Systemic Lupus Erythematosus.--II

Abstract

726 SEPT. 28, 1957 ADVANCES IN HAEMORRHAGE AND SHOCK BHJR MMICAKL JOURNA L dangers from transfusion at the wrong time and the wrong speed, and we are concerned with learning how the judgment necessary to reduce these risks can be acquired and taught.The second question is that of supplies. In some parts of the world there are difficulties, but in Britain there are big reserves of voluntary donors yet untapped. The difficulties are organizational. If blood is needed it can be obtained. As for cost: what is it worth to save a life or a hundred lives ? Certainly with full modern resuscitation we can do more than save lives-particularly when our injured patients get to hospital quickly. Modern transfusion allows the latest developments in plastic and orthopaedic surgery to be applied at an earlier stage. The lessons we have learnt at the Birmingham Accident Hospital must be shared more widely and especially with our first-line allies-the first-aid workers -so well typified by the thousands who have been trained by the surgeons of the St. John Ambulance Brigade. SummaryTraditional teaching on the first-aid treatment of "shock " is criticized. The older practices are traced to their theoretical origin in observations based on the experience of the first world war.First-aid teaching needs to be revised on the basis of a recognition of the role of blood transfusion. This in turn must be based on an understanding of the extent of blood loss. Further evidence has been produced to show that blood loss is as important in civilian injuries as in battle casualties. Modern transfusion has been made possible by the development of blood banks. Modern techniques for the investigation of blood volume have helped the development of clinical aids to the assessment of blood loss and transfusion indications.An appreciation of the role of transfusion in the prevention and treatment of shock requires reconsideration of the need for early diagnosis and treatment, with early transfer to hospital as a basis of first aid for moderate and major injuries. Fluids by mouth are rarely indicated in first aid. The disadvantages of heat treatment are discussed.The significance of " primary shock " is discussed, and it is suggested that many forms of early circulatory change following injury are not necessarily harmful unless associated with loss of blood or other fluid from the circulation.Suggestions are made for revision of the section on "Shock " in the St. John manual First Aid to the Injured.Brief reference is made to the dangers of transfusion and the possibilities of obtaining adequate supplies of stored blood.

Perspective Chapter: Pulmonary System and Sjogren’s Syndrome

“…This concept of a systemic illness manifesting in various organs was already familiar facilitating him to launch it as a unique disease. Decades prior, Dr. William Osler described systemic lupus on several patients (in 1895 and 1903) who presented with multiorgan involvement, other than the skin [57]. During the postwar era, in the 1950s, several Perspective Chapter: Pulmonary System and Sjogren's Syndrome DOI: http://dx.doi.org/10.5772/intechopen.102803 scientists uncovered thyroid antibodies, and following Dr. Hashimoto's hypothesis from 1912, in which he sustained the thyroid gland to be the target of specific autoantibodies.…”