Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A three-year prospective study was conducted to evaluate right atrial silicone elastomer catheters for long-term venous access in adults with acute leukemia. Objectives included establishing the safety of catheter insertion in thrombocytopenic patients and the feasibility of maintaining the catheter during septicemia. Seventy-one catheters were placed in 57 consecutive patients entering intensive leukemia therapy. Excessive bleeding occurred at three catheter insertion sites. Eight catheter-related infections occurred. In 34 of 36 noncatheter-related and two catheter-related bacteremias, catheters were left in place with intensive monitoring. In 20, bacteremia cleared. Fourteen patients died; in eight autopsies, no evidence of catheter-related mortality was found. Catheters were in use 6,799 days, including 3,932 home use and 2,570 granulocytopenic days. The data indicate that thrombocytopenia does not preclude catheter insertion and that catheters can be safely maintained in septicemic granulocytopenic patients.
JAMA 1982 Dec 03
PMID:A prospective study of prolonged central venous access in leukemia. 714 50

Streptococcus pneumoniae infection has been the predominant cause of death among children with sickle cell anemia (SS). We report our observed change in the pattern of progression of septicemia to meningitis and death in nonimmunized SS children who were not receiving prophylactic penicillin in the face of a persistently high incidence of pneumococcal disease. Of 233 SS children less than ages 6 years observed for 781 person-years, the overall incidence rate of pneumococcal septicemia was 5.9 episodes per 100 person-years. Prior to July 1972, of 23 children who had pneumococcal septicemia, eight (35%) died and meningitis developed in 15 (65%), whereas since July 1972, 11 children have had pneumococcal septicemia, but no children died and meningitis developed in only two (18%). This decrease in major morbidity is attributed to the establishment of a clinical program that provides close medical supervision of the SS child with fever and the rapid institution of parenteral antibiotic therapy.
JAMA 1981 May 08
PMID:Pneumococcal septicemia in children with sickle cell anemia. Changing trend of survival. 723 Mar 69

In a retrospective analysis of maintenance dialysis (MD) in a relatively homogeneous population of 24 patients (18 men, six women) who first received MD between 1964 and 1968 and who were initially free of other complicating diseases, we have confirmed that age at initiation of dialysis, sustained hypertension, and elevated calcium-phosphate product are significant risk factors for cardiovascular mortality. In patients without these risk factors sepsis has become the major cause of death, accounting for five (35.7%) of 14 deaths. The limit for long-term survival in an MD patient in whom the well-recognized risk factors are prevented or controlled is not yet apparent.
JAMA 1980 Jul 04
PMID:Maintenance hemodialysis. Survival beyond the first decade. 738 52

Bacteriologic cultures were performed on the tips of pulmonary artery catheters removed from 153 critically ill patients, who had required pulmonary artery catheterization for management of hypovolemic or septicemic shock or for hemodynamic monitoring during mechanical ventilation with positive end-expiratory pressure. Positive results were obtained in 29 (19%) of the cases. Infection of indwelling pulmonary artery catheters may result from contamination during placement or removal or from transient or persistent bacteremia. Colonization was probable in 17 cases, and contamination in 12. There were no instances of sepsis definitely attributable to the catheter. Positive catheter-tip culture was associated significantly with known presence of a focus of infection before catheter insertion and with periods exceeding four days that the catheter remained in place.
JAMA 1981 Mar 13
PMID:Infection of pulmonary artery catheters in critically ill patients. 746 21

Six hundred nine private patients with systemic lupus erythematosus were followed up for a mean of ten years. Ninety percent were female; 79% were white. Three hundred sixty-nine received diagnosis before 1970, and 234 after. Three hundred seventy-nine did not have nephritis; 230 did. The overall ten-year survival was 79% (87% without nephritis, 65% with nephritis). Male patients did consistently worse than female patients. No overall white vs nonwhite difference was noted. The presence of nephrotic syndrome at the onset of nephritis was a poor prognostic sign, but its development later was not. Patients younger than 16 years without nephritis have an excellent prognosis. One hundred twenty-eight patients died (82 with nephritis, 46 without nephritis). The most common causes of death were renal disease and sepsis. Improved survival of this series may reflect closer follow-up, better nutritional status, and treatment at earlier stages of disease.
JAMA 1981 Mar 06
PMID:Systemic lupus erythematosus--survival patterns. Experience with 609 patients. 746 97

Asthma mortality has increased not only in the United States but also across the world. Recent studies confirm the benefit of inhaled steroids compared with beta-agonists. Sepsis is now defined as the presence of SIRS with a confirmed infectious process.
JAMA 1995 Jun 07
PMID:Pulmonary and critical care medicine. 775 34

The systemic inflammatory response syndrome (SIRS) is an acute illness characterized by generalized activation of the endothelium. The most severe form of the syndrome is found in patients with shock due to gram-negative sepsis. We examined both animal and limited human data for the contribution of cytokines to this syndrome. Cytokines are endogenously produced proteins of small molecular weight and multiple biological effects. The cytokines interleukin 1 (IL-1) and tumor necrosis factor (TNF), as well as interferon-gamma and interleukin 8, are discussed. Laboratory investigations suggest that these cytokines play a critical role in SIRS by promoting the biochemical and clinical characteristics of SIRS. The biochemical changes induced by TNF and IL-1 include increased synthesis of nitric oxide, prostaglandins, platelet-activating factor, and endothelial cell adhesion molecules. Specific blockade of TNF using neutralizing antibodies or soluble receptors to TNF in animal models of SIRS reduces mortality and severity of disease. Similar results have been observed blocking IL-1 using soluble IL-1 receptors or IL-1 receptor antagonists. Preliminary clinical studies suggest that blockade may be useful in treating human SIRS. The various strategies for blocking IL-1 and TNF are presented; in addition, their mechanism(s) of action and safety in humans are discussed. We conclude that based on animal studies and preliminary clinical trials, strategies to block IL-1 or TNF may benefit patients with the syndrome, although thorough clinical trials have not been completed.
JAMA 1993 Apr 14
PMID:Anticytokine strategies in the treatment of the systemic inflammatory response syndrome. 845 16

The Dalkon shield tail theoretically can provide a mechanism whereby pathogenic bacteria can move from the vagina to the uterine cavity and cause sepsis. However, an in vitro experiment was run for 3 months and Escherichia coli did not move up the tail. Therefore, if a patient is satisfied with the Dalkon shield, it is not necessary to remove it. However, pregnancy can cause the IUD tail to enter the uterine cavity bringing bacterial contaimination with it. Therefore, Dalkon shield wearers should be adivsed to report to their physician as soon as a period is missed.
JAMA 1975 Sep 01
PMID:Escherichia coli transport by Dalkon shield string. (Letter to the editor). 1225

In five cases of meningitis or septicemia in children, the causative organism was Neisseria subflava. The organism is similar to N meningitidis. Only one previous case of meningitis caused by N subflava in a child has been found in the literature, but this organism may be more commonly pathogenic than has been thought. The clinical findings and course are not unlike those of septicemia and meningitis due to N meningitidis.
JAMA 1966 Mar 07
PMID:Neisseria subflava as a cause of meningitis and septicemia in children. Report of five cases. 1260 64

Polymyxin B fiber column is a medical device designed to reduce blood endotoxin levels in sepsis. Gram-negative-induced abdominal sepsis is likely to be associated with high circulating endotoxin. In June 2009, the EUPHAS study (Early Use of Polymyxin B Hemoperfusion in Abdominal Sepsis) was published in JAMA. Sixty-four patients who underwent emergency surgery for intra-abdominal infection between December 2004 and December 2007 were enrolled with severe sepsis or septic shock. Intervention patients were randomized to either conventional therapy (n = 30) or conventional therapy plus two sessions of polymyxin B hemoperfusion (n = 34). The main outcome measures were change in mean arterial pressure (MAP) and vasopressor requirement, and secondary outcomes were the PaO(2)/FiO(2) (fraction of inspired oxygen) ratio, change in organ dysfunction measured using sequential organ failure assessment (SOFA) scores, and 28-day mortality. At 72 h, MAP increased (76 to 84 mm Hg; p = 0.001) and the vasopressor requirement decreased (inotropic score: 29.9 to 6.8; p = 0.001) in the polymyxin B group, but not in the conventional therapy group (MAP: 74 to 77 mm Hg; p = 0.37; inotropic score: 28.6 to 22.4; p = 0.14). The PaO(2)/FiO(2) ratio increased slightly (235 to 264; p = 0.049) in the polymyxin B group, but not in the conventional therapy group (217 to 228; p = 0.79). SOFA scores improved in the polymyxin B group, but not in the conventional therapy group (change in SOFA: -3.4 vs. -0.1; p = 0.001), and 28-day mortality was 32% (11/34 patients) in the polymyxin B group and 53% (16/30 patients) in the conventional therapy group (unadjusted HR: 0.43, 95% CI: 0.20-0.94; adjusted HR: 0.36, 95% CI:0.16-0.80). The study demonstrated how polymyxin B hemoperfusion added to conventional therapy significantly improved hemodynamics and organ dysfunction and reduced 28-day mortality in a targeted population with severe sepsis and/or septic shock from intra-abdominal Gram-negative infections.
 ...
PMID:PMX endotoxin removal in the clinical practice: results from the EUPHAS trial. 2051 2


<< Previous 1 2 3 4 5 6 7 8 Next >>