[Recent studies of physiopathology of the infectious process. 3 major pathogenetic models].

With reference to recent bibliographical data and their own experience, the authors discuss the existence of three major mechanisms (models) in toxi-infectious aggression, namely: -- direct, cellular, performed by toxin-enzymes, aggressins, hemolysins, invasins, cytopathogenic effects; -- unspecifically mediated (by nervous or humoral mediators); -- specific mediators (by immune effectors, humoral immunoaggressive mechanisms or cellular induced mechanisms). The text is illustrated by examples with reference to aetiological entities than can be listed in the corresponding pathogenetic system and therapeutical lines.

[Current possibilities of optimizing emergency tetanus immunization].

Retrospective analysis of the tetanus cases, admitted over a six year period, shows the high risks involved by the insufficient immunoprotection. The failure of emergency immunization, with its effects on the incidence and evolution of the disease, may be accounted for by : the difficulty in establishing the vaccination past history, probable decrease of protection with time due to basal immunization, inconstant response to the booster dose, immunodepressive side effects, the drawbacks of antitoxic serum. With reference to their own experience and the published data concerning the methods applied for obtaining a more rapid response to anatoxin and possible optimizing of the protective titre concurrent with the incubation period of tetanus.

[Risks of therapy in infectious shock].

On the basis of their experience in the intensive therapy unit, correlated with modern pharmacokinetic data, the authors discuss the adverse effects induced by polyvalent therapy in septic shock, and which may be listed in the group of iatrogenic pathointerference. To the biochemical and functional alterations of shock may be added the possible effects of antibioticotherapy, corticotherapy, plasma expanders, lipid emulsions, crystalloid solutions, alkaline correcting solutions, osmotic diuretics, oxygenotherapy, vasoactive drugs, heparin and epsilon-amino-caproic acid. The possible summation of these effects should be indicated in the rules for observance by the medical staff of intensive therapy units.

[Pathogenicity expressed by inhibition of the Pasteur effect].

The experiments carried out demonstrate that under the influence of tetanus exotoxin, Gram-negative bacteria endotoxins, staphylococcal infection and infestation with Tr. spiralis, inhibition of the Pasteur effect occurs. Recently published data show that the same manifestation of pathogenicity is induced by diphtheria alpha and delta exotoxin, staphylococcal toxin, Pseudomonas aeruginosa exotoxin, staphylococcal enterotoxin, streptolysin O, infections with Cl.

[Comparative evaluation of risk factors in acute generalized tetanus].

The investigations included a group of 26 patients with acute generalized tetanus, cared for in the Clinic according to a unitary method. A number of 17 prognostic, clinical and laboratory criteria were analyzed from the viewpoint of the pathogenic and clinicoevolutive incidence and significance. According to the severity, lethal course of the disease the following sequence was established in order of gravity: serum sickness, kypokaliemia, hyperpyruvicemia greater than an incubation of less 6 days, invasion within less than 24 hours, hyperlactacidemia greater than age over 60 years, persistent hypertension and tachycardia, hyperazoltemia, hyperglycemia, frequent paroxysmal contractions (before sedation) greater than late admission to hospital, associated cardiopulmonary pathology, hyponatriemia insufficient dressing of the wound and rural environment.

[Fuctional-metabolic disorders in typhoid infection].

The complex biologic investigation of thyphoid fever is dictated by the necessity of instituting a pathogenetic therapy, especially in the toxic and complex forms. Performing 178 fuctional-metabolic tests in 50 cases of typhoid fever (of which 10 severe and complicated forms), the authors established the prognostic value energy deficiency (approximately P), lactate, alkaline reserve and GPT. Azotemia is only characteristic in the forms with renal involvement, and the other transaminases may be positive even whe the liver is not enlarged.

[Possibilities of correcting some metabolic disorders in experimental endotoxic shock by treatment with a combination of alpha-lipoic acid and epsilon aminocaproic acid].

Alpha-Lipoic acid associated with xi-aminocaproic acid proves to have a protector effect in the posttreatment of endotoxinic shock in rabbits, produced by the administration of E. coli O111, in doses of 1.5 mg/kg body weight.

[Major objectives of pathogenic therapy of septicemia].

On the bases of the published data and their own experience the authors outline the context of the functional biochemical alterations that give an orientation in the choice of the major objectives of pathogenic therapy in the course of septicemias. Analysis of the frequency and intensity of these alterations make it possible to establish therapeutical priorities. In this sense it is demonstrated that hyperazotemia, hyperalbuminemia, low alkaline reserve, elevated serum lactate and a decrease in the plasma Na+/K+ ratio are characteristic of septicemia with a state of toxiinfectious shock.