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)

Following its introduction into the market, PAPM/BP (panipenem/betamipron) was clinically studied in 188 evaluable cases out of 207 cases primarily of respiratory infectious diseases treated at the pediatric departments of 15 hospitals. In the clinical evaluation, the drug proved effective in three of three cases of sepsis; three of three cases of suppurative meningitis; nine of ten cases of laryngopharyngitis, six of seven cases of tonsillitis, 56 of 63 cases of acute bronchitis, 90 of 98 cases of pneumonia, and one of one case of phyothorax, all of which are respiratory infectious diseases; one of one case of secondary infection of a chronic respiratory disease; and two of two cases of lymphadenitis, which is a disease of the soft dermal structure. The overall efficacy rate was 91.0% (171/188 cases). In the bacteriological study, Gram-positive bacteria were eliminated in five of five strains of S. aureus, 30 of 31 strains of S. pneumoniae (96.8%), and three of three strains of S. pyogenes. Gramnegative bacteria were eliminated in 15 of 17 strains of H. influenzae (88.2%), three of four strains of M. catarrhalis, and two of two strains of K. pneumoniae. The overall elimination rate was 92.1% (70/76 strains). In the 23 strains of S. pneumoniae that were examined, penicillin-resistant strains accounted for 56.5%, showing an elimination rate of 100%. No serious adverse effects were observed, and the incidence of adverse effects was 1.45%. As for abnormalities in laboratory tests, levels of GOT and GPT increased in eight cases (3.88%), LDH increased in one case (0.48%), and neutropenia occurred in one case (0.51%). These results suggest that PAMP/BP could be considered the first choice in the treatment of infectious diseases in pediatrics, due to its effectiveness and high level of safety.
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PMID:[Clinical and bacteriological studies on panipenem/betamipron in pediatrics. Kanagawa Research Group for Infectious Diseases of Children]. 964 2

About one-third of patients undergoing chemotherapy treatment suffer oral mucositis, an inflammatory-like change of the oral mucosa. Severe pseudomembranous/ulcerative mucositis can lead to secondary infection of lesions, sepsis and even cessation of treatment. Patients receiving curative head-neck irradiation are most susceptible and children undergoing chemotherapy are three times more likely to be affected. Mucositis is a costly side-effect of cancer therapy due to the extra time patients spend in hospital and currently there is no consistently effective treatment. Experimental studies with TGF-beta 3, a potent negative regulator of epithelial and haematopoietic stem cell growth, have shown that it is possible to temporarily arrest oral mucosal basal cell proliferation, and could therefore offer a new effective and safe form of preventative intervention for patients about to undergo aggressive regimens of cancer therapy.
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PMID:New frontiers in the management of chemotherapy-induced mucositis. 980 55

The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and microorganisms consists of both non-immunological and immunological defence mechanisms. The main constituents of the intestinal barrier are the endothelial and epithelial barriers. The epithelial barrier selectively restricts micromolecular permeation and almost completely restricts macromolecular permeation, while the endothelial barrier has a very limited restriction to micromolecules and only partly to macromolecules. Maintenance of the barrier depends on the integrity of cellular plasma membranes and tight junctions, as well as the elaboration of endothelial and epithelial secretory products. Focal denudation of the barrier results in permeation of potentially threatening luminal compounds including antigens, proteases, H+, bacteria and endotoxin, and also other factors chemotactic for inflammatory cells. By initiating inflammation and thus acting on subepithelial tissues, such factors can further influence endothelial and epithelial transport and barrier function. The repair of endothelial and epithelial injury is also complex, and both restitution and enhanced endothelial and epithelial cell proliferation are likely to be important. At present, however, mechanisms for intestinal epithelial and endothelial permeation, their alterations in disease and potential ways to prevent or repair injury, are still not fully elucidated.
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PMID:Role of intestinal permeability in monitoring mucosal barrier function. History, methodology, and significance of pathophysiology. 984 20

Death from acute severe pancreatitis results from infection and multiple organ system failure occurring late in the course of illness. Patients with necrotizing pancreatitis involving at least one-third of the organ are at highest risk of secondary infection and death. We conducted a MEDLINE search to identify human trials of prophylactic antibiotics in acute pancreatitis. Results of early studies of prophylactic ampicillin to avoid secondary infection and death were negative, but the studies included patients with mild disease who are at low risk for infection. Antibiotics were beneficial in four recently completed studies: imipenem significantly reduced pancreatic and nonpancreatic sepsis (p< or =0.01); cefuroxime reduced all infectious complications (p<0.01) and deaths (p=0.0284); a regimen of ceftazidime, amikacin, and metronidazole reduced all infectious complications (p<0.03); and protocol use of imipenem significantly reduced pancreatic infection compared with nonprotocol antibiotics (p=0.04) and no antibiotics (p<0.001). Based on these results, we suggest early antibiotic prophylaxis in patients with necrotizing pancreatitis, but the best drug and duration of therapy are unknown.
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PMID:Prophylactic antibiotics for severe acute pancreatitis: the beginning of an era. 1033 22

INTRODUCTION: Mucositis induced by antineoplastic drugs is an important, dose-limiting, and costly side effect of cancer therapy. The ulcerative lesions produced by mucotoxic chemoradiotherapy are painful, restrict oral intake and, importantly, act as sites of secondary infection and portals of entry for the endogenous oral flora. The overall frequency of mucositis varies and is influenced by the patient's diagnosis, age, level of oral health, and type, dose, and frequency of drug administration. Some degree of mucositis occurs in approximately 40% of patients who receive cancer chemotherapy. Approximately one-half of those individuals develop lesions of such severity as to require modification of their cancer treatment and/or parenteral analgesia. The condition's incidence is consistently higher among patients undergoing conditioning therapy for bone marrow/peripheral blood progenitor cell transplantation, continuous infusion therapy for breast and colon cancer, and therapy for tumors of the head and neck associating concomitant chemotherapy and radiotherapy. Among patients in the high-risk protocols, severe mucositis occurs with a frequency in excess of 60%. Concomitant with mucositis is often a chemotherapy-induced myelosuppression. The neutropenia that results puts the patient with oral mucositis at significant risk for systemic infection. Patients with mucositis and neutropenia have a relative risk of septicemia that is greater than four times that of individuals without mucositis. The morbidity of all mucositis can be profound. It is estimated that approximately 15% of patients treated with radical radiotherapy to the oral cavity and oral pharynx will require hospitalization for treatment-related complication. In addition, severe oral mucositis may interfere with the ability to deliver the intended course of therapy, leading to significant interruptions in treatment, and possibly impacting on local tumor control and patient survival. It is also not unusual for mucositis to necessitate delays in cancer chemotherapy particularly with those agents that are known to be mucotoxic, including 5-fluorouracil with or without folinic acid, methotrexate, doxorubicin, etoposide, melphalan, cytosine arabinoside and cyclophosphamide. In addition to its impact on a patient's treatment course, on quality of life, and morbidity and mortality, mucositis can also have a significant economic cost. This is particularly true in the autologous and allogeneic bone marrow transplant settings for hematologic malignancies, where the length of hospital stay may be prolonged due to severe mucositis.
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PMID:Mucositis: Its Occurrence, Consequences, and Treatment in the Oncology Setting. 1038 37

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis spss/pc+ program was utilized for descriptive statistics, adjusted standardized X2-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245 (59.5%) were men and 167 (40.5%) were women. Age were 0-14 years 79 (19.2%), 15-44 years 125 (30.4%), 45-64 years 104 (25.2%), over 65 years 104 (25.2%). 2) There was significant association between age and the sexes (X2 = 39.17, P = 0.00). 3) There was significant association between age and history of falls (X2 = 44.41, P = .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis (X2 = 140.66, P = .00), chief medical diagnosis were hypertension (34), diabetes mellitus (22), arthritis (11), stroke (8), fracture (7), pulmonary tuberculosis (6), dementia (5) and cataract (5). 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives, antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness (X2 = 2.87, P = .41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips (35.2%), trips (9.5%) and collision (4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1 pm to 6 pm and 7 am to 12 am. 9) The places of fall accident were roads (22.6%), house-stairs (16.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows (10.9%), hospital (7.5%), ice or snowy ways (5.8%), bathroom (4.9%), playground, park (4.9%), subway-stairs (4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking (37.6%), turning around or reaching for something (20.9%), going up or down stairs (19.2%), exercise, working (17.4%), up or down from a bed (2.7%), using wheelchair or walking aids, standing up or down from a chair (2.2%) and standing still (2.2%). 11) Anatomical locations of injuries by falls were head, face, neck (31.3%), lower extremities (29.9%), upper extremities (20.6%), spine, thorax, abdomen or pelvic contents (11.4%) and unspecified (2.9%). 12) Types of injures were fracture (47.6%), bruises (13.8%), laceration (13.3%), sprains (9.0%), headache (6.6%), abrasions (2.9%), intracranial hemorhage (2.4%) and burns (0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers (1.46%) died from fall injuries. The two fallers died from intracranial hemorhage and the four fallers died of secondary infection; pneumonia (2), sepsis (1) and cellulitis (1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.
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PMID:[A study on fall accident]. 1043 5

Epidermolysis bullosa is a group of hereditary blistering disorders for which there is no definitive therapy. Wound care is an important component of management. Regular dressing changes are required to protect blistered and eroded skin, and to prevent secondary infection and sepsis. These dressing changes can be very painful for patients with extensive erosions. We report our experience of pain management in an 11-year-old boy with severe junctional epidermolysis bullosa. Amitryptiline and cognitive behavioral techniques were effective in relieving chronic pain and discomfort. Oral midazolam 0.33 mg/kg administered 20 minutes prior to baths and dressing changes substantially improved his tolerance of wound care.
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PMID:Pain management of junctional epidermolysis bullosa in an 11-year-Old boy. 1063 47

Acute pancreatitis develops precipitously, changing the patient's condition from apparent good health to a critically ill status. Of patients who succumb, 80 per cent die from secondary infection in the pancreas-peripancreatic area. Infection supervenes in the second week or later after onset. Prophylactic antibiotic(s) appear to be helpful in avoiding, delaying, and/or lessening secondary sepsis. Once infection develops, treatment requires open debridement of necrotic material, drainage, and appropriate antibiotic therapy; or mortality will approach 100 per cent. Infecting organisms are commonly Escherichia coli, Klebsiella, Staphylococcus, Enterococcus, Bacteroides, and/or fungi. Antibiotics felt to be preferable for prophylactic therapy include 1) imipenem-cilastatin, 2) a quinolone + metronidazole, and 3) possibly an extended-spectrum penicillin. Treatment should be continued for 2 weeks or until recovery. Because fungus infections are occurring more often, prophylaxis with fluconazole may be warranted.
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PMID:Acute pancreatitis: management of complicating infection. 1069 44

Listeria monocytogenes causes sepsis and meningitis in immunocompromised hosts and a devastating maternal/fetal infection in pregnant women. In recent years a more benign gastroenteritis in normal hosts has been described. Listeria has been increasingly identified as a food-borne pathogen, and large-scale contamination of processed foods with resulting outbreaks has occurred in recent years, possibly as a result of consolidation of the food industry. Experimental listeriosis in mice has proven to be an extraordinarily useful model for analyzing cell-mediated immune host defenses. Contrary to original concepts, we found that neutrophils, not macrophages, are the prime effectors during early infection. CD8+ T cells are then responsible for lysing infected hepatocytes through perforin-related (early primary and secondary infection) or Fas-L/Fas mechanism (late primary). Of interest, non-classical MHC class Ib restricted recognition mechanisms exist early, whereas MHC class Ia mechanisms can be detected throughout infection.
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PMID:An updated model of cell-mediated immunity--listeriosis: clinical and research aspects. 1095 86

The phenomenon of calciphylaxis is rare, but potentially fatal. It has been recognised for a long time in patients with chronic renal failure with secondary hyperparathyroidism. Disturbed calcium and phosphate metabolism can result in painful necrosis of skin, subcutaneous tissue and acral gangrene. Appearance of the lesions is distinctive but the pathogenesis remains uncertain. The beneficial effects of parathyroidectomy are controversial. However, correction of hyperphosphataemia or occasionally hypercalcaemia is imperative. Fulminant sepsis as a consequence of secondary infection of necrotic and gangrenous tissue is a frequent cause of patient morbidity and mortality.
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PMID:Calciphylaxis. 1152 12


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