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)

During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra-abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient.
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PMID:Worldwide clinical data on efficacy and safety of ciprofloxacin. 328 11

The Gardnerella vaginalis-infection of the urogenital tract is of clinical importance in females and of epidemiological importance in males. Females suffer from Bacterial Vaginosis, with a foul-smelling grey vaginal discharge with a pH of 5.0-5.5 which contains "clue cells", and from Sepsis. The isolation and identification of G. vaginalis i necessary in man. If G. vaginalis-infection is suspected, simultaneous infections with further STD-agents such as N. gonorrhoeae, C. trachomatis etc should be excluded. Metronidazole (1 g/day for 5 days) is the drug of choice in G. vaginalis-infection.
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PMID:[Gardnerella vaginalis infection. Clinical aspects, diagnosis and therapy]. 331 83

The functional antibacterial activity of an intravenous immunoglobulin preparation (Swiss Red Cross Immunoglobulin, SRK-Ig) was tested both in vitro and in vivo. Using type III group B streptococci as a model system, the intravenous immunoglobulin preparation was shown to enhance phagocytosis and killing of the bacteria by human neutrophils. There was good activity to several type III strains, and for efficient opsonization both antibody and complement were required. In an animal model of neonatal group B streptococcal sepsis, passively administered immunoglobulin enhanced survival with 27/37 (73%) treated animals surviving compared to only 3/16 (19%) controls. These studies demonstrate that the intravenous immunoglobulin preparation SRK-Ig has retained functional activity and may have potential value for prophylaxis or therapy of certain bacteria infections.
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PMID:Functional antibacterial activity of a human intravenous immunoglobulin preparation: in vitro and in vivo studies. 634 30

Serum amino acid (AA) levels were determined for 18 cholecystectomy patients who had preserved and immediately utilized G-I function for absorption of 3,000 kcal/day elemental diet. Ten were given 132 gm AA/day; eight were given only 66 gm AA/day. Historical controls were 27 comparable patients who had received conventional hypocaloric intravenous (IV) regimens. Unfed patients' branched chain AAs (BCAAs) + TYR were depressed initially, then rebounded by day 3 or 4. Their glucogenic AAs were still depressed after 72 hours. Complete restoration of the basal pattern required five to ten days. Fully nourished patients maintained basal levels of all AAs on day 1. Every AA rose above basal, some with statistical significance as early as day 2. Moderately fed patients had BCAA depression, but for only 24 hours. LEU, ILE, VAL, TYR, MET, ASP, LYS, and ARG had already returned to basal levels on day 2, while the remaining AAs were much less depressed than in the unfed controls. All fed patients were discharged uneventfully 24-48 hours postcholecystectomy. The positive protein balance and elevated AA levels correlate with enhanced wound healing, host sepsis resistance, and shortened hospitalization.
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PMID:Elevation of postoperative plasma amino acid concentrations by immediate full enteral nutrition. 643 8

The therapeutic effect of a polyvalent immunoglobulin preparation for intravenous use was tested in 82 newborns with bacterial infections. 35 of the children had neonatal sepsis, whereas in the other 47 bacteremia was not detectable. Treatment consisted either of antibiotics only or of antibiotics combined wih immunoglobulin SRK on an alternating basis for the first six days. Immunoglobulin substitution was tolerated without complications. In the group of infants with neonatal sepsis, two of 20 (10%) who were substituted with immunoglobulin and four of 15 (26%) who received no immunoglobulin died. Likewise, in the group of patients without detectable bacteremia, two of 21 on immunoglobulin substitution (10%) and four of the 26 who were not substituted (15%) died. The low mortality observed in the present study was attributed to efforts at early diagnosis and conventional early treatment on the one hand, and to immunoglobulin substitution on the other. To detect possible late sequelae of immunoglobulin therapy, particularly in hypogammaglobulinemic premature newborns, clinical and immunological investigations were performed in the septic patient group at the age of one to four years. There were no indications that administration of immunoglobulins during the neonatal period might have had an adverse effect on psychomotor and somatic development or on the immunological maturation of the infants.
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PMID:[Immunoglobulin substitution in the treatment of neonatal septicemia]. 730 48

Nitric oxide (NO) is an important mediator of the hemodynamic effects of sepsis; however, its microcirculatory effects are unknown. To determine the role of NO in the small intestinal (SI) microcirculation, an intact SI loop was exteriorized from decerebrate rats into a controlled Krebs' bath. Bacteremic rats received 10(9) Escherichia coli intravenously. Videomicroscopy was used to measure arteriolar diameters (A1, A3) and optical Doppler velocimetry to quantitate flow. In controls, topical NO synthase (NO-S) substrate L-arginine (L-ARG; 10(-4) M) did not affect diameters or flow. Inhibition of NO-S by N omega-nitro-L-arginine methyl ester (L-NAME; 10(-4) M) caused constriction (A1 = -18%; A3 = -24% from baseline diameter) and reduced A1 flow by 62%. These alterations were similar to bacteremic controls (A1 = -20%; A3 = -18%; A1 flow = -42%), despite the increased cardiac output (+21%). L-NAME treatment of bacteremic rats resulted in further constriction (A1 = -31%; A3 = -32%) and decreased A1 flow (-75%). Topical L-ARG (10(-4) M) ameliorated constriction (A1 = -6%; A3 = +7%) and improved blood flow (-5%) during bacteremia. We conclude that: 1) NO is important for basal SI microvascular tone; 2) bacteremia causes SI arteriolar constriction and hypoperfusion; 3) NO-S inhibition during sepsis may exacerbate SI vasoconstriction and hypoperfusion.
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PMID:Role of nitric oxide in the small intestinal microcirculation during bacteremia. 753 19

Streptococci of Lancefield Group B (GBS) are known to cause maternal sepsis and neonatal infection, whereas streptococci Lancefield Group A (GAS) cause vulvo-vaginitis in both children and adults. Prevalence of SGB colonization of the lower genital tract of normal women is between 4-18%, with higher rates found in hospital personnel and delivery rooms. Such high carriage rates may be a significant factor in nosocomial transmission of GBS to neonates. Symptomatic infection is uncommon and usually secondary to other pathological states. Amnionitis is a complication of vaginal carriage of GBS and there is now evidence that chorioamnionitis is associated with pre-term labour and its attendant problems. GBS infection of the male genitalia has also been described. Intrapartum chemoprophylaxis has been shown to prevent early onset GBS disease of the neonate. Prevalence of GAS in the genital tract is lower than that for GBS, but is more likely to be symptomatic. The response to penicillin is usually prompt. Optimal drug regimens need to be determined, particularly for use in pregnancy.
Int J STD AIDS
PMID:Streptococci and the genital tract. 884 14

Cytomegalovirus retinitis is a major cause of morbidity in patients with AIDS. The conventional treatment approach has involved insertion of a central venous catheter and intravenous administration of ganciclovir and/or foscarnet. This has been associated with systemic toxicity, line-related sepsis, and implications for patient quality-of-life. An oral formulation of ganciclovir has now been licensed for use as maintenance therapy in CMV retinitis. Multicentred trials comparing oral and intravenous ganciclovir have suggested that although the efficacy may be marginally reduced with the oral formulation, the associated toxicity is significantly lower. With careful and informed decision-making by both clinician and patient, the opportunity exists to enhance the quality of life in this patient group.
Int J STD AIDS
PMID:Oral ganciclovir: a new option for patients with CMV retinitis. 865 3

In order to describe the clinical features of HIV (non-AIDS), particularly injection drug use (IDU) related HIV, in patients attending the Regional Infectious Diseases Unit in Edinburgh, a prospective review utilizing the WHO staging system of the 680 HIV positive patients, 30% of whom were women and 68% were infected via IDU, was undertaken. Despite the fact that the majority of drug users and heterosexuals enrolled asymptomatic, by 1993, 71% of the patients had developed some HIV related clinical problem. The important clinical problems observed for the cohort were; minor skin problems, minor bacterial infections, major bacterial sepsis, oral thrush, oral hairy leucoplakia, significant weight loss of > 10%, HIV related thrombocytopenia and of course AIDS. Unlike previous reports from other areas, in Edinburgh drug users were not more likely than other risk groups to develop severe bacterial disease. Differences in morbidity and mortality rates by risk group but not by gender were noted but these may well be affected by the very different enrolment pattern observed in the various risk groups. The pre-AIDS mortality rates for drug users were remarkably similar to published rates from other centres.
Int J STD AIDS
PMID:Clinical features of early HIV in the Edinburgh City Hospital cohort. 873 35

Leucopenia and neutropenia in HIV appears to be much less common than in the context of haematological malignancies although severe neutropenia (< 0.75 x 10(9)/l) occurs in as many as 70% of patients with AIDS often related to concomitant drug therapy. In addition to low numbers of neutrophils there is also some evidence of defective neutrophil function in HIV/AIDS (chemotaxis, bacterial killing, phagocytosis and superoxide production). However the frequency and importance of these defects is as yet not known because simple and reproducible tests of neutrophil function are not yet available to the majority of clinicians. Despite the relative scarcity of severe neutropenia in early HIV, bacterial sepsis is a major clinical problem which usually manifests itself as either pneumonia, bacteraemia or both at a frequency of between 8-20 per 100 person years depending upon location, risk activity etc. Amongst drug users, the inhalation of recreational drugs particularly after Pneumocystis carinii pneumonia (PCP) has been shown to be a major risk factor for pneumonia. The incidence of bacterial sepsis in patients with AIDS is more difficult to determine since it is often overshadowed by other more dramatic opportunistic infections. However, throughout the course of AIDS, bacterial infections are a common problem particularly in the presence of one or both of concomitant drug therapy and indwelling intravenous lines utilized in late stage disease. Consequently, since bacterial infections are common and cause considerable morbidity and mortality they should be considered in the differential diagnosis of most presentations.
Int J STD AIDS 1997 Jan
PMID:Bacterial infections in HIV: the extent and nature of the problem. 904 75


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