Preliminary results and rationale for the use of intrathecal papaverine for the prevention of paraplegia after aortic surgery.
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Biomedical subjects
Publications and source records attributed to A Salgado.
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Radioimmunoassay (TPA Prolifigen RIA) was used to determine the serum concentration of TPA in 333 patients with different kinds of non-tumoral diseases. Amounts higher than 90 U/l, that was taken as the upper normal limit, were observed in 40 per 100 of the cases, being higher than 200 U/l in 10 per 100. The frequency of abnormal amounts of TPA in non-tumoral diseases obliges to eliminate them before making a diagnosis of cancer.
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Sepsis is the most important cause of mortality in the Intensive Care Units. At present, sepsis is understood to be the inflammatory response of the host to infection, rather than a direct effect of microbial aggression. From the clinical standpoint, this inflammatory response is known as systemic inflammatory response syndrome (SIRS). Pathophysiologically, SIRS is characterized by the activation of several groups of cell (monocytes/macrophages, PMNs, and endothelial cells) and by the release of inflammatory mediators (cytokines and others). Tumor necrosis factor (TNF) is the first cytokine released by endotoxin action over monocyte/macrophage. TNF secretion, modulated by interferon gamma (IFN gamma) and interleukin 10 (IL-10), is followed by release of other cytokines such as interleukins (IL) (IL-1, IL-6 and IL-8). These mediators are able to act over hemostasis activating the extrinsic pathway through tissue factor expression. The action of the mediators over endothelial cells induces an increase in plasminogen activator inhibitor type 1 (PAI-1) levels with inhibition of fibrinolysis. Both coagulation activation and fibrinolysis blockade result in fibrin deposit in the microvascular system. The complexity of the mechanisms implicated in systemic inflammatory response make a general rule so difficult to establish, because patient response is highly individualized and it is not possible to know which moment of this dynamic process is being analyzed.
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