[Biochemical distrubances in patients with systemic inflammatory response syndrome (sirs) and sepsis. Part II. Laboratory markers used in diagnostics and sepsis monitoring]. / Zaburzenia biochemiczne w przebiegu zespoøu uogólnionej odpowiedzi zapalnej (sirs) i sepsy Cz. II. Laboratoryjne markery wykorzystywane w diagnostyce i monitorowaniu sepsy.

At present, the only reasonable action which reduces the case fatality rate at patients with severe sepsis and septic shock is the early diagnosis of infection which allows to introduce effective therapy. Although sepsis is a typical clinical syndrome recognized in connection with infection, it should be remembered that infection does not reveal itself in each case. Also bacteriological blood culture does not confirm it in most cases. In view of few characteristic, especially in the initial phase of sepsis, clinical symptoms, laboratory investigations describing the present state of immune response of organism find a huge application. In our work we made an attempt to bring closer the latest markers of inflammatory reaction and infection such as acute phase proteins procalcytonin (PCT), proANP and lipopolisacharyde binding protein (LBP).

[Biochemical disturbances in patients with Systemic Inflammatory Response Syndrome (SIRS) and sepsis. Part I. Biochemical disturbances in patients with sepsis]. / Zaburzenia biochemiczne u chorych z zespolem uogólnionej odpowiedzi zapalnej (SIRS) i sepsa. Cz. I. Zaburzenia biochemiczne u chorych z sepsa.

Analysis of biochemical transformations occurring in the course of SIRS and sepsis inclines a critical attitude towards, obligatory nowadays, criteria of these states. They are non-specific and, in an unsatisfying way, they define the state of a current immunological response of the organism from the laboratory as well as clinical point of view. The purpose of the project of a new approach to sepsis--PIRO is to create a more objective, measurable system of evaluation of clinical state of a patient suspected of sepsis.

[Does the estimation of acute phase protein concentrations in cerebrospinal fluid and/or in serum in patients with viral meningitis carry diagnostic importance? Part I. Lymphocytic meningitis caused by epidemic parotitis]. / Czy oznaczanie stezen bialek ostrej fazy w plynie mózgowo-rdzeniowym lub/i w surowicy w wirusowym zapaleniu opon mózgowo-rdzeniowych u dzieci ma znaczenie diagnostyczne? Czesc I. Limfocytarne zapalenie opon mózgowo-rdzeniowych wywolane wirusem nagminnego zapalenia przyusznic.

OBJECTIVE: We examined whether an acute phase reaction could occur in children with lymphocytic meningitis of homogeneous etiology (parotitis epidemic from the Paramyxoviridae family), a sign of which would be an increase in concentrations of acute phase proteins (APP's) in cerebrospinal fluid (CSF) and/or in blood serum. We also tested the usefulness of the determination of selected APP's concentrations in CSF and serum in diagnosis and monitoring of the course of the disease, provided that an increase in concentrations of selected APP's were discernible. METHODS: Cases were 78 children with lymphocytic meningitis as a complication of parotitis epidemic. Controls were 30 healthy children (control group K1) and 19 children hospitalized with suspected meningitis (control group K2). The following APP's presence in CSF and serum were tested: C-reactive protein (CRP), alpha-2-haptoglobin (HPT), alpha-1-antitripsin (AAT) and alpha-1-acid glycoprotein (AAG), alpha-2-ceruloplasmin (CER) and alpha-2-macroglobulin (AMG). The results were compared and analyzed. RESULTS: The results of the research show a significant increase in all APP's determined, except for CRP and AAG, in children with parotidal meningitis. CONCLUSIONS: Determination of CRP concentration either in CSF or in serum is not useful in diagnosis of parotidal meningitis and in differentiation of lymphocytic and bacterial forms of the disease.