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

The immune system was studied in 30 cases of local infection (pneumonia) and 56 cases of generalized infection (sepsis). Predominantly children with immunologic deficiency of the humoral type (77% of the cases) characterized by unscheduled fatty transformation of the thymus, underdevelopment of B-zones of lymphoid organs, low level of IgM production and the lack of IgG and IgA production were found to die with pneumonia, whereas children with physiological immaturity of the immune system and in smaller numbers (41% of the cases) with deficiency of immunity of the cellular and phagocytic type as confirmed by immaturity of the thymic tissue or its dysplasia with hypoplasia of lymphoid organs died with sepsis. Immunological deficiency of the humoral type is accompanied by suppurative destructive lesions of the respiratory organs, immunodeficiency of the cellular and phagocytic type by necrotic changes in the septic focus and mucous membranes of the organs contacting the environment.
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PMID:[The immune system and its relation with infection process in children]. 660 38

Morbidity and mortality patterns were examined among 968 pediatric patients on the island of Dominica. These children, whose ages ranged from newborn to 13 years, were seen by the consulting pediatrician at Princess Margaret Hospital during a 9-month period in 1978-79; 852 children were seen as inpatients. A total of 477 cases of infectious disease were diagnosed among inpatients alone. Stool examination in a subsample of these children revealed parasites (mostly Trichuris) in roughly half. Also found was a relatively high prevalence of chronic health problems, especially rheumatic heart disease (34 cases), mental retardation (28 cases), epilepsy (31 cases), and sickle cell anemia (21 cases). Examination of the hospital records of 100 of the inpatients ages 6 months-5 years demonstrated that 34% were low weight-for-age according to the World Health Organization classification. There were 34 deaths (9 pediatric patients and 255 newborns). The high neonatal mortality is attributed to an unusually high incidence of immaturity and prematurity, irregular and insufficient hospital oxygen supply, and a septicemia epidemic. Although these findings reflect patterns of the more serious diseases, they could be useful in planning preventive health measures. The high prevalence of malnutrition points to a need for nutrition education, promotion of breastfeeding, promotion of vegetable growing, and the introduction of a home-based growth chart. The high incidence of diarrhea, typhoid fever, and helminthiases highlights problems with general hygiene, latrines, and water supply. There is also a need for follow-up facilities for children with rheumatic heart disease, epilepsy, and sickle cell anemia. It is suggested that hospital care could be improved by dividing pediatric and neonatology wards into 5 units: isolation ward, malnutrition ward, semi-intensive care unit, general pediatrics, and pediatric surgery.
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PMID:Morbidity and mortality patterns among pediatric patients in Dominica (West Indies). 662 10

The short-term outcome with survival rate, causes of death and neonatal complications in a 6-year material comprising 253 infants treated with intermittent positive pressure ventilation (IPPV) in the neonatal period has been analyzed in relation to different primary disorders necessitating IPPV treatment. The total survival rate was 53%. For the different diagnoses the survival rates were: hyaline membrane disease (HMD) 41%, apnoea repetens of immaturity 85%, severe birth asphyxia 46% and septicemia 59%. The total rate of pneumothorax during IPPV was 15% but occurred more often in the HMD group (28%). Trends in survival rates over the study period are discussed as are measurements for improvements.
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PMID:Evaluation of mechanical ventilation in newborn infants. I. Techniques and survival rates. 698 51

Splenic dysfunction accounts for the greatest deficit in immune function in children with homozygous SCD. This dysfunction, coupled with the natural immunologic immaturity of all young children subjects the young child with SCD to an immense risk of severe pyogenic infections. To data, experience would suggest that pneumococcal vaccines may provide only modest protection in the child with SCD less than 5 years of age. Antipneumococcal antibody responses are poor in children less than two years of age. All reported failures of pneumococcal vaccine among children with SCD have occurred in children less than three years of age and offending pneumococci have been of groups 6 and 23. Prophylactic antibiotic regimens have yet to be submitted to rigid scientific investigation and their utility in eliminating the risk of pneumococcal sepsis in asplenic hosts is unknown.
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PMID:Infections in sickle cell anemia: pathogenesis and control. 703 72

Lymphoid system was studied morphologically in 61 infants aged under 1 year dying of sepsis, nonseptic inflammatory diseases and non-inflammatory processes. It was established that in sepsis generalization of the immune response and decompensation of the lymphoid system occurred in the development of which previous disorders of immune responsiveness (thymus pathology, immaturity of the lymphoid system of premature babies, respiratory viral infections) are of great importance. Unlike sepsis, local inflammatory processes are characterized predominantly by limited immune reaction and decompensation of lymphoid system has a local character. In babies of the first month of age reactions of the T-lymphocyte system predominate, in older babies those of the B-lymphocyte system.
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PMID:[Immunomorphologic aspects of sepsis in children under 1-year-old]. 708 93

Management recommendations for pregnancies complicated by premature rupture of the membranes must consider both the neonatal morbidity and mortality of immaturity associated with prompt delivery and the infectious risks to the mother and fetus associated with prolonged observation. Because these considerations are critical in pregnancies with prematurely ruptured membranes and premature but potentially viable infants, 116 pregnancies with this complication between 28 and 36 weeks' gestation were reviewed. All patients received careful in-hospital surveillance. Six patients (5.2%) developed amnionitis prior to labor. Nine infants (7.1%) developed neonatal sepsis, with the predominant pathogen being the group B beta-hemolytic streptococcus. A decrease in the incidence of respiratory distress syndrome (RDS) and patent ductus arteriosus (PDA) with progressive duration of membrane rupture was observed. The perinatal survival in this study was 96.9%. These findings suggest that in similar patient populations an expectant management plan may be employed with minimal infectious risks to mother and fetus.
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PMID:Conservative management of premature rupture of the membrane. 722 12

A total population of 29,395 neonates cared for in the six-year period from 1971 to 1976 was reviewed for evidence of autopsy-proven kernicterus. A total of 327 neonates died and 232 were autopsied. The only cases of kernicterus occurred in four near-term infants with antemortem proven sepsis. All four of these infants weighed more than 2,200 gm and were delivered after gestations of either 36 or 37 weeks. These cases of kernicterus occurred during a period when more aggressive management of hyperbilirubinemia in low-birth-weight infants had apparently eliminated immaturity as a predisposing factor in the development of kernicterus, uncovering bacterial infection as the major remaining etiologic co-factor.
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PMID:The association of kernicterus with bacterial infection in the newborn. 735 31

Most frequent complications of infusion therapy in children include thrombosis and thrombophlebitis of the umbilical and subclavian veins. In the perinatal period thrombophlebitis of the umbilical vein is due to exogenous infection and becomes the source of umbilical sepsis. Thrombophlebitis of the subclavian vein in nurslings results more frequently from endogenous infection. Because of morpho-functional immaturity in infancy, hyperhydration of tissues is extreme, with vacuolar dystrophy of cells up to their necrosis, particularly in the liver and kidneys. Artificial pulmonary ventilation (APV), particularly in premature newborns, is frequently accompanied by breaks of alveolar septae, development of bullous and interstitial emphysema, pneumothorax. In deeply premature infants APV may be ineffective because of immaturity of the lung tissue.
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PMID:[Complications of resuscitation and intensive therapy in infants (proceedings)]. 740 15

Clinical data on infants born in 1973 and 1978 at the All-India Institute of Medical Sciences Hospital were collected and analyzed as to obstetrical composition, birth weight and gestational age characteristics, perinatal and neonatal mortality rates, and cause of neonatal mortality. Most of the patients belonged to the underpriviliged social class. Although there was a greater predominance of high-risk maternal factors in 1978 because of the policy of preferential bookings of high-risk mothers, the incidence of low-birth weightness and immaturity was lower than in 1973. The perinatal mortality rate in 1978 is higher because of increased incidence of late fetal deaths but the overall neonatal mortality is significantly lower (p0.05), partly because of overall improvement in the birth weight and gestational groups (p0.05). Generally, there was a trend of improved neonatal outcome and survival of low birth weight and preterm infants in 1978. The leading cause of neonatal mortality in 1973 was septicemia; in 1978, it was hyaline membrane disease. Prompt recognition and adequate management of infants with breathing difficulties at birth, as well as prevention of nosocomial nursery infections will further reduce neonatal mortality.
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PMID:Impact of special care services on perinatal and neonatal outcome. 742 14

Host defenses in the human neonate are limited by immaturity in phagocytic immunity. Such limitations seem to predispose infected newborns to neutropenia from an exhaustion of the neutrophil reserve. Among the critical defects thus far identified in neonatal phagocytic immunity is a specific reduction in the capacity of mononuclear cells to express granulocyte colony-stimulating factor (G-CSF) after stimulation. However, the safety, pharmacokinetics, and biological efficacy of administration of recombinant human (rh)G-CSF to infected human newborns to compensate for this deficiency is unknown. Forty-two newborn infants (26 to 40 weeks of age) with presumed bacterial sepsis within the first 3 days of life were randomized to receive either placebo or varying doses of rhG-CSF (1.0, 5.0 or 10.0 micrograms/kg every 24 hours [36 patients] or 5.0 or 10.0 micrograms/kg every 12 hours [6 patients]) on days 1, 2, and 3. Complete blood counts with differential and platelet counts were obtained at hours 0, 2, 6, 24, 48, 72, and 96. Circulating G-CSF concentrations were determined at hours 0, 2, 6, 12, 14, 16, 18, 24, and 36. Tibial bone marrow aspirates were obtained after 72 hours for quantification of the bone marrow neutrophil storage pool (NSP), neutrophil proliferative pool, granulocyte progenitors, and pluripotent progenitors. Functional activation of neutrophils (C3bi expression) was determined 24 hours after rhG-CSF or placebo administration. Intravenous rhG-CSF was not associated with any recognized acute toxicity. RhG-CSF induced a significant increase in the blood neutrophil concentration 24 hours after the 5 and 10 micrograms/kg doses every 12 and 24 hours and it was sustained as long as 96 hours. A dose-dependent increase in the NSP was seen following rhG-CSF. Neutrophil C3bi expression was significantly increased at 24 hours after 10 micrograms/kg every 24-hour dose of rhG-CSF. The half-life of rhG-CSF was 4.4 +/- 0.4 hours. The rhG-CSF was well tolerated at all gestational ages treated. The rhG-CSF induced a significant increase in the peripheral blood and bone marrow absolute neutrophil concentration and in C3bi expression. Future clinical trials aimed at improving the outcome of overwhelming bacterial sepsis and neutropenia in newborn infants might include the use of rhG-CSF.
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PMID:A randomized, placebo-controlled trial of recombinant human granulocyte colony-stimulating factor administration in newborn infants with presumed sepsis: significant induction of peripheral and bone marrow neutrophilia. 752 Jul 70


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