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

Vindesine, a new vinca alkaloid, has shown therapeutic activity in several human malignancies. A phase II study in 26 patients with squamous cell carcinoma of the esophagus was performed. Sixty percent of these patients had received prior chemotherapy. The starting dose was 3.0 mg/m2, which was escalated by 0.5 mg/m2 to a maximum of 4.5 mg/m2. Treatment was given once weekly for 7 weeks and every other week thereafter. Twenty-three patients were evaluable for response and toxicity. One complete remission (3 months), three partial remissions (5, 4, and 2+ months), and two minor responses (1.5 and 1 month) were seen. The major toxic effects were peripheral neuropathy, leukopenia, fever and myalgias, and alopecia. There was one drug-related death from leukopenia and sepsis. Vindesine has demonstrated therapeutic activity in esophageal carcinoma. Further studies with this agent are indicated.
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PMID:Vindesine in the treatment of esophageal carcinoma: a phase II study. 52 35

Twenty patients with several histologic subtypes of non-Hodgkin lymphoma who had become resistant to combination chemotherapy were treated with a five-day course of the epipodophyllotixin VP-16. Of 19 evaluable patients, 8 (42%) responded to treatment with 1 complete response and 7 partial responses. The median duration of response was 5.5 months. Seven of the responders had a diffuse lymphoma and 1 had a nodular lymphoma. Of the responders who had diffuse histiocytic lymphoma (DHL), diffuse mixed lymphoma (DML), and diffuse undifferentiated lymphoma (DUL)--the more aggressive histologies in the Rappaport classification--6 of 13 (46%) evaluable patients responded to therapy. Responses were seen in node-dominant, skin-dominant, and marrow-dominant disease. Toxicity was mainly hematopoietic, 53% of patients experiencing leukopenia ( less than 2,000 cells per cu mm) and 68% of patients experiencing thrombocytopenian 2,000 cells per cu mm) and 68% of patients experiencing thrombocytopenia ( less than 100,000 platelets per cu mm). There were two deaths attributable to profound leukopenia with sepsis. The activity of VP-16 in patients who have previously been extensively treated with multiple drugs including vincristine supports its activity in the lymphomas and suggests its lack of cross-resistance with vincristine. The inclusion of VP-16 in primary treatment protocols in the diffuse lymphomas should be considered.
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PMID:Activity of the epipodophyllotoxin VP-16 in the treatment of combination chemotherapy-resistant non-Hodgkin lymphoma. 75 59

Of 237 cases of gram-negative rod bacteremia observed at the UCLA Medical Center during a 12 month period, 52 (22 per cent) occurred while the patient was receiving antibiotics which inhibited the infecting organism by disc diffusion tests. One half of the plasma samples available from 42 such patients with "breakthrough" bacteremia had subinhibitory circulating antibiotic levels when cultures were positive. Sepsis documented within 72 hours of initiation of therapy was usually due to antibiotic-sensitive Esch. coli and was associated with inadequate antibiotic levels; the patient was usually treated with a penicillin or cephalosporin. The source of bacteremia was most frequently the urinary tract or the biliary tree. In contrast, sepsis occurring more than 72 hours after the administration of antibiotics was frequently caused by multiple antibiotic-resistant Esch. coli in patients treated with gentamicin in adequate dosage and was associated with leukopenia or undrained purulent collections. Therapy ultimately failed in 20 cases (48 per cent): in early "breakthrough" bacteremia, failure was associated with subinhibitory antibiotic levels, and in late "breakthrough" bacteremias with inadequate drainage or impaired host defenses.
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PMID:Simultaneous antibiotic levels in "breakthrough" gram-negative rod bacteremia. 78 12

Thirty-six renal transplant recipients with 47 episodes of septicemia were studied carefully at the bedside, in the laboratory, and, all too frequently, at autopsy. Gram-negative bacilli were the pathogens most commonly responsible, folloed in order of frequency by gram-positive cocci, polymicrobic etiologic agents, Listeria monocytogenes, and fungi. Infections of the transplant site (urinary tract or transplant wounds) caused septicemia in 51% of the cases. Other portals of entry included the lung, the abdomen, the meninges, the endocardium, and miscellaneous sites. The outcome of septicemia was fatal in 36% of the episodes. There was a significantly higher mortality for episodes of septicemia associated with pneumonia, persistent bloodstream infection, leukopenia, metastatic abscesses, clinical shock, and acute respiratory failure. The high mortality of septicemia in renal allograft recipients demands that extremely careful attention be given to subtle clinical clues denoting the onset and predicting the course of the disorder.
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PMID:Septicemia in renal transplant recipients. 79 Jul 36

Bone marrow toxicity occurred in 4 of 15 patients treated with 5-fluorocytosine (5-FC) for serious fungal infections. The development of marrow toxicity appeared to be related to serum 5-FC levels of 125 mug/ml or greater. In three patients, accumulation of toxic levels of 5-FC was related to diminished renal function. One patient with acute renal failure and prolonged high levels of 5-FC developed marrow aplasia and died of bacterial sepsis. Three patients experienced leukopenia, which was readily reversed when the dosage of 5-FC was decreased and the serum concentration was lowered. With careful monitoring of serum 5-FC concentration and renal function, the dose-related toxic effects of 5-FC on the marrow can be avoided.
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PMID:Bone marrow toxicity associated with 5-fluorocytosine therapy. 84 28

During a 14 month period there were 364 episodes of bacteremia and fungemia at Memorial Sloan-Kettering Cancer Center. The first nine months of the study were retrospective, and the next five prospective. In patients with leukemia or lymphoma (group 1), Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were the most frequently isolated organisms. The mortality in this group was 40.5 per cent. In the patients with solid tumor (group 2), Esch. coli, Staph. aureus, Bacteroides sp. and Candida sp. were most frequent. Mortality was 27.8 per cent. The source of infection in both groups was often indeterminate. High mortality was associated with pulmonary and intraabdominal infection and with Ps. aeruginosa, K. pneumoniae or polymicrobic sepsis. Factors of prognostic significance were the causative microorganism, source of infection and shock. Although mortality was higher in patients with leukopenia than in those with normal leukocyte counts, the differences were not significant. The mortality in this series was low considering the severity of the underlying diseases and the immunosuppressed state of many of the patients. In a prospective, randomly controlled study, mortality was further diminished by infectious disease consultation at the time the positive blood culture was reported. Severe fungal superinfection, predominantly aspergillosis and candidiasis, was found in 52 per cent of the autopsy patients with leukemia or lymphoma (group 1), but in only 8 per cent of those with solid tumors (group 2).
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PMID:Bacteremia and fungemia complicating neoplastic disease. A study of 364 cases. 87 Nov 28

Retrospective evaluation of the occurrence of septicemia and meningitis in 200 children who had staging laparotomy iwth splenectomy for Hodgkin's disease revealed 20 episodes occurring in 18 children. Symptoms were usually fulminant; only 10 of these patients survived their episode. Infections occurred eight days to three years after splenectomy. Adolescents, as well as younger children, were affected; half were older than 10 years of age. Leukopenia was not a major factor in onset or survival since the average white-cell count was 12,000 in both survivors and children who died. Pneumonococcus accounted for 50 per cent, and streptococcus for 15 per cent of infections; there was one episode each of Haemophilus influenzae and meningococcus; in 25 per cent, no organism was isolated. Predominance of penicillin-sensitive organisms and high mortality suggest that penicillin prophylaxis and the protection offered by bacterial vaccines should be evaluated in children with Hodgkin's disease whose staging laparotomy includes splenectomy.
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PMID:Septicemia and meningitis in children splenectomized for hodgkin's disease. 95 75

The hematological responses of neonatal calves with acute enteric infections were compared to the responses of calves with septicemia and experimentally induced endotoxemia. The mean hematocrit of septicemic calves (45.0% +/- 7.8) was similar to that of calves with primary enteric infections (45.3% +/- 7.0) but the total plasma protein concentration of septicemic calves (5.8g/100 ml +/- 0.69) was significantly lower than that of calves with primary enteric infections (8.6 g/100 ml +/- 1.5). The difference in total plasma protein concentration was due primarily to the hypogammaglobulinemia observed in septicemic calves. The leukocytic response to septicemic calves was similar to that of nonsepticemic calves with enteric infections. In most calves of both groups, moderate but significant leukocytosis and neutrophilia were observed. Marked leukopenia was observed terminally in 2 of 9 septicemic calves but in only 1 of 26 calves with primary enteric infections. Leukopenia was a characteristic finding in calves with experimental endotoxemia. Leukopenia developed within 5 minutes following intravenous administration of endotoxin and persisted until death in most calves. In calves which lived 12 hours or longer, there was a biphasic leukocytic response with leukocytosis being observed 24 hours following endotoxin administration.
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PMID:Hematology of the neonatal calf. II. Response associated with acute enteric infections, gram-negative septicemia, and experimental endotoxemia. 110 59

The pathogenic effects produced in mice by intraperitoneal (i.p.) injection of a Bacillus species (OSU 372) are presented. This organism belongs to group 3 of the genus, and members of this group have not heretofore been shown to be pathogenic for mice even under experimental conditions. However, this organism is capable of producing a fatal involvement in doses which are not considered to be overwhelming. The mean lethal dose (LD50) of the organism for 20-25 g mice by the i.p. route is about 1 times 10-8 bacteria/mouse. A rapid drop in body temperature along with severe dehydration were noted in infected animals, and hematologic studies indicated that leukopenia and hemoconcentration also occurred. Although a transient septicemia developed, the bacteria could not be recovered from the tissues of fatally infected mice after a certain point in time. Results prevented indicate that the animals died of hypovolemic shock. A possible parallel with human bacillary infection is drawn.
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PMID:An experimentally pathogenic Bacillus species. II. The pathogenicity of the organism for mice. 112 25

The purpose of this study was to determine the value of prophylactic granulocyte transfusions in preventing death from sepsis. An intravenous dose of 10(9) Escherichia coli was lethal when given to granulocytopenic rats 6 days following irradiation with 750 rads. Only one of 22 irradiated animals survived the septicemia. Although normal (nonirradiated) animals experienced a transient leukopenia from this dose of organisms, it was less than LD10 for the normal host. There were no deaths in a group of animals receiving irradiation only. A group of 14 irradiated animals was given a single granulocyte transfusion 2 hr before the septic inoculum, and 57% of these animals survived (p less than 0.01). No antibiotic therapy was administered to any of these animals. Irradiated animals who received granulocytes and recovered from sepsis had earlier granulocyte reconstitution than animals irradiated but not given the septic challenge. Platelet reconstitution was the same in both groups. In the rat model, prophylactic granulocyte support of septc animals led to improved survival. It was concluded that granulocyte prophylaxis may be of value in selected patients with transient bone marrow failure who are therefore at high risk from sepsis.
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PMID:Prophylactic granulocyte support in experimental septicemia. 125 16


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