June, 20th – 27th, 2016
June, 20th – 27th, 2016
Inflammation is a protective response to infection or injury. The inflammatory response is controlled primarily by cytokines, which are endogenous mediators of the immune system. Cytokines are produced by various different cell types in response to multiple types of stimuli and have overlapping biologic activity. Cytokines also are directly involved in the activation of cells at the inflammatory site. Movement of leukocytes to the inflammatory site is directed along a chemotactic gradient, where the strongest concentration of chemoattractants is at the site of inflammation. Cytokines are involved at each step of this process and act both locally and systemically to initiate, maintain, and finally resolve the inflammatory response. The interplay among these proinflammatory cytokines, antiinflammatory cytokines, and naturally occurring cytokine inhibitors determines the inflammatory response and its effectiveness. Because of the immaturity of the immune system of newborn cytokine is specific. Tumor necrosis factor- (TNF-) and interleukin-6 (IL-6) amplify the immune response through activation of the cytokine cascade and the production of other proinflammatory cytokines and chemokines. In a group of proinflammatory cytokines TNF- and IL-6 have undoubtedly significant role in the cytokine cascades of physiological and pathophysiological responses.
Key words: interleukin-6, tumor necrosis factor-alpha, newborn
This is a retrospective study using a hospital electronic database incorporating a total of 82,666 patients, from March 1st, 2015 to February 28th, 2017, who underwent triage in an urban, academic clinical hospital emergency department (ED) and were treated in the Internal Medicine Emergency Department (IMED) and the Surgery Emergency Department (SED). The primary outcomes were the distribution of patients in triage categories, performance indicators and length of stay (LOS) in the ED. The percentage of patients assessed and treated within the recommended timelines for Australasian Triage Score (ATS) Categories 1, 4 and 5 were within the recommended limits. In ATS Category 2, the IMED achieved a 59.99% efficiency rate and the SED a slightly higher rate of 62.6% whilst an ideal target would be 80%. Similarly, in ATS Category 3 patients, the IMED only achieved an adherence of 66.95% and the SED 65.67% as opposed to the 75% performance threshold. Overall, on a monthly basis, in the IMED, 1806.96 patients were assessed and treated; their average length of stay (LOS) was 4 hours and 57 minutes. In comparison, in the SED, 1719.5 patients were assessed monthly, with an average LOS of 2 hours and 40 minutes. Considering our results, we conclude that extra staff and resources should be deployed in order to achieve better performance indicators in the second and third ATS Categories and to decrease the LOS in the ED in order to ameliorate the quality of care and patient access.
Key words: efficiency, organizational, emergency service, hospital/organization & administration, length of stay/statistics & numerical data, patient admission/statistics & numerical data, time factors, triage/statistics & numerical data, croatia
Hemorrhagic disease of the newborn, with incidence 1% to 2% of newborn babies is often a serious problem and urgent condition in pediatric intensive care unit. Article describes a case of coagulation disorder in premature infant and the management of that case.
Key words: newborn, hemorrhagic disease, coagulation disorder
Respiratory distress (RD) is the commonest reason for admission in Neonatology intensive care units (NICU) and it is caused by respiratory and non-respiratory illnesses. The goal of the study is to find out most important causes of RD in preterm babies with 32 or more weeks of gestation, and to compare the etiology factors for RD in those preterm and in full term babies. Retrospective study in the NICU, Clinical Hospital Osijek, during the year 2016 was done. Almost 20% of admitted in NICU have RD, 34% of preterm babies of or older than 32 weeks, and 12% of terms babies. Among newborns with RD 61% were boys, and 39% girls. Among all live born 4% of boys and 2, 6% of girls had RD. Mother’s illnesses as a cause of RD were found in 23, 2% and illnesses of the child in the other 60, 1%. Complications during delivery caused RD in the last 4% of newborns (some neonates have had more than one reason for RD). In 18, 9% of newborns the etiological factor was not found, and RD is probably genetically caused. The proportion of unknown causes is higher in preterm babies (22%). RD in term babies is mainly caused by illnesses of the child himself, and in preterm by mother’s illnesses.
Key words: neonatal respiratory distress, sepsis, complications in pregnancy, gestational diabetes