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

When bacterial infections exceed or overcome the ability of a kitten's immune system to provide protection, life-threatening illnesses such as neonatal sepsis often occur. Many kittens with neonatal sepsis show unusual presentations or a wide variety of clinical presentations that may not be immediately recognized as being associated with sepsis. Because neonatal sepsis causes unexpected sudden death, kittens suspected of having sepsis should be treated immediately. In most instances, initial antimicrobial therapy is selected empirically. Kittens are treated by giving intravenous or intraosseous fluids for dehydration, oxygen to counter tissue hypoxemia, and glucose if hypoglycemia is present. The beta-lactam antimicrobial agents such as the penicillins, cephalosporins, and the combination of beta-lactam antimicrobials and beta-lactamase inhibitors are considered to be the first choice in the treatment of any septicemic kittens.
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PMID:Feline neonatal sepsis. 842 91

Nutritional support for critically ill patients with diabetes mellitus will be successful when nutrition meets the patient's metabolic needs; blood glucose levels are maintained between 100 and 200 mg/dL; complications of hyperglycemia, sepsis, and hypoglycemia are prevented; insulin dosages take basal metabolic needs, stress level, pharmacologic therapy, and the degree of illness into account; and nutritional support is provided in the least invasive manner possible. Providing nutritional support without adequate glycemic control and appropriate insulin administration is counterproductive for the patient. Careful monitoring of blood glucose and blood chemistries, along with the physical assessment of patients receiving nutritional support, are essential to successful treatment. Further research is necessary to define better which levels of glycemic control are most beneficial for providing optimal nutritional support for critically ill patients with diabetes mellitus.
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PMID:Nutritional support for the patient with diabetes. 844 2

To investigate whether the inhibition of protein kinases including protein kinase C can antagonize endotoxicosis, the in vivo effects of K252a, a potent inhibitor of protein kinases, on endotoxin-induced lethality and glucose dyshomeostasis were determined in conscious rats. Sprague-Dawley rats (260-340 g) were divided into the following four groups: Group DS, 2.5% dimethyl sulfoxide (DMSO), 6 ml/kg iv + 0.9% saline, 2 ml/kg iv; group KS, K252a in 2.5% DMSO, 4 mg/kg iv + 0.9% saline; group DE, 2.5% DMSO + endotoxin (E. coli), 15 mg/kg iv; and group KE, K252a in 2.5% DMSO + endotoxin. A quarter of DMSO or K252a solution was continuously infused over a 15 min period before a bolus injection of either saline or endotoxin. The remaining dose was administered over a 180 min period after saline or endotoxin. All animals in the DS and KS groups survived for 24 hrs. K252a significantly improved endotoxic lethality. It attenuated the initial hyperglycemia, and late hypoglycemia, hyperlactacidemia, and base deficit after endotoxin. However, K252a had no influence on the endotoxic alterations of blood pressure, PaCO2 or PaO2. These results suggest that the activations of protein kinases, particularly protein kinase C, are involved in the pathogenesis of lethal endotoxicosis and sepsis.
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PMID:K252a, a potent protein kinase inhibitor, improves endotoxic lethality and glucose dyshomeostasis. 846 75

Sepsis-induced glucose dyshomeostasis has been characterized by an initial hyperglycemia followed by a progressive hypoglycemia. It is well known that the liver plays a predominant role on regulating the homeostatic level of blood glucose. Furthermore, recent studies indicate that protein kinase A, activated by c-AMP, contributes to the role of glycagon in glucogenolysis and glyconeogenesis. Kinetic studies of protein kinase were completed. During late sepsis, in order to further understand the pathophysiology of hepatic glucose disturbances during sepsis. This study investigates the role of protein kinase A in the liver regulating carbohydrate metabolism during early sepsis. The work was performed by using an animal septic model, induced by cecal ligation and puncture (CLP) operation. Through the measurement of blood sugar, a two phase change in sugar level was found. That is, blood sugar significantly increased at 4.5 hrs after CLP operation (p < 0.05) and then significantly decreased at 18 hrs (p < 0.01). In the kinetic studies of protein kinase A, the results showed that, during early sepsis, the activities of both type I (eluted at low ionic strength) and type II (eluted at high ionic strength) protein kinase A were unchanged. Moreover, the kinetic parameters, Vmax and S0.5, of protein kinase A showed no significant difference between two groups. As such, it is suggested that hyperglycemia during early sepsis is not connected to the regulation of protein kinase A.
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PMID:[Kinetic studies of protein kinase A in rat liver during early sepsis]. 849 56

A newborn infant had metabolic acidosis, tachypnea, and hypoglycemia. After the initial diagnosis of neonatal sepsis, she was given antibiotics but failed to respond. Further investigation revealed that her mother had taken aspirin throughout pregnancy. This case illustrates the similarities between symptoms of neonatal sepsis and those of a toxic reaction to salicylate.
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PMID:Toxic reaction to salicylate in a newborn infant: similarities to neonatal sepsis. 850 77

In a newborn rat model of sepsis, the changes of nitric oxide and the protective effects of methylene blue or/and dexamethason were investigated. The results revealed that plasma nitric oxide levels were elevated at 6 h and peaked at 12 h after bacterial challenge. The treatment with methylene or/and dexamethasone was found to blunt hypoglycemia and hyperlacticemia, to reduce the occurrence rate of loss of response to pain, and to prolong the survival time. Moreover, therapy by dexamethasone was shown to decrease the 24 h mortality. The results suggested that nitric oxide play an important role during the course of fatal P. aeruginosa sepsis, but it is clear that the clinical value of nitric oxide and its inhibitors need to be further studied.
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PMID:Changes of nitric oxide and protective effects of nitric oxide inhibitors in newborn rats with sepsis. 858 Apr 89

A 71-year-old patient with high-grade non-Hodgkin's lymphoma stage IVB, severe lactic acidosis and tumor-associated hypoglycemia is described. Endocrine causes of hypoglycemic episodes were excluded because of low serum concentrations of insulin and "insulin-like growth factor 1", and normal concentrations of growth hormone and thyroid hormone. Clinical conditions associated with lactic acidosis such as diabetes mellitus, biguanide intoxication, septicemia, acute hypoxemia, or circulatory insufficiency were ruled out. Enhanced glucose metabolism within the tumor was visualized by positron emission tomography employing 2-fluro-2-deoxy-D-glucose (FDG) as a tracer. A markedly elevated tumor necrosis factor-alpha (TNF-alpha) level was found which decreased after cytoreductive therapy paralleling the normalization of serum lactate. In contrast to the majority of cases of lymphoma-associated lactic acidoses reviewed to date, in our case lactate elimination was not reduced.
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PMID:Lactic acidosis and hypoglycemia in a patient with high-grade non-Hodgkin's lymphoma and elevated circulating TNF-alpha. 859 16

The present study on 5330 patients admitted to the internal intensive care unit over the five year period (1990-1994) indicated that consciousness disorders are most frequently associated with poisoning. On admission, the state of consciousness of 665 of these 5330 patients was retrospectively evaluated. Poisoning by drugs was most common among intoxications (93 patients of 154 cases of poisoning). Coma, which is the most severe manifestation of consciousness disorder, occurred very often in these patients. Poisoning caused by other agents was connected with other forms of consciousness disorders. Low Glasgow Coma Score (GCS) was a severe predictor, while the number of deaths among patients with GCS > 10 was low. Sepsis was the next most common cause of consciousness disorder among our patients (88 patients). Death rate in these patients was high, amounting to almost 50%, regardless of GCS on admission, suggesting that the severity of main event determines the outcome. Glycemia disorders, including hypoglycemia, hyperglycemia as well as hyperosmotic state, did not result in lethal outcome, regardless of GCS on admission. The highest death rate was registered in patients with cardiopulmonary arrest and lowest GCS on admission. Patients with cardiogenic shock, despite high GCS on admission, had high death rate.
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PMID:[Causes of disorders of consciousness in internal medicine intensive care units]. 864 56

Exchange transfusion has an important role in the treatment of hyperbilirubinemia of the newborn. It is used in attempts to prevent kernicterus when bilirubin levels are high. We describe our experience in 203 exchange transfusions performed on 143 infants (81 males and 62 females) with hyperbilirubinemia during 1983-1992. In only 30% of cases was there a specific etiological diagnosis of the jaundice based on a positive Coombs test, G6PD deficiency, or the presence of sepsis or maternal diabetes; the rest were idiopathic. 57% of the neonates were premature (26-36 weeks of gestation). Premature neonates underwent more transfusions than full-term infants (1.6 vs 1.2). There was no direct death from exchange transfusion; morbidity was 6.3% (including bradycardia, apnea, thrombocytopenia, hypoglycemia and hyponatremia). Most complications occurred in preterm infants and those severely ill. All complications were treated immediately and there were no sequelae.
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PMID:[Complications of exchange transfusion in term and preterm newborns]. 868 93

This report describes the development of a rat peritonitis model that simulates a slow, sustained bacterial release from the gut. Septic animals (SEP) received an intraperitoneal infusion of a bacterial inoculum (6.5 x 10(8) colony forming units Escherichia coli) over 12 h, while control rats (CON) received a sterile inoculum. This model yielded a 52% mortality over 7 days in SEP, with deaths usually occurring 24-48 h after the onset of infusion. Septic rats showed greater febrile responses and body weight losses than those of CON, as well as mild hyperlactacidemia, hypoglycemia, and episodic bacteremia. Maximum bacterial counts in peritoneal fluid and several organs of SEP were observed at 36 h, with bacterial counts progressively decreasing by 7 days to levels similar to those observed at 12 h. Lung and spleen wet weights increased by 17% at 36 h and 7 days post-infection in SEP. Histological evaluation of random organ samples revealed mild to moderate morphological changes in SEP while CON showed no or minimal changes in the parameters measured during the study. This new model of chronic peritonitis in the rat reproduces many of the clinical features observed in human sepsis, and thus should prove to be a useful tool in further studies of the pathophysiology of peritonitis.
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PMID:A sustained release bacterial inoculum infusion model of intra-abdominal infection in conscious rats: bacteriology, metabolism, and histopathology. 879 58


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