Changes of platelet surface antigens in patients suffering from abdominal septic shock.

Sepsis and related syndromes account for a high morbidity and mortality caused by the development of multiorgan failure. Pathogenesis of sepsis is complex, involving humoral as well as cellular factors. Since the role of platelets is still undefined in this concern, we investigated CD63, CD62P, CD36, and CD31 expression on platelets of patients in septic shock (n = 18) using a flow cytometric assay in whole blood. Samples were drawn within 24 hours of onset. We found thrombocytopenia accompanied by a significantly higher expression of CD63, CD62P, and CD31 and a significant downregulation of CD36 in comparison to healthy volunteers (n = 18). Changes in CD63 and CD62P expression indicates platelet activation. Because CD62P, CD36, and CD31 mediate interaction of platelets with leukocytes, subendothelial matrix and probably endothelial cells as well as platelet adhesion/aggregation, our findings suggest an involvement of platelets in leukocyte/endothelial cell interaction in septic shock. We suspect that thrombocytopenia is not due to bone marrow depression, but rather is due to consumption of highly activated platelets in the microcirculation. We feel that our observations may offer a rationale for potentially beneficial effects of antiplatelet therapy in sepsis; however, further studies have to evaluate its beneficial impact as well as its potential risk for bleeding complications.

[Upper Austria model study to assess the prevalence and incidence of congenital abnormalities]. / Modellstudie Oberösterreich Zur Ermittlung der Häufigkeit und Inzidenz angeborener Fehlbildungen.

Among the 15.998 live births recorded in Upper Austria in the year 1985, a representative malformation rate of 1.79, respectively a representative incidence of 17.94 in 1000 live births is reported. The incidences of characteristic malformations and of single malformations combined in malformation groups are determined. An instrument of investigation, especially developed for and successfully used in this examination in form of an illustrated questionnaire is introduced.