共查询到20条相似文献,搜索用时 15 毫秒
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Nyström T 《Clinical science (London, England : 1979)》2007,113(2):79-81
It has been suggested that Type 2 diabetes may, in part, be precipitated or accelerated by an acute-phase reaction as part of the innate immune response, in which large amounts of cytokines are released from adipose tissue, creating a low-grade inflammatory milieu. There is also firm evidence that atherosclerosis is an immune-mediated inflammatory disease. Therefore it is reasonable to imply that low-grade inflammation is an important pathogenetic factor in atherosclerosis and cardiovascular events in patients with Type 2 diabetes. Over the last few years, there have been a lot of promising clinical markers proposed to link inflammation and atherosclerosis. Of these markers, hs-CRP (high-sensitivity C-reactive protein) might be a prognostic marker for further cardiovascular events, although this has been refuted recently. In this issue of Clinical Science, Castoldi and co-workers have demonstrated that, in patients with Type 2 diabetes categorized into low (<1.0 mg/l), medium (1.0-3.0 mg/l) and high (>3.0 mg/l) hs-CRP groups, serum levels of hs-CRP correlated with lipopolysaccharide-stimulated release of interleukin-1beta and interleukin-6 in whole blood. This finding may indicate that low-grade inflammatory activity might influence cytokine production in these patients. 相似文献
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Eddie Garcia Abdul H. Zaid Diane P. Calello Lisa McHugh Grant Arzumanov Najaf Asrar Ari Sapin Kristin G. Fless 《The Journal of emergency medicine》2018,54(4):e61-e64
Background
Botulism is a paralytic disease caused by the neurotoxin produced by Clostridium botulinum. The majority of cases are due to ingestion or injection drug use. Wound botulism from traumatic injury is exceedingly rare, with only one to two cases reported each year in the United States.Case Report
A 27-year-old man presented to the Emergency Department with diplopia, dysphagia, and progressive weakness 10 days after sustaining a gunshot wound to his right lower leg. He had been evaluated for the same complaints at a different facility the day prior and was discharged. His wound appeared well-healing, but a high suspicion for wound botulism led to rapid consultation with the state Poison Control Center and the Centers for Disease Control and Prevention. The patient developed worsening respiratory insufficiency and required mechanical ventilation. Expeditious treatment with equine heptavalent botulinum antitoxin resulted in significant recovery of strength in 4 days. Serum toxin bioassay tested positive for botulinum neurotoxin type A.Why Should an Emergency Physician be Aware of This?
Wound botulism now accounts for the majority of adult botulism in the United States. It should be considered in any patient with signs of neuromuscular disease and a recent injury, even if the wound appears uninfected. 相似文献15.
Phillips E 《The Canadian nurse》1999,95(8):43-44
It's Nursing Week and you are at a booth in a busy shopping mall. After spending a couple of hours talking with people, answering questions and taking blood pressure readings, you start to sip a well-earned cup of coffee. You glance down the mall and observe a middle-aged man suddenly clutch at his chest and fall to the floor. You alert your colleagues to call 911 as you run down the mall to do what you can. You reach the man, announce, "I know CPR," and initiate resuscitation. You have just spent an invigorating day on the ski slopes. As you drive home, you are horrified to see a car spin out of control and roll over into the ditch a couple of car lengths ahead of you. Suddenly you face a dilemma. You are an experienced nurse who wants to help and yet, lurking in the back of your mind, there is the nagging fear that you could be sued. You wonder if are you legally obligated to stop and assist. Could you be liable if you fail to do so? 相似文献
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Vanek M 《Emergency medical services》2002,31(10):110, 113-110, 116
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Walters G 《Palliative medicine》2004,18(5):404-408
The idea of a 'good death' is one which has been central to the palliative care movement but which in fact predates it. A number of recent articles have grappled with the concept. It is a subject which is difficult to quantify scientifically and this article explores the territory using a number of philosophical, theological, historical and literary sources. The changing meaning of the concept is traced through the premodern, modern and postmodern periods. In particular the influence on Western ideals about death of the two paradigmatic stories of the deaths of Socrates and Jesus are examined. It is argued that the dualistic thinking of Plato, which often underlies our thinking about death, is no longer adequate and the author offers the thinking of the Spanish philosopher Miguel de Unamuno as an alternative way of approaching our attitudes to death. Although the article does not seek to give a definitive answer to the question it raises, it suggests that thinking about good death should be broadened to accept the struggle with which many people face their death. 相似文献
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Marini JJ 《Critical care medicine》2008,36(10):2922-2925
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