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

According to cell cycle synchrony principles, bleomycin was infused for 48 hours, followed by a dose of either methotrexate or hydroxyurea after a 24-hour rest, in 36 adult patients with disseminated carcinoma. In this preliminary study, a 59% response rate was noted among patients with epidermoid carcinoma of the head and neck. Four of four patients with transitional cell carcinoma of bladder and one patient with hypernephroma also responded. No responses were noted among five patients with epidermoid carcinoma of the lung. The length of response ranged from 1 to 8 months (median, 2 months). Seventy-seven percent of the responders had extensive prior radiotherapy. The first patient treated had fatal sepsis with leukopenia, which prompted a widening of the treatment interval. Subsequently, toxicity was mainly mild or absent, the moderate or severe toxicity was primarily neutropenia, which was reversible. The use of low-dose bleomycin infusion is safe and may play a role in cancer therapy in combination with other agents specific for certain tumors. The length of infusion should be determined by the cell cycle of the tumor, if its potential synchronizing capabilities are to be exploited.
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PMID:Intravenous bleomycin infusion as a potential syncronizing agent in human disseminated malignancies: a preliminary report. 6 5

Thirty-nine patients with advanced epidermoid carcinoma of the head and neck were treated with a combination of cis-dichlorodiammineplatinum(II), methotrexate, bleomycin, and vincristine. Twenty-nine patients were evaluable for response and 39 were evaluable for toxicity. With this regimen toxicity was acceptable and the following rates were observed in a total of 139 treatment courses: 100% (nausea and vomiting), 3% (decreased creatinine clearance), 4% (thrombocytopenia), 5% (leukopenia), and 2% (pulmonary fibrosis). There was one death due to sepsis during a period of chemotherapy-induced leukopenia. Although the patients treated with this regimen had advanced disease and had been treated aggressively previously, an overall response rate of 24% was observed, with three patients (10%) having a complete response. Median duration of response was 7 + months. These results indicate that this intensive combination chemotherapy has a sufficiently favorable risk/benefit ratio to allow its evaluation in randomized clinical trials in patients with head and neck cancer.
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PMID:Cis-dichlorodiammineplatinum(II), methotrexate, bleomycin, and vincristine in head and neck cancer: a pilot study. 9 8

Severe neutropenia, in the absence of generalized bone marrow depression, is a rare complication in adults receiving chrysotherapy for rheumatoid arthritis and has not been described in children. Isolated, severe neutropenia developed in five children with systemic onset JRA while they were receiving gold injections. This potentially fatal complication occurred within eight weeks of beginning therapy in four patients, and after 24 weeks of well-tolerated therapy in the fifth. Leukopenia preceded neutropenia in two children. Localized infection was successfully treated in one child; septicemia was fatal to a second child. Neutropenia resolved within eight to 14 days of its onset in the four survivors; chelation with dimercaprol in one child did not appear to alter the recovery time. It is suggested that a systemic onset of JRA in children less than 6 years of age identifies a higher risk group developing severe neutropenia during chrysotherapy. Cessation of gold therapy upon recognition of a decreasing neutrophil count may prevent or ameliorate a developing neutropenia; careful observation for, and early treatment of, infection may alter its outcome.
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PMID:Neutropenia associated with chrysotherapy for juvenile rheumatoid arthritis. 10 49

A patient with acute leukemia developed two separate episodes of Bacillus cereus septicemia during one hospitalization. Leukopenia as a consequence of cytotoxic chemotherapy preceded both illnesses. The course of the infections was favorably influenced by the return of adequate numbers of circulating granulocytes and aminoglycoside therapy. Only one other compromised host is known to have recovered from this otherwise fatal disease.
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PMID:Recovery from Bacillus cereus sepsis. 11 55

The antiendotoxin effect of polymyxin B was investigated in experimentally induced septicemia in rabbits. The Pasteurella multocida organisms were sensitive to the antibacterial action of penicillin but not to polymyxin B. Animals pre-treated with polymyxin showed positive blood cultures and significantly reduced plasma endotoxin levels (Limulus test) with normal white blood cell and platelet counts when analyzed 6 hr after the injection of live organisms. Polymyxin therapy given after the animals had established septicemia-endotoxemia reduced the plasma endotoxin levels and improved the survival, but had no effect on the leukopenia and thrombocytopenia. The best survival data were obtained in rabbits who were treated with both penicillin and polymyxin. The data suggest that polymyxin is effective in neutralizing the endotoxic effects from live organisms and that the timing and perhaps duration of the polymyxin treatment is of critical importance. In addition, a modified Limulus lysate method was developed which showed that quantitative plasma endotoxin determination could be made more sensitive by prior heating of the plasma to remove the natural inhibitors.
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PMID:Effect of polymyxin B sulfate on endotoxin activity in a gram-negative septicemia model. 21 10

Investigated were a total of 30 cattle 6 of which had experimental surgery infection and 24 showed spontaneously developing suppurative infection. The animals were studied in terms of general status, blood picture, quality of urine and synovia, and rumen content. The dynamis was followed up of the development of sepsis and purulent artritis. It was found that in case of suppurative surgical infections in cattle the general status was invariably affected, the severity of the process depending on its localization and developmental phase. Changes were observed also in the eye fundus and in the urinary and the digestive system. There were anemia and leukopenia which alternated with leukocytosis, and transient changes in the values of the erythrocyte sedimentation rate and the blood electrolytes. The SGOT values almost constantly increased, and the hemoculture was not positive in all cases.
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PMID:[Clinical and experimental studies of suppurative surgical infection in cattle]. 34 55

Serum antibodies to exotoxin A and type-specific lipopolysaccharide were measured by passive hemagglutination in 52 patients with Pseudomonas aeruginosa septicemia. Their comparative protective activities were evaluated by relating the titers of each at the onset of bacteremia to subsequent outcome. High acute serum antitoxin and antilipopolysaccharide titers (log2 reciprocal mean titers greater than 5) were associated with survival (76% of 17 with high vs. 46% of 24 with low antitoxin titers, P = 0.05; 85% of 13 with high vs. 48% of 29 with low antilipopolysaccharide titers, P = 0.03). In contrast, neither antibody titer was significantly associated (P less than or equal to 0.05) with patients' age or sex, severity of underlying disease, presence of leukopenia, steroid or immunosuppressive therapy. Despite a correlation between acute titers of the two antibodies (r = 0.33, P = 0.06), they appeared to protect independently and additively. Whereas 75% of 8 patients with high antitoxin titers and only 38% of 16 with low titers survived with low antilipopolysaccharide titers (P = 0.10), 100% (6/6), 73% (8/11), and 38% (6/16) survived, respectively, when both, one, or neither antibody was present in high titer (P = 0.01). Furthermore, the association between high acute serum antitoxin titers and survival was more pronounced in patients with rapidly fatal underlying disease (P = 0.06) and leukopenia (P = 0.12) than in more favorable prognostic and immune categories. These data indicate that serum antibodies to exotoxin A and lipopolysaccharide are found in most patients with P. aeruginosa septicemia and both are protective. Both antibodies may have therapeutic or prophylactic potential, whereas serum antiexotoxin A antibodies may be particularly beneficial in compromised hosts.
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PMID:Protective activity of antibodies to exotoxin A and lipopolysaccharide at the onset of Pseudomonas aeruginosa septicemia in man. 42 53

Consecutive newborn autopsy cases were divided into infected and noninfected groups on the basis of pathologic findings and cultures, and were compared to a concomitant consecutive group of neonatal survivors with proven bacterial sepsis. Newborns dying with bacterial infection often demonstrated leukopenia, neutropenia, and thrombocytopenia, usually associated with normal bone marrow cell production. Those with nonfatal sepsis frequently had neutrophilia with an increase in absolute band counts. Of infected newborns 80% showed one or more hematologic abnormalities as did 43% of newborns dying without bacterial infection. Of newborns dying with bacterial infection 13% had no hematologic abnormality. Blood cultures were negative in 18% (seven) of the infants dying with bacterial infection. Abnormalities of the white blood cell, differential and platelet counts are not invariably specific for bacterial infection nor do normal values adequately exclude it. Blood cultures may be negative in newborns dying with significant foci of bacterial infection.
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PMID:Diagnosis of neonatal bacterial infection: hematologic and pathologic findings in fatal and nonfatal cases. 45 May 62

Respiratory distress is the most frequent symptom initiating referral to neonatal intensive care centers. Previous reports have indicated that 40% of infants with sepsis proved by blood culture had respiratory symptoms as their clinical presentation. In this prospective study there were 145 consecutive infants referred because of respiratory distress. Two-site blood cultures were collated with all other clinical and laboratory data to confirm a diagnosis of septicemia. There was a 4.8% incidence of bacteremia, and clinical and laboratory parameters confirmed septicemia in 3.5% of infants studied. Sixty percent of these infants had group B streptococcal sepsis, and 80% had leukopenia. The low incidence of confirmed septicemia in infants referred because of respiratory distress suggests that antibiotic therapy should not be routine.
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PMID:Incidence of sepsis in neonates with clinical respiratory distress. 48 82

A cluster of three cases of staphylococcal septic endarteritis originating from percutaneously inserted brachial artery catheters for regional cancer chemotherapy prompted an epidemiologic and clinical study of bacteremic infections associated with this therapeutic modality. Nine cases were identified over a 3 1/2-year period (1.6% of all catheterizations), all caused by Staphylococcus aureus. The cluster followed discontinuation of hexachlorophene for scrub of the extremity prior to cannulation; phage-typing suggested the three cases were caused by the patients' own strains of Staphylococcus. These infections produced a distinctive clinical syndrome which facilitates implicating the catheter in the genesis of fever occurring in a patient receiving intra-arterial chemotherapy: early localized pain (89%) and hemorrhage (78%), and Osler's nodes distally (44%), later followed by local inflammation (78%), purulence (56%) and signs of systemic sepsis (100%) (each factor, p less than or equal to .005). Duration of cannulation did not influence susceptibility to infection. However, difficult cannulations or need for repositioning the catheter (p = .0096), prior radiation therapy (p = .033), leukopenia (p less than .05) and hypoalbuminemia (p less than .05) were all associated with septicemia. In the 25 months since implementation of specific control measures, there have been no further catheter-related septicemia in 310 catheterization (p less than .001). Guide-lines for prevention and management of these infections are provided.
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PMID:Septic endarteritis due to intra-arterial catheters for cancer chemotherapy. I. Evaluation of an outbreak. II. Risk factors, clinical features and management, III. Guidelines for prevention. 49 11


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