Systemic versus localized coagulation activation contributing to organ failure in critically ill patients

In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation not only leads to activation of coagulation but coagulation also considerably affects inflammatory activity. The intricate relationship between inflammation and coagulation may not only be relevant for vascular atherothrombotic disease in general but has in certain clinical settings considerable consequences, for example in the pathogenesis of microvascular failure and subsequent multiple organ failure, as a result of severe infection and the associated systemic inflammatory response. Molecular pathways that contribute to inflammation-induced activation of coagulation have been precisely identified. Pro-inflammatory cytokines and other mediators are capable of activating the coagulation system and downregulating important physiological anticoagulant pathways. Activation of the coagulation system and ensuing thrombin generation is dependent on an interleukin-6-induced expression of tissue factor on activated mononuclear cells and endothelial cells and is insufficiently counteracted by physiological anticoagulant mechanisms and endogenous fibrinolysis. Interestingly, apart from the overall systemic responses, a differential local response in various vascular beds related to specific organs may occur

The Impact of Global Pressures on the Affective Well-Being of Australian Managers' Performance

Implicit in the drive for international competitiveness is the recognition that high-performing managers are essential for organisations to achieve and sustain competitive advantage. A critique is made of the global economic pressures impacting on Australian managers' jobs. Elements of affective well-being and intrinsic job satisfaction that predict managers' performance are identified. Recommendations are made about how managers' jobs might be changed to enhance, or to avoid a decline in, affective well-being, intrinsic job satisfaction and performance, in order to improve overall organisational effectiveness. The emphasis is on investigating an aspect of human behaviour with the potential to enhance managerial performance. Organisations have the potential to gain a competitive advantage through HRM initiatives, when these are derived from and integrated with organisational strategies

Squeezing the Pips: International Pressures on Managers' Affective Well-being and Performance

Implicit in the drive for international competitiveness is the recognition that high erforming managers are essential for organisations to achieve and sustain competitive advantage. A critique is undertaken of the global economic pressures impacting on Western managers' jobs. The emphasis was on investigating an aspect of human behaviour with the potential to enhance managerial performance. Despite mixed empirical evidence from decades of research, there is support in the literature for the notion the 'happy-productive worker thesis.' A study is presented to establish which indicators of Australian managers' affective well-being and intrinsic job satisfaction predict dimensions of their contextual and task performance. A contribution of this study was to provide qualified support for the 'happy-productive worker thesis' by linking these conceptual bases and theories to managers' affective well-being, intrinsic job satisfaction and performance

Inhibition of hydroxyapatite formation in the presence of titanocene–aminoacid complexes: an experimental and computational study

Organometallic compounds have been used in various fields of chemistry, medicine and materials science. Central metal, stereochemical configuration and functional groups of the substitutes give to the organometallic compounds very special and selective properties. These properties have been used successfully in selective-antitumor-targeting, as well as anti-arthritic drugs. In the present investigation we study the influence of two organometallic compounds on the inhibition of crystallization of hydroxyapatite. These compounds are complexes of Ti(IV) with the general formula [Cp2Ti(aa)2]2+2Cl−, where Cp = η5-C5H5 cyclopentadienyl and aa the amino acid glycine or alanine. The experiments were conducted according to the constant composition technique in supersaturated solutions containing calcium and phosphate ions. The kinetic results indicate a surface diffusion controlled mechanism of the hydroxyapatite (HAP) crystals. The experiments prove that the presence of [Cp2Ti(Ala)2]2+2Cl− and [Cp2Ti(Gly)2]2+2Cl− complexes affects drastically the profile formation rate of the HAP crystals under biological conditions. The complex with the amino acid alanine provides a stronger inhibition of the formation rate comparing to the complex with glycine. The experimental observations are supported by computer calculations. © 2014, Springer Science+Business Media New York

Pseudohyperkalemia in serum: the phenomenon and its clinical magnitude

We investigated in detail the difference between serum and plasma potassium levels in patients with several conditions associated with pseudohyperkalemia. In total, 435 patients with either thrombocytoses, erythrocytoses, leucocytoses, or a mixed-type disorder and 30 healthy controls were included. In each case, the index Dk (serum potassium minus plasma potassium) and the index Dk100 (Dk x 100,000/platelets), which indicates the Dk value that corresponds to platelets of 100,000/mm(3) were estimated. Median Dk was significantly higher in the groups with platelet, erythrocyte, or mixed-type disorders than in the controls (P = 0.001). Among these groups, Dk values were significantly higher in patients with thrombocytosis or mixed-type disorders compared with those with erythrocytosis (P < 0.001, for both). Furthermore, no significant difference was observed in Dk values between controls and patients with white blood cell disorders (P = 0.74). Dk values did not exceed 2.61 mmol/L, whereas Dk100 values were inversely related to platelet counts (r = - 0.351, P < 0.01). In conclusion, pseudohyperkalemia is mainly present in patients with thrombocytosis or mixed-type disorders, probably as a result of the degranulation of platelets, which offers a potassium load to the surrounding plasma at the time of clot formation in vitro. However, the degree of pseudohyperkalemia does not increase proportionally with the increase of platelet counts, which may be associated with transfer of part of potassium load from the plasma back into red and white blood cells