Raised cortisol:DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity.

The detrimental effect of stress on the immune response increases with age, though the mechanisms responsible are not fully understood. The physiological response to stress is regulated in part by the adrenocortical system. Adrenal hormones dehydroepiandrosterone sulphate (DHEAS) and cortisol have opposing effects on the innate immune system, DHEAS enhances while cortisol suppresses immunity and the molar ratio of cortisol to DHEAS increases with age.

Effects of hypertonic dextran in hypovolaemic shock: a prospective clinical trial.

The aim of this paper is to report the results of prospective clinical trials of hypertonic saline dextran (HSD) in the resuscitation of hypovolaemic shock in critically injured patients. There are many types of fluids, which can be administered intravenously. Recent interest in the usage of HSD solution has confirmed that they have a place in resuscitation of a patient in shock.

Management of chronic pain in whiplash injury.

We investigated the response of chronic neck and shoulder pain to decompression of the carpal tunnel in 38 patients with whiplash injury. We also determined the plasma levels of substance P (SP) and calcitonin gene-related peptide (CGRP), which are inflammatory peptides that sensitise nociceptors. Compared with normal control subjects, the mean concentrations of SP (220 v 28 ng/l; p < 0.