Background Bone marrow (BM) dysfunction is common in severely injured trauma patients with release of hematopoietic progenitor cells (HPC) into the peripheral blood. Granulocyte colony stimulating factor (G-CSF) is a potent stimulator of HPC mobilization. We hypothesized that plasma G-CSF levels are elevated following trauma and correlate with post-injury anemia and infection Study Design Blood from 83 severely injured patients was collected at several time points for determination of G-CSF levels and HPC mobilization and compared to healthy volunteers. Data were categorized by age, gender, Injury Severity Score (ISS), and whether patient was in shock. Hemoglobin and transfusion requirements as well as hospital acquired infection data was recorded. Data are expressed as mean ± SEM. Results After trauma, there is a 50-fold increase in plasma levels of G-CSF in trauma patients compared to controls (1640.4±304.3 vs. 33.0±6.8, p<0.001). Patients who presented in shock had 5 time higher G-CSF levels than non-shock trauma patients and 75-fold increase compared to control (2528.7±536.4 vs. 728.0±191.0 vs. 33.0±6.8, p<0.001). Age, gender and ISS had no effect on G-CSF levels. HPC mobilization was sustained for up to 10 days following injury and involved multiple cells types. Higher G-CSF levels were is also associated with lower hemoglobin levels and greater transfusion requirements 3 weeks after injury and a higher incidence of hospital acquired pneumonia and bacteremia. Conclusions Plasma G-CSF is markedly elevated after injury and is greater in patients who present in shock. The rise in C-CSF was also associated with prolonged mobilization of HPC. Elevation of G-CSF in humans following severe trauma may play a significant role in the development of post traumatic BM dysfunction, anemia and infection.

ARTYKUŁY ORYGINALNE <140/90 mmHg in all HT patients and to <130/80 mmHg in HT patients with diabetes, as well as in patients at high cardiovascular risk [9]. There are numerous differences between the American guidelines (JNC-7) published in 2003 and current European guidelines. Most of the differences derive from a still better knowledge of the pathophysiology and progress in hypertension treatment over the last four years [10]. Likewise the etiology of "white coat hypertension" (WCH) is not finally explained [11-13]. It is considered that anxiety reactions, as an effect of the presence of medical personnel when measuring blood pressure (BP), play a significant role in the development of that phenomenon [14-16]. Incidence of WCH depends among others on the assumed standards of blood pressure values, a number of ambulatory visits, demographical factors and the patients' age [17-19]. According to analysis performed by Hansen et al. [20] WCH concerns over 10% of the general population. "White coat hypertension" is diagnosed at increased values of blood pressure within medical facilities, while measurements carried out outside such facilities remain within normal limits [17]. According to ESH and ESC guidelines of 2007, the values of blood pressure for clinical measurements should be "White coat hypertension" in type 2 diabetic patients "Nadciśnienie białego fartucha" u chorych na cukrzycę typu 2

Laparotomic attenuation of an intrahepatic portosystemic shunt (IHPSS) is more difficult than an extrahepatic one, and results in a higher risk of complications because the identification of the aberrant vessel in the liver remains often a challenge. Excessive preparation and traction of the parenchyma results in trauma, bleeding, and prolonged surgery, which is what worsens the prognosis. Therefore, based on computed tomographic angiography, we printed 3-dimensional (3D) individual patient liver models, scaled 1:1, and used them for surgery planning and as a guide during intraoperative identification of the shunt in four dogs with IHPSS. The advantages of the 3D technology are simple and precise planning of the surgery, fast intraoperative identification of the shunt, and low invasive dissection of the liver parenchyma. We conclude that 3D technology can potentially raise the recovery rate. To the best of our knowledge, this was the first application of 3D models in the surgery of canine IHPSS.

No abstract