SOMETHING ABOUT DEFINITION AND EPIDEMIOLOGY OF SEPSIS

Učestalost sepse raste ali je zahvaljući naporima kampanja i razvoju smjernica za liječenje sepse došlo do smanjenja smrtnosti. Ipak, ukupni se broj umrlih zbog sepse čak i povećava, jer veći broj ljudi obolijeva. Sepsu treba smatrati hitnim stanjem, gotovo usporedivo s akutnim srčanim infarktom. S obzirom na veliku učestalost i visoku smrtnost jako je važno defi niciju sepse pokušati poboljšati. Definicija je važna i radi potrebe različitih istraživanja kao i aplikacije rezultata istraživanja u praksi. U siječnju 2014. tijekom 43. kongresa društva intenzivne medicine u San Francisku započelo se radom na novoj defi niciji. Vjerojatno bi nova defi nicija sepse bila ono što se danas podrazumijeva pod teškom sepsom. Planira se da će ta nova definicija vjerojatno biti dovršena tijekom 2015. godine.The prevalence of sepsis continues to increase, although, thanks to the efforts of the campaigns and the development of guidelines for sepsis treatment, the fatality rates have diminished, however, the sepsis total mortality is growing due to increased morbidity. Sepsis should be considered as an emergency almost similar to acute myocardial infarction. With regard to the high prevalence and high mortality rate, it is important to improve the defi nition of sepsis. This defi nition is also important in different researches, as well as in the application of the results in daily practice. In January 2014, at the 43rd Annual Congress of Society of Critical Care Medicine in San Francisco, the work on establishing a new defi nition of sepsis was started. New defi nition of sepsis probably would represent what is known today as severe sepsis. The new defi nition could probably be accomplished during 2015

Atypical clinical presentation of an acute abdomen

Prikazali smo slučaj šezdesetogodišnjeg bolesnika s atipičnom kliničkom slikom akutnog abdomena. Bio je bezbolnog trbuha, uz očuvano, spontano pražnjenje crijeva. Atipičnoj prezentaciji akutnog abdomena kod našeg bolesnika mogli su pridonijeti prethodno preboljeli moždani udar i šećerna bolest.We have presented a case of a sixty-year-old patient with atypical clinical manifestations of acute abdomen: the abdomen was painless with preserved spontaneous bowel movement. Stroke and diabetes could contribute to such an atypical presentation

Endocarditis of native mitral valve which was presented like refractory septic shock

We showed the case of a sixty-fve-yearold woman who developed refractory septic shock as a result of endocarditis of the native mitral valve with maintained neat systolic function of the lef ventricle and moderate mitral regurgitation. Streptococcus sanguinis was isolated from hemoculture. Te patient did not have clearly known predisposing factors for the development of endocarditis, nor had elevated temperature. She died 32 hours afer being admitted to the hospital

Relationship between Polymorphonuclear Leukocyte Count in Bronchoalveolar Lavage Fluid and Bacterial Content in Gram’s Stain and Bacterial Content in Final Microbiological Report

Eighty samples of bronchoalveolar lavage fluid (BALF) were obtained from the total of 48 patients (22 females and 26 males) and analyzed. Eighteen of those patients were organ transplant recipients.The relationship between polymorphonuclear leukocyte (PMN) count in direct sample and semi quantitative Gram-positive and Gram-negative bacterial content were analyzed in BALF samples. PMN count in direct sample and Gram-positive and Gram-negative bacterial content of the final microbiological report was compared as well. On the total number of samples PMN count in direct samples of BALF was statistically significant regarding the presence of Gram-positive bacteria in the same sample; it was nearly significant regarding the presence of Gram-negative bacteria; and it was statistically significant for the total bacterial content. If BALF samples are divided into those obtained from organ-transplant and those obtained from non- -organ-transplant patients, positive, statistically significant relationship is found in the organ-transplant group, more specifically for the relationship between PMNs and total bacterial content. When PMN count in direct microbiological sample was compared with the results of the final microbiological report, statistically significant relationship was found neither with respect to all BALF samples, nor after dividing them into »organ-transplant« and »non-organ-transplant« group. We did not find differences caused by gender