Immunological Screening And Immunotherapy In Critically Ill Patients With Abdominal Infections

Over two decades an abundance of knowledge has been accumulated focus ing on the understanding of the molecular and cellular pathomechanisms of stressful conditions like systemic inflammation and sepsis. We have learned that there is a clear correlation between the magnitude of the inciting traumatic event and the degree of inflammatory dysbalance. The immunoinflammatory disintegration comprises a simultaneous col lapse of the otherwise very smoothly balanced pro- and antiinflammatory vectors of cytokine regulation. Most recently, we understood that it is predominantly the dysregulation of antiinflammatory mediators that plays a pivotal role for the phenomenon of trauma-induced depression or paralysis of cell-mediated immune responses. The substantial intellectual and logistic investments of numerous investi gators towards understanding the biology of sepsis inevitably lead us towards a rewarding status in terms of reaching spheres of clinical relevance. From the evolutionary collection of a multitude of ex-vivo and in-vivo immuno mechanistic parameters, some were found to represent most significant bio logical markers to support the clinician to characterize better the severity of inflammatory illness and to predict outcome. Chapter one of this book, authored by G. Grass and E.A.M. Neugebauer, analyses elegantly our current knowledge on the assessment of the immuno logical status in terms of risk and prognosis of sepsis.

Source control is the key to the management of surgical infections. Surgical decision making is based on the marriage of evidence from clinical studies, inferences from biology, and the elusive component of surgical experience; this book combines these three elements. We have recruited an international group of authors who are acknowledged leaders in the field of surgical infectious diseases. We have challenged them to integrate evidence with experience and an understanding of biology so as to create overviews that will help the clinician who must make the difficult decisions. And we have kept them honest by asking a second group of equally eminent commentators to provide supporting or alternative views - in essence, to recreate the kind of dialogue that takes place between clinicians discussing a difficult problem. This is THE manual for the authoritative management of surgical infections!

The International Symposium on Medical Data Analysis is an important - riodical opportunity to exchange ideas and ?rst-hand experiences with groups interested in the medical applications of innovative hardware and software tools. The massive information available through continuous improvements in the various modeling approaches to Medical Data Analysis is re?ected in the - sults, dealing with quite di?erent topics, presented during the Third Edition of the Symposium (ISMDA 2002). They have been grouped into the following four categories: (1) Data Mining and Decision Support Systems; (2) Medical Informatics and Modeling; (3) Time-Series Analysis; and (4) Medical Imaging. In setting up the symposium program we tried to avoid, even with the sho- age of time, parallel sessions. Thus, all participants had the chance to catch all the oral presentations, and we hope that this third proceedings volume will extend this chance also to non-participants. As for the previous volumes, it c- tains extensive up-to-date chapters on Medical Data Analysis, packed with ideas, suggestions, and solutions to many problems typical of this ?eld.

This volume is published under the auspices of the World Federation of Societies of Intensive Care Medicine, which consists of 48 members societies (both medical and nursing) - a truly world wide organisation - and whose aim is to promote excellence in the care of critically ill patients. The volume will be distributed to delegates on occasion of the 9th International Congress of the World Federation of Societies of Intensive and Critical Care Medicine, to be held in Buenos Aires at the end of August 2005.

This is the definitive, gold-standard text on sepsis and multiple-organ dysfunction. It is comprehensive and thoroughly referenced: the one text in which all current knowledge on this important topic is brought together. The book is written by a team of international contributors, overseen by an internationally acclaimed editorial team.

This book examines in detail the topic of sepsis, with a focus on intra-abdominal sepsis. Particular attention is devoted to source control in the management of the infection, antimicrobial therapy and sepsis support, which represent the cornerstones of treating patients with this problem. The importance of a multidisciplinary approach is highlighted not only by the instructive and informative sections on the acute manifestations of appendicitis, cholecystitis, and cholangitis, perforations and diverticulitis, Clostridium difficile infection and the role of candida in abdominal sepsis, but also by an extensive discussion of issues including antimicrobial resistance, damage control surgery, principles of antimicrobial therapy, hemodynamic support, adjunctive therapies, and thromboprophylaxis. Abdominal sepsis is the host’s systemic inflammatory response to intra-abdominal infections. It is associated with significant morbidity and mortality rates, and represents the second most common cause of sepsis-related mortality at intensive care units. Gathering contributions by authoritative experts from all around the world, this book will allow acute care surgeons, abdominal surgeons, intensive care clinicians, and students to broaden their understanding of intra-abdominal sepsis in daily clinical practice.