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  • 1
    ISSN: 1432-1238
    Keywords: Host resistance ; Cell-mediated immunity ; Recall skin antigens ; Critically ill surgical patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The cell-mediated immunity (CMI) of 47 critically ill surgical patients admitted to an Intensive Therapy Unit was assessed by their response to recall skin antigens and found to be markedly reduced. Thirty-seven patients showed no reaction to initial skin testing (NR), and there were 21 deaths in this group. Ten patients reacted (R) to initial skin testing and only one of these patients died (p〈0.025). Repeat skin testing was performed on 22 NR patients. Eight became R on repeat testing and there was one death in this group, whilst 14 remained NR and there were 11 deaths in this group (p〈0.025). The major clinical difference between R and NR patients was a greater incidence of severe sepsis in the NR patients. These findings suggest that the use of recall skin antigens to assess CMI may be a valuable investigation in critically ill surgical patients and that initial and persisting failure to react to skin tests is associated with a poor outcome.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 7 (1981), S. 291-295 
    ISSN: 1432-1238
    Keywords: Serum proteins ; Recall skin antigens ; Critically ill surgical patients ; Sepsis ; Outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum protein levels were found to be markedly reduced in 44 critically ill surgical patients after they had been resuscitated in an intensive therapy unit (ITU). There was no difference in initial protein levels between those patients who survived and those who died, or between those patients who reacted to skin testing with recall antigens and those who showed no reaction. However, albumin and transferrin levels were lower in those patients who had major sepsis (p〈0.02). Twenty-six of the patients remained in the ITU for more than five days. Repeat measurements made in these patients shortly before death or discharge from the ITU showed that prealbumin and transferrin levels were still not different in 17 survivors and 9 non-survivors. However, the mean albumin level was lower in the non-survivors (p〈0.02), although nearly all of the survivors also continued to have low levels of albumin. There was no improvement in serum protein levels in 10 patients who, on skin testing, converted from being non-reactors to reactors. Although reduced serum protein levels were a common finding in critically ill patient, they were not clearly related to outcome or the response to recall skin antigens and this suggests that these tests may be altered by different mechanisms.
    Type of Medium: Electronic Resource
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