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)

The interrelationships between various components of the non-immune inflammatory response (white cell count, plasma lactoferrin, C-reactive protein, ferritin, iron and iron-binding capacity), were studied serially in a variety of inflammatory conditions including acute lobar pneumonia, active pulmonary tuberculosis, rheumatoid arthritis on gold therapy and sepsis in the face of marrow hypoplasia induced by chemotherapy. Lactoferrin concentrations paralleled the white count in all groups. They were highest in pneumonia and tuberculosis, mildly elevated in rheumatoid arthritis and markedly decreased in neutropenic sepsis. Very high initial lactoferrin concentrations were associated with a poor prognosis in acute pneumonia. C-reactive protein and ferritin concentrations remained elevated through the period of study in acute pneumonia and neutropenic sepsis, while they gradually normalised over weeks in subjects with tuberculosis or rheumatoid arthritis on therapy. In pneumonia and tuberculosis moderate hypoferraemia and a reduced iron-binding capacity were evident. In contrast, a raised percentage saturation was present in neutropenic sepsis, probably related to erythroid marrow suppression. Comparisons between ferritin, lactoferrin and C-reactive protein in the various groups supported the concept that ferritin behaves in part as an acute phase reactant and that hypoferraemia in inflammation is due to deviation of iron into ferritin stores. The suggestion that lactoferrin is responsible for the hypoferraemia and hyperferritinaemia was not supported by the present data. Iron deficiency appeared to limit the hyperferritinaemic response in rheumatoid arthritis, while erythropoietic inhibition by chemotherapy dampened the hypoferraemic response in neutropenic sepsis.
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PMID:The non-immune inflammatory response: serial changes in plasma iron, iron-binding capacity, lactoferrin, ferritin and C-reactive protein. 378 68

The levels of C-reactive protein (CRP) were assayed in 282 serial sera of 70 patients with hematologic malignancies who were under antineoplastic medication, and surveyed with frequent blood cultures. The mean peak value of CRP in febrile patients with bacteriologically verified sepsis was 162 mg/l and differed significantly (p less than 0.001) from that (23 mg/l) of afebrile patients with negative blood cultures, but not from that (115 mg/l) of febrile patients without confirmed bacteremia. All the values in afebrile patients with negative blood cultures were less than 100 mg/l; 71% of their peak values were less than 40 mg/l. Thus the malignancy itself or its treatment did not considerably mount CRP response.
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PMID:Levels of C-reactive protein in patients with hematologic malignancies. 386 31

The levels of 12 serum proteins including 'acute-phase reactants', immunoglobulins and albumin were measured in 20 patients suffering from thermal burns. The acute-phase reactants: C-reactive protein, alpha-l antitrypsin, alpha-l antichymotrypsin, haptoglobin and orosomucoid, all increased in concentration. Highest levels, which showed significant correlations with injury severity, occurred at 6-8 days post-burn. The levels of albumin, alpha-l lipoprotein and transferrin were decreased. The immunoglobulins IgG, IgA and IgM showed an initial decrease followed by a steady return to normal levels. Four patients, of whom three died, developed serious sepsis. The levels of alpha-l antichymotrypsin and C-reactive protein were much higher in patients with sepsis than in those without sepsis. The highest levels occurred during and often before the episode of sepsis was clinically evident. The immunoglobulins especially IgG and IgA were lower in those patients who developed sepsis than in those who did not. The results suggest that the serum levels of either C-reactive protein or alpha-l antichymotrypsin could be used both as an aid to diagnosis of sepsis and also to monitor the effect of therapy.
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PMID:The effects of septic complications upon the serum protein changes associated with thermal injury. 387 52

Preliminary evidence (n = 15) with semiquantitative (latex) determinations of C-reactive protein (CRP) suggested an unreliable CRP response in systemic Group B streptococcal infection. Recent experience with sequential, quantitative determinations of CRP in 10 infants surviving GBS infection documents that CRP can rise rapidly with systemic infection and fall rapidly with appropriate treatment. One infant with asymptomatic bacteremia had no increase in CRP, but in nine others with sepsis and/or meningitis the peak concentrations were from 4.2 to 31.9 mg/dl. Duration of elevated CRP ranged from 2 days in benign illness to 17 days in severe meningitis. Two infants with neurologic sequelae had concentrations greater than 20 mg/dl. Leukopenia, neutropenia and elevated immature neutrophil:total neutrophil ratio were frequently observed at the onset of infection. Leukocyte counts may be most helpful in making an early diagnosis, whereas CRP concentrations may document response, influence duration of antibiotic therapy and provide prognostic information.
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PMID:Response of C-reactive protein in neonatal Group B streptococcal infection. 388 78

Responses to bacteremia include fever, leukocytosis, elaboration of acute-phase proteins, hypoferremia, and increased protein catabolism. To evaluate the role of prostaglandins in the mediation of these responses, the effects of intravenous ibuprofen (12.5 mg/kg X dose) were studied in eight dogs infused with live Escherichia coli. Thirteen dogs served as noninfected controls. Two of the eight animals that received ibuprofen died during the study, whereas all control animals with sepsis survived. Prostaglandin inhibition prevented the rise in temperature resulting from sepsis, while alterations in white cell count, C-reactive protein, and serum iron levels were unaffected. In addition, protein catabolism appeared to be similar in both groups. This minimal metabolic effect coupled with observed renal side effects makes the use of nonsteroidal, anti-inflammatory agents in sepsis of questionable benefit.
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PMID:Limited effects of prostaglandin inhibitors in Escherichia coli sepsis. 389 41

To investigate the metabolic effects of interleukin-1 and its role as a mediator of host responses to trauma and sepsis, we injected seven healthy male subjects with etiocholanolone, an inflammatory agent that stimulates systemic responses thought to be mediated by interleukin-1. The subjects were fed a constant diet during each 4-day study and received three daily intramuscular injections of etiocholanolone, 0.10 mg/kg. Etiocholanolone injection resulted in inflammation, fever, leukocytosis, increased serum C-reactive protein, hypoferremia, and increased plasma activity of interleukin-1/lymphocyte-activating factor. Plasma concentrations of the counterregulatory hormones were normal. Protein metabolism, as reflected in nitrogen balance, 15N turnover, and forearm flux of alanine and glutamine, was unaltered. Serum glucose and insulin levels and tissue responsiveness to insulin were normal. This dissociation of acute-phase and catabolic responses may reflect the magnitude of the stimulus; higher levels of interleukin-1 may initiate catabolic responses. Alternatively, other mediators such as the counterregulatory hormones may direct the catabolic responses that occur after injury and sepsis.
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PMID:The induction of interleukin-1 in humans and its metabolic effects. 389 42

Multivariate statistical methods, multiple regression (RA) and automatic interaction detector analysis (AID) were used to study the possibility of an early prediction of staphylococcal etiology in 249 of 851 patients with verified septicemia or endocarditis. The variables included pertinent symptoms and signs and laboratory data available soon after admission. 10 of the 70 variables initially studied showed simple, or in various combinations, a statistically significant partial correlation to staphylococcal etiology in the AID. The highest predictive value with a high probability for staphylococcal etiology was recorded for combinations of the variables: i.v. narcotic addiction and septic pulmonary embolism; non-addiction, wound infection, and hospitalization within 4 weeks; non-addiction, absence of skin infection, presence of foreign body, and age less than 60 yr. Staphylococcal etiology was contradicted by the absence of i.v. narcotic addiction, skin infection, foreign body, septic skin manifestation, surgical procedure within 4 weeks, joint symptom and a C-reactive protein less than or equal to 10 mm. Thus, a prediction of etiology may be valuable in choosing therapy before definite confirmation by positive blood cultures or when blood cultures remain sterile.
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PMID:Prediction of staphylococcal etiology among patients with septicemia with or without endocarditis by multivariate statistical methods. 399 4

Adequate opsonic capability is vital for normal host defense against infection. The presence of complement fraction 3 (C3) indicates both classical and alternative pathways of complement activation, while complement fraction 4 (C4) indicates only classical pathway activation. C-reactive protein (CRP) functions as an opsonic substance. We measured serum levels of C3, C4, and CRP in 32 trauma patients. Six suffered minor injuries and 26 suffered major injuries. Nineteen of the major-injury patients developed post-trauma sepsis. Complement levels fell immediately after injury and remained low for approximately 8 days in all patients. CRP levels rose by 12 h, peaked at 48 h, and correlated with the severity of injury and the presence of sepsis. Elevated CRP levels after 4 days postinjury indicated the presence of sepsis in all cases. CRP elevations preceded clinical diagnosis by an average of 2.4 days. Serial measurements of CRP are valuable in monitoring the course of trauma patients and may indicate the presence of septic complications before clinical detection.
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PMID:Responses of opsonic substances to major trauma and sepsis. 402 47

In 93 preterm and term infants with proven neonatal septicemia and/or meningitis different leukocyte indexes were evaluated at onset of septicemia [absolute neutrophil count, immature neutrophil count, immature to total neutrophil ratio (I/T-ratio)]. 75% of the patients who developed septicemia within the first three days of life and 60% of all neonates with septicemia or meningitis could be identified by an elevated I/T-ratio, the most sensitive leukocyte count. Thrombocytopenia was observed in only 33% of the patients. Additional analysis of IgM and fibrinogen was neither helpful in identifying neonatal infections nor a valuable follow-up parameter of successful treatment. In contrast C-reactive protein (CRP) was increased in 88% of all infants with neonatal septicemia and/or meningitis at time of diagnosis; when used in combination neutrophil indexes and CRP even improved the sensitivity of a single laboratory screening test.
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PMID:[Early diagnosis of neonatal infection]. 405 29

No single diagnostic test for neonatal sepsis is both rapid and reliable. Combining leukocyte (wbc) counts with acute phase reactants (APR) enhances diagnostic accuracy. The most helpful wbc counts are leukopenia (less than 5.0 x 10(9)/l), increased immature/total neutrophils (greater than or equal to 0.2) and profound neutropenia (less than 1.0 x 10(9)). Of the APR, C-reactive protein responds most rapidly, but alpha 1-acid glycoprotein (orosomucoid), haptoglobin and mini-ESR (greater than or equal to 15 mm/h) are also useful. Rapid, quantitative determinations of APR are now available with nephelometric techniques. Abnormal wbc counts frequently appear before APR changes in group B streptococcal infection. Sequential determinations of wbc counts and APR may provide valuable diagnostic and prognostic information.
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PMID:White blood cells and acute phase reactants in neonatal sepsis. 608 34


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