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)

Trimethoprim-sulfamethoxazole (TMP-SMZ) has traditionally been employed as an oral formulation for infections in ambulatory pediatric patients. However, therapeutic concentrations of TMP and SMZ in serum and CSF are more consistently attained after intravenous administration. Serum half-life increases with the age of the child, and few significant toxic effects are observed with intravenous administration. Either the necessity to optimize bioavailability because of the underlying seriousness of disease or a desire to avoid other drugs that may be responsible for adverse reactions or hypersensitivity should direct the clinician to administer an intravenous preparation. Serious pediatric infections that might warrant the consideration of intravenous TMP-SMZ include shigellosis, salmonellosis, typhoid fever, nocardiosis, gram-negative bacillary septicemia or meningitis, and infections due to Pneumocystis carinii and malarial parasites. Infections due to Listeria will respond to TMP-SMZ, and infections due to Citrobacter diversus, Acinetobacter species, Pseudomonas cepacia, and Flavobacterium meningosepticum are especially susceptible to TMP-SMZ.
 ...
PMID:Use of trimethoprim-sulfamethoxazole in pediatric infections: relative merits of intravenous administration. 355 55

The possibility of bilateral femoral neuropathy after microsurgical tuboplasty for the reversal of sterilization is possible. There seems to be little awareness of this condition by gynecologists and fertility surgeons. This type of femoral neuropathy has an excellent prognosis and only physiotherapy is necessary to aid muscular function. Some cases have been reported where recovery has been extremely slow, normal functions had taken months, and some disability lasted years. The femoral nerve is not included in the pelvis, therefore injury through operative procedures are unlikely. The self-retaining retractors were used in all reported cases and verified through clinical experience. There are 2 types of injury to the femoral nerve: Direct pressure on the nerve itself by retractor blades, and impingement of the psoas muscle and the nerve against the lateral pelvic muscle. Factors that increase the possibility of this condition include diabetes mellitus, rheumatism, gout, alcoholism, malnutrition, syphilis, tuberculosis, typhoid fever, tetanus, liver abscesses, sepsis of distal parts of the body, polyarteritis nodosa, anticoagulants, and bleeding diseases. Femoral neuropathy has been observed after using self-retaining retractors such as O'Connor, O'Sullivan, Mann, Collin and Balfour. The preventive measures suggested are to use a retractor with appropriate blade depth.
 ...
PMID:Bilateral femoral neuropathy after microsurgical reversal of tubal sterilization: case report and analysis of contributing factors. 362 33

A significant proportion of the illness and death of diarrhoeal diseases in the developing world is estimated to be due to the diarrhoea associated with measles. During February 1983-January 1984 a prospective study of measles in a hospital in Northeastern Thailand was conducted. A total of 550 cases of measles were studied. Diarrhoea was the most frequent complication of measles, occurring in 233 cases (42.4%). The largest proportion (46.2%) of cases with diarrhoea occurred in May-July. Children with measles aged 6-11 months had the highest frequency of diarrhoea (65.7%). Cases aged 1 year and 0-5 months had diarrhoea rates of 60% and 57% respectively. The proportion of measles cases with diarrhoea decreased with increasing age. Only 9.1% (9/99) of stools sent for bacteriological culture were positive. In three of these Shigella spp. were isolated. The rest were non-typhoid Salmonella (2), enteropathogenic Escherichia coli (2), Vibrio cholera (1), and Vibrio parahaemolyticus (1). Other complications among measles cases were pneumonia in 168 (30.5%), otitis media in 28 (5.1%), convulsion in 13 (2.4%), croup in 9 (1.6%), encephalitis in 4 (0.7%), and sepsis in 1 (0.2%). Seven cases (1.3%) died, 4 from pneumonia, 2 from encephalitis, and 1 from sepsis.
 ...
PMID:Measles-associated diarrhoea in northeastern Thailand. 373 7

Based on 140 cases of typhoid fever observed in the pediatrics service of the Menzel Bourguiba hospital (Tunisia), the authors demonstrate that such an endemic disease still exists in rural areas, with a peak during autumn-winter season. They underline the importance of the contamination due to water. The disease strikes all groups of age. Infants represent 15% of the patients. On its clinical and biological aspect, the disease is significantly different in child or infant. Blood cultures are positive in 2/3 of the cases, while fecal cultures are positive only in 1/3 of the cases. Despite some complications occurring in 1/6 of the cases, evolution is generally favourable. However, infant septicemia is severe, causing death in 1/3 of the cases.
 ...
PMID:[Typhoid fever in children in Tunisian rural areas. Epidemiologic and clinical study]. 380 52

During 1980-1984, 51 patients with enteric fever (typhoid/paratyphoid fever and salmonellosis) biliary tract sepsis, and other Gram-negative infections were treated with temocillin at 3 medical centres in Bangkok, Thailand. This article summarises the results in the 42 evaluable patients (14 males, 28 females); 10 patients with enteric fever, 2 patients with salmonellosis; 12 patients with biliary tract sepsis, and 18 patients with other Gram-negative infections. Overall, 86% of the patients were clinically cured or improved. Bacteriological eradication or marked reduction in the number of organisms was achieved in 95% of the patients. In 10 cases of enteric fever and 2 cases of salmonellosis all bacterial pathogens were eradicated, but 1 case of Salmonella paratyphi infection failed clinically. Eleven of 12 biliary tract infections were clinically cured or improved, and organisms were eliminated from all 10 bacteriologically assessable patients. The majority of patients received 1 to 2g of temocillin given by intravenous infusion twice daily for 5 to 14 days. Temocillin was well tolerated by all patients.
 ...
PMID:Use of temocillin in typhoid fever, hepatobiliary disease and other infections. 392 21

Cefotiam (CTM) was evaluated for its safety and efficacy in children. Twenty-six patients were treated with 40 to 200 mg/kg per day of CTM by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (1), pneumonia (4), empyema (2), urinary tract infection (2), typhoid fever (1), acute enterocolitis (2), partially-treated purulent meningitis (1), and suspected septicemia in neuroblastoma (1); and the remaining ten patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (1), Staphylococcus aureus (4), Haemophilus influenzae (4), Escherichia coli (1), enteropathogenic Escherichia coli (1), Salmonella typhi (1), and Campylobacter jejuni (1). All but two patients of bacterial infections were cured after the CTM therapy, and the rate of efficacy was 87.5%. Diarrhea (3), urticaria (1), transient elevation of GOT and GPT (1), and transient eosinophilia (3) were found to be associated with the CTM therapy. However, no severe adverse reactions were encountered. Half life of the serum CTM level was 0.93 +/- 0.13 hours, and excretion into the urine was rapid. CSF concentration obtained 1 hour after an intravenous injection of 21 mg/kg of CTM in a case with inflamed meninges was 1.5 mcg/ml, and the CSF/serum ratio was 9.0%. From these data, CTM appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.
 ...
PMID:[Clinical evaluation of cefotiam therapy in children (author's transl)]. 627 Apr 13

Pharmacokinetics and clinical effects of ceftizoxime (CZX), a new cephalosporin antibiotic, were investigated and following results were obtained. 1) Ceftizoxime was given by intravenous injection or drip infusion for 1 hour at a single dose of 30 mg/kg. After intravenous injection, the mean peak serum level of 3 children was 95.9 mcg/ml at 15 minutes and half-life time was 1.18 hours. After 1 hour drip infusion, the mean peak serum level of 3 children was 79.5 mcg/ml at the end of infusion and half-life time was 1.20 hours. The urinary level was high and the mean urinary recovery rate was 69.6% and 63.4% up to 6 hours after intravenous injection and 1 hour drip infusion, respectively. 2) CZX was administered in dose of 39--76 mg/kg to 7 pediatric patients (4 cases of purulent meningitis, 2 of septicemia with purulent meningitis, and 1 of aseptic meningitis) by a single intravenous injection. In patients with purulent meningitis, passage into the cerebrospinal fluid was relatively as good as 30% of serum level at the same time in the presence of remarkable signs of inflammation, but poor in cases of mild inflammation or aseptic meningitis. 3) Cerebral puncture fluid level in 1 patient with cerebral abscess was as good as 65.5% of serum level at the same time. 4) CZX was given to 28 cases of respiratory tract infection, 1 of tonsillitis with otitis media, 6 of scarlet fever, 1 each of maxillary sinusitis and bacterial endocarditis, 6 of purulent meningitis, 2 of septicemia, 5 of septicemia suspected, 2 of septicemia with purulent meningitis, 1 each of osteomyelitis, typhoid fever, peritonitis and biliary tract infection, 16 of urinary tract infection, 14 of skin and soft tissue infection, and 1 of external otitis, totaling 87 cases. The mean daily dose of 101.6 mg/kg was administered for an average of 10 days mainly by intravenous injection 4 times daily. Clinical results obtained were excellent in 34 cases, and good in 46. Bacteriological effectiveness rate was 100%. As for side effects, fever, fever with rash, fever with cough and diarrhea appeared in 1 each case out of 182 cases including 95 drop out cases. As for laboratory findings, eosinophilia, thrombocytopenia, elevation of GOT, that of GOT with GPT, and that of GOT with LDH appeared in 10, 2, 2, 3 and 1 cases, respectively.
 ...
PMID:[Pharmacokinetics and clinical effects of ceftizoxime in pediatric field (author's transl)]. 627 4

Overwhelming infections caused by encapsulated bacteria, salmonella spp. and Plasmodium falciparum (in malarious areas) are an important cause of morbidity and death in patients with sickle cell disease. Bacterial infections afflicting these patients include fulminant meningitis and septicaemia caused by Str. pneumoniae and H. influenzae type b, and non-typhoid salmonellosis. Children less than five years of age are at greatest risk for meningitis and septicaemia, while salmonella osteomyelitis is probably common to all age groups. The most important contributing factors to this increased susceptibility to encapsulated bacteria are: a state of functional asplenia, an opsonophagocytic defect due to an abnormality of the alternative complement pathway, and a deficiency of specific circulating antibodies. Devitalisation of gut and bone due to repetitive vaso-occlusive crises, saturation of the macrophage system with red cell breakdown products of chronic haemolysis, and underlying splenic and hepatic dysfunction all predispose to salmonella infections. Seventy per cent of septicaemias and meningitis among under-fives with sickle cell disease is caused by Str. pneumoniae. Septicaemia frequently presents with sudden fever, few prodromal features, and a deceptive appearance of well-being, followed within hours by rapid relentless progression to shock and death. Adrenal haemorrhage is common, and mortality can be as high as 50 per cent, unless intravenous antibiotic, with or without steroid therapy, is promptly initiated. The clinical presentation of bacterial meningitis, its management and mortality follow the normal patterns, but recurrent meningitis and cerebrovascular morbidity are common in patients with sickle cell disease. An acute pulmonary involvement, indistinguishable from bacterial pneumonia (the 'chest syndrome') is the commonest single complication of sickle cell disease at any age. Str. pneumoniae is responsible for about half of the episodes. The protective values of the pneumococcal vaccine and long-term penicillin prophylaxis remain to be established in sickle cell disease. Over 70 per cent of haematogenous osteomyelitis in sickle cell disease is caused by salmonellae. The distinction from vaso-occlusive bone crisis is often difficult, but the presence of multiple, often symmetrical bone involvement, diaphyseal fissuring and involucrum should suggest osteomyelitis rather than bone infarction. Chloramphenicol remains the drug of choice and often has to be given in high doses for up to six weeks. The role of surgery is limited by the presence of multiple bone involvement and the known anaesthetic risks in this group.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Sickle cell disease and infection. 631 9

Five focal non typhoid salmonellosis (NTS) are reported in a group of 342 kidney transplant recipients. There is no relationship between the unusual presentation of NTS (septicemia, pneumonia, orchitis, prostatis, urinary tract infections) and the serotypes (S. typhi-murium, S. panama). With the therapeutic immunodepression, many host factors are important to induce the unusual presentation of NTS: major surgery, urologic abnormalities, preexisting uraemic state. The major importance of decreased host resistance is emphasized by the absence of relationship between death and bacterial resistance. The use of lysotypes exclude the role of an intrahospital contamination.
 ...
PMID:[Extradigestive forms of nontyphoid salmonellosis in renal transplant patients: 5 cases]. 636 9

We have developed a new, specific, and highly sensitive enzyme-linked immunosorbent assay (ELISA) which quantitates activation of the alternative pathway in human serum, plasma, or on the surface of activators. The ELISA detects the third component of complement (C3b), proteolytic fragment of complement Factor B (Bb), and properdin (P) complex or its derivative product, C3b,P. In the method, activator-plasma mixtures, plasma containing an activated alternative pathway, or other samples are added to the wells of microtitration plates precoated with antibody to P. C3b, Bb,P or C3b,P complexes which become bound are quantitated by subsequently added, enzyme-labeled, anti-C3. The resulting hydrolysis of the chromogenic substrate is expressed as nanograms of C3b by reference to a C3 standard curve. In addition to absolute specificity for activation of the pathway because of the nature of the complex detected by the assay, the ELISA is highly sensitive and able to reproducibly detect 10-20 ng/ml of C3b,P complexes in serum. This value corresponds to 0.0015% of the C3 in serum. In a series of studies to validate the parameters of the ELISA, reactivity was found to be dependent on the presence of alternative pathway proteins, the functional integrity of the pathway, and on the presence of magnesium. Sheep erythrocytes were converted to activators by treatment with neuraminidase. By using a variety of activators, the kinetics of activation and the numbers of bound C3b molecules quantitated by the ELISA were very similar to those measured by C3b deposition. The ELISA also detected identical activation kinetics when MgEGTA-serum and a mixture of the purified alternative pathway proteins were used as sources of the pathway. ELISA reaction kinetics also correlated with the restriction index, a measure of alternative pathway-activating ability. These studies cumulatively validate the ELISA as a direct and quantitative assay for alternative pathway activation. The sensitivity of the ELISA has permitted its use to detect direct alternative pathway activation by several viruses. The ELISA has also shown that certain classical pathway activators trigger the amplification loop of the alternative pathway while others do not. In addition, stable ELISA reactive complexes appeared in the supernatant of mixtures of serum with certain, but not other activators. The ability of the ELISA to detect activation which has already occurred and the stability of the reactive complexes permits studies of clinical sera. Normal human sera (20) contained low levels (5-20 ng/ml) of ELISA-reactive complexes. A proportion of sera from individuals with the adult respiratory distress syndrome (9-10), typhoid fever (8-10), malaria (3-5), gram-negative sepsis (9 of 47), acute trauma and shock (6 f 25), and systemic lupus erythematosus (3 of 29) showed elevated levels of complexes reactive in the alternative pathway ELISA. In contrast, nine sera from patients with circulating C3 nephritic factor were not reactive in the ELISA.
 ...
PMID:Development and application of an enzyme-linked immunosorbent assay for the quantitation of alternative complement pathway activation in human serum. 641 67


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