Multiple organ dysfunction syndrome pathogenesis and care: a complex systems' theory perspective.

Aims And Objectives: To discuss multiple organ dysfunction syndrome (MODS) from a complex systems' theory perspective and to delineate a conceptual framework for the development and care of MODS.

Background: MODS is an intricate and devastating manifestation of critical illness characterized by widespread aberrant molecular, cellular and systemic responses.

Design And Methods: Narrative literature review (MEDLINE, CINAHL databases) and knowledge synthesis with the theoretical assertions of chaos and complex systems' theory.

Association between subjective descriptors of coronary pain and disease characteristics: a pilot study in a Hellenic rural population.

Purpose: We explored whether the way Hellenic patients describe their cardiac chest pain (verbal descriptions of the nature, intensity, temporal quality, location and radiation) associates with the diagnosis [acute myocardial infarction (AMI) versus unstable angina (UA)] as well as with the location of the coronary lesions.

Methods: A cross-sectional correlational design was employed to study 80 consecutive coronary care patients (44 with AMI, 36 with UA) from northwestern Hellas.

Results: Pain intensity did not differ significantly between AMI and UA, in contrast to treatment-seeking behaviour and accompanying symptoms (p< or =0.

Genomic variations and susceptibility to sepsis.

The considerable variability in septic patients' outcomes, which exceeds our understanding of the pathophysiology of sepsis and defies our current prognostic tools, has prompted investigation in the genetic variations that may predispose individuals for increased susceptibility to sepsis and adverse outcomes. This article aims to critically review current evidence from genetic association studies regarding the role of genetic polymorphisms in sepsis. Findings regarding polymorphisms in intercellular messenger mediators (cytokines), membrane-bound inflammatory receptors, intracellular signaling cascades, heat shock proteins, coagulation/fibrinolysis pathways, apoptotic mechanisms, and neuroendocrine axes are presented and discussed.