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

Hepatic ischemia should be considered in serious liver injury, liver tumor resection and liver transplantation. There are other conditions that decrease hepatic blood flow and cause hepatic ischemia, such as hemorrhagic shock, sepsis, hepatic artery ligation, trauma, and certain vascular lesions. In this study, effects of nimodipine (a calcium channel blocker) and pentoxyfylline (a derivative of methylxanthine) on duration and degree of hepatic ischemia in rats at normothermic and hypothermic conditions are investigated. This study was performed on 6 groups of Wistar Albino type rats, each group consisting of 7 rats. Groups were separated into normothermic (A) and hypothermic (B) conditions AI-Control group, AII-Nimodipine group and AIII-Pentoxyfylline group, B IV-Control group, BV-Nimodipine group and BVI-Pentoxyfylline group respectively. After hepatic pedicle occlusion lasting 45 min, blood samples were drawn from the rats for evaluation of alanine aminotransferase (ALT), aspartate transaminase (AST) and lactate dehydrogenase (LDH) values. Moreover, hepatic biopsies were taken to assess pathological changes under electron microscopy. These changes were evaluated through a grading system. As a result; it has been shown that both nimodipine and pentoxyfylline delayed effects of hepatic ischemia in a statistically significant manner in comparison with the control group and these effects were found to be more significant in hypothermic conditions.
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PMID:Effects of nimodipine and pentoxyfylline in prevention of hepatic ischemic damage in rats at normal and hypothermic conditions. 1849 96

Sepsis is still a major cause of the high mortality rate in the intensive care unit. Many studies have been published about the severity of sepsis, but the cause of mortality in sepsis and multiorgan failure is still obscure. This study investigated the effects of caffeic acid phenethyl ester (CAPE) particularly on the inflammatory and related histopathological changes in the lung, liver and kidney in an experimental sepsis model. Forty Sprague Dawley rats were used in this study, and were divided into four groups of ten rats each, as follows: Group I was given intraperitoneal saline infusion treatment. Group II was given intraperitoneal CAPE infusion treatment. Sepsis was induced in the animals in Group III (sepsis with saline infusion), while Group IV rats underwent induced sepsis plus CAPE infusion treatment (sepsis with CAPE infusion). Sampling was performed 48 h after treatment. The induction of sepsis resulted in a significant increase in serum glucose, leukocytes, urea, creatinine, LDH levels in BAL, plasma MDA, AST and ALT levels in the sepsis + saline group. The use of CAPE significantly decreased these parameters. Histopathological examination revealed less congestion, portal inflammation, and focal necrosis of the liver, and less congestion, edema, and emphysematous and inflammatory changes in the lung in the sepsis + CAPE group than in the other groups. These results support that CAPE may be used for the treatment of organ failure during sepsis.
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PMID:Effects of caffeic acid phenethyl ester (CAPE) on sepsis in rats. 1860 6

Sepsis continues to be a challenge in clinic. Therapeutic strategies focus on local host defenses and the inhibition of overwhelming inflammation response. The present study aimed to investigate the protective effects and the underlying mechanisms of the ethanol extract of Alpinia katsumadai Hayata seeds (EAKH) on polymicrobial sepsis induced by cecal ligation and puncture (CLP) in mice. It was shown that oral administration of EAKH at 1 h before and 2 h after CLP significantly elevated the survival rate and the mean arterial pressure of mice. Histological examination and serum ALT/AST assessment demonstrated that EAKH protected the animals from lung and liver tissue injury and dysfunction. Although EAKH was devoid of direct bacteriostatic or bacteriocidal activities, it facilitated peritoneal bacteria clearance and increased leukocyte migration into peritoneal cavity of septic mice. Furthermore, EAKH remarkably decreased serum pro-inflammatory cytokine (TNF-alpha, IL-1beta and NO) levels in septic mice. These findings demonstrated that EAKH has preventive effects on mouse sepsis induced by CLP, which may be attributed to elevating local defense via promoting leukocyte migration to infection focus and attenuating systemic inflammation.
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PMID:Alpinia katsumadai Hayata prevents mouse sepsis induced by cecal ligation and puncture through promoting bacterial clearance and downregulating systemic inflammation. 1884 87

The French Indian Ocean island Mayotte was hit by an outbreak of chikungunya in January 2005. The purpose of this retrospective study is to report data recorded over a five-month period (February - June 2006) in the pediatric-neonatal department of the Hospital Center in Mayotte. The study cohort includes a total of 50 children in whom chikungunya was confirmed by molecular tools. Mean age was 9.3 years and the male-to-female sex ratio was 1:5. The main symptoms were intense pain (88%), high fever (82%), and skin rash (80%) that was less common in children under 2 years of age. Neurological complications were observed in 46% of patients including hypotonia (22%) that occurred mainly in newborns, meningitis syndrome (18%) and convulsions (16%) that occurred mainly in children over 2 years of age. Infectious complications included pneumonia (4%), pyelonephritis (2%), and possible nosocomial septicemia due to Pseudomonas (6%). The main hematological abnormalities were lymphopenia (27%) and thrombopenia (16%). Serum CRP values were moderately high (mean, 25 mg/l). Elevated AST (24%) and ALT (10%) values were observed. High CSF protein levels were noted in 30% of cases. A total of 25 children required hospitalization for more than 10 days. There were two deaths in newborns infected before the seventh day of life. The main risk factors for hospitalization longer than 10 days were premature birth and age at the time of chikungunya infection.
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PMID:[Confirmed chikungunya in children in Mayotte. Description of 50 patients hospitalized from February to June 2006]. 1906 81

Liver abnormalities are common in septic patients. The study was aimed at investigating the alterations in aminotransferase levels during acute pyelonephritis in adults. Serum aminotransferases (AST and ALT) were determined in 421 patients (aged 16-90 years, 79.8% females) admitted to the hospital because of acute pyelonephritis. Abnormally high aminotransferase (sAST or sALT) levels were present in 21.4% (95% CI 17.6-25.9%) of patients without pre-existing liver disease (n=401). Aminotransferase abnormality was moderate in the majority of cases. After adjusting for confounders, aminotransferase abnormality was associated with age and with signs of sepsis (particularly, high body temperature and low blood pressure). Aminotransferase levels tended to normalize during convalescence. In conclusion, the management of patients with pyelonephritis should take into account that moderate and self-limited abnormalities in aminotransferase levels are frequent during the acute phase of the disease.
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PMID:Abnormalities in aminotransferase levels during acute pyelonephritis. 1939 79

Lemierre's syndrome is a rare but a life threatening condition which affects young healthy individuals, was first described by Dr.Andre Lemierre in 1936. Incidence rates are between 0.6 and 2.3 per million population. It is found more commonly in males, with a male to female ratio of approximately 2:1. Its pathogenesis consists of the development of infectious thrombophlebitis in the internal jugular vein or one of its branches caused by a focal sepsis, mostly localized in the oropharynx, leading to generalized multiorgan metastatic infections, generally to the lung. This computerized tomography (CT) neck with intravenous contrast is from a 24 year old female who presented with a two day history of fever, hypotension and respiratory failure. The physical exam was positive for diminished breath sounds bilaterally on lung exam. Complete blood count revealed a leukocytosis of 16,200 u/L with 70% neutrophils and 9% bands, hemoglobin of 13.4mg/dl and severe thrombocytopenia with a platelet count of 34,000 u/L; comprehensive metabolic panel revealed sodium 140mmol/L, potassium 2.9mmol/L, bicarbonate 26mmol/L, blood urea nitrogen (BUN) 16mg/dl, creatinine 0.8mg/dl, calcium 7.2 mg/dl, albumin 2.4g/dl, total bilurubin 3.1mg/dl, AST 81 U/L, ALK 101 U/L, ALT 35U/L. CT chest revealed multiple cavitary opacities in both lungs. Blood cultures were positive for Fusobacterium necrophorum. CT scan neck showed a filling defect of the right internal jugular vein consistent with a thrombus and multiple enlarged cervical lymph nodes. Treatment is medical with intravenous antibiotics and anticoagulation. References: 1. Carlson ER, Bergamo DF, Coccia CT. Lemierre's syndrome: two cases of a forgotten disease. J Oral Maxillofac Surg 1994; 52:74-78. 2. Moore-Gillon J, Lee TH, Eykyn SJ, Phillips I. Necrobacillosis: a forgotten disease. BMJ 1984;288:1526-1527. 3. Jones C, Siva TM, Seymour FK, O'Reilly BJ. Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. J Laryngol Otol 2006;120:502-504 4. Mohammed Iqbal Syed et al. Lemierre Syndrome: Two Cases and a Review. Laryngoscope, 117:1605-1610, 2007 5. Vohra A, Saiz E, Ratzan KR. A young woman with a sore throat, septicaemia, and respiratory failure. Lancet 1997; 350:928.
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PMID:"A forgotten disease": a case of Lemierre syndrome. 1946 52

Sepsis remains the leading cause of death in intensive care units. Uncontrolled systemic inflammation and an impaired protein C pathway are two important contributors to sepsis pathophysiology. Based on the beneficial effects of the saponin fraction from Astragalus membranaceus roots (SAM) against inflammation, liver dysfunction, and endothelium injury, we investigated the potential protective roles and underlying mechanisms of SAM on polymicrobial sepsis induced by cecal ligation and puncture (CLP) in mice. SAM, orally administered 1 h before and after CLP, significantly elevated the survival rate of mice. At 96 h after CLP operation, all mice in the model group died, whereas 33.3% of mice in the SAM (400 mg/kg)-treated group survived. SAM attenuated both inflammatory factors and their abilities to induce tissue dysfunction, which was mainly evidenced by decreased infiltration of polymorphonuclear leukocytes, tissue edema, and lung wet-to-dry weight ratio, lowered levels of myeloperoxidase (MPO), nitric oxide (NO), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in serum, as well as downregulated expressions of iNOS and IL-1beta mRNA in livers. Furthermore, we addressed the effects of SAM on the protein C (PC) pathway, closely linked with sepsis. In CLP-induced septic mice, SAM elevated the impaired expression of PC mRNA in livers. In vitro, SAM reversed the decreased expressions of thrombomodulin (TM) and endothelial PC receptor (EPCR) mRNA induced by lipopolysaccharide (LPS) in endothelial cells. These findings suggest that SAM is able to restore the impaired protein C pathway. Taken together, the current study demonstrates that SAM has protective effects on polymicrobial sepsis in mice. The mechanisms of action involve anti-inflammation and upregulation of the PC pathway.
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PMID:Saponin fraction from Astragalus membranaceus roots protects mice against polymicrobial sepsis induced by cecal ligation and puncture by inhibiting inflammation and upregulating protein C pathway. 1954 65

This study is to explore the effect of remifentanil on inducible nitric oxide synthase (iNOS) expression, IL-6 and IL-10 levels, myeloperoxidase (MPO) activity, white blood cell count in bronchoalveolar (BALF), ALT and AST activity in septic mice. Forty male KM mice were randomly divided into four groups, sham group, cecal ligation and puncture group (CLP group), remifentanil treatment group (R1 group), and remifentanil control group (R2 group). The mouse model of CLP was used to observe ALT and AST activity, white blood cell count in BALF and myeloperoxidase (MPO). IL-6 and IL-10 in lung and liver tissue were assayed by enzyme-linked immunosorbent assay (ELISA). Lung and liver tissues were harvested for determination of iNOS expression by Western blot analysis. The pathologic changes were observed under electron microscope. Compared with sham group, iNOS protein expression, white blood cell count in BALF, ALT and AST activity, MPO activity, IL-6 and IL-10 levels were markedly increased in CLP group. Compared with CLP group, iNOS protein expression, IL-6 and IL-10 levels, white blood cell count in BALF, ALT and AST activity, MPO activity of R1 group were significantly lower. The pathologic changes induced by sepsis were significantly attenuated by remifentanil under electron microscope. Remifentanil could suppress inflammatory responses and inhibit iNOS expression in septic mice. Remifentanil might have a protective effect against sepsis. Its action mechanisms are probably involved in the inhibition of inflammatory factor production and suppression of iNOS expression.
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PMID:Protective effects of remifentanil on septic mice. 1975 55

Human melioidosis caused by Burkholderia pseudomallei is a severe septic disease that is associated with high mortality, even under appropriate antibiotic treatment. The therapeutic effects of low-dose hydrocortisone plus ceftazidime, and of ceftazidime alone, have recently been investigated in the treatment of acute, severe sepsis caused by B. pseudomallei, both in normal BALB/c mice and in BALB/c mice with streptozotocin-induced diabetes. The mice were infected and then treated intravenously, from day 1 or day 2 post-infection, with saline (as a control, given twice daily for 10 days), low-dose hydrocortisone (given in twice-daily doses of 5 mg/kg, for 5 days) plus ceftazidime (given in twice-daily doses of 1200 mg/kg, for 10 days), or the same doses of ceftazidime alone. Although the infected, untreated mice all died within 14 days, almost all of the treated animals were still alive at the end of the follow-up, 30 days post-infection. The addition of the steroid appeared to have no benefit, with bacterial loads and plasma concentrations of tumour necrosis factor, aspartate aminotransferase, alanine aminotransferase and creatinine decreasing similarly in all the treated groups. The infected diabetic mice given hydrocortisone-ceftazidime from day 1 (but not those given just ceftazidime from day 1) showed an increase in their blood glucose concentrations. When infected mice were treated with the low-dose steroid and lower doses of the antibiotic (in twice-daily doses of 120-600 mg/kg), the steroid not only offered no apparent benefit but seemed to reduce survival. It therefore appears that low-dose hydrocortisone, as an adjunct to antibiotic treatment, does not provide benefit in the treatment of murine melioidosis and may have negative effects on human cases of the disease who have diabetes mellitus.
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PMID:Use of a low-dose steroid as an adjunct in the treatment, in mice, of severe sepsis caused by Burkholderia pseudomallei. 1982 85

Sepsis is a systemic inflammatory response syndrome (SIRS) when an infection is the etiology of SIRS. Our previous studies have indicated that the release of the sympathetic neurotransmitter, norepinephrine (NE), from the gut is increased in sepsis, and that NE potentiates endotoxin-induced tumor necrosis factor (TNF)-alpha upregulation via the A subtype of alpha(2)-adrenoceptors (i.e., alpha(2A)-AR) expressed on the surface of Kupffer cells. A specific antagonist for alpha(2A)-AR, 2-[(4,5-dihydro-1H-imidazol-2-yl) methyl]-2,3-dihydro-1-methyl-1H-isoindole maleate (BRL-44408 maleate), reduces TNF-alpha secretion in cultured Kupffer cells. We, therefore, hypothesize that administration of BRL-44408 maleate inhibits inflammatory responses and reduces organ injury in sepsis. To study this, sepsis was induced in male rats by cecal ligation and puncture (CLP). At 5 h after CLP, BRL-44408 maleate (0.3125, 0.625, 1.25, 2.5, or 5.0 mg/kg BW) or vehicle (1-ml normal saline) were administered intravenously over a period of 30 min. Blood and intestinal samples were collected at 20 h after CLP. Serum levels of TNF-alpha, interleukin (IL)-6, IL-10, keratinocyte-derived chemokine (KC), macrophage inflammatory protein-2 (MIP-2), liver enzymes (i.e., aspartate aminotransferase (AST) and alanine aminotransferase (ALT)), and lactate were measured. The intestinal levels of TNF-alpha, IL-6, and myeloperoxidase (MPO) activities were also analyzed. In additional groups of animals, the necrotic cecum was excised at 20 h post-CLP, and the 10-day survival was recorded. Our results showed that serum levels of proinflammatory cytokines (TNF-alpha and IL-6), anti-inflammatory cytokine (IL-10), chemokines (KC, MIP-2), liver enzymes (AST and ALT), lactate, and intestinal levels of TNF-alpha, IL-6, and MPO were significantly elevated at 20 h after CLP. Administration of BRL-44408 maleate significantly reduced serum levels of proinflammatory cytokines, chemokines, liver enzymes, and lactate, and dramatically decreased TNF-alpha, IL-6, and MPO levels in the gut. However, it has no statistical effects on the elevated serum levels of IL-10. Moreover, BRL-44408 maleate at the doses of 2.5 or 5.0 mg/kg BW significantly increased the survival rate after CLP and cecal excision. In conclusion, modulation of the sympathetic nervous system by blocking alpha(2A)-AR appears to be a novel treatment for inflammatory conditions such as sepsis.
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PMID:Antagonism of alpha2A-adrenoceptor: a novel approach to inhibit inflammatory responses in sepsis. 1989 27


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