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

Single-pulse administration of rhG-colony-stimulating factor (CSF) to neonatal rats was previously demonstrated to induce peripheral neutrophilia and modulate bone marrow (BM) neutrophil storage and proliferative pools (NSP + NPP). In this study, we investigated the prolonged effects of 7 days of rhG-CSF therapy (5 micrograms/kg/per day). Sprague-Dawley newborn rats (less than or equal to 24 hours) were injected intraperitoneally (IP) (daily for 7 days) with rhG-CSF or phosphate-buffered saline/human serum albumin (PBS/HSA). RhG-CSF induced a significant early and late peripheral neutrophilia: 6,905 +/- 1,625 (day 1) and 9,223 +/- 515 microL (day 7) v 1,275 +/- 90/microL (P less than or equal to .0001). In addition, 7 days of rhG-CSF resulted in a significant increase in the BM NSP: 3,247 +/- 190/microL v 1,677 +/- 339/microL (P less than or equal to .001). There was, however, no depletion or significant change in the BM NPP. Seven days of rhG-CSF also induced a mild increase in BM CFU-GM colony formation (P less than or equal to .01). There was, however, no significant change in liver/spleen CFU-GM colonies or in the CFU-GM proliferative rate in either the BM or liver/spleen cultures. Finally, 7 days of prophylactic rhG-CSF therapy resulted in a synergistic response with antibiotic therapy and significantly modulated the mortality rate during experimental group B streptococcal sepsis (GBS) (100% v 50%) (GvsC) (P less than or equal to .001). Pulse rhG-CSF administered at 6 hours or 18 hours after GBS inoculation, however, failed to act synergistically with antibiotics to improve survival or prevent peripheral neutropenia. This study suggests that 7 days of prophylactic rhG-CSF therapy induces peripheral neutrophilia, myeloid maturation, increases neutrophil BM reserves and also may provide immunologic enhancement of neonatal host defense during experimental GBS in term neonatal rats.
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PMID:Seven-day administration of recombinant human granulocyte colony-stimulating factor to newborn rats: modulation of neonatal neutrophilia, myelopoiesis, and group B Streptococcus sepsis. 169 22

Advances in medical technology and knowledge have influenced morbidity and mortality in surgically treated diseases. The authors have compiled four consecutive retrospective studies of demography, morbidity and mortality of patients with acute pancreatitis to summarize the experience from 1956 to 1985 at the Montreal General Hospital with 629 patients. The death rate has remained unchanged. Hypotension, gastrointestinal bleeding and respiratory failure have assumed lesser roles as major complicating factors. Renal failure and gram-negative aerobic pancreatic sepsis are the common causes of death. The last two reviews revealed that surgical debridement and drainage combined with appropriate biliary procedures salvaged two-thirds of the patients with sepsis. Deteriorating nutritional status, heralded by a fall of serum albumin level below 30 g/L, is associated with a poor prognosis. Interval cholecystectomy in patients with mild biliary tract pancreatitis is associated with a low death rate (0.01%).
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PMID:Acute pancreatitis--30 years' experience at a teaching hospital. 202 95

We determined total plasma calcium levels in 44 critically ill patients without evidence of renal or hepatic failure, 25 of them with active systemic infection. Plasma Ca was 7.49 +/- 0.1 mg/dl in the septic group compared to 8.46 +/- 0.2 in non septic patients (p < 0.01). Corresponding levels of serum albumin were 2.26 +/- 0.1 and 3.05 +/- 0.2 milligrams, respectively (p < 0.01). Corresponding corrected plasma Ca levels were 9.19 +/- 0.1 and 9.39 +/- 0.1 mg/dl (NS). No correlation of lactate and plasma Ca levels was found. Mortality was 56% for septic and 16% for non septic patients. Patients with hypocalcemia had 53% mortality rate compared to only 16% in normocalcemic patients. PTH levels were normal in all but one patients, thus ruling out a rapid installation secondary hyperparathyroidism. Hypoperfusion does not appear related to ionic Ca levels given the lack of correlation of Ca and lactate levels. Mortality is related to sepsis and hypoalbuminemia but not to corrected Ca plasma levels.
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PMID:[Plasma calcium levels in critical patients with and without sepsis]. 184 18

Forty-three patients who had sepsis and multiple organ failure (critical illness) were studied prospectively to determine the incidence and severity of peripheral nerve function and to correlate such function with a number of variables. Electrophysiologic studies indicated a primary axonal degeneration of motor and sensory fibers in 30 (70 percent). Fifteen (30 percent) had the clinical signs of difficulty in weaning from assisted ventilation, weakness of limb muscles, and reduced or absent deep tendon reflexes. Full recovery from the polyneuropathy occurred among the 23 (53 percent) who survived, except three who had a very severe polyneuropathy. A peripheral nerve function index, computed from electrophysiologic measurements, showed statistically significant (p less than 0.01) negative correlations with the time in the critical care unit, and the serum glucose value; the serum albumin level showed a positive correlation. Multiple regression analyses indicated all three factors accounted for 47 percent (r2 = 0.4678) of all potential variables. In a separate analysis, the nerve function index correlated with the amplitude of the diaphragm compound muscle action potential (p less than 0.01). The results were consistent with the polyneuropathy being due to the same mechanisms that are currently postulated to cause dysfunction in this syndrome of other organ systems (including the neuromuscular respiratory system).
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PMID:Peripheral nerve function in sepsis and multiple organ failure. 184 61

Protein and electrolyte disturbances in hepatic and muscle tissues are related to trauma, sepsis, or short term starvation or semistarvation. The consequences of a prolonged semistarvation are poorly understood. For five weeks, male adult rats were offered 50% of the diet until they had a weight loss of 40%, after which protein and electrolyte (Ca++, Mg++, Zn++, Na+, K+) changes in the liver and soleus and extensorum digitorum longus muscles were analyzed. There was a significant weight loss after 5 weeks of semistarvation. Hepatic protein and serum albumin were not changed, but the authors observed a significant muscle protein depletion. A fall in Zn++ levels in the blood was accompanied by a rise in muscle and liver concentrations. The rise in Ca++ and Mg++ concentration in blood and in the muscles might be related to the enhanced proteolysis. Results suggest that the early changes of protein and electrolyte metabolism at tissue level with semistarvation impair muscular and hepatic functions as they delay adequate response to trauma and infection.
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PMID:[Effects of food restriction on the protein and electrolyte composition in the liver and muscles of rats]. 188 80

Critically ill patients have increased rates of sepsis partly due to a down-regulated immune system. Nutrients may modulate the immune system. The following studies were performed to determine whether arginine is one of these "essential" nutrients for the immune system. Thirty-two male Sprague-Dawley rats (weighing 175 g) were divided into two groups that were pair-fed with either an elemental, arginine-supplemented enteral diet, or the same diet with arginine removed and replaced with glycine. Both diets were isocaloric, isoosmolar, and isonitrogenous. After 6 days on the diet, animals underwent testing. There were no significant differences between the arginine-supplemented and the arginine-free diet groups in blood glucose or hematocrit. The arginine-supplemented animals had higher serum albumin (4.1 +/- 0.1 mg/dL v 3.6 +/- 0.1 mg/dL; P = .035) and serum protein levels (5.2 +/- 0.1 mg/dL v 4.3 +/- 0.1 mg/dL; P = .041); and had higher thymus gland (0.53 +/- 0.03 g v 0.44 +/- 0.02 g; P less than .0001) and spleen weights (0.66 +/- 0.01 g v 0.57 +/- 0.01 g; P less than .01). Daily total urinary nitrogen excretion, nitrogen balance, and weight gain showed a tendency for the arginine-supplemented animals to retain more of their nitrogen calories. There was no difference in the amount of hydroxyproline (OHP) found in the wound cylinders of either group (both 25.6 micrograms OHP/cm polytetrafluoroethylene) but the arginine-supplemented group's wounds had greater wound bursting strengths (429 +/- 3 g/cm v 350 +/- 7 g/cm; P = .044).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of an arginine-free enteral diet on wound healing and immune function in the postsurgical rat. 191 87

During an 11-year period, 41 patients with Crohn's disease were placed on home parenteral nutrition (HPN) for a mean of 1,083 days (range: 33 to 3,258 days). Data were retrospectively analyzed to determine whether HPN had an effect on the course of their disease, i.e., on the number of operative procedures performed and the intensity of required medical therapy. Data represented information obtained during a total of 121 patient-years of HPN for Crohn's disease. The main indications for HPN were short bowel syndrome (66%) and high stoma output. Twenty-four of 41 patients (59%) underwent surgery for Crohn's disease during the course of HPN. There was no significant difference between the number of procedures performed per patient per year of Crohn's disease during pre-HPN and HPN periods (p greater than 0.25). Although there was no significant change in body weight, both serum albumin and transferrin levels increased during HPN (p less than 0.01 and p less than 0.01, respectively). Twenty-nine percent of patients were taking prednisone while on HPN, compared with 54% of patients during the pre-HPN period (p less than 0.01). HPN appeared to result in a significant improvement in the numerically assessed quality of life. During the HPN period, 24 patients had 1 or more HPN-related complications that required 1 to 13 hospital admissions (mean: 1.8). These complications included catheter sepsis in 19 patients, blocked or damaged catheters in 15 patients, and dehydration and/or electrolyte imbalance in 5 patients. Eight patients died, with 7% of deaths secondary to catheter-related sepsis. Although permanent HPN is associated with an identifiable morbidity and mortality and is not associated with a reduction in the frequency of surgery for Crohn's disease, benefits include a decrease in the intensity of medical therapy, an improvement in patients' nutritional state, and a significant perceived improvement in patients' quality of life. Without HPN, we believe all patients would have died secondary to malnutrition and/or dehydration.
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PMID:A century of home parenteral nutrition for Crohn's disease. 197 2

The object of this is to evaluate the influence of several micronutrients on the survival rate of septic patients following abdominal surgery. A retrospective assessment was done of sixty-one patients suffering from neoplastic or non-neoplastic pathology associated to septicemia. On admission the following parameters were determined: number of total lymphocytes, serum albumin, transferrin, zinc, copper, magnesium, iron, calcium, phosphorus, and copper/zinc levels. The differences obtained between surviving and non-surviving patients were analyzed. The most relevant findings revealed statistically significant lower serum albumin, zinc and transferrin values in the latter group. We conclude by stating that such parameters may be of prognostic value in this type of patients, and that supplemental micronutrients must be administered in order to improve prognosis.
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PMID:[Micronutrients in severe septic aggression. Their usefulness as prognostic markers]. 207 2

Physicians and surgeons have long recognized that septic illness may be accompanied by abnormal brain functions; however, no systematic, comprehensive study has been done to define the clinical and laboratory features of the syndrome of sepsis-associated encephalopathy. We undertook such a prospective study in a tertiary care hospital and found that of 69 patients with fever and microbial cultures, 32 had marked brain dysfunction, 17 showed mild encephalopathy, and 20 were clinically nonencephalopathic. Severe cases showed obtundation and paratonic rigidity while milder cases showed confusion, inappropriate behavior, inattention, disorientation, and writing errors. There were no focal neurological deficits. The following factors correlated with the severity of brain dysfunction: adult respiratory distress syndrome; fatal outcome; certain types of EEG abnormality; axonal peripheral neuropathy; elevated peripheral white blood cell count; elevated serum levels of alkaline phosphatase, bilirubin, creatinine, phosphate, potassium, and urea; reduced blood pressure and reduced serum albumin level. Our data suggest that brain functions fail with dysfunction of other organs in septic illness. Pathogenetic mechanisms are discussed. The brain dysfunction should be regarded as potentially reversible, even in severely encephalopathic cases. Prompt control of the infection is the most important measure in controlling the encephalopathy and in preventing the increased mortality found with severely encephalopathic patients.
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PMID:The encephalopathy associated with septic illness. 207 9

A freely mobile jacket and tether system was developed for the investigation of total parenteral nutrition (TPN)-induced metabolic bone disease and complications of prolonged TPN in 12 Macaca fascicularis nonhuman primates. The animals received TPN for 49 +/- 7 d (means +/- SEM), providing 82 +/- 2 kcal.kg-1.d-1. Serum glucose increased from 3.6 +/- 0.2 mmol/L at baseline to 8.3 +/- 1.9 mmol/L (p less than 0.01) during TPN, and serum albumin decreased from 38 +/- 1 g/L at baseline to 29 +/- 1 g/L (p less than 0.001) during 2.75% amino acid TPN and 30 +/- 2 g/L (p less than 0.01) during 5% amino acid TPN infusion. No significant changes were seen in serum prealbumin, total protein, bilirubin, alanine aminotransferase, and 5'-nucleotidase during TPN infusion. Major complications included catheter sepsis, hyperglycemia, diarrhea, and premature death in six animals. Thus, metabolic complications of prolonged TPN support may be investigated in a freely mobile nonhuman primate.
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PMID:Long-term parenteral nutrition in unrestrained nonhuman primates: an experimental model. 210 76


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