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January 1, 2007

Mediators or Markers of Injury, Inflammation, and Infection (Harbingers of Doom or Predictors of Disaster) and Biologic Puzzles or Ambiguities

Arch Surg. 2007;142(1):89-93. doi:10.1001/archsurg.142.1.89

This is a review of 2 topics: (1) mediators and activities whose levels or performances indicate or predict an unfavorable outcome and (2) biologic activities (puzzles) in which too much of a substance (mediator) is bad but too little is even worse and vice versa (the just right physiological principle). Mediators or activities may predict disaster but, by and large, knowing this does not help us take better care of patients. They certainly contribute to our understanding of disease. Biologic puzzles may help us better understand clinical situations. Knowledge of such studies should help us to better understand the processes of injury, illness, inflammation, and sepsis and to devise further studies to improve the care of our patients.

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