vasopressorer och mätning av laktat- och leukocyter. Konklusion: Genom kontinuerlig och uppdaterad utbildning, implementering av evidensbaserade riktlinjer och ett bra teamarbete kan minska mortaliteten. Senges teori om lärande organisationer visar på vikten av teamarbetet. Vidare forskning bör fokusera på hur kunskapsnivåerna kan förbättras då resultatet redovisar kunskapsbrist hos vårdpersonal.Background: Sepsis requires that early treatment measures are initiated, otherwise the patient risks enduring severe complications which in the worst case can lead to death. As the disease state is expressed through diffuse symptoms, this early initiation of treatment measures can be difficult, which places high demands on the care staff’s knowledge. Aim: To map the care staff’s knowledge regarding definition, identification and management of sepsis at an early stage in emergency care. Method: Literature study based on nine quantitative articles. Database searches were performed in CINAHL, PubMed, Scopus and Web of science. The articles are quality reviewed and analyzed with Friberg's analysis model and compiled in text and tables. Results: Knowledge gaps are reported. The professions with a higher level of education report higher levels of knowledge. The lowest levels of knowledge are reported regarding reduced body temperature, fluid infusion, vasopressors and measurement of lactate and leukocytes. Conclusion: Through continuous and updated training, implementation of evidence-based guidelines and good teamwork can reduce mortality. Seng's theory of learning organizations shows the importance of teamwork. Further research should focus on how the levels of knowledge can be improved as the results report a lack of knowledge among care staff.
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Rabelo, Isabela Peixoto. "Níveis de proteínas de fase aguda em equinos expostos à sobrecarga de carboidratos associada à alcalinização cecal /." Jaboticabal, 2019. http://hdl.handle.net/11449/191291.
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Orientador: Carlos Augusto Araújo ValadãoResumo: Avanços acerca da fisiopatologia da laminite equina permitiram imputar como fator primário e deflagrador dos estágios iniciais dessa doença, a ativação da cascata inflamatória. Sabe-se que equinos submetidos à sobrecarga de carboidratos, podem desenvolver laminite e que essa afecção se dá por mudanças na microbiota do trato gastrintestinal. A laminite induz alterações sistêmicas que repercutem nos valores de proteínas de fase aguda (PFA). Com este estudo, buscou-se encontrar uma associação entre os valores dessas proteínas com a evolução dos sinais clínicos de equinos expostos à sobrecarga de carboidrato (amido de milho na dose de 17,6 g/kg de peso vivo, diluído em água na proporção de um quilo/litro, fornecido via sondagem nasogástrica) e tratados com solução tampão intracecal (composto contendo 3,5 g de hidróxido de alumínio, 65,6 g de hidróxido de magnésio e 1,2 g de simeticona, diluído em água destilada em volume equivalente à metade do volume administrado via sondagem nasogástrica). Dez equinos hígidos foram divididos de maneira aleatória e fatorial (2x2), em quatro grupos (n=5): controle (GCC), controle + tratamento (GCT), laminite (GAC), laminite + tratamento (GAT). Os animais do GCC e GAC integraram, respectivamente, GAT e GCT, respeitando um intervalo de 15 dias entre o procedimento experimental. Eles foram avaliados durante sete momentos (T0h, T4h, T8h, T12h, T24h, T48h, T72h), nos quais também foram coletadas amostras de sangue venoso para obtenção do soro e realiz... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: It’s is known that the inflammatory response plays an important role in the development of the equine laminitis, mostly in its early stages. Among several risk factors, horses submitted to carbohydrate overload can develop this syndrome, due to changes in the cecal pH and microbiota, followed by an increase in the transmural absorption of several luminal contents, such as bacterial endotoxins. The acute phase response that occurs after injury elicits the overproduction of several proteins by the liver, called acute phase proteins (APP). However, there are few studies using proteinogram to characterize the inflammatory response during the development of this syndrome. The aim of this study was to correlate APP values with clinical signs of horses submitted to carbohydrate overload (17.6 g.kg-1 BW of corn starch solution, administered via nasogastric tube) and treated with a buffer solution (3.5 g of aluminum hydroxide, 65.6 g of magnesium hydroxide and 1.2 g of simethicone, administered into the cecum through catheterization). Ten healthy horses were divided in a factorial and randomized way into four groups (n = 5): control (GCC), control + treatment (GCT), laminitis (GAC), laminitis + treatment (GAT). The animals from GCC and GAC integrated GAT and GCT, respectively, respecting an interval of 15 days between the experimental procedure. They were evaluated during seven moments (T0h, T4h, T8h, T12h, T24h, T48h, T72h), in which blood were also collected to obtain serum to perfo... (Complete abstract click electronic access below)
Mestre
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Zimmermann, Thomas, Steffen Albrecht, S. Hanke, and Gagern Georg von. "Selen in der Intensivmedizin." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134145.
Full textAbstract:
Mit der Entdeckung des Selens als essentielles Spurenelement und der Glutathionperoxidase als Selenoenzym sowie der Tatsache, daû Selenmangel relativ weit verbreitet ist, wurde erstmals ein Zusammenhang zu einigen schweren Erkrankungen hergestellt (Keshan-Krankheit, Kaschin-Beck-Syndrom). Interessant ist dabei, daû sich trotz dieser und anderer bekannter Selenmangelerkrankungen eine Therapie in der Humanmedizin nur langsam zu etablieren beginnt, waÈ hrend die Selensupplementation in der VeterinaÈ rmedizin bereits Standard ist. Die Autoren beschaÈ ftigen sich seit 1990 mit der Rolle des Spurenelements Selen bei septischen Krankheitsbildern in der Intensivmedizin, beim ReperfusionsphaÈnomen nach gefaÈûchirurgischen Eingriffen und in der Onkologie. Sie konnten zeigen, daû die adjuvante Therapie der akuten Pankreatitis und der Sepsis mit Natriumselenit einen positiven Effekt auf das Outcome der Patienten zu haben scheint (eine multizentrische, doppelblinde, randomisierte Sepsisstudie zur Validierung dieser Ergebnisse ist in Vorbereitung). Neue Erkenntnisse zur Beeinflussung von Transkriptionsfaktoren durch Selen bei systemischem Inflammationssyndrom und Sepsis erlauben eine wissenschaftlich fundierte Interpretation der klinischen Ergebnisse. Weitere molekularbiologische Untersuchungen werden das Spurenelement Selen zu einem der interessantesten Forschungsprojekte der naÈ chsten 10 Jahre in Intensivmedizin und Onkologie machenSince selenium was discovered as an essential trace element being widely distributed, and since glutathione peroxidase is known as a selenoenzyme, associations with several severe diseases were established (Keshan disease, Kaschin-Beck syndrome). Despite these known selenium deficiency diseases a related human therapy is still not established so far. In veterinary medicine, however, substitution of selenium is already a standard therapy. Our laboratory investigates the role of selenium since 1990. This includes investigations about the effects of selenium in acute inflammatory diseases in intensive care, in the reperfusion phenomenon following vascular surgery, and in oncology. In acute pancreatitis and sepsis, adjuvant therapy using sodium selenite seems to have positive effects on the overall outcome of patients (a multicenter, double-blind, randomized trial on sepsis is being prepared). New findings concerning the influence of selenium on transcription factors in inflammatory processes will permit a scientifically sound interpretation of clinical results. With further investigations in molecular biology the trace element selenium will become, in the next decade, one of the most interesting topics in intensive care and oncology
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Kallam, Ramana Reddy. "Influence of gut function on SIRS and clinical outcomes in surgical patients." Thesis, University of Hull, 2012. http://hydra.hull.ac.uk/resources/hull:8007.
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Background: The GI tract is a highly complex organ system with multitude of functions. Gastrointestinal dysfunction remains an unrecognised clinical entity in day to day clinical practice hence it is possible many patients are inadequately managed resulting in poorer clinical outcomes. Recognising gut failure and early initiation of gut directed therapies may influence clinical outcomes. Aims: This thesis aims to review available literature for importance of gut function and its influence on SIRS and clinical outcomes and investigate the state of gut function and its influence on SIRS and clinical outcomes in surgical patients, further develop a method to optimise gut function and test the influence of this optimisation package on clinical outcomes in elective surgical patients. Methods: A series of clinical studies in elective surgical patients to investigate the influence of gut function on clinical outcomes. Results: Inadequate gut function was common in patients with pancreatitis and the persistent gut failure was associated with SIRS, MODS and poorer clinical outcomes. Critically ill patients with gut failure had increased prevalence of SIRS however this has not resulted in increased mortality or poorer clinical outcome. Elective GI surgical patients developed gut dysfunction in the post operative period more commonly than patients who underwent breast surgery and this was associated with increased prevalence of SIRS and septic morbidity. Optimisation of gut function was associated with early return of gut function and improved clinical outcomes in elective surgical patients. Conclusion: Recognition of gut failure is important in day to day clinical practice and gut failure is associated with poorer outcomes in surgical patients. Gut directed therapy to optimise gut function is associated with improved clinical outcomes.
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EHEMBA, LAMBERT. "Traitement des symetries topologiques en simulation infra-rouge dans l'approche darc-sirs." Paris 7, 1993. http://www.theses.fr/1993PA077250.
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Ce travail se situe dans le cadre du systeme darc-sirs visant a la simulation des spectres infra-rouge et raman, a partir d'une description topologique de la structure moleculaire. Son objet essentiel est la prise en compte des symetries moleculaires et des couplages entre vibrateurs voisins. Ces effets se traduisent par la disparition de certaines bandes (vibrations interdites en ir ou raman) et le dedoublement de certains modes en composantes symetrique ou antisymetrique, eventuellement inactives. Le chapitre 1 concerne d'abord un rappel sur le systeme de simulation darc-sirs. Il presente ensuite l'influence sur les spectres ir et raman des symetries moleculaires. Le chapitre 2 concerne la detection de la symetrie topologique locale autour d'une liaison. Cette recherche est conduite a partir de frels ordonnees. Le chapitre 3 est consacre a la description detaillee du systeme expert developpe pour le traitement des intensites: isir (intensites en spectroscopies ir ou raman). Apres detection des caracteristiques de symetrie, isir declenche les regles d'extinction selon le type de molecule et de symetrie detectee. Le chapitre 4 presente quelques exemples d'applications. Pour pouvoir integrer, dans la logique des frels, les effets de couplages entre vibrateurs, nous avons introduit la notion de frel a metadonnees ou metafrels. Cette approche constitue, cependant, seulement une etude exploratoire conduite dans les limites strictes: situations ou topologie suffit a detecter les symetries, traitement dans la logique des frels utilises dans sirs
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Souza, Fonseca Guimaraes Fernando de. "Natural killer cells responsiveness to Toll-like receptor agonists during bacterial sepsis." Thesis, Paris 5, 2012. http://www.theses.fr/2012PA05T049.
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Au cours d’une infection, les cellules de l’immunité innée sont capables de reconnaître via les Toll-like receptors (TLR) des motifs appelés pathogen-associated molecular patterns. Les cellules natural killer (NK) contribuent au processus inflammatoire en produisant de nombreuses cytokines. Chez la souris, nous avons montré que l’expression du TLR2 et du TLR4 dans les cellules NK spléniques est intracellulaire, comme pour le TLR9. La réponse des NK aux agonistes des TLR2, 4 et 9 nécessite la présence de cytokines accessoires (IL-15 et IL-18), afin d’obtenir une production significative des cytokines pro-inflammatoires IFN- et GM-CSF. En revanche, dans un modèle de sepsis polymicrobial, les NK spléniques de souris présentent une diminution dramatique de leur production d’IFN- et de GM-CSF en réponse aux agonistes des TLR. Cette diminution est sous le contrôle des cellules T régulatrices (Treg) et due au TGF-1. L’analyse des voies de signalisation nous a permis de montrer que la production de GM-CSF est abolie chez les cellules NK de souris déficientes pour STING en réponse au CpG-DNA. Ces résultats mettent en lumière une voie alternative et cytoplasmique pour la détection de l’ADN bactérien dans les cellules NK, différente de la voie classique TLR9-MyD88 dépendante. De plus, nous avons montré un trafic du récepteur TLR2 depuis l’intérieur vers la surface des cellules NK. La migration du TLR2 à la surface des NK nécessite la molécule UNC93B1, précédemment décrite comme transporteur endosomal de TLR.Chez les cellules NK humaines circulantes (sous-populations CD3-CD56bright et CD3-CD56dim), nous avons montré que l’expression des TLR2 et 4 est majoritairement intracellulaire, comme pour le TLR9 et comme chez la souris. La production d’IFN- par les NK de sujets sains en réponse aux agonistes des TLR nécessite également la présence de cytokines accessoires. Nous montrons que cette production est fortement altérée pour les NK des patients admis en soins intensifs et ayant un sepsis ou un syndrome de réponse inflammatoire systémique (SIRS). De même nous avons trouvé des différences entre les patients et les sujets sains dans l’expression du CD69 (marqueur d’activation précoce) et des TLR eux-mêmes. Cette étude indique que les NK des patients sepsis et SIRS deviennent tolérants aux agonistes des TLR en terme de production d’IFN-, de manière similaire à ce qui a été décrit pour d’autres cellules comme les monocytesAs sensors of infection, innate immune cells are able to recognize pathogen-associated molecular patterns by receptors such as Toll-like receptors (TLR). NK cells contribute to inflammatory processes by the production of numerous cytokines. In mice, we have shown that the protein expression of TLR2 and TLR4 in naive NK cells from spleen is predominantly intracellular, similarly to TLR9. The responsiveness of purified NK cells to TLR2, 4 or 9 agonists in vitro requires the presence of accessory cytokines (IL-15 and 18) to trigger a significant production of IFN- and GM-CSF. In contrast, NK cells purified from a model of in vivo polymicrobial sepsis, showed a dramatic reduction in their capacity to respond to TLR agonists in terms of IFN- and GM-CSF release due an inhibitory cross talk with Treg cells mediated by TGF-1. Analyzing the signaling pathways involved in cytokine production in response to CpG-DNA, we found that GM-CSF production was abolished in NK cells from STING-deficient mice, revealing that this intracytoplasmic receptor acts as a TLR9/MyD88-independent alternative sensor to bacterial DNA in NK cells. Additionally we show that intracellularly expressed TLR2 traffics to the cell surface of NK cells, by a mechanism involving UNC93B1, a protein previous described as an endosomal TLR carrier.In human peripheral blood NK cells (CD3-CD56bright and CD3-CD56dim subsets), we show that TLR2 and 4 protein expression is primarily intracellular, similar to TLR9, and similar to our findings in murine NK cells. The ex vivo responsiveness of human blood NK cells to TLR2, 4 or 9 agonists also requires accessory cytokines, to promote secretion of IFN-. In intensive care patients diagnosed with systemic inflammatory response syndrome (SIRS) and sepsis, IFN- production was significantly decreased. We also discovered modulations in the expression of CD69 (early activation marker) and in that of TLR themselves. This study indicates that NK cells undergo tolerance in response to TLR agonists during SIRS or sepsis, similarly to other cells, such as monocytes
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Keyser, Eric J. "Exhaled nitric oxide and the Systemic Inflammatory Response Syndrome (SIRS) after cardiac surgery." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31247.
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Background. Septic patients produce increased nitric oxide (NO). We postulated increased exhaled nitric oxide (exNO) in SIRS after cardiopulmonary bypass surgery (CPB).Methods. Forty-two intubated patients were studied postoperatively and at two-hour intervals for eight hours or until extubated. Hemodynamic indices, including indexed systemic vascular resistance (SVRi) and cardiac index (CI) were measured. ExNO was analyzed by ozone chemiluminescence.
Results. Six patients (14%) Manifested SIRS, defined as SVRI <1800 dynes·sec/cm5/m2. ExNO indexed by expired volume of minute ventilation and body surface area (exNO· V˙Ei) was less in SIRS patients at each interval. Overall, normal exNO·V˙Ei was 4.3 +/- 0.4 nL/min/m2 with a Cl of 2.56 +/- 0.05 L/min/m 2 and an SVRI of 2488 +/- 62 dynes·sec/cm5/m 2, whereas in SIRS exNO·V˙Ei was 0.7 +/- 0.3 (p < 0.001) with a Cl of 2.97 +/- 0.09 (p < 0.001) and an SVRi of 1826 +/- 86 (p < 0.001).
Conclusions. Pulmonary production of NO in post-CPB SIRS differs from sepsis and may not be reflective of systemic levels. Increased pulmonary blood flow may scavenge lung production of NO thereby decreasing exhaled levels.
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Stumpf, Anne [Verfasser]. "Einflussgrößen für Design und Entwicklung eines Antikörper-Microarray am Modellsystem SIRS / Anne Stumpf." München : Verlag Dr. Hut, 2018. http://d-nb.info/1174426810/34.
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Alves, Frederico Silva de Sousa. "Canine parvovirus and sepsis : SIRS criteria evaluation and implementation of a PIRO classification." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2020. http://hdl.handle.net/10400.5/19691.
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Dissertação de Mestrado Integrado em Medicina VeterináriaSepsis is a severe condition associated with high prevalence and mortality rates. Parvovirus enteritis is a predisposing factor for sepsis, as it promotes intestinal bacterial translocation and severe immunosuppression. This makes naturally parvovirus infected dogs a suitable study population as far as sepsis is concerned. The main objective of the present study was to evaluate the differences between two sets of SIRS (Systemic Inflammatory Response Syndrome) criteria in outcome prediction, parallelly the possibility of stratifying and classify septic animals using a proposed animal adapted PIRO (Predisposition, Infection, Response, Organ dysfunction) scoring system was also assessed. The 72 animals enrolled in this study were subjected to a score for each of the PIRO elements (except for the Infection, as all were considered to have the same infection score) and to two sets of SIRS criteria, assessing their correlation with the outcome. The data was retrieved from the clinical records of the Infectious Disease Isolation Unit (IDIU) of the Veterinary Teaching Hospital (VTH) of the Faculty of Veterinary Medicine (FMV) of the University of Lisbon (ULisboa). Concerning the SIRS criteria, it was found that the proposed alterations were significantly associated with the outcome (OR = 4.09, p < 0,05), contrasting with the original SIRS criteria (p=0.352) that did not correlate with the outcome. No significant statistical association was found between Predisposition (p=1), Response (p=0.1135), Organ dysfunction (p=0.1135) or total PIRO score (p=0.093) and outcome. The results obtained reveal the need for consensual and more specific criteria to assess SIRS and sepsis. The results suggest that augmenting the criteria specificity may improve their prognostic value, thus making them more useful in clinical management and treatment decision. This work represents a contribution for the development of an approved set of criteria, to could contribute not only to the classification of septic dogs but also to the improvement of sepsis diagnosis. Further studies are still needed to conclude about the best criteria to be used, but this study can serve as base from which further studies can adapt and improve. Additional more specific criteria, mainly inflammatory and organ dysfunction biomarkers, should be added to the proposed PIRO scoring system in order to improve the its´ prognostic value and clinical utility. Further studies should focus on improving classification systems and finding new biomarkers that would allow a timely intervention in sepsis affected animals and improve sepsis survival rate.
RESUMO - Parvovirose Canina e Sépsis: Avaliação dos critérios de SIRS e Implementação da classificação PIRO - A sépsis esta associada a uma elevada prevalência e taxa de mortalidade. A Parvovirose canina predispõe para o aparecimento de sépsis secundaria à translocação bacteriana intestinal e imunossupressão. Este facto faz dos cães naturalmente infetados com parvovírus uma boa população para o estudo de sépsis. O principal objetivo deste estudo foi avaliar as diferenças entre dois conjuntos de critérios de SRIS (Síndrome de Resposta Inflamatória Sistémica) sobre a sua capacidade de prognóstico, assim como avaliar a possibilidade de implementação de um sistema de estratificação de animais sépticos com base no modelo PIRO (Predisposition, Infection, Response, Organ dysfunction). Os 72 animais da amostra foram submetidos a dois conjuntos de critérios SIRS e classificados para cada um dos elementos constituintes do PIRO (com exceção da infeção, sendo que todos os animais foram considerados como tendo a mesma classificação para a Infeção), avaliando a sua relação com o desfecho. Os dados foram recolhidos a partir dos registos clínicos da Unidade de Isolamento de Doenças Infeciosas (UIDI) do HEV-FMV-UL. Em relação aos critérios de classificação SRIS, os resultados revelaram que a alteração proposta aos critérios originais resulta numa associação estatisticamente significativa com o desfecho (OR = 4.09, p < 0,05), contrastando com os resultados observados quando aplicados os critérios originais (p=0.352) que não se correlacionam significativamente com o desfecho. Não foi encontrada nenhuma associação estatisticamente significativa entre a Predisposição (p=1), Resposta (p=0.1135), Disfunção Orgânica (p=0.1135) ou PIRO total (p=0.093) e o desfecho clínico. Os resultados obtidos revelam a necessidade de critérios mais específicos para a avaliar SRIS e sépsis. Os resultados sugerem que o aumento da especificidade pode melhorar o seu valor prognóstico. Este trabalho representa uma contribuição para o desenvolvimento de um conjunto de critérios consensual e aprovado para a classificação de animais sépticos, servindo de base para estudos futuros. Mais critérios com uma maior especificidade, como marcadores bioquímicos inflamatórios e de disfunção orgânica, devem ser adicionados ao sistema PIRO proposto. Estudos futuros devem concentrar-se em melhorar os sistemas de classificação existentes e descobrir novos biomarcadores que permitam uma intervenção atempada em animais afetados por sépsis, melhorando a taxa de sobrevivência.
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Zimmermann, Thomas, Steffen Albrecht, S. Hanke, and Gagern Georg von. "Selen in der Intensivmedizin." Karger, 2000. https://tud.qucosa.de/id/qucosa%3A27562.
Full textAbstract:
Mit der Entdeckung des Selens als essentielles Spurenelement und der Glutathionperoxidase als Selenoenzym sowie der Tatsache, daû Selenmangel relativ weit verbreitet ist, wurde erstmals ein Zusammenhang zu einigen schweren Erkrankungen hergestellt (Keshan-Krankheit, Kaschin-Beck-Syndrom). Interessant ist dabei, daû sich trotz dieser und anderer bekannter Selenmangelerkrankungen eine Therapie in der Humanmedizin nur langsam zu etablieren beginnt, waÈ hrend die Selensupplementation in der VeterinaÈ rmedizin bereits Standard ist. Die Autoren beschaÈ ftigen sich seit 1990 mit der Rolle des Spurenelements Selen bei septischen Krankheitsbildern in der Intensivmedizin, beim ReperfusionsphaÈnomen nach gefaÈûchirurgischen Eingriffen und in der Onkologie. Sie konnten zeigen, daû die adjuvante Therapie der akuten Pankreatitis und der Sepsis mit Natriumselenit einen positiven Effekt auf das Outcome der Patienten zu haben scheint (eine multizentrische, doppelblinde, randomisierte Sepsisstudie zur Validierung dieser Ergebnisse ist in Vorbereitung). Neue Erkenntnisse zur Beeinflussung von Transkriptionsfaktoren durch Selen bei systemischem Inflammationssyndrom und Sepsis erlauben eine wissenschaftlich fundierte Interpretation der klinischen Ergebnisse. Weitere molekularbiologische Untersuchungen werden das Spurenelement Selen zu einem der interessantesten Forschungsprojekte der naÈ chsten 10 Jahre in Intensivmedizin und Onkologie machen.Since selenium was discovered as an essential trace element being widely distributed, and since glutathione peroxidase is known as a selenoenzyme, associations with several severe diseases were established (Keshan disease, Kaschin-Beck syndrome). Despite these known selenium deficiency diseases a related human therapy is still not established so far. In veterinary medicine, however, substitution of selenium is already a standard therapy. Our laboratory investigates the role of selenium since 1990. This includes investigations about the effects of selenium in acute inflammatory diseases in intensive care, in the reperfusion phenomenon following vascular surgery, and in oncology. In acute pancreatitis and sepsis, adjuvant therapy using sodium selenite seems to have positive effects on the overall outcome of patients (a multicenter, double-blind, randomized trial on sepsis is being prepared). New findings concerning the influence of selenium on transcription factors in inflammatory processes will permit a scientifically sound interpretation of clinical results. With further investigations in molecular biology the trace element selenium will become, in the next decade, one of the most interesting topics in intensive care and oncology.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Hamacher, Lena [Verfasser], and Gerhard [Akademischer Betreuer] Wess. "Kardiales Troponin I bei Hunden mit systemischem Entzündungssyndrom (SIRS) / Lena Hamacher. Betreuer: Gerhard Wess." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2015. http://d-nb.info/1068767154/34.
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Veseli, Kujtim [Verfasser], and Tobias [Akademischer Betreuer] Walker. "Frühe Marker des sterilen systemischen Inflammationssyndroms (SIRS) nach Herzoperationen / Kujtim Veseli ; Betreuer: Tobias Walker." Tübingen : Universitätsbibliothek Tübingen, 2017. http://d-nb.info/1196703213/34.
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FONSECA, Karine Gonçalves da. "Estudo de um modelo epidemiológico do tipo SIRS com taxa de incidência não linear." reponame:Repositório Institucional da UNIFEI, 2017. http://repositorio.unifei.edu.br/xmlui/handle/123456789/967.
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O objetivo principal deste trabalho foi explorar a dinâmica de um modelo epidemiológico com a taxa de incidência não linear βSIᵖ / (1+αIq). Além de estudar o modelo com a taxa de incidência geral, estudou-se dois casos com p e q fixos (p = 1 e q = 2, incidência não monótona; p = q = 2, incidência saturada). A existência e a estabilidade dos múltiplos equilíbrios endêmicos do modelo epidemiológico foram analisadas. Mostra-se que o número de indivíduos infecciosos tende a zero à medida que o tempo evolui ou existe uma região do gráfico de tal forma que a doença será persistente se a posição inicial estiver nessa região e a doença desaparecerá se a posição inicial estiver fora desta região. A existência de ciclos limite também é discutida. A teoria da bifurcação local foi aplicada para explorar o comportamento dinâmico do modelo. As formas normais do modelo foram obtidas para diferentes tipos de bifurcações, incluindo as bifurcações de Hopf e Bogdanov-Takens as quais somente não ocorrem quando a taxa de incidência é não monótona. O primeiro coeficiente de Liapunov foi calculado para determinar as bifurcações de Hopf.
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YAO, JIANHUA. "Systeme sirs-ss : simulation spectrale ir et raman, par association sous-structures/sous-spectres." Paris 7, 2000. http://www.theses.fr/2000PA077236.
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Un systeme de simulation spectrale ir/raman, sirs-ss (spectres ir/raman simules par la methode de correlations sous structures/sous spectres), a ete concu et developpe. Ce logiciel de simulation spectrale ir/raman consiste en deux volets principaux : 1. La construction des bases de donnees sous-structures/sous-spectres ir/raman ; 2. La simulation des spectres ir/raman. Quatre types de bases de donnees, associant information structurale et information spectrale, molecules simples, fragments particuliers, frels de foyer atome, frels de foyer liaison, ont ete construits dans sirs-ss en utilisant la methode du data mining. Elles ont ete ordonnees d'apres les proprietes des fragments, la notion frel (precis ou flou) et les statistiques du cas (chemical abstract service). Dans ces bases, la description structurale est effectuee a partir de l'ensemble des informations sur les atomes et les liaisons. La simulation des spectres ir/raman est realisee par l'extraction systematique des sous structures pertinentes incluses dans la molecule cible, sous structures auxquelles sont associees les bandes caracteristiques correspondantes. Les divers modules de reconnaissance des fragments, ont ete realisees en adaptant au probleme l'algorithme d'ullmann. De nombreux tests effectues et des etudes comparatives avec les (rares) logiciels existant dans le domaine etablissent que sirs-ss est un systeme fiable et convivial.
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Kern, Hartmut [Verfasser], D. M. [Gutachter] Albrecht, and W. [Gutachter] Lorenz. "SIRS und Sepsis nach kardiochirurgischen Eingriffen / Hartmut Kern ; Gutachter: D. M. Albrecht, W. Lorenz." Berlin : Humboldt-Universität zu Berlin, 2001. http://d-nb.info/1207663948/34.
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Monteiro, Sousa Claudio. "Exploration transcriptomique et logique de la voie TLR4 dans le contexte physiopathologique du sepsis." Thesis, Lyon, 2016. http://www.theses.fr/2016LYSE1098/document.
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Le sepsis est un syndrome observé chez des patients associant une infection documentée (microbiologiquement ou cliniquement suspectée) à une réponse inflammatoire systémique (Systemic Inflammatory Response Syndrome : SIRS).Celui-ci peut évoluer vers un sepsis sévère s'il est associé à la défaillance d'un ou de plusieurs organes. Le choc septique est l'association d'un état septique grave et d'une défaillance hémodynamique caractérisée par une chute aiguë de la pression artérielle ne pouvant pas être corrigée par une procédure standard de remplissage vasculaire. Les syndromes septiques sont aujourd'hui la première cause de mortalité en unités de réanimation. Cette mortalité élevée, en particulier pour les cas les plus graves tels que les chocs septiques, témoigne d'une absence de traitements curatifs pour cette pathologie. Partant de l'hypothèse que les syndromes septiques graves sont la conséquence d'une perte de contrôle précoce de la régulation de la réponse inflammatoire, nous avons étudié, via deux démarches complémentaires, l'initiation de la voie de signalisation TLR4 et les mécanismes intracellulaires contribuant à sa régulation. Dans un premier temps, l'utilisation d'approches transcriptomiques nous a permis d'identifier la voie de signalisation mTOR comme discriminante entre des patients sains (SIRS induit par l'injection d'endotoxines) et des patients souffrant de syndromes septiques graves. Nous avons ensuite développé et utilisé des techniques de modélisation logique pour simuler in silico le rôle joué par la voie mTOR dans la résolution d'une réponse inflammatoire. Ces résultats encourageants ouvrent des perspectives pour de nouvelles applications thérapeutiques dans le domaine du sepsisSepsis is a syndrome observed in patients combining a documented infection (microbiologically or clinically suspected) with a systemic inflammatory response (Systemic Inflammatory Response Syndrome : SIRS). It may progress to severe sepsis if it is associated with failures of one or more organs. Septic shock is the combination of a severe sepsis and a hemodynamic dysfunction characterized by an acute fall in blood pressure that cannot be corrected by a procedure of vascular filling.Sepsis syndromes represent today the first cause of mortality in intensive care units around the world. This poor survival rate, in particular for the most severe cases, such as septic shock, testifies a real curative therapeutic demand.Based on the assumption that severe sepsis syndromes are the consequence of a loss of control in early mechanisms of inflammatory response regulation, we studied via two complementary approaches the initiation of TLR4 signaling pathway and the intracellular mechanisms contributing to its regulation.First, the use of transcriptomic approaches allowed us to identify the mTOR signaling pathway as discriminating between healthy patients (SIRS induced by the infusion of endotoxins) and patients with severe septic syndromes. We then developed and used logic modeling approaches to in silico simulate the role played by the mTOR signaling pathway in the resolution of an inflammatory response. These encouraging results open perspectives for new therapeutic applications in the field of sepsis
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Corrêa, Sílvia Verônica de Magalhães e. "Avaliação da tromboelastografia em cães clinicamente normais e na detecção precoce da coagulação intravascular disseminada (CID) em cães com pancreatite." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-08052017-100403/.
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A Coagulação Intravascular Disseminada (CID) é uma síndrome caracterizada pela ativação sistêmica da coagulação sanguínea, levando à trombose microvascular difusa e podendo comprometer a função de múltiplos órgãos. O acelerado consumo de plaquetas e fatores de coagulação pode, no entanto, dar origem a um estado de hipocoagulabilidade, o que confere à CID uma característica paradoxal na qual o excesso de coagulação pode causar uma diátese hemorrágica. Doenças que levam à Síndrome de Resposta Inflamatória Sistêmica (SIRS) estão entre os principais gatilhos da CID. A pancreatite é uma dessas doenças. O maior desafio para o médico veterinário é diagnosticar a CID na fase precoce, silenciosa e de hipercoagulabilidade, visto que os testes laboratoriais de rotina, como contagem de plaquetas, tempo de protrombina (TP) e tempo de tromboplastina parcial ativada (TTPA), detectam apenas o estado de hipocoaguabilidade, que se estabelece na fase mais avançada da síndrome. Nesse contexto ganham importância os analisadores tromboelastográficos, equipamentos que avaliam a coagulação em sangue total e que, ao menos em tese, podem informar a velocidade de formação do coágulo, a força máxima que ele atinge e os padrões de sua dissolução. Este estudo é o primeiro realizado em cães com o aparelho ReoRox G2 (MediRox), uma da marcas disponíveis no mercado. Limites de referência para as variáveis do aparelho foram definidos a partir da análise do sangue de 49 animais clinicamente saudáveis para três tipos de reação: acelerada com fator tecidual (TF), acelerada com TF e um antagonista de agregação plaquetária (abciximab) e apenas com sangue recalcificado. Em seguida, foram comparados a esse intervalo de referência os valores obtidos pela análise tromboelastográfica do sangue de seis pacientes com pancreatite recém-diagnosticada. Nos três tipos de reação pelo menos 50% dos pacientes do Grupo Pancreatite apresentaram alterações sugestivas de hipercoagulabilidade. A variável MAXELAST (força máxima do coágulo) foi a que esteve alterada com mais frequência entre os animais doentes. Não houve alteração nos marcadores de velocidade de fibrinólise. Estudos prospectivos que associem outras variáveis de trombose, protocolos de tratamento e prognóstico de pacientes com doenças subjacentes que predisponham à CID são necessários para que se possa afirmar que o traçado obtido pela tromboelastografia realmente representa um estado de hipercoagulabilidade in vivo em pacientes com pancreatite.Disseminated Intravascular Coagulation (DIC) is a syndrome characterized by systemic activation of blood clotting, leading to diffuse microvascular thrombosis and may compromise multiple organ function. The accelerated consumption of platelets and coagulation factors may, however, originate a state of hypocoagulability, which gives the DIC a paradoxical characteristic in which excess coagulation can lead to a hemorrhagic diathesis. Diseases which cause Systemic Inflammatory Response Syndrome (SIRS) are among the major triggers of DIC, including pancreatitis. The greatest challenge for veterinarians is to diagnose DIC in the early, silent and hypercoagulable phase, since routine laboratory tests, such as platelet count, prothrombin time (PT) and activated partial thromboplastin time (APTT), detect only the state of hypocoagulability, which occurs in the most advanced stage of the syndrome. In this context, thromboelastography analyzers stand out. They are equipment which evaluate coagulation in whole blood and, at least in theory, inform the speed of clot formation, its maximum force and how it dissolves. This is the first study performed in dogs with the ReoRox G2 (MediRox), one of the brands available in the market. Limits of reference were defined from blood analysis of 49 healthy animals for three reaction types: accelerated with tissue factor (TF), accelerated with TF and a platelet aggregation antagonist (abciximab) and with only recalcified blood. Next, values obtained by blood thromboelastographic analysis of six patients with newly diagnosed pancreatitis were compared to this reference range. In all three types of reactions, at least 50% of patients in the Pancreatitis Group presented alterations suggestive of hypercoagulability. The variable MAXELAST (maximum clot strength) was the one that was most frequently altered among ill animals. There was no change in fibrinolysis rate markers. Prospective studies associating other thrombosis variables, treatment protocols, and prognosis of patients with underlying diseases predisposing to DIC are necessary to confirm that the pathway obtained by thromboelastography actually represents a state of hypercoaguability in vivo in patients with pancreatitis.
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Jaber, Samir. "Syndrome inflammatoire de réponse systémique (SIRS) sévère en chirurgie cardiaque : évaluation d'une antibiothérapie (résultats préliminaires)." Montpellier 1, 1996. http://www.theses.fr/1996MON11151.
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Dal, Ponte Silvana Teixeira. "Valor diagnóstico e prognóstico do CD64 na sepse." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/129642.
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INTRODUÇÃO: A sepse é uma resposta inflamatória sistêmica causada por infecção suspeita ou confirmada. As avaliações clínicas são essenciais para a sua detecção e tratamento precoce. Hemoculturas podem demorar até dois dias para produzir um resultado, e nem sempre são confiáveis. No entanto, estudos recentes sugeriram que a expressão de CD64 de neutrófilos pode ser uma alternativa sensível e específica para o diagnóstico de uma infecção sistêmica. OBJETIVO: Analisar a diferença de valores entre CD64 de indivíduos com síndrome de resposta inflamatória sistêmica (SIRS), e sepse suspeita ou confirmada, que satisfazem os critérios de diagnóstico para SIRS ao chegar na unidade de emergência. MÉTODO: Este foi um estudo de coorte prospectivo observacional. A amostra foi composta de 109 pacientes com idade de 18 anos ou mais, com critérios de SIRS na chegada ao serviço de emergência. Expressão CD64 foi medida no prazo de 6 horas de internação, e novamente após 48 h. RESULTADOS: A análise da curva ROC sugeriu que um corte de 1.45 dos níveis de CD64 poderia diagnosticar sepse com uma sensibilidade de 0,85, especificidade de 0,75, uma precisão de 82,08%, um valor preditivo positivo de 0,964, um valor preditivo negativo de 0,375 e uma razão de verossimilhança de 3,3381. A área sob a curva foi de 0,832. CONCLUSÃO: CD64 parece ser útil como biomarcador, sensível e específico para discriminar entre SRIS e sépsis.INTRODUCTION: Sepsis is a systemic inflammatory response to suspected or confirmed infection. Clinical evaluations are essential for its early detection and treatment. Blood cultures may take as long as two days to yield a result, and are not always reliable. However, recent studies have suggested that neutrophil CD64 expression may be a sensitive and specific alternative for the diagnosis of systemic infection. OBJECTIVE: To analyze the difference in CD64 values between subjects with systemic inflammatory response syndrome (SIRS), suspected or confirmed sepsis, who meet diagnostic criteria for SIRS upon arriving at an emergency unit. METHOD: This was a prospective observational cohort study. The sample consisted of 109 patients aged 18 years with criteria for SIRS on arrival to Emergency department. CD64 expression was measured within 6 hours of hospital admission, and once again after 48 h. RESULTS: ROC curve analysis suggested that a cutoff of 1.45 for CD64 expression could diagnose sepsis with a sensitivity of 0.85, a specificity of 0.75, an accuracy of 82.08%, a positive predictive value of 0.964, a negative predictive value of 0.375 and a positive likelihood ratio of 3.3381. The area under the curve was 0.832. CONCLUSION: CD64 appears to be a useful, sensitive and specific biomarker in discriminating between SIRS and sepsis.
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RUGGERONE, BEATRICE. "OXIDATIVE-ANTIOXIDATIVE COMPOUNDS AND LIPID PARAMETERS AS POTENTIAL DIAGNOSTIC AND PROGNOSTIC MARKERS IN ANIMALS WITH SIRS." Doctoral thesis, Università degli Studi di Milano, 2019. http://hdl.handle.net/2434/619500.
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Nowadays in veterinary medicine the discrimination between an inflammatory status and a systemic inflammatory response syndrome (SIRS) sometimes related to an infectious disease and with a poorer prognosis, could be difficult, both for the clinicians and the clinical pathologists. An early diagnosis would permit to avoid unnecessary use of antibiotics (mainly to contain the problem of antibiotic resistance) and to establish an appropriate monitoring plan.
The aim of the two first described works was to validate in horses the Paraoxonase-1 (PON-1), a negative acute phase protein already used in dogs; 120 healthy horses of different sex, age and breed were enrolled; then, this protein was evaluated as a possible diagnostic and prognostic markers of SIRS in this species; PON-1 did not seem to be useful to this aim. The prognostic value was not evaluable because of the small amount of survivors in the SIRS group that did not permit a serial evaluation of PON-1 values.
The second part of the thesis is about the Protein Carbonyls (PCOs), that are already used as sepsis markers in humans; a Western Blotting method was initially validated to detect PCOs in canine serum from healthy patients; then, a spectrophotometric method, that could be cheaper and faster than the first one, was employed. With this method, serum from healthy dogs and from dogs with septic or non-septic inflammation was used to measure PCOs. Results between groups were compared to evaluate if PCOs could be considered as possible diagnostic markers of sepsis in association with PON-1 and C-reactive protein (CRP). This marker seemed to be useful to distinguish dogs with sepsis from dogs with sterile inflammation or healthy, but not to give prognostic information.
An increase in the amount of the enrolled dogs would consent to enforce the hypothesis that PCOs could become a reliable support to diagnose sepsis.
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Sans, Soler Marc. "Unattended design of wideband planar filters based on stepped impedance resonators (SIRs) through aggressive space mapping (ASM)." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/664688.
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La síntesis de circuitos planares de microondas capaces de satisfacer un conjunto de especificaciones es un tema de interés en la actualidad dentro del campo de la ingeniería de microondas. A pesar de que la mayoría de las herramientas software de diseño asistido y los simuladores electromagnéticos disponibles en el mercado incluyen optimizadores, obtener la topología del circuito que cumple con las especificaciones es generalmente complicado. La convergencia a la solución óptima no está siempre garantizada a no ser que el layout inicial sea muy próximo al que ya proporciona la respuesta objetivo y la experiencia del diseñador juega un papel clave en este proceso de optimización a medida que la complejidad del circuito aumenta.
Por otro lado, los filtros de microondas single-ended y, más concretamente, los filtros de microondas balanceados, se han convertido en dispositivos esenciales debido a los recientes avances en el desarrollo de las tecnologías de comunicación modernas, dónde elevados niveles de integración y sistemas más complejos son requerimientos fundamentales. Por lo tanto, un proceso sistemático capaz de proporcionar el layout del filtro que cumple con las especificaciones requeridas sería muy bien recibido para la comunidad de los ingenieros de microondas.
Esta tesis está orientada a la síntesis automática de filtros de microondas planares single-ended y balanceados que proporcionan respuestas pasa banda y de banda ancha. Estas estructuras se basan en elementos resonantes semi-concentrados, implementados mediante una combinación de secciones de líneas de transmisión de alta y baja impedancia, más conocidos como Resonadores de Salto de Impedancia (SIRs). La estrategia de optimización, basada en la técnica de Aggressive Space Mapping (ASM), tiene el objetivo de generar el layout del filtro que satisface las especificaciones siguiendo un proceso totalmente desasistido. De este modo, este método de síntesis automática puede dar lugar a la implementación de una herramienta de optimización asociada a este tipo de filtros basados en SIRs, adecuada para ser incorporada en cualquier software existente en el mercado dedicado al diseño de dispositivos de microondas
Con este propósito, algoritmos basados en ASM son desarrollados en esta tesis para la síntesis automática de distintas topologías de filtros de microondas single-ended y balanceados basados en SIRs. Los procedimientos para el diseño automático de éstos dispositivos son descritos en detalle y su funcionalidad es validada mediante su aplicación a la generación de distintos layouts destinados a satisfacer un conjunto particular de especificaciones en cada caso. Los procesos de síntesis automática desarrollados y los resultados obtenidos revelan que esta metodología de optimización puede ser aplicada a muchos otros tipos de filtros, y han conducido a este trabajo de investigación a contribuir en el estado del arte con nuevas estrategias en la formulación del ASM y con innovadoras topologías de filtros pasa banda de banda ancha.The synthesis of planar microwave circuits able to satisfy a set of given specifications has been a subject of interest in the microwave community for years. Despite the fact that most commercially available computer aided design tools and electromagnetic solvers include optimizers, obtaining the circuit topologies that satisfy the design requirements is generally cumbersome. Convergence to the optimum solution is not always guaranteed unless the seeding layout is already very close to the one providing the target response, and designer experience plays a key role in such optimization process as long as the circuit complexity increases. On the other hand, single-ended and, more specially, balanced microwave filters have become essential devices with the recent advances in the development of wireless communication technologies, where higher levels of integration and more complex microwave systems are key requirements. Therefore, a systematic procedure able to provide the filter layout satisfying the required specifications would be very welcomed by microwave engineers. This thesis is focused on the automatic synthesis of single-ended and balanced planar microwave filters providing wideband bandpass responses. Such filter structures are based on semi-lumped resonant elements, implemented by a combination of high and low impedance transmission line sections, also known as Stepped Impedance Resonators (SIRs). The optimization approach, based on the Aggressive Space Mapping (ASM) technique, is aimed to generate the filter layout from design specifications following a completely unattended scheme. Therefore, such filter optimization scheme can represent the first step towards an optimization tool for this type of SIR-based filters suitable to be part of any commercially available engineering software focused on microwave design. To this end, specific ASM-based algorithms are developed in order to automatically synthesize multiple single-ended and balanced filter topologies based on SIRs. The proposed automatic design procedures are thoroughly detailed and validated through its application to generate several filter layouts starting from different sets of practical specifications. The reported procedures and the results obtained reveal that this optimization methodology can be extended to many other filter structures, and have lead this research work to contribute to the state of the art with innovative strategies in the ASM formulation as well as with novel synthesized passband filter topologies.
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Mann, Valesco Wladimir. "Alterationen der immunologischen Antwort im Rahmen des eskalierenden SIRS nach kardiopulmonalem Bypass unter Berücksichtigung ihrer prognostischen Wertigkeit." [S.l.] : [s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=968397360.
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Correa, Amor Alicia. "Validation of the Spanish SIRS: Beyond Linguistic Equivalence in the Assessment of Malingering among Spanish Speaking Clinical Populations." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc30448/.
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Malingering is the deliberate production of feigned symptoms by a person seeking external gain such as: financial compensation, exemption from duty, or leniency from the criminal justice system. The Test Translation and Adaptation Guidelines developed by the International Test Commission (ITC) specify that only tests which have been formally translated into another language and validated should be available for use in clinical practice. Thus, the current study evaluated the psychometric properties of a Spanish translation of the Structured Interview of Reported Symptoms (SIRS). Using a simulation design with 80 Spanish-speaking Hispanic American outpatients, the Spanish SIRS was produced reliable results with small standard errors of measurement (SEM). Regarding discriminant validity, very large effect sizes (mean Cohen's d = 2.00) were observed between feigners and honest responders for the SIRS primary scales. Research limitations and directions for future research are also discussed.
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Ramos, Vitorino de Assis Vladimir. "Da epidemiologia para a neurociência: entendendo Neurônios disparantes acoplados eletricamente através do Modelo sirs estocástico na rede hipercúbica." Universidade Federal de Pernambuco, 2006. https://repositorio.ufpe.br/handle/123456789/6685.
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A função de resposta de neurônios disparantes sensoriais individuais (taxa de disparo versus intensidade de estímulo) tem uma faixa dinâmica pequena. Por exemplo, em neurônios sensoriais do olfato, somente 10 dB de intensidade de estímulo podem ser razoavelmente codi ficados, se a saturação e o ruído de baixo estímulo forem desprezados. Isso está em completo contraste com a grande faixa dinâmica observada no próximo passo sináptico: a resposta dos glomérulos e das células mitrais do olfato pode ter faixa dinâmica duas vezes maior. Há evidência experimental de que o acoplamento elétrico entre neurônios (via junções de abertura ou interações efáticas) pode ser responsável por essa melhora da faixa dinâmica. Para calcular o efeito do acoplamento elétrico na resposta coletiva de neurônios disparantes, estudamos o modelo epidêmico SIRS estocástico na rede hipercúbica e reinterpretamos os estados suscetível-infectado-recuperado-suscetível, como polarizado-disparando-refratário-polarizado, respectivamente. Estendemos o modelo recentemente estudado por Jaewook Joo e Joel L. Lebowitz [1], introduzindo um estímulo sensorial externo (que, no contexto epidemiológico, acrescenta uma taxa de infecção espontânea). Fizemos os cálculos analíticos da aproximação de campo médio simples e da aproximação de pares, bem como simulações numéricas. Mostramos que, devido à amplificação via ondas excitáveis, a faixa dinâmica cresce com o acoplamento elétrico até um valor crítico, acima do qual a rede apresenta atividade auto-sustentada. Acima da criticalidade, a faixa dinâmica diminui com o acoplamento elétrico, porque a atividade auto-sustentada mascara o baixo estímulo. A maior faixa dinâmica é, então, obtida precisamente na transição de fase de não-equilíbrio, fornecendo um exemplo bem definido de processamento ótimo na criticalidade. Além disso, o valor máximo da faixa dinâmica para a rede hipercúbica d-dimensional diminui com d
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Whitmore, Laura Christine. "Neutrophil priming and host inflammation: The roles of NOX2 and toll-like receptors." Diss., University of Iowa, 2014. https://ir.uiowa.edu/etd/3215.
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Neutrophils, essential innate immune cells, recognize danger signals through receptors on their surface. Upon receptor ligation, neutrophils may undergo priming, a process involving limited reactive oxygen species (ROS) generation and partial degranulation. Priming facilitates neutrophil migration and prepares the cell for an enhanced response to a secondary stimulus, including a spike in ROS generation by NADPH oxidase 2 (NOX2). It is well established that NOX2-derived oxidants are involved in pathogen killing and that off-target effects can cause host tissue damage; however, several lines of recent evidence also support an anti-inflammatory function for NOX2 oxidants. First, patients with chronic granulomatous disease exhibit sterile inflammatory phenomena. Second, neutrophils lacking NOX2 function (genetically or pharmacologically) have an inflammatory phenotype under resting conditions. Finally, NOX2-deficient mice exhibit enhanced localized inflammation in several disease models. The goals of this thesis were to investigate an anti-inflammatory function for NOX2 during systemic inflammation and to further elucidate mechanisms of neutrophil priming, with particular focus on priming through Toll-like receptor 2 (TLR2). Using a murine model of sterile systemic inflammatory response syndrome (SIRS), we observed that NOX2-deficient mice had dramatically increased mortality compared to WT mice. While both genotypes developed SIRS, characterized by hypothermia, hypotension, and leukopenia, the WT mice recovered within 48 h whereas the NOX2-deficient mice did not. Moreover, NOX2 function limited the extent of pulmonary pathology as significant lung injury was noted in the NOX2-deficient mice compared to the WT mice. Plasma analysis revealed that several inflammatory cytokines were persistently elevated in the NOX2-deficient mice, likely contributing to the ongoing inflammatory response. One of the complications seen in human SIRS patients is the development of multiple organ dysfunction syndrome (MODS). Thus, we next investigated the role of NOX2 in the progression from SIRS to MODS. Cellular analysis revealed continued neutrophil recruitment to the peritoneum and lungs of the NOX2-deficient mice and altered activation states of both neutrophils and macrophages. Histology showed multiple organ pathology indicative of MODS in the NOX2-deficient mice, and several inflammatory cytokines were elevated in lungs of the NOX2-deficient mice. Overall, these data suggest that NOX2 function protects against the development of MODS and is required for normal resolution of systemic inflammation. As we utilized a TLR2/6 agonist (zymosan) to induce SIRS in our in vivo model, we wanted to investigate neutrophil priming through TLR2 in an in vitro model. Notably, we determined that a TLR2/6 agonist, FSL-1, primed neutrophils from all donors to a similar extent, evidenced by direct and primed ROS generation, MAPK signaling, limited degranulation, and cytokine secretion. Surprisingly, Pam3CSK4, a TLR2/1 agonist, primed neutrophils from a subset of donors to a much greater extent than neutrophils from other donors. We demonstrated that the different neutrophil priming responses were the consequence of a common TLR1 polymorphism. In sum, the data presented here significantly advance our understanding of the roles of NOX2 and TLR2 signaling in host inflammation and neutrophil priming. This research could advance the development of therapies that target pathogenic neutrophil subsets in inflammatory conditions without compromising innate immune function
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Heilmaier, Martina Stefanie. "Systemische Entzündungsreaktionen (SIRS) bei der Korrektur kongenitaler Herzfehler, low flow cardiopulmonary bypass (LFCPB) versus deep hypothermic cardiac arrest (DHCA)." [S.l.] : [s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=972224033.
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LOPES, ANA LUIZA SZUCHMACHER VERISSIMO. "SERVING TWO SIRS: CASE STUDIES ABOUT THE PSYCHOLOGICAL CONTRACT AND THE DINAMIC IN WORK RELATIONSHIP OF OUTSOURCED IT PROFESSIONAL." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2006. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=8907@1.
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As constantes mudanças organizacionais provocadas pela
tecnologia da
informação e pelo aumento da competitividade global
implicam em
transformações profundas nas relações de trabalho. Nas
grandes empresas, é clara
a intensificação da prática da terceirização do setor de
TI para empresas
especializadas na prestação de serviços em tecnologia.
Isso faz com que o
profissional de TI terceirizado passe a se relacionar
diretamente com duas
empresas: a contratante e a contratada. O presente estudo
tem como objetivo
analisar como este indivíduo constrói o seu contrato
psicológico com essas
empresas e como ele percebe a sua situação no novo
contexto do mercado de
trabalho. Para tal, foram realizados estudos de caso em
três empresas de atuação
nacional que contratam este tipo de serviço em TI.
Utilizou-se o método de
pesquisa qualitativa com a realização de entrevistas semi-
estruturadas com os
profissionais de TI terceirizados em tais empresas. Nos
resultados observou-se
que o contrato psicológico é moldado por fatores que vão
além dos limites do
vínculo empregatício, sendo influenciado, entre outros
aspectos, pelas forças do
mercado, pelo contexto de vida pessoal, e pelo grau de
identificação do indivíduo
com as duas empresas.The continuous organizational changes caused by information technology and by the increase in global competition entail deep transformations in work relationships. The IT sector of large companies are increasingly resorting to outsourcing these services from IT specialized firms. It makes the outsourced IT professional deal directly with two firms: the contractor and the contracted. The present study aims at analyzing how this individual develops his psychological contract within these two firms, and how he becomes aware of his situation in a new labor market context. To this end, case studies were carried out in three companies operating domestically. The qualitative research method was used for effecting semi-structured interviews with outsourced IT professional in such firms. Results showed that the psychological contract is molded by factors other than the limits of the employment contract. For example, such factors as market forces, one´s personal life, and the degree of individual identification with both firms.
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Friedenberg, Steven Gene. "The role of mitochondrial DAMPs on the inflammatory response in an in vitro model of canine SIRS." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365174635.
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Kohlhoff, Birgit Renate [Verfasser]. "Einfluss einer mit Omega-3-Fettsäuren angereicherten parenteralen Ernährung auf die Adhäsionsmolekülexpression intensivpflichtiger Patienten mit SIRS / Birgit Renate Kohlhoff." Greifswald : Universitätsbibliothek Greifswald, 2011. http://d-nb.info/1012607607/34.
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Roche, Vincent. "Impacts de l'incertitude et de l'ambiguïté sur la pratique des SIRS, exploration à l'aide d'études de cas en assainissement industriel." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ60604.pdf.
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Roche, Vincent. "Impacts de l'incertitude et de l'ambiguïté sur la pratique des SIRS : Exploration à l'aide d'études de cas en assainissement industriel." Phd thesis, Ecole Nationale Supérieure des Mines de Saint-Etienne, 2000. http://tel.archives-ouvertes.fr/tel-00850649.
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En aménagement du territoire, les modalités de conception et d'utilisation d'un Système d'Information à Référence Spatiale (SIRS) dépendent du type de contexte décisionnel auquel il est intégré : la gestion, la planification stratégique ou la négociation. De ce fait, le SIRS doit témoigner, de manière appropriée, des besoins en gestion de l'incertitude et de l'ambiguïté caractéristiques d'un type de contexte décisionnel. D'une part, ces deux concepts sont illustrés par le niveaux requis de flexibilité du processus de traitement de l'information. D'autre part, ils s'expriment au travers de la qualité de l'information classiquement caractérisée par son exactitude, sa complétude, sa cohérence, son opportunité et son intelligibilité, mais aussi par son réalisme, son interprétation, sa dialectique, sa projection et son originalité. Nous proposons un guide d'aide à la pratique des SIRS issu du croisement entre les caractéristiques des contextes décisionnels retenus et les attributs relatifs à la qualité de l'information. Des applications SIG sont développées pour chaque type de contexte décisionnel afin de confronter la pertinence de ce guide avec ces études de cas. Une application SIG en question : un organisme chargé de la gestion du milieu récepteur souhaite hiérarchiser ses interventions de contrôle réglementaire auprès des établissements industriels. Il peut, à l'aide d'un SIG, simuler le trajet probable de déversements toxiques potentiels en temps d'orage afin de déterminer les risques localisés d'impact sur le milieu récepteur, de même que les sources potentielles de pollution industrielle. Une application SIG en planification stratégique : un organisme chargé de la planification du traitement des effluents industriels souhaite analyser la faisabilité d'options de gestion collective en tenant compte d'indicateurs d'économies d'échelle, de coûts de transport et de vulnérabilité au déversement. Le couplage d'un SIG avec une procédure opérationnelle composée de fonctions d'optimisation sous contraintes peut constituer un support d'aide à la décision. Une application SIG en négociation coopérative : un organisme animant un processus de négociation relatif à la gestion collective des effluents industriels souhaite stimuler le débat entre acteurs publics et privés aux perceptions, valeurs et intérêts différents. Il peut proposer une méthode d'aide à la négociation basée sur les principes du jeu de rôle et sur un couplage entre un SIG et une méthode d'analyse multi-critères dans le but de rechercher une combinaison "contextualisée" d'options individuelles et collectives d'assainissement industriel tout en respectant les règles d'une négociation coopérative.
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Fang, Haoshu [Verfasser], Ruth [Akademischer Betreuer] Grümmer, and Uta [Akademischer Betreuer] Dahmen. "Inflammation, SIRS and Sepsis after hepatobiliary surgery : is lipopolysaccharide binding protein the link? / Haoshu Fang. Betreuer: Ruth Grümmer ; Uta Dahmen." Duisburg, 2012. http://d-nb.info/1024851958/34.
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Lahiri, Rajiv. "Changes in innate immune function predict post-operative systemic inflammatory response syndrome (SIRS) following major hepatico-pancreatico-biliary (HPB) surgery." Thesis, Queen Mary, University of London, 2014. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8952.
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Introduction Patients undergoing major surgery are at risk of life-threatening complications including systemic inflammatory response syndrome (SIRS) and sepsis. Early identification of patients at risk of SIRS would allow tailored post-operative care and improve survival. Elevated serum IL-6 levels have been shown patients with poor post-operative outcomes, but the mechanisms underlying this response are unknown. We studied these mechanisms in patients undergoing major surgery to identify early biomarkers of altered inflammatory responses and poor clinical outcomes. Methods Serial blood samples were taken from consenting, adult patients undergoing major hepatic or pancreatic surgery pre-operatively and on days one and two post-operatively. Patients with inflammatory co-morbidities, pre-operative sepsis and those taking anti-inflammatory medications were excluded. Peripheral blood mononuclear cells (PBMCs) were isolated, stimulated for 24 hours with lipopolysaccharide (LPS) or flagellin and cytokine production was quantified by ELISA. PBMC surface expression of CD14, CD16, TLR4 and TLR5 was assessed by flow cytometry. Transcription factor phosphorylation was evaluated using Phosflow. SIRS was defined by internationally agreed consensus criteria. Results Serum concentrations of IL-6 on postoperative Day 2 were significantly increased in 12 patients who developed SIRS (median postoperative day 6) compared with 27 patients who did not. PBMCs from SIRS patients following surgery (before clinical signs of SIRS) displayed significantly greater TLR4 and TLR5 expression and produced significantly more IL-6 in response to LPS and flagellin. Consistent with these data, TLR-driven phosphorylation of NF- 5 κB was increased post-operatively, and interferon alpha-mediated STAT1 phosphorylation was higher pre-operatively in SIRS patients. Differences in TLR4 and TLR5 expression were greatest in the CD14++CD16+ ‘intermediate’ monocyte population. Intermediate monocyte TLR4 and TLR5 expression post-operatively predicted SIRS development with an accuracy of 0.89 - 1.0 (calculated areas under the receiver operator curves). Conclusion Markers of innate immune dysfunction can be used 5 days before the onset of clinical signs to identify patients at risk of SIRS.
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Wigger, Olivier. "Usefulness of a clinical diagnosis of critical illness polyneuro-myopathy in patients with SIRS and acute respiratory failure to predict outcome /." Bern : [s.n.], 2008. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Schaefer, Helen Leanne [Verfasser]. "Investigations on the quantitative and qualitative protein excretion in urine of dogs with Severe Inflammatory Response Syndrome (SIRS) / Helen Leanne Schaefer." Berlin : Freie Universität Berlin, 2012. http://d-nb.info/1027151302/34.
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Balaban, Ümniye [Verfasser], and Christel [Akademischer Betreuer] Weiß. "Mathematische Modelle zur Prognose und Differentialdiagnose der Sepsis anhand eines SIRS-Algorithmus und Routineparameter der Intensivstation / Ümniye Balaban ; Betreuer: Christel Weiß." Heidelberg : Universitätsbibliothek Heidelberg, 2019. http://d-nb.info/119176043X/34.
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Chaloupka, Jan. "Modelování dopadů norem kvality a ochrany před klamavou reklamou na užitek spotřebitelů." Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-19168.
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In this thesis we explore the importance of consumer protection (concretely protection against misleading advertising and minimal quality standards of product) for providing consumers' utility. Our target is to discover whether these protections are necessary for providing consumers' utility or not, and whether are the consumers able to provide themselves equal or higher utility (then can mentioned protections do), scilicet through their mutual communication and buying behavior. Furthermore, we want to discover, if can happen a situation in which the mentioned protection decline the consumers' utility, in comparison with situation, when no protections exist. These conclusions are stated for concrete product (LCD TV) and concrete society (little community within the Czech Republic society), whereas we explore the influence of consumer protection both on utility of whole community and on utility of each social class within different proportions of these classes within society. For this research has been created an original multi-agent model, in which we simulate consumer behavior and companies behavior on market. The important parts of the model architecture are presented in this thesis: principles of social structure creation (based on the knowledge about social groups and different types of social ties), buyer behavior and principles of consumer communication through social network, and decision of companies about product characteristics. In conclusion we have interpreted the simulation results and have stated an importance of consumer protection in tested society buying tested product.
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Gürsoy, Dilek. "Die Bedeutung des Gerinnungs- und Komplementsystems bei der Ausbildung eines "systemic inflammatory response syndroms" (SIRS) nach Eingriffen mit Hilfe extrakorporaler Zirkulation (EKZ) /." Düsseldorf, 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000254035.
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Ortlieb, Lutz Volker [Verfasser]. "Bedeutung eines Fast-Track-Konzeptes für die systemische Inflammation (systemic inflammatory response syndrome = SIRS) nach offener Aneurysmaausschaltung [[Elektronische Ressource]] / Lutz Volker Ortlieb." Ulm : Universität Ulm. Medizinische Fakultät, 2013. http://d-nb.info/1036215199/34.
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Santos, Maria Carolina Seabra Coelho de Albuquerque. "Relação entre os sinais clínicos e os achados laboratoriais de hematologia e provas bioquímicas em cadelas com piómetra." Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2010. http://hdl.handle.net/10400.5/2211.
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Dissertação de Mestrado Integrado em Medicina VeterináriaA piómetra é uma das doenças ginecológicas mais frequentemente observadas em cadelas idosas. Como consequência de ciclos éstricos repetidos, o útero da cadela sofre alterações associadas a hiperplasia quística endometrial (HQE). Durante o estro, o útero comprometido é invadido por bactérias patogénicas oportunistas, essencialmente Eschericia coli, que, possuindo determinados factores de virulência, são capazes de proliferar no seu interior. Devido à acumulação de fluido secretado pelas glândulas uterinas, à presença de quistos endometriais e a uma imunidade local reduzida, estão criadas condições propícias para o estabelecimento da infecção com a subsequente acumulação de pús no interior do útero e a manifestação de diferentes graus de doença sistémica. Esta associação é comummente referida como complexo HQE-piómetra. A etiopatogenia da doença mantém-se pouco clara mas crê-se estar associada a uma disfunção uterina relacionada com um desequilíbrio na resposta do endométrio à progesterona. A idade, a raça, o número de partos e a administração de progestagénios são alguns dos factores que predispõem ao desenvolvimento da piómetra. Os sinais clínicos variam de acordo com a patência do cérvix e são mais evidentes nas piómetras fechadas, as quais se acompanham frequentemente de manifestações sistémicas, alterações em vários órgãos e na homeostasia, choque endotoxémico e morte. O diagnóstico pode ser realizado através da avaliação da história pregressa, da evidência dos factores predisponentes, dos sinais clínicos, dos exames laboratoriais e da ecografia. Enquanto a piómetra fechada requer frequentemente tratamento cirúrgico urgente, novas opções de tratamento médico para as piómetras abertas têm sido publicadas. Com este trabalho pretende-se rever a etiopatogenia da piómetra, os seus aspectos clínicos, diagnóstico e tratamento, o modo através do qual se desenvolve a reacção sistémica, bem como avaliar a relação entre os sinais clínicos ou a ocorrência de Síndrome de Resposta Inflamatória Sistémica (SRIS) e a gravidade da doença. Tendo por base uma amostra de 170 cadelas com piómetra, observou-se anemia em 51,2%, alterações no leucograma em 90,1%, alteração de ALT e/ou FA em 29,4%, azotémia em 17,6%, ocorrência de SRIS em 78,9% e uma taxa de mortalidade de 10,6%. A análise estatística sugere que a diminuição da ingestão de água, a ocorrência de piómetra fechada, de SRIS ou de febre, a contagem de bastonetes, o hematócrito, a creatinina e o intervalo entre o primeiro sinal clínico e a consulta poderão ser usados como indicadores de prognóstico nesta doença.
ABSTRACT - Pyometra is one of the most common gynaecological diseases in old bitches. As a consequence of repeated oestrus cycles, the bitch uterus goes through modifications associated to cystic endometrial hyperplasy (CEH). During oestrus, the compromised uterus is invaded by opportunist pathogenic agents, mainly Eschericia coli, that, possessing certain virulent factors, are capable of striving inside it. Due to the accumulation of fluid which is produced by the uterine glands, the existence of endometrial cysts and the local reduced immunity, proper conditions to the infection establishment are created and then pus accumulates in the uterine lumen and different grades of systemic disease are shown. This association is commonly referred as CEH-pyometra complex. The etiopathogenesis of the disease remains unclear but it is believed to be associated with an uterine dysfunction related to an unbalanced answer of the endometrium to progesterone. Age, breed, birth giving number and the administration of progestagens are some of the factors which are prone to the development of pyometra. The clinical signs vary according to the cervix patency and are more visible in closed pyometras. These usually go along with systemic signs, changes in several organs and in homeostasis, endotoxic shock or even death. The diagnosis can be done by evaluating the history, by the evidence of predisposed factors, clinical signs, lab exams or ultrasonography. While the closed pyometra usually require an urgent surgery, new options of medical treatment for open pyometra have been published. This work aims at reviewing the pyometra etiopathogenesis in bitches as well as its clinical aspects, diagnosis and treatment, the way the systemic reaction occurs and also determine the correlation between the clinical signs or the occurrence of Systemic Inflammatory Response Syndrome (SIRS) and the seriousness of the disease. Being based on a sample of 170 bitches suffering from pyometra, anaemia was observed in 52,2%, changes in the leucogram in 90,1%, changes in the liver lesion tests in 29,4%, azotemy in 17,6%, ocurrence of SIRS in 78,9% and a death rate of 10,6%. In this study, statistic analysis suggest that the decrease in water intake, the occurrence of a closed pyometra, SIRS or fever, the band cells count, the packed cell volume, the creatinine and the time difference between the first clinic sign and ovariohysterectomy can be used as prognostic indicators in this disease.
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Pevec, Till. "Dexamethason-21-isonicotinat als Begleittherapie bei Kühen mit Systemic Inflammatory Response Syndrome." Doctoral thesis, Universitätsbibliothek Leipzig, 2007. http://nbn-resolving.de/urn:nbn:de:bsz:15-20071210-143013-1.
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Dexamethason-21-isonicotinat als Begleittherapie bei Kühen mit Systemic Inflammatory Response Syndrome Schlüsselwörter: Dexamethason, SIRS, Phagozytoseaktivität/Burstaktivität von Monozyten und neutrophilen Granulozyten, Tumornekrose Faktor alpha
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Torrente, Artero Carlos. "Aspectos diagnósticos y pronósticos de la concentración de albúmina en el paciente canino con síndrome de respuesta inflamatoria sistémica." Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/284391.
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Acid-base disturbances have been reported in the veterinary literature concerning the field of the small animal intensive care. Such disorders have diagnostic, therapeutic, and prognostic implications in terms of morbidity and mortality in such population. Besides albumin is a weak acid that can affect pH and plays a key role in the metabolic component of the acid-base balance often is not taken into account during the acid-base assessment.
The main goal of the first study was to compare the traditional and the quantitative approaches for the assessment of acid-base imbalances in hypoalbuminemic dogs. This study was designed as a prospective observational clinical study and included the evaluation of 105 critically ill patients and 135 healthy patients as controls. Jugular venous-blood samples were collected from each patient on admission to determine: TP, Alb , BUN, Glu , hematocrit, , Na+ , Cl- , K +, Pi , pH , pCO2 , HCO3 - , AG, AGalb and /or AGalb-phos, SBE, SID, Atot , and SIG. Patients were divided into two groups according to the severity of hypoalbuminemia: mild hypoalbuminemia (Alb = 2.1 to 2.5 g /dL) and severe hypoalbuminemia (Alb ≤ 2.0 g/dL). According to the HH approach most frequent imbalances were simple disorders (51.4 %) mainly metabolic acidosis (84.7%), in most cases associated to a high AG acidosis. However, when using the quantitative method 58.1% were complex disorders, and SIG acidosis (74.3 %) and Atot alkalosis (33.3 %) were the most frequent acid -base imbalances.
The second study allowed us to conclude that the agreement between the traditional and quantitative methods of interpretation of acid-base balance was poor, and many imbalances were detected using the quantitative approach but would remain undetected using the traditional approach to acid-base status. Moreover, these alterations were different according to the severity of hypoalbuminemia and characteristics of the disease in each hypoalbuminemic patient, especially in SIRS/septic patients.
In humans, SIRS is relatively frequent condition and is associated with high mortality rates. However, data on the incidence of SIRS and the usefulness of biomarkers in veterinary medicine is scarce.
The main goal of the second study was to determine the diagnostic and prognostic value of plasma iron vs the inflammatory markers albumin, CRP and fibrinogen on admission and over the ICU stay of dogs with SIRS. This study was designed as prospective observational study and included 116 client-owned dogs: 54 dogs with SIRS/sepsis, 42 with local inflammation and 20 clinically healthy dogs as a control group. Blood samples were taken on admission in all study groups, and then on alternate days until discharge or death in both inflammation groups. On admission, dogs with SIRS had significantly lower plasma iron (65 ± 5.8 µg/dL, p=0.001) concentrations than dogs with local inflammation (89.5 ± 6.2 µg/dL, p=0.001). Plasma iron, albumin, and CRP were able to separate dogs in the SIRS/sepsis group from those presenting local inflammation with AUCs for the ROCs curves of 0.679, 0.834, and 0.704 respectively.
The admission values for these variables did not separate survivors and non survivors within the SIRS/sepsis group. However, the increase in iron and the decrease in CRP, from admission to discharge, was higher in survivors than in non-survivors within the SIRS/septic group (22.8 vs. 2.51 μg/dL respectively, p = 0.021 for iron; -67.1 vs. -4.1 mg/L respectively, p = 0.002 for CRP), resulting in discharge iron and CRP concentrations for survivors similar to those in the local inflammation group.
The second study allowed us to conclude that hypoferremia is a sensitive marker of systemic inflammation in dogs. In this study, the increase in iron concentrations during the hospitalization period of SIRS/septic dogs was associated to a better prognosis, suggesting that plasma iron in combination with other biomarkers of inflammation such as CRP and albumin might be used to monitor the inflammatory process.