Serum TNF levels in neonatal sepsis and septic shock.

Tumor necrosis factor (TNF-alpha) has been implicated as a principal mediator in the pathogenesis of septic shock. TNF-alpha was measured by immunoradiometric assay in serum samples from 23 full-term infants with sepsis (15 with severe infection and 8 with septic shock) and in 20 healthy full-term newborns. Serum TNF-alpha levels were significantly higher in the group with sepsis, at the time of admission to the neonatal intensive care unit, than in the healthy neonates. The highest TNF levels were found in those newborns with septic shock, particularly in those who died. Although the method is far too slow for any clinical routine work, our results suggest that the presence of elevated serum TNF-alpha levels could be considered a sensitive and specific test for predicting septic shock and its clinical outcome.

[Lymphoproliferative syndromes associated with rheumatoid arthritis]. / Síndromes linfoproliferativos asociados a artritis reumatoide.

Rheumatoid arthritis predispose to several lymphoproliferative syndromes, some of them are of doubtful neoplastic type, as the lymphoproliferative disease of granular lymphocytes, whereas others are clearly malignant, as non-Hodgkin's lymphomas and multiple myeloma. In this paper, we review the potential etiological agents, mainly the reduction of the "natural killer" activity and immunity disorders against virical oncogenes. The onset of monoclonal gammopathy in rheumatoid patients is also stressed, due to its potential prognosis value in the development of lymphoid neoplasias.