Pathophysiologische Aspekte des septischen Schocks w�hrend der Schwangerschaft

Abstract

Summary. Sepsis in obstetrics as a clinical entity has changed during the last 40 years.The previously feared pyemia due to gram positive microbial agents has shifted to a predominantly gram negative infections which exert an entirely different pathophysiology and, therefore symptomatology as well. Septic shock in the majority of cases is caused by lipopolysaccharides liberated from the cell walls of gram negative organisms. Bacteremia is of considerably less significance.Present evidence suggests that the basic mechanism of the severe course of the endotoxic shock is adrenergic hyperstimulation of the mierocirculation. The pooling of blood is followed by stasis, loss of plasma in the extracellular compartment, metabolic acidosis and a shift to the anaerobic metabolism. Disseminated intravascular coagulation with fibrin deposition in the microch'culation is the leading cause for ischemia and final organ necrosis of organ systems. Although many mechanisms have to be clarified, especially in regard to cardiovascular response, considerably more data are available than for exotoxins from gram positive bacteria. Gram positive infection is, however, infrequently cause related to shock. The mortality of endotoxin shock in the obstetrical field could be drastically reduced due to better understanding of the mechanism and improved treatment regimen. Zusammen]assung. Septisehe Zustandsbilder in der Geburtshilfe

Inducible CRISPR-targeted “knockdown” of human gut Bacteroides in gnotobiotic mice discloses glycan utilization strategies

“…LC-MS datasets of monosaccharides and glycoside linkages plus MALDI-TOF MS data are available in GlycoPOST (ID: GPST000298 and GPST000284 ) ( 62 , 63 ). Code used for this manuscript is accessible at gitlab.com/zbeller31/knockdown_manuscript_v2 (general analysis, ( 64 )), gitlab.com/zbeller31/metatranscriptomics_pipeline (RNA-Seq processing/mapping, ( 65 )), and gitlab.com/Gordon_Lab/COPRO-Seq (COPRO-Seq, ( 66 )).…”