Multi-system

For nearly a century, epinephrine (adrenaline) has been the cornerstone of the acute management of anaphylaxis [1-6], a sudden-onset multi-systemic allergic reaction that can cause death. The World Health Organization lists epinephrine as an essential medication for anaphylaxis [7], Where national guidelines are available for the acute management of anaphylaxis, they universally recommend injection of epinephrine as the initial medication of choice [8]. 

Clinical improvement, especially the disappearance of fever or defervescence, is the best parameter to judge the response to therapy. However, clinical improvement can be difficult to monitor objectively in critically ill patients with multi-system disease. Also, clinical improvement can be very slow for certain infections, e.g. tuberculosis. The peripheral blood leukocyte count including the presence of early stages in leucocyte differention and the level of serum C-Reactive Protein (CRP, an acute phase protein) are parameters that can be sequentially determined to monitor improvement. For monitoring the effect of treatment of chronic infections such as endocarditis or osteomyelitis, weekly determination of the erythrocyte sedimentation rate has been proven useful. 

Some examples of ternary alloy precursors are also shown. Their general properties were examined and their microstructures were directly observed by transmission electron microscopy. Thus, catalysts synthesized from multi-system alloys had high solubility of additional elements into a major element, and might be expected to work as new catalysts. 

Eatough, D.J., A. Wadsworth, D.A. Eatough, J.W. Crawford, L.D. Hansen, and E.A. Lewis, 1993. A multi-system, multi-channel diffusion denuder sampler for the determination of fine particulate organic matter in the atmosphere. Atmos. Environ. 27 1213-1219. 

It seems clear that these exposures can be directly linked to the chronic illnesses Gulf War veterans are experiencing, the symptoms impacting on many different systems in the body causing multi-symptom, multi-organ and multi-system adverse effects. Table 6.2 examines the known agents in Iraq s arsenal and their potential effects on exposures to the body. 

MCS is a multi-system disease, meaning that several organ systems are affected. (See entry 24 for a definition of MCS.) This is the reason for the variation in symptoms. 

Multi System Involvement v nth Emphasis on Neurologic Symptoms... 

Multi System Involvement w ith Emphasis on Neurologic Syndromes... 

Multi System Involvement with Emphasis on Neurologic Involvement... 

Rosset L, Descombes E, Fellay G, Regamey C. Toxicite multisystemique de la colchicine et insuffisance renale a propos d un cas. [Multi-systemic toxicity of colchicine and renal failure apropos of a case.) Schweiz Med Wochenschr 1998 128(49) 1953-7. 

Systemic sclerosis is a multi-system connective tissue disorder characterized by intimal proliferation and fibrosis in small arteries and arterioles, and degenerative changes with fibrosis in the skin and certain internal organs. The... 

Myotonic dystrophy shows not only myotonia, but also dystrophic changes of muscle and other multi-system involvement. In this disease membrane abnormalities were also detected in muscle1 8 1,9 and erythrocytes. 

NLSD is characterized by muscular weakness, ichthyosis, neuropathy and multi-systemic TAG storage [100, 101]. Unlike WD, this disease is accompanied by mas-... 

Study of tissue samples from lungs of Iranian casualties who died as a result of exposure to mustard gas has revealed a pattern identical with that described above. In all, tissue from four patients was studied. Alveolar capillary congestion, haemorrhage, oedema, the formation of hyaline membranes and fibrosis were seen. The casualties died as a result of multi-system organ failure and the changes in the lung parenchyma were very similar to those seen in cases of Adult Respiratory Distress Syndrome (ARDS) (Maynard, unpublished observations). 

F. Other Guidelines. A useful rule of thumb is, if lymphocytes have decreased by 50% and are less than 1000/mm3, then the patient has received a significant radiation exposure. In the event of combined injuries, the use of lymphocytes may be unreliable. Patients who have received severe burns or multi-system trauma often develop lymphopenia. It is important to note that individuals with concurrent viral infections would have a lymphocytosis based on their illness. 

The mechanical system used for this evaluation consisted of several automated components feed control, reactants preparation, synchronized injected reactant pulses, reactor temperature and pressure and residence time control, on-line analytical, fraction collector for product sample collection, as well as programming for multi-system coordination. 

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