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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical trial of cefotiam was made in children and the following results were obtained. 1. Pharmacodynamic studies of the drug in CSF of experimental staphylococcal meningitis in rabbits showed a CSF/serum ratio of T 1/2 of 3.52, which was relatively high, but a percentage of CSF/serum ratio of AUC of only 3.42% up to 3 hours, suggesting a low efficiency of passage of the drug into CSF. 2. Blood concentrations of the drug were determined in children after an intravenous bolus injection of 20 mg/kg and were 46 mcg/ml (15 min.) and 26 mcg/ml (30 min.), T 1/2 being 40.8 min., Urinary recovery rate was 91.3% up to 4 hours in one patient and 61.9% up to 6 hours in another, respectively. 3. Thirteen patients with the following 14 episodes of infections were treated with cefotiam; urinary tract infection (5 cases), pneumonia (5), empyema (1), tonsillitis (1) and suspected sepsis (2). An overall efficacy rate was 100%, i. e., excellent in 12, good in 2 and no failure. No adverse reactions were clinically discernible and only laboratory abnormalities were transient or slight elevations of transaminase levels in 2 patients. 4. Based on the above results, it was concluded that cefotiam is a potent new antibiotic in the treatment of bacterial infections. Spectrum and antibacterial activity of the drug suggest that the drug particularly indicated for pneumonia.
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PMID:[Clinical evaluation of cefotiam in children (author's transl)]. 627 Apr 21

Ceftizoxime (FK 749, CZX) was evaluated in 24 children with a suspicion of bacterial infection. Of the 17 confirmed bacterial infections, 16 were shown to be effective (effective rate, 94.1%). The diagnosis included acute pharyngitis (2), pneumonia (6), staphylococcal empyema (1), cervical purulent lymphadenitis (2), acute enterocolitis (2), acute pyelonephritis (1), SSSS (1) and suspected septicemia (2). The etiological pathogens recovered were Streptococcus anginosus (1), Streptococcus pneumoniae (1), Staphylococcus aureus (2), Haemophilus influenzae (3), enteropathogenic Escherichia coli (1) etc. A case of suspected Pseudomonas aeruginosa septicemia was not effectively treated with CZX. The serum half-life of CZX was 1.36 hours after intravenous bolus infection. A cerebrospinal fluid level of CZX was 6.2 mcg/ml 1 hour after intravenous bolus injection of 1 g (23.8 mg/kg) in a child with inflamed meninges. No severe adverse reaction was encountered with the CZX therapy. The data suggest that CZX is an excellent candidate for the first choice parenteral antibiotic in the pediatric infections.
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PMID:[Clinical evaluation of ceftizoxime in the pediatric infections (author's transl)]. 627 2

A 14-year-old boy with deep burns, blunt abdominal trauma and extensive muscle damage is described. The patient was operated on for a ruptured liver, developed acute tubular necrosis, had 3220 gr of necrotic tissue removed in serial tangential excisions, had an above elbow amputation of the left hand, removal of necrotic ribs and excisions of necrotic spinal processes, developed sepsis twice, empyema of right pleura, had open infected knee joints and was successfully treated until complete healing over a period of four months. The successful outcome seems to be due to early and aggressive surgical treatment, hemodialysis, total parenteral nutrition for over two months, antibiotic therapy, cryoprecipitate and devoted nursing, occupational and physiotherapy.
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PMID:Very deep high temperature burns associated with blunt abdomino-thoracic trauma. 634 51

Fifty patients with chronic empyema thoracis, without bronchopleural fistula, were treated by drainage and twice-daily instillations of 2% taurolidine (Taurolin; Continental Ethicals) for 14 days. No antibiotics were used. Forty-three patients completed the treatment and 7 were withdrawn from the trial, 3 because of evidence of bronchopleural fistula and 1 each because of pain during instillation, associated chest-wall cellulitis, an unexplained, acute epilepsy-like episode during instillation, and inadvertent administration of antibiotics. All 43 patients who completed the trial showed an excellent clinical response with control of the local and systemic toxic effects of sepsis. A rapid falling-off in the volume and purulence of pleural drainage fluid was noted. Twenty-four of the 43 patients (55,8%) were rendered bacteriologically sterile by the treatment. Instillation of 2% taurolidine was therefore an effective form of monotherapy in cases of chronic empyema thoracis without bronchopleural fistula.
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PMID:Taurolidine instillation as therapy for empyema thoracis. A prospective study of 50 patients. 635 21

A survey of 89 patients with subdural empyema was conducted to assess the incidence of late seizures and morbidity in this disease. Twenty-four patients died during the acute stage of the illness and, of the 65 survivors, 13 were lost or had incomplete follow-up review. Hemiparesis occurred in 48 of the survivors during the acute stage, and all but nine recovered completely. Thirteen patients had a visual field deficit and all recovered; in three of these 13 who had speech disorders the deficits persisted. Recovery from neurological morbidity was not related to the type of surgical treatment; however, the mortality rate was improved by craniotomy. The same incidence of early seizures occurred in those who died (62%) as in those who survived (63%). Of those who had no early seizures, 42% had late seizures, the majority appearing within 16 months. Of those who had early seizures, 71% did not have subsequent attacks. The highest incidence of seizures occurred in patients who had their empyema in the second and third decades of life. The incidence of late seizures was not influenced by the method of surgical treatment, the degree of deterioration of consciousness during the acute stage of the illness, nor by occurrence of early seizures. A significantly increased incidence of early seizures was associated with paranasal sepsis, but not with late seizures.
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PMID:Late seizures and morbidity after subdural empyema. 640 70

Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.
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PMID:Empyema following intra-abdominal sepsis. 647 70

Cefotetan (CTT), a new cephamycin antibiotic having a long serum half-life (2.93 +/- 0.78 hours), was evaluated for its safety and efficacy in children. Twenty-four patients were treated with a daily dose of 30 to 100 mg/kg of CTT by intravenous administrations mostly in 2 divided doses. The diagnoses of the effective patients were acute bronchitis (5), pneumonia (4), acute urinary tract infections (4), acute enterocolitis (2), presumed septicemia (1), and phlegmon (1); and the effectiveness was 77.3%. The pathogens recovered from these patients were S. pneumoniae (1), H. influenzae (3), S. marcescens (1), E. coli (2), and K. oxytoca (1). CTT was not effective in staphylococcal pneumonia and empyema (each 1 case), in Pseudomonas pneumonia (2), and in a case of brain abscess and mastoiditis of unknown etiology. Diarrhea (2), and transient elevations of the serum GOT, GPT, and LDH (1) were associated with the CTT therapy, but no severe adverse reaction was encountered. The CSF level of CTT seemed to be lower among several new cephalosporins. From the present study, CTT appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections. A twice-a-day schedule was recommended from its long serum half-life.
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PMID:[Clinical evaluation of cefotetan in pediatrics]. 658 31

Thirty two patients with empyema of the gall bladder were identified among 1327 cases of gall-bladder disease presenting to one hospital over a six year period. Abdominal pain had been present for a median of eight days and, in eight cases, for between one and four months. In a few cases, the disease was painless and was discovered unexpectedly at postmortem or at operation for unrelated disease. The serious nature of the complaint was belied by the often scanty physical signs. Less than half the patients had a pyrexia of more than 37.5 degrees C and the presence of sepsis was rarely suspected clinically. Eight patients (25%) died, usually from unsuspected septicaemia. This considerable mortality might be reduced by the wider use of blood culture in cases of apparent 'cholecystitis' and by greater awareness that empyema of the gall bladder is sometimes chronic, painless, and afebrile.
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PMID:Empyema of the gall bladder - reappraisal of a neglected disease. 664 80

Animal models were established for Staphylococcus aureus generalized infection (septicemia), and for localized S. aureus infection (osteomyelitis and empyema) to evaluate the possible use of a S. aureus latex agglutination (Lat-SA) test as an indicator of S. aureus infection. Plasma, obtained from animals before and after S. aureus challenge, was used for the test. In the models of generalized infection, all nine rabbits and 13 of 20 (65%) rats had a positive Lat-SA test together with a positive blood culture. Only 3 of the 14 (21%) rats with negative blood cultures after S. aureus challenge had a positive test (P less than 0.05). In the models of localized infection, plasma samples were positive in all animals at some time after bacterial challenge, even if the animal was not bacteremic. Aspirates from bone marrow (2/2) for the osteomyelitis model and pleural exudate (2/2) for the empyema model were Lat-SA test positive and yielded S. aureus on culture. Plasma obtained from these animals before injection with bacteria were all negative by the Lat-SA test, as were plasma samples obtained from two rabbits after injection with S. epidermidis. Since these models mimic human disease, the Lat-SA test may be useful as a diagnostic aid for S. aureus infection in man. Further studies will be necessary to evaluate this.
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PMID:Staphylococcus aureus latex agglutination (Lat-SA) test for the diagnosis of S. aureus infection. 667 59

Endoscopic sphincterotomy (ES) is widely used in the treatment of patients with common bile duct (CBD) stones following cholecystectomy. The technique has now been extended to patients with gallbladders still present and the results of ES in 100 such patients is reported. Fifty-nine were considered unsuitable for surgery (Group A), in 38 ES was performed as a preliminary to cholecystectomy (Group B) and in 3 ES was performed following emergency cholecystostomy (Group C). ES was achieved in 98 patients and stones completely extracted in 91 patients. In Group A 5 patients required surgery, in 3 because of technical failure and in 2 because of empyema of the gallbladder. One patient who presented in extremis died following failure to extract a large CBD stone. On follow-up (4-50 months), 16 patients have died but in only one from gallbladder sepsis, and one has had a cholecystectomy for pain. In Group B choledochotomy was avoided in 29 of the 37 patients who agreed to cholecystectomy. In Group C no further surgery was required and all patients in Groups B and C remain well. These results indicate that ES is an effective technique for treating patients with CBD stones with the gallbladder in situ, either alone in patients considered unsuitable for surgery or as an adjunct to surgery.
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PMID:The management of common bile duct calculi by endoscopic sphincterotomy in patients with gallbladders in situ. 668 76


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