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

This study aimed to validate retrospective caregiver interviews for diagnosing major causes of several neonatal illness and death in Dhaka, Bangladesh. The sample consisted of 149 infants aged 28 days with one or more suspected diagnoses of low birth weight (LBW)/severe malnutrition, preterm birth, birth asphyxia, birth trauma, neonatal tetanus, pneumonia, meningitis, septicemia, diarrhea, congenital malformation or injury. The study pediatricians performed a standardized history and physical examination and ordered laboratory and radiographic tests according to study criteria. Overall, LBW/severe malnutrition, premature birth and tetanus can be detected in newborn infants by caregiver interview with high sensitivity and specificity, whereas the diagnoses of pneumonia and birth asphyxia are more difficult but still feasible. Algorithms with sensitivity and specificity 80% were identified for neonatal tetanus, LBW/severe malnutrition and preterm delivery. Algorithms with specificities 80% for birth asphyxia and pneumonia had sensitivities 70%, or alternatively had high sensitivity with lower specificity. In settings with limited access to medical care, retrospective caregiver interviews provide a valid means of diagnosing several of the most common causes of severe neonatal illness and death.
 ...
PMID:Validation of caregiver interviews to diagnose common causes of severe neonatal illness. 998 89

An incidence study on nosocomial infections in critically ill infectious disease patients was carried out in the intensive care unit (ICU) of a university hospital for infectious diseases over a 7-year period (1 January 1990 to 31 December 1996). A total of 660 patients who stayed in the ICU for over 48 h were prospectively observed. The patients were divided into two groups: one with central nervous system infections (442 patients) and the other with other severe infections (218 patients). The risk of nosocomial sepsis and pneumonia was significantly higher in patients suffering from severe central nervous system infections. The incidence of sepsis was 24.2% vs 11.4% (relative risk 1.95; 95% confidence interval 1.32-2.89); the incidence of pneumonia was 30.5% vs 14.7% (relative risk 2.09; 95% confidence interval 1.47-2.96). The incidence of urinary tract infection was 14.3% vs 13.3% (relative risk 1.07; 95% confidence interval 0.71-1.61). Density rates of nosocomial septic episodes were 21.1 +/- 37.1 vs 11.7 +/- 32.4 episodes/100 central venous-line days (P < 0.006). Nosocomial pneumonia occurred only in mechanically ventilated patients (36.9 +/- 61.2 vs 28.5 +/- 65.8 episodes per 1000 ventilatory days, P = 0.012). Nosocomial urinary tract infection occurred only in patients with urinary catheters (11.6 +/- 60.7 episodes/1000 urinary catheter days vs 18.7 +/- 90.1, P = 0.886). Multivariate regression analysis identified age, diagnosis of CNS infection, duration of urinary tract catheterization, the use of central venous lines and mechanical ventilation as independent risk factors of nosocomial sepsis. Duration of mechanical ventilation, use of steroids and diagnosis of CNS infection were independent risk factors of nosocomial pneumonia. A subanalysis identified tetanus patients to be at particular risk of nosocomial infections.
 ...
PMID:Nosocomial infections in critically ill infectious disease patients: results of a 7-year focal surveillance. 1002 1

A total of 2432 live births and 46 stillbirths were studied in some of the tea gardens of Dibrugarh district of upper Assam. The neonatal mortality rate was 46.5 per 1000 live births per year. Immaturity (21.2%), fever/sepsis (13.3%), breathing disorder (12.4%), neonatal tetanus (11.5%) and neonatal diarrhoea (8.8%) accounted for most of the neonatal deaths. There were 42.9% low birth weight infants and this was associated with 92.8% of total neonatal deaths and 34.3% of preterm babies were associated with 90.7% of neonatal deaths. The case fatality rate among low birth weight and preterm babies was 9% and 11% respectively. High risk of neonatal deaths had been found among the neonates in case of no maternal immunisation, delivery attended by untrained person and newborn care at home.
 ...
PMID:A study of neonatal deaths in the tea gardens of Dibrugarh district of upper Assam. 1021 18

This paper focuses on Buruli-ulcer disease, the third most common mycobacterial disease among immunocompetent people. Buruli-ulcer disease is caused by an infection with Mycobacterium ulcerans, which belongs to the large group of environmental mycobacteria. It is endemic in many countries, usually in areas of tropical rain forest. Transmission of infection is through abraded skin or mild traumatic injuries after contact with contaminated water, soil, or vegetation. This disease mostly affects children which manifest from painless nodules to large, undermined ulcerative lesions that heals spontaneously but slowly. Buruli-ulcer disease is accompanied by few systemic symptoms, but occasionally secondary infections resulting in sepsis or tetanus cause severe systemic disease and death. However, extensive scarring can lead to contractures of the limbs, blindness, and other adverse complications. Management of the disease is still primarily surgical, and includes excision, skin grafting, or both. Although Bacillus Calmette-Guerin vaccine has mild but a significant protective effect, vaccine developments directed at the toxin produced by M. ulcerans are needed.
 ...
PMID:Mycobacterium ulcerans infection. 1060 56

Female genital mutilation (FGM) has been practiced worldwide, clothed under the tradocultural term "circumcision." Indications for its practice include ensuring virginity, securing fertility, securing the economic and social future of daughters, preventing the clitoris from growing long like the penis, and purely as a "tradition." Outlawed only in the United Kingdom, Sweden, and Belgium, no law forbids it in most other countries. Classified into four identified types, the current perpetrators are mainly quacks, but trained medical personnel still connive at and encourage FGM. Early complications include hemorrhage, urinary tract infection, septicemia, and tetanus. Late complications include infertility, apareunia, clitoral neuromas, and vesicovaginal fistula. Reasons for the ritual persisting include fear that legislation would force it underground and it will be performed in unsterile conditions, belief that it is racist to speak out against FGM, "tolerance" by health professionals, continued use of the term "female circumcision," lack of awareness of the culture of immigrants by the physicians in areas where FGM is not culturally practiced, and sporadic or uncommitted eradication efforts. We believe there is no reason for the continued practice of FGM. It should incur global abolition, the same way slave trade or Victorian chastity belts have done. We advocate that in medical communications the term "female genital mutilation" be used in place of "female circumcision." World leaders should include unacceptable cultural practices such as FGM in the "world summit" agenda. The year 1999 should be declared the year for global eradication of FGM.
 ...
PMID:Female genital mutilation: A global bug that should not cross the millennium bridge. 1051 51

Anti-inflammatory substances are released during septic shock that modulate monocyte function. Decreased monocyte responsiveness to bacterial toxins and decreased expression of human-leukocyte-associated antigen-DR (HLA-DR) have been reported during septic shock and critical illness. Impaired antigen presentation has been inferred from these observations but has not been demonstrated. We assessed antigen presentation and costimulatory molecule expression in 12 age-matched control subjects, 10 noninfected critically ill patients (CINS), and 17 critically ill patients with sepsis (CIS). Antigen presentation was assessed by using in vitro lymphocyte 5-bromo-2-deoxyuridine (BrdU) incorporation in response to tetanus toxoid. The expression of HLA-DR and the costimulatory molecules CD28, CD86, and CTLA-4 was assessed by flow cytometry. Serum interleukin-10 (IL-10) was also measured by enzyme-linked immunosorbent assay. Serum IL-10 levels were significantly elevated in CIS patients (91 +/- 38 pg/mL) as compared with levels in control subjects (5 +/- 4 pg/mL)(P < .05). Lymphocyte BrdU incorporation increased by 710% +/- 243% in control subjects but by only 144% +/- 62% in CIS patients and 76% +/- 31% in CINS patients (P < .01 vs control). Monocyte HLA-DR expression, monocyte CD86 expression, and lymphocyte CD28 expression were significantly decreased in CIS patients (P < .01) as compared with control subjects. Conversely, lymphocyte CTLA-4 expression was significantly increased in CIS patients (P < .05 vs control). Monocyte CD86 expression was also significantly decreased in CINS patients as compared with control subjects. These data indicate that antigen presentation is decreased in critically ill patients with sepsis. This appears in part related to decreased expression of HLA-DR and the costimulatory molecules CD86 and CD28. Increased expression of the negative signal receptor CTLA-4 may also impair antigen presentation in patients with sepsis.
 ...
PMID:Decreased response to recall antigens is associated with depressed costimulatory receptor expression in septic critically ill patients. 1069 60

This is a report of a retrospective study of 24 children managed for penetrating abdominal injury over 10 years, and it represents 34% of all abdominal injuries in children in that period. Falls onto sharp objects within and around the home were responsible for ten of the injuries, seven were injured by animal horns and four were sporting injuries. Violence and road traffic accidents were uncommon. Most patients (67%) had evisceration of omentum or intestine, and one of these was found at laparotomy to have a jejuno-jejunal intussusception. Seven children had injury to hollow viscera. There were three deaths, one each from overwhelming sepsis, tetanus and haemorrhage.
 ...
PMID:Penetrating abdominal injuries in children in Nigeria. 1071 17

Tetanus is an acute neurological disease characterized by muscle rigidity and spasms, autonomic dysfunction and in severe forms requires respiratory and hemodynamic support. Though it is entirely preventable by immunization, it still occurs in developing countries causing significant morbidity and mortality. Intensive care management of tetanus is fraught with problems of ventilator-associated pneumonia, nosocomial sepsis and a variety of other complications. Various treatment protocols have been tried in managing diverse manifestations of severe tetanus but the consensus is yet to emerge. In this review we have discussed the pathophysiology, clinical features and management controversies and suggest on basis of our experience use of high dose diazepam (20-120 mg/kg/day) and vecuronium with mechanical ventilation if required for control of spasms, and early detection of autonomic dysfunction and use of propranolol, in our circumstances.
 ...
PMID:Post-neonatal tetanus: issues in intensive care management. 1133 25

One million newborn infants die every year by bacterial infections, which often have entered the body via the umbilicus. A Cochrane systematic review on "Topical umbilical cord care at birth" by J Zupan and P Garner is reviewed. Zupan and Garner conclude that simply to keep the umbilical cord dry and clean is sufficient for healthy, term neonates in rich countries; disinfectants do not offer any advantage. However, cleaning the umbilical cord with disinfectants may reduce the risk of serious bacterial infections in babies in poor countries or in neonatal wards. Observational studies in poor countries indicate that the life of numerous infants can be saved if pregnant women are vaccinated against tetanus and disinfectants are substituted for harmful cord care traditions. This Cochrane review is credible, but it should be updated and considered tentative since no data on sepsis are included. The search strategy should be better described and observational studies (case control and cohort studies) from poor countries should be included since there are no randomized control trials from these countries.
 ...
PMID:[A Cochrane review on the umbilical cord care and prevention of infections. Antiseptic solutions are not necessary in developed countries but life-saving in developing countries]. 1202 10

The Health Council of the Netherlands (Gezondheidsraad) assessed the vaccination of infants against both group-C meningococci and pneumococci in terms of general criteria and basic principles for inclusion in the national vaccination programme. Vaccination against meningococci C in the Netherlands is expected to prevent about 300 cases of meningococcal disease (meningitis or sepsis), 22 deaths and 12 cases of severe lasting problems (neurological problems or amputations) per year. Vaccination against pneumococci may prevent about 100 cases of meningitis or sepsis, 3200 cases of pneumonia, 36,000 cases of acute otitis media, 11 deaths, 11 cases of severe permanent damage (neurological problems, deafness) per year. The Health Council advised implementing vaccination against group-C meningococci as soon as possible, through 2 injections at the ages of 5 and 6 months or through 1 injection shortly after the child's first birthday, and to carry out a catch-up programme for all children and adolescents up to and including 18 years of age. The council also advised starting a vaccination programme against pneumococci, at ages 2, 3 and 4 months, as soon as the current vaccinations against diphtheria, tetanus, pertussis and polio and against Haemophilus influenzae type b are combined into 1 injection (in 2002 or 2003). In view of the concentration of pneumococci disease in the first years of life, a catch-up programme is not indicated in this case. The Health Council emphasised the importance of microbiological and clinical monitoring of potential adverse effects and of public education programmes. The cost of vaccination against group-C meningococci is comparable to that of other accepted programmes for primary prevention. Compared to other programmes and at the current vaccine price, the cost of vaccination against pneumococci is high.
 ...
PMID:[Universal vaccination against group-C meningococci and pneumococci; summary of the advice from the Health Counsil of the Netherlands]. 1221 5


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>