Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of our experience with the technique of fine needle catheter jejunostomy and early postoperative feeding through the catheter over a 12-month period are presented. Of the 43 patiening with an elemental diet without complications, 3 (7 per cent) were not fed for different reasons and 13 (30 per cent) developed complications that led to temporary or permanent cessation of the feeding. One patient in this group died of inhalation pneumonia. The voluntary food intake of 12 of the patients who were fed by jejunostomy after major colorectal surgery was assessed daily for 2 weeks after operation and compared with that of 12 control patients who did not have nutritional support. No significant difference in voluntary food intake was found between the two groups. The changes in body composition and plasma proteins and the clinical outcome of 20 of the patients fed by jejunostomy after major colorectal surgery were also compared with those of 20 matched controls. Body weight and lean body mass (as assessed by total body potassium and arm muscle circumference) and plasma prealbumin fell significantly in the control patients but not in those fed by jejunostomy. However, plasma transferrin decreased in both groups and there was no significant difference in clinical outcome in terms of complication rate or duration of postoperative hospital stay. The study would suggest that this technique of jejunostomy feeding should be reserved for selected cases where it may prove to be of real value, rather than being used routinely.
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PMID:Fine needle catheter jejunostomy--an assessment of a new method of nutritional support after major gastrointestinal surgery. 11 1

Two clinical isolates of Pasteurella multocida associated with bovine pneumonia were examined for iron acquisition. Both isolates were capable of obtaining iron for growth from bovine but not from human, avian, equine or porcine transferrin. This correlated with specific binding of bovine transferrin by iron-limited cells or isolated membranes. No siderophore was detected in the strains by a general screening assay. In response to iron-limited conditions, a number of high molecular mass iron-regulated outer membrane proteins were produced including an 82 kDa receptor protein which was affinity isolated with biotinylated transferrin. In contrast, avian strains of P. multocida could not use transferrin-bound for growth and did not express either transferrin binding activity or the 82 kDa receptor protein.
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PMID:Evidence for non-siderophore-mediated acquisition of transferrin-bound iron by Pasteurella multocida. 183 48

We measured extravascular density (EVD) and the pulmonary transcapillary escape rate (PTCER) for 68Ga-transferrin using positron emission tomography in 14 normal volunteers and 29 patients with radiographic infiltrates, including six patients with congestive heart failure (CHF), eight patients with the adult respiratory distress syndrome (ARDS), and 15 patients with focal pneumonia. Contralateral, radiographically normal regions were also evaluated in the patients with focal pneumonia. Mean EVD was elevated in the patients with CHF, ARDS, and pneumonia in regions of radiographic infiltrate compared with values from normal subjects (p less than 0.05), but it was not significantly different among the three patient groups. PTCER in normal subjects and in patients with CHF was not significantly different (21 +/- 11 versus 44 +/- 16 x 10(-4) min-1, respectively, p = NS). PTCER was elevated in regions of infiltrate because of either pneumonia (173 +/- 99) or ARDS (170 +/- 79). PTCER was also elevated in regions contralateral to those with focal infiltrate during pneumonia, even though these regions were radiographically normal and had normal EVD values. These results suggest that PTCER is a sensitive but nonspecific index of abnormal pulmonary vascular permeability, which may be useful for classifying patients in clinical studies of pulmonary edema.
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PMID:A positron emission tomographic comparison of pulmonary vascular permeability during the adult respiratory distress syndrome and pneumonia. 198 72

A study was conducted to evaluate factors which might influence the prognosis of persons with pneumonia owing to Streptococcus pneumoniae. Serum iron, total iron binding capacity and unbound iron binding capacity (UIBC), were evaluated in 35 such patients. Of the 10 patients with UIBC levels less than 130 micrograms per dl on admission to the hospital, six died, three had complications, and only one recovered uneventfully. Of the 25 surviving patients, 21 (84 percent) had UIBC greater than 130 micrograms per dl on admission. Positive blood cultures were also correlated with survival. However, the strongest prognostic indicator was the combination of UIBC and blood culture results. Only 14 percent of patients with abnormalities in both parameters survived, whereas 80 percent to 88 percent of those with negative blood culture and/or normal UIBC survived. This suggests that insufficient unsaturated transferrin may facilitate bacteremia and contribute to lethality of pneumococcal pneumonia.
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PMID:Low levels of unsaturated transferrin as a predictor of survival in pneumococcal pneumonia. 232 29

Recent animal models suggest that enteral feeding (TEN) compared to parenteral nutrition (TPN) improves resistance to infection. This prospective clinical trial examined the impact of early TEN vs. TPN in the critically injured. Seventy-five patients with an abdominal trauma index (ATI) greater than 15 and less than 40 were randomized at initial laparotomy to receive either TEN (Vivonex TEN) or TPN (Freamine HBC 6.9% and Trophamine 6%); both regimens contained 2.5% fat, 33% branched chain amino acids, and had a calorie to nitrogen ratio of 150:1. TEN was delivered via a needle catheter jejunostomy. Nutritional support was initiated within 12 hours postoperatively in both groups, and infused at a rate sufficient to render the patients in positive nitrogen balance. The study groups (TEN = 29 vs TPN = 30) were comparable in age, injury severity and initial metabolic stress. Jejunal feeding was tolerated unconditionally in 25 (86%) of the TEN group. Nitrogen balance remained equivalent throughout the study period, at day 5 TEN = -0.3 +/- 1.0 vs. TPN 0.1 +/- 0.8 gm/day. Traditional nutritional protein markers (albumin, transferrin, and retinol binding protein) were restored better in the TEN group. Infections developed in 5 (17%) of the TEN patients compared to 11 (37%) of the TPN group. The incidence of major septic morbidity was 3% (1 = abdominal abscess) in the TEN group contrasted to 20% (2 = abdominal abscess, 6 = pneumonia) with TPN. This clinical study demonstrates that TEN is well tolerated in the severely injured, and that early feeding via the gut reduces septic complications in the stressed patient.
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PMID:TEN versus TPN following major abdominal trauma--reduced septic morbidity. 250 9

This study was designed to test the hypothesis that protein depleted surgical patients are at an increased risk of postoperative complications following major surgery; 101 patients and 59 normal volunteers had measurements of nutritional status (weight loss (%), midarm muscle circumference, plasma transferrin and prealbumin concentration and a direct measurement of pre-operative protein depletion, the protein index) and the patient's postoperative course was carefully monitored from the time of operation until discharge. The patients were divided into two categories on the basis of the extent of protein depletion: non-protein depleted patients (4% mean protein loss) and protein depleted patients (39% mean protein loss). The protein depleted patients had a significantly higher incidence of major complications, pneumonia and stayed in hospital longer (both overall stay and postoperatively).
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PMID:Protein depletion and surgical risk. 325 Apr 31

A hundred patients scheduled for elective abdominal surgery were randomized to either general anaesthesia (low-dose fentanyl) and systemic morphine for postoperative pain or combined general anaesthesia and epidural analgesia with etidocaine 1.5% intraoperatively (T4-S5) and bupivacaine 0.5% 5 ml/4 h for 24 h and morphine 4 mg/12 h for 72 h. Postoperative pain was better controlled by the epidural regimen (P less than 0.0001). We found no significant reduction in postoperative mortality (6% to 2%), pneumonia (28% to 20%), cardiac dysrhythmia (10% to 5%) and wound complications (14% to 11%) by the epidural analgesic regimen. The incidence of deep venous thrombosis (125I-fibrinogen scan) was 32% after general anaesthesia and low-dose heparin and 34% after epidural analgesia with no prophylactic antithrombotic treatment (P greater than 0.9). Postoperative weight loss and decrease in serum-albumin and serum-transferrin, as well as the reduction in haemoglobin and the need for postoperative transfusions, were similar in the two groups. Convalescence, as assessed by postoperative fatigue, restoration of bowel function (flatus, bowel movement and food intake) and the time until the patients were self-aided at their preoperative level, was not reduced by epidural analgesia. Since 50% of the patients in each group suffered from one or more of the above-mentioned postoperative complications, this epidural regimen was not effective in reducing postoperative morbidity after major abdominal surgery despite the achievement of adequate pain relief.
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PMID:A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery. 408 79

161 children followed up postoperatively following splenectomy, 29% had spherocytosis, 14% Hodgkin's disease, 12% traumatic rupture of the spleen, 11% portal hypertension and 7% idiopathic thrombocytopenia. Postoperatively a slight wound infection occurred in 5% of the children, while complications were seen in 2% which could be interpreted as directly caused by the operation; in 23 patients, however, (i.e. 15%), severely infections occurred such as pneumonia, meningitis and sepsis. The lethality rate of the infected children was 31.8%. Postoperatively we determined the leucocyte count, thrombocytes and erythrocyte count, the immunoglobulins IgG, IgA, IgM and IgE, the serum concentrations of the complement components C3, C4 and the serum proteins alpha 1-antitrypsin and transferrin. The data obtained were compared with the corresponding data reported in the literature.
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PMID:[Complications of splenectomy in childhood (author's transl)]. 704 92

In convalescents after and in patients with sepsis, purulent meningoencephalitis, severe pneumonia the study of iron metabolism provided biochemical criteria of iron excess: low serum transferrin against high transferrin iron, elevated ferritin. The risk of hyperferremia rises considerably after blood or erythrocyte transfusions. The liver got affected in the presence of infectious toxicosis. The authors believe it risky to practice uncontrolled administration of iron preparations in subjects recovering from severe bacterial and inflammatory diseases in view of threatening hemochromatosis.
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PMID:[The iron overload syndrome in patients with severe bacterial inflammatory diseases and convalescents]. 802 Jul 29

Relationship was studied between the polymorphism of alpha 1-antitrypsin (Pi), haptoglobin (Hp) and transferrin and the development of chronic unspecific impairment of children lungs. Combination of protein isoforms PiM3M3 and Hp 1-1 was found to increase the risk of the lungs unspecific impairments in persons with lingering pneumonia and caused more severe development of the disease. Relatively low activity of the isoform PiM3M3, as compared with other forms of the PiMM system, and more intensive and nonadequate rate of lipid peroxidation in patients containing HP 1-1 appear to be responsible for aggravation of these impairments.
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PMID:[Isoprotein composition of alpha 1-antitrypsin, haptoglobin, transferrin, and lipid peroxidation in the blood in inflammatory lung diseases in children]. 830 77


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