RESUMO
The systemic inflammatory response syndrome (SIRS) is a major cause of morbidity and mortality, and is thought to be due to an over-amplification of an inflammatory response. The Toll-like receptor 4 ( TLR4 ) Asp-299-->Gly polymorphism has been shown to reduce lipopolysaccharide responsiveness. We examined whether this TLR4 polymorphism is associated with severity of SIRS. A trend was found between the minor allele and mortality in SIRS (odds ratio of 4.3; P =0.076), suggesting a role for TLR4 signalling in the severity of SIRS.
Assuntos
Glicoproteínas de Membrana/genética , Polimorfismo Genético , Receptores de Superfície Celular/genética , Síndrome de Resposta Inflamatória Sistêmica/genética , APACHE , Adulto , Genótipo , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Receptor 4 Toll-Like , Receptores Toll-LikeRESUMO
Paediatric intensive care (PIC) in the UK is currently fragmented and poorly organised, and changes to Trust status and the competitive marketplace may increase this tendency. This article contains an exploration of the rationale for providing PIC in dedicated units, and draws on recent reports by the British Paediatric Association (1993) and the National Health Service Centre for Reviews and Dissemination (1994) to propose a national strategy for the development of supra-regional PICUs.
