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

Researchers analyzed 1972, 1977, 1982, 1987 data on neonatal tetanus death and birth attendants from the Comprehensive Rural Health Services Project in rural Ballabgarh, India which comprised 28 villages. Health workers visited each house in an area monthly. Even though they began vaccinating pregnant women with the tetanus toxoid (TT) in 1970, the TT coverage percentage did not fall substantially until between 1977-1982 (31.6%-70%), by 1983, TT coverage stood at 93%. It was not until TT coverage reached 85% did neonatal tetanus deaths fall significantly. In 1982, they gave every women near the end of pregnancy a sterilized delivery kit complete with gauze, half a razor blade, and thread. The health workers instructed the women to request anyone who delivers the child to use the contents of the kit. Regardless of the year, around 90% of deliveries occurred at home. Except for 1982, untrained individuals attended about 70% of deliveries. 1982 was the year with the highest percentage of trained dais involved in home delivery (27.6%). The percentage of deliveries my primary health care staff did rise from 4.2-12.1% between 1972-1987, however. In this time period, neonatal mortality fell gradually from 42.3-17.9. Moreover neonatal deaths from tetanus fell consistently but dramatically from 14.6-0. The drop in tetanus related deaths between 1972-1977, was not significant, however, because tetanus and septicemia were not differentiated and health staff seldom saw tetanus cases in hospitals. In conclusion, the Comprehensive Rural Health Services Project of India should expand prenatal care including TT to all pregnant women, distribute sterilized delivery kits to these women between 36-40 weeks gestation, and include instructions on how to use the contents of the kit.
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PMID:Control of tetanus neonatorum in a rural area. 193 45

A new kit for probe feeding permits to provide dosaged and continuous administration of nutritional mixtures with a certain speed and intervals. The complex is supplied with a device that permits to maintain a certain temperature of the mixture (if necessary the range of heating and cooling varies from 10 to 40 degrees C) and an electromixer, that prevents the mixture viscosity increase. The kit is successfully used for enteral (probe) feeding in patients with acute purulent infection and sepsis.
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PMID:[A kit for conducting enteral feeding]. 250 May 74

Prostaglandin E2 (PGE2) has been known to modulate immune responses by inhibiting T-cell activation following hemorrhagic and traumatic injury. Recently, we documented a sepsis-related depression in concanavalin A (ConA)-induced T-cell proliferation and intracellular Ca2+ (Ca2+i) mobilization. The present study evaluated the potential role of PGE2 in the sepsis-related attenuation in Ca2+ signaling and proliferation in T cells. Sepsis was induced in rats by implanting into their abdomen fecal pellets containing Escherichia coli (150 CFU) and Bacteroides fragilis (10(4) CFU). A group of rats implanted with septic pellets were treated with indomethacin at three consecutive time points. Levels of PGE2 in blood were measured with a radioimmunoassay kit. ConA-induced [Ca2+]i mobilization in T cells obtained from indomethacin-treated and untreated rats was measured with Fura-2 and microfluorometry. We observed a 10-fold increase in PGE2 levels in the circulation of septic rats compared with levels in rats implanted with bacterium-free sterilized pellets. The proliferative response and Ca2+i mobilization were significantly depressed in T cells obtained from septic rats 48 h after implantations compared with those in rats implanted with sterile pellets. However, treatment of rats with the cyclooxygenase inhibitor indomethacin prevented the sepsis-related depression in ConA-induced T-cell Ca2+i mobilization as well as proliferation. Further, incubation of T cells from nonimplanted control rats with PGE2 resulted in a substantial depression in both T-cell proliferation and Ca2+i mobilization. The restoration of T-cell proliferation and Ca2+ signaling after indomethacin treatment of septic rats and the depression in the mitogen responsiveness in T cells previously exposed to PGE2 suggest that the PGE2 does play a significant role in the modulation of T-cell responses in septic rats and that such PGE2-induced suppression in T-cell activation is likely due to an attenuation in Ca2+ signaling.
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PMID:Role of Ca2+ in prostaglandin E2-induced T-lymphocyte proliferative suppression in sepsis. 762 37

The early diagnosis of postoperative bacterial meningitis (BM) may be difficult. CSF cultures may remain sterile. Clinical features and routine laboratory data often fail to give an evidence. As early antibiotic therapy is essential in such patients, a rapid diagnosis is required. Different authors proposed the D(-) isomer of lactic acid as an early and effective marker of infection in the body fluids (including CSF). D(-) lactate is produced by bacteriae and fungi; L(+) lactate may be produced also by human tissues in anaerobic situations. We conducted a prospective study in a neurosurgical intensive care unit to evaluate this technique for the diagnosis of meningitis following craniotomy. Fifty-four patients were included, 40 in group A (not infected or infected out of the CNS), 4 in group B (suspected BM), 10 in group C (BM with positive CSF cultures). No patient suffered from septicemia, haemodynamic or ventilatory instability, nor metabolic disorder. Clinical data, CSF and blood samples (cytology, conventional biochemistry, D(-) and L(+) lactate, bacteriology) were collected at inclusion and, in group B and C patients, at day 2, 5 and at clinical recovery. D(-) lactate measurements were performed with an enzymatic method adaptated from a Boehringer Mannheim kit (for determination in foodstuff). Statistics were based on the comparison of group A vs C patients. D(-) and L(+) lactate concentrations in the CSF were significantly higher in group C patients, and blood concentrations were similar.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Value of D(-) lactate determination for the fast diagnosis of meningitis after craniotomy. An initial study]. 773 13

There is no satisfactory assay procedure of PAF in human whole blood in terms of sensitivity, reproducibility and simplicity. This is due to coexisting lipids from plasma and cellular membranes which inhibit measurement of PAF in various assay procedures, including bioassay. In the present study, an attempt was made to eliminate these interfering lipid inhibitors from blood samples. Lipids in human whole blood were extracted according to the method of Bligh & Dyer and the organic layer was dried under a stream of nitrogen. Then, the dried organic layer was dissolved in diethyl-ether and the solution was kept at -20 degrees C which was then centrifuged. The resulting supernatant was then applied to an anion-exchange column and the PAF fraction was obtained by step-wise gradient elution. The fraction was further purified by normal phase HPLC. Then PAF in the final sample was determined by sensitive bioassay using rabbit platelets containing fibrinogen and epinephrine. The recovery rate of PAF throughout this procedure was constant and satisfactory (37.4 +/- 9.7%), which was confirmed using [3H]-PAF. The lower limit of the present assay was estimated to be 5pg in 1 ml of blood and it was sensitive enough to detect PAF in blood samples from healthy volunteers and patients with sepsis or liver cirrhosis. Furthermore, attempts were made to compare the sensitivity and the recovery of our method with these of a commercially available radioimmunoassay (RIA) kit for PAF. However, it was not possible to detect any amount of authentic PAF added to whole blood.
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PMID:A new method of purification and sensitive bioassay of platelet-activating factor (PAF) in human whole blood. 829 90

Although studies have indicated that hepatocellular function is depressed early after the onset of sepsis, it remains unknown whether liver endothelial cell function is also compromised under such conditions. To study this, male rats were subjected to polymicrobial sepsis by cecal ligation and puncture (CLP), followed by administration of 3 ml/100 g body wt normal saline subcutaneously to these and to sham-operated animals. Blood samples (0.2-ml aliquots) were taken from the carotid artery, portal vein, and hepatic vein at 2, 5, 10 (i.e., hyperdynamic sepsis), or 20 hr (hypodynamic sepsis) after CLP, and plasma hyaluronic acid (HA) was determined using a Pharmacia assay kit. In addition, HA clearance was assessed at 5, 10, or 20 hr after CLP by injecting 30 micrograms/100 g body wt HA intravenously. Plasma HA was determined at 2-40 min after the administration of HA. The results indicate that plasma levels of HA in blood from three different sites did not increase significantly until 10 hr after CLP. Clearance of HA decreased only at 20 hr after CLP, compared to sham-operated animals. These results suggest that the increased plasma levels of HA at 10 hr after the onset of sepsis are solely due to the increased release/production of the polysaccharide. Since circulating HA is cleared exclusively by the liver endothelial cell, the results demonstrate that liver endothelial cell dysfunction (i.e., the increased circulating HA levels and decreased HA clearance) occurs only during the late, hypodynamic stage of polymicrobial sepsis.
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PMID:Liver endothelial cell function is depressed only during hypodynamic sepsis. 912 93

Interleukin (i.l.)-8 levels in serial serum samples of 10 burned patients were analysed. The total body surface areas (TBSAs) of the burn injury ranged 30 to 85 per cent. Of these ten patients, five recovered and the other five, who were septic, died. On admission at about 5-13 h postburn, one of the five survivors and two of the non-survivors had serum IL-8 levels higher than 18.1 pg/ml, which is the detection limit of the IL-8 assay kit. The serum IL-8 values of six healthy laboratory personnel included in the present study were all less than 18.1 pg/ml. Afterwards, an initial peak serum IL-8 response was detected within 2-4.5 days postburn. Significant differences in the peak serum IL-8 levels were not found between patients with TBSAs of greater or less than 50 per cent and patients who survived or expired from burn injury. In the survivors, serum IL-8 remained low, whereas IL-8 increased markedly, starting at about one week postburn in four of the five non-survivors with confirmed sepsis. Significant differences in the maximum serum IL-8 levels were detected between patients who recovered vs. those who died from the thermal injury. In conclusion, the results showed that there was an increase in serum IL-8 postburn. Serum IL-8 was significantly higher in the septic patients, who all died. This cytokine may play a significant role in the pathophysiology of sepsis in burned patients.
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PMID:Changes in levels of serum IL-8 in burned patients. 956 23

Recent advances in pacemaker leads have contributed to the improvement of their stability at the anchored sites. However, we sometimes have difficulty in removing them. We have experienced the removal of 16 leads in 10 patients (male: 7, female: 3) in the last 5 years. The age of patients ranged from 48 to 87 years, and the average was 60. The reasons for the removal were as follows; pocket infection in 6 cases, sepsis in 1 case, ischemic skin erosion in 1 case, retained fractured ventricular lead in 1 case, fracture of Accufix atrial lead in 1 case. The methods of removal consisted of using the removal kit, the snare or the basket snare transvenously, direct surgical approach or a combination of them. We used the removal kit alone in 12 electrodes (6 atrial, 6 ventricular), and removal of 5 atrial and 3 ventricular leads were successfully by this method only. The removal of 4 leads by kits alone failed, so that 2 ventricular leads were removed transvenously, one atrial and one ventricular lead were removed surgically, and 1 ventricular lead was left untreated. Finally, we were able to remove 15 of 16 leads (93.3%) successfully. This experience indicates that these interventions should be performed as less invasively as possible, yet we should give an explanation to the patients as to the options we may employ when we have failed in the intended procedure.
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PMID:[Removal of the endocardial pacemaker leads--experience with 16 leads in 10 patients]. 965 21

Septic episodes in thermal injuries are usually hallmarked by a series of physiologic parameters that include tachypnea, prolonged paralytic ileus, hyperthermia or hypothermia, altered mental status, thrombocytopenia, leukocytosis or unexplained leukopenia, acidosis, and hyperglycemia. Recent studies with polycystic kidney disease have clearly indicated that the limulus amebocyte lysate (LAL) assays were predictive of fungal infections in this patient population. Because both bacteria and fungi produce lipopolysaccharide that can be identified with the LAL assay, we randomly assayed sequential sera of 45 patients with major thermal injuries for positivity in the LAL assay, with use of the QCL-1000 kit (BioWhittaker, Walkersville, Md). The average burn size of this patient population was 63.43% total body surface area. The average age of the patient was 6.2 years. The sex distribution included 30 males and 15 females. The infectious agents included gram-positive cocci and gram-negative rods, and 14 patients had concomitant fungal infections. Eighty-five percent of the patients tested were positive for endotoxin, with levels ranging from < 0.1 EU/mL to > 1.0 EU/mL. The predominant organism isolated before or on the date the serum was drawn was Pseudomonas aeruginosa (51%), followed by Klebsiella pneumoniae (15%). The remaining 34% were a variety of Enterobacteriaceae. Of the 14 patients who yielded a fungus, 3 had negative LAL assays. Two patients with an elevated LAL grew only Staphylococcus epidermidis in the bloodstream and the wounds. These data clearly indicate that the LAL assay cannot be relied on as the sole predictor of septic episodes; however, it can be an adjunctive test to confirm sepsis when the other parameters have been considered.
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PMID:Is the limulus amebocyte lysate the sole predictor of septic episodes in major thermal injuries? 984 41

Collectively, TORCH infections create more neonatal morbidity than early-onset group B streptococcal sepsis. Fortunately, the incidence of maternal infection by CMV or toxoplasmosis is low (2-10 per 1,000 births). There have been tremendous advances in direct antigen testing and in the sensitivity and specificity of IgG and IgM testing. Consistently, research laboratories show more accurate results than in the past. Unfortunately, commercial laboratories are using older, single-kit testing. The relatively poor degree of reliability can lead to unnecessary obstetric intervention or elective termination. Any positive pathogen-specific IgM on maternal serum should have additional confirmatory testing in a reputable research laboratory before any intervention. Direct antigen testing or multiple testing would seem to be appropriate for confirmation. This may include amniocentesis of fetal blood sampling. The research on the newer tests is based of the evaluation of blood from seriously immunocompromised subjects. Extrapolations of test accuracy to similar tests on healthy, pregnant women and their fetuses are likely to be in error. The application of these accurate tests to the obstetric population is a critical research need.
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PMID:Diagnosis of perinatal TORCH infections. 1007 1


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