chestiuni medicale

[originaltup]

Stie cineva din ce a mai citit, rejetul hiperacut de grefa e tipul II sau III de sensibilitate? Si daca se poate sa-mi spuna si sursa de unde stie.
Eu inclin sa merg pe ce scrie in Robbins, ca ar fi tipul III (reactie Arthus) dar am gasit literatura destul de serioasa care afirma ca ar fi tip II.

[originaltup]

Pt Cerbu: cam cat de bine e cotata in US, Robbins' Pathology ?

[Khaos]

Eu cred ca este tipul II si tin minte ca ne-au dat acest exempl;u de multe ori la Imunologie (Bara) ca fiind II.

[originaltup]

Mda, asa spune in majoritatea cartilor cu exceptia lui Robbins care este totusi o carte foarte serioasa.
Asa o varianta de compromis ar fi ca pasul initial ar fi unul de tip II dar cea care produce cele mai grave modificari ar fi reactia de tip III consecutiva.

Hyperacute rejection occurs when preformed antidonor antibodies are present in the circulation of the recipient. Such antibodies may be present in a recipient who has already rejected a kidney transplant. Multiparous women who develop anti-HLA antibodies against paternal antigens shed from the fetus may also have preformed antibodies to grafts taken from their husbands or children. Prior blood transfusions from HLA-nonidentical donors can also lead to presensitization because platelets and white cells are particularly rich in HLA antigens. In such circumstances, rejection occurs immediately after transplantation because the circulating antibodies react with and deposit rapidly on the vascular endothelium of the grafted organ. Complement fixation occurs, and an Arthus-type reaction follows.

This form of rejection occurs within minutes or hours after transplantation and can sometimes be recognized by the surgeon just after the graft vasculature is anastomosed to the recipient's. In contrast to the nonrejecting kidney graft, which rapidly regains a normal pink coloration and normal tissue turgor and promptly excretes urine, a hyperacutely rejecting kidney rapidly becomes cyanotic, mottled, and flaccid and may excrete a mere few drops of bloody urine. The histologic lesions are characteristic of the classic Arthus reaction. There is a rapid accumulation of neutrophils within arterioles, glomeruli, and peritubular capillaries. Immunoglobulin and complement are deposited in the vessel wall, and electron microscopy discloses early endothelial injury together with fibrin-platelet thrombi. These early lesions point to an antigen-antibody reaction at the level of vascular endothelium. Subsequently, these changes become diffuse and intense, the glomeruli undergo thrombotic occlusion of the capillaries, and fibrinoid necrosis occurs in arterial walls. The kidney cortex then undergoes outright infarction (necrosis), and such nonfunctioning kidneys are removed.

Robbins Pathologic Basis of Diseases, 5th edition[quote]Hyperacute Rejection.

[HELGA]

Ce stiti despre vaccinul anti hepatita A+B?

[cerbu]

Ce stiti despre vaccinul anti hepatita A+B?

\

Twinrix, facut de GlaxoWelcome

ca si Engerix, sunt trei doze 0, 1 si 6 luni.

seroconversia pentru A este 91,6%, 97.7% si 99.6%( dupa fiecare doza, respectiv)

pentru hepatita B seroconversia este:17,9%, 61.2% si 95.1

pentru comparatie, seroconversia pentru hepatita B daca se utilizeaza combinatia Engerix+ Havrix este 7.5%, 50.4% si 92.3%. pentru hepatita A este oarecum similara.

sursa: PDR

[cerbu]

Pt Cerbu: cam cat de bine e cotata in US, Robbins' Pathology ?

scuze pentru raspuns intarziat. raspunsul este sorry, no idea!

[HELGA]

Merci,Cerbu.
Daca am facut Engerix acum 6 ani,cred ca merge acum si un Twinrix,nu ?Da' sa nu ma trimiti sa-mi dozez anticorpii,please

[cerbu]

should be ok, ambele sunt HbS recombinant. nu-ti tebuie decat un booster, nu trebuie sa repeti seria. probabil ca e overkill hep A-wise, chances are you already had it.

[cerbu]

uite un articol( mai vechi) din New England care mie mi se pare foarte util in practica de zi cu zi.

[cerbu]

nu stiu de ce nu pot sterge

[tapirul]

ce vrei sa stergi? Cere si ti se va da, bate si ti se va deschide.
De sters nu mai pot sterge (si edita as well) decat moderatorii. Au fost destule incidente cu useri care si-au sters posturile.
So, think twice, post once.

[cerbu]

am vrut sa sterg tot mesajul, era postat de doua ori. am intrat sa-l editez within the time frame, dar nu am putut sterge.

[tapirul]

don't worry about double posts, in general moderatorii le aranjeaza.

[dumbego]

poate cineva sa-mi povesteasca despre medicatzie in cancerul de colon?
multzumiri anticipate

[originaltup]

Cat de detaliat? Ca asa din memorie iti spun regimul standard, adica 5-fluorouracil + levamisole.
+/- radioterapie
evident astea ca ajutor pt chirurgie.
Pt mai mult tre' sa mai citesc un pic.

[dumbego]

ash prefera ceva mai mult. dar merci oricum. o sa ma straduiesc sa ma documentez shi singura.

[cerbu]

dumbego, try this:

http://www.medscape.com/viewarticle/431265_print