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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sublethal doses of vincristine (VNC) and bacterial lipopolysaccharide (LPS) administered simultaneously to adult male mice resulted in markedly enhanced mortality. All of 10 strains of Pseudomonas aeruginosa tested, 4 of 7 strains of Bacteroides, and 6 of 10 strains of Listeria monocytogenes were able to substitute for purified LPS in enhancing mortality in VNC-treated mice. Inoculation of mice with each of 10 strains of Pseudomonas, each of 7 strains of Bacteroides, and about half of the 10 strains of Listeria tested elicited increased resistance to the lethal action of purified LPS. The patterns of responses of mice receiving a lethal combination of 2 mg of LPS/kg and 1 mg of VNC/kg resembled those of mice receiving a lethal dose of 10 mg of VNC/kg alone or 15 mg of LPS/kg alone with respect to (i) serum glutamic pyruvate transaminase activity, (ii) hematocrit values, and (iii) thrombocytopenia. The patterns of responses of mice receiving a lethal combination of LPS and VNC resembled those of mice receiving a lethal dose of LPS alone with respect to (i) hypothermia, (ii) retention of sulfobromophthalein, (iii) fibrinogen level, (iv) prothrombin activity, (v) blood urea nitrogen levels, and (vi) time of death. These data are consistent with the proposition that the combination of VNC and LPS produces a fatal renal failure. Histological studies confirmed that there was extensive renal damage in mice treated with lethal doses of LPS alone or a lethal combination of LPS and VNC.
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PMID:Enhanced toxicity for mice of combinations of bacterial lipopolysaccharide and vincristine. 94 80

Clearance of Pseudomonas aeruginosa from the blood stream in normal dogs was measured. An intravenous infusion of bacteria at a dose of 10(6) per milliliter per minute for two or five hours resulted in reproducible bacteremia in the 10(2) range per milliliter of blood without systemic side-effects. An identical bacterial infusion 24 hours later was characterized by enhanced clearance of bacteria and partial pyrogenic tolerance. A lethal bacterial dose of 4 X 10(7) per milliliter per minute infused for five hours exhibited an eightyfold higher bacteremia, shock and death within 24 hours. These events were characterized by leukopenia, hypothermia and hypoglycemia. Experimental results indicated that intact leukocyte bactericidal activity is the most important defense mechanism of the host in bacterial systemic infections.
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PMID:Pathophysiologic alterations during bacterial infusions for the study of bacteremic shock. 119 1

To determine the importance of bacteremia in hospitalized patients with diarrhea in Bangladesh, from September 1982 through August 1983 the authors obtained blood for culture from 1,824 patients who were suspected of having sepsis (44% of all admissions). Nontyphoid bacteremia occurred in 243 patients. The most common pathogens were the Enterobacteriaceae (n = 66 episodes), Staphylococcus aureus (n = 65), Pseudomonas aeruginosa and other non-glucose-fermenting bacilli (n = 50), Streptococcus pneumoniae (n = 40), and Haemophilus influenzae (n = 16). When compared with an equal number of control patients without bacteremia, bacteremic patients were significantly (p less than 0.05) more likely to be under 1 year of age (46.5% of bacteremic patients vs. 30.0% of control patients) and more often had abdominal tenderness (20.1% vs. 11.5%), hypoproteinemia (a serum protein level less than 60 g/liter) (58.9% vs. 42.9%), and a prior intravenous infusion (49.0% vs. 30.9%). The case-fatality rate was 29.7% in bacteremic patients versus 7.8% in controls (relative risk (RR) = 3.8, p less than 0.001). Factors that were associated with an increased risk of death in bacteremic patients were infection with a Gram-negative pathogen (RR = 2.48), decreased peristalsis (RR = 2.66), hypoproteinemia (RR = 3.36), hypothermia (RR = 2.54), and hypotension (RR = 2.19). Bacteremia appears to be an important link between diarrheal illness and death in Bangladesh. In children with diarrhea who are suspected of being septic, early implementation of antimicrobial therapy that is effective against the broad range of pathogens identified appears to be indicated.
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PMID:Bacteremia during diarrhea: incidence, etiology, risk factors, and outcome. 200 Aug 55

Over the period of 2 months between October and November, 1987, 190 episodes of septicemia in adults were monitored at Veterans General Hospital-Taipei. The most common causative microorganisms were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus. The most frequent sources of infection came from intra-abdominal (gastro-intestinal as well as hepato-biliary), urinary and respiratory tract. Its overall mortality was 34.7%. Factors associated with a higher mortality from septicemia were old age, rapidly fatal underlying disease, hospital acquired infection, hypothermia, hypotension/shock, high-risk source of infection (from respiratory tract, skin/soft tissue, surgical wound or other unknown source), high-risk microorganisms (Candida species, Ps. aeruginosa or K. Pneumoniae) and inappropriate antimicrobial therapy. Identification of these factors may help early correction of reversible factors and improve its prognosis.
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PMID:Septicemia in adults: II. Factors in prognosis. 281 80

Sepsis remains a significant cause of morbidity and mortality in newborn infants. From January 1983 to April 1988, 166 cases of neonatal sepsis with positive blood cultures were collected at V.G.H.--Taichung. Among them 140 newborn babies were delivered at private clinic (outborn babies), 26 cases were inborn babies. Of the inborn babies, 20 cases (76.9%) were early onset sepsis (the onset of illness within 96 hours of life) and 6 cases (23.1%) were late onset sepsis (the onset of illness beyond 96 hours of life). Off the outborn babies, 64 cases (45.7%) were early onset sepsis and 76 cases (54.3%) were late onset sepsis. The Gram positive organism (51.9%) was more common than the Gram negative organism in the inborn babies, on contrary, the Gram negative organism (59.0%) was more common in the outborn babies. The most common pathogenic organism of the inborn babies was Enterococcus (22.2%) and E. coli (22.2%), followed by Pseudomonas spp (11.1%) and Staphylococcus aureus (11.1%). The most common pathogenic organism of the outborn babies was Enterococcus (17.4%), followed by E. coli (16.1%), Staphylococcus aureus (9.9%) and Klebsiella spp (8.1%). The antibiotics sensitivity tests to the pathogens didn't show any significant difference between these two group babies. In this clinical study, we found that the first choices of antibiotics were ampicillin plus aminoglycosides. The clinical symptoms and signs were nonspecific. The most common findings were lethargy, fever, hypothermia and poor feeding. Of the inborn babies, 17 cases (65.4%) had the predisposing factor(s). Of the outborn babies, 42 cases (30%) had the predisposing factor(s).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical observation of neonatal sepsis]. 281 81

We studied 385 episodes of nosocomial bloodstream infections occurring over 45 months to ascertain if the etiologic organisms were independent predictors of death and morbidity. Independent predictors of death included respiratory failure, oliguria, metabolic acidosis, hypotension, increased age, antibiotic therapy in cases where susceptibility data were unknown, and infection with Pseudomonas aeruginosa. If parameters associated with septic shock were excluded, increased age, severity of disease, and infection with Candida spp. or P. aeruginosa predicted death. Infection with P. aeruginosa, Enterococcus, and Klebsiella pneumoniae predicted hypotension; severity of disease, polymicrobial infection, and infection with Candida spp., Enterococcus, Enterobacter, or Serratia marcescens predicted oliguria; infection with Candida spp. or P. aeruginosa, increased age, severity of disease, and inability to meet hospital financial obligations without assistance predicted respiratory failure. Inability to meet hospital financial obligations without assistance and severity of disease predicted hypothermia; infection with Candida spp. or P. aeruginosa and sex (male) predicted metabolic acidosis.
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PMID:Etiologic organisms as independent predictors of death and morbidity associated with bloodstream infections. 361 32

A rough mutant of Escherichia coli (J5), which expresses a core lipopolysaccharide antigen common to gram-negative organisms on its cell surface, was used to immunize rabbits. Passively transferred anti-E. coli J5 rabbit antiserum (anti-J5 RS), normal rabbit serum (NRS), and saline were compared in a guinea pig model of intravenous gram-negative sepsis, with E. coli 0111:B4 and Pseudomonas aeruginosa as challenge organisms. Physiologic monitoring demonstrated a consistent pattern associated with gram-negative sepsis in this model: hypothermia, hypotension, bradycardia, a fall in white blood cell count and platelet count, and persistence of challenge organisms within the circulation. Pretreatment with anti-J5 RS prevented hypothermia and the fall in platelet count while augmenting bacterial clearance. Survival was markedly enhanced by anti-J5 RS, but not by NRS or saline. Concomitant heparin pretreatment was thought to be a significant factor in demonstrating the protective effect in this model. Parallel in vitro cross-reactivity measured by an enzyme-linked immunosorbent assay and an opsonization assay demonstrated that anti-J5 RS extensively cross-reacted with a variety of gram-negative bacilli. Demonstration of enhanced opsonization by anti-J5 RS of gram-negative organisms was thus well correlated with enhanced systemic clearance of bacteria and improved survival subsequent to intravenous bacterial challenge.
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PMID:Immunotherapy of gram-negative bacterial sepsis: enhanced survival in a guinea pig model by use of rabbit antiserum to Escherichia coli J5. 704 94

A 5-month-old male infant developed junctional ectopic tachycardia after surgical repair for ventricular septal defect. Management with sotalol and moderate hypothermia was initially successful, but he died from Pseudomonas aeruginosa pneumonia. The safety of treatment with hypothermia is discussed.
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PMID:Fatal pneumonia complicating hypothermia for the treatment of postoperative junctional ectopic tachycardia. 865 17

A 14-year-old boy presented with a 1-week history of hypothermia and obtundation. His medical history included surgical resection of craniopharyngioma with postoperative visual impairment and panhypopituitarism. The patient's rectal temperature remained persistently lower than 35 degrees C during the first 3 days of hospitalization. His blood pressure was 90/56 mmHg on admission. The peripheral blood leukocyte count was 2.7 x 10(10)/L with 18% neutrophils, 19% band forms, 44% metamyelocytes, 3% myelocytes, and 16% lymphocytes. The C-reactive protein concentration was 133.9 mg/L. Two separate blood cultures both yielded Pseudomonas putida. The patient was treated with amikacin and ceftazidime along with aggressive fluid therapy. Replacement therapy directed at his hormonal deficiencies was initiated as soon as his hemodynamic status was stabilized. The patient responded well to therapy with a gradual rise in body temperature and improvement in general activity. A growth experiment carried out on the P. putida isolate showed that the bacteria grew more rapidly at 30 degrees C than at 37 degrees C. The clinical course of the patient, as well as the results of the laboratory study, suggest that hypothermia may predispose human infection with P. putida.
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PMID:Hypothermia predisposing to Pseudomonas putida sepsis in a child with panhypopituitarism. 958 82

Septic episodes in thermal injuries are usually hallmarked by a series of physiologic parameters that include tachypnea, prolonged paralytic ileus, hyperthermia or hypothermia, altered mental status, thrombocytopenia, leukocytosis or unexplained leukopenia, acidosis, and hyperglycemia. Recent studies with polycystic kidney disease have clearly indicated that the limulus amebocyte lysate (LAL) assays were predictive of fungal infections in this patient population. Because both bacteria and fungi produce lipopolysaccharide that can be identified with the LAL assay, we randomly assayed sequential sera of 45 patients with major thermal injuries for positivity in the LAL assay, with use of the QCL-1000 kit (BioWhittaker, Walkersville, Md). The average burn size of this patient population was 63.43% total body surface area. The average age of the patient was 6.2 years. The sex distribution included 30 males and 15 females. The infectious agents included gram-positive cocci and gram-negative rods, and 14 patients had concomitant fungal infections. Eighty-five percent of the patients tested were positive for endotoxin, with levels ranging from < 0.1 EU/mL to > 1.0 EU/mL. The predominant organism isolated before or on the date the serum was drawn was Pseudomonas aeruginosa (51%), followed by Klebsiella pneumoniae (15%). The remaining 34% were a variety of Enterobacteriaceae. Of the 14 patients who yielded a fungus, 3 had negative LAL assays. Two patients with an elevated LAL grew only Staphylococcus epidermidis in the bloodstream and the wounds. These data clearly indicate that the LAL assay cannot be relied on as the sole predictor of septic episodes; however, it can be an adjunctive test to confirm sepsis when the other parameters have been considered.
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PMID:Is the limulus amebocyte lysate the sole predictor of septic episodes in major thermal injuries? 984 41


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