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 past twenty years 793 strains of Listeria monocytogenes were isolated from human beings in the Netherlands; of these 193 were taken from neonates and babies up to two months old. Isolations from adults came from patients (242) as well as clinically healthy people (358). Septicaemia appeared to occur to an equal extent in men and women (20 and 29 respectively), whereas meningitis was found more often in men than in women (50 and 22 respectively). A clear predisposition for L.m. develops after administration of immunosuppressive treatment and also in cases of liver disorders. Among veterinary surgeons listeriosis has been observed as an occupational disease. Isolations from animals have shown that L.m. may cause infections in every species of warm-blooded animal. Next to meningitis and abortus chronic and atypcial symptoms of the disease may be observed in animals. Epizootic spread of the disease has hardly ever been observed in the Netherlands. In clinically healthy humans and animals both the haemolytic and the non-haemolytic type of L.m. have been isolated from feces; as regards the latter type it is very questionable whether it has any pathogenic significance. When inoculating 10 days old hen's eggs the haemolytic strains will kill all embryo's within 4 days whereas all embryo's inoculated with non-haemolytic strains will survive. Both types of strains have also been isolated from waste- and surface waters. As regards epidemiological and epizootiological aspects the conclusion is warranted that continued research will be needed to get a clear picture of the course of infection of L.m. When isolating strains from contaminated material the so-called cold enrichment icubation at 4 degrees C continues to be of great value; in the course of our experiments the nalidixic-acid trypaflavine serum agar proved to be a very good selective medium. A number of stable biochemical reactions of L.m. are rather characteristic (salicine+, galactose-) but provide no clue to distinguish between haemolytic and non-haemolytic strains.
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PMID:Listeriosis in humans and animals in the Netherlands (1958-1977). 677 41

The provision of adequate nutritional support to ventilator patients (VP), although important, is still overlooked in many hospitals. All VP in our intensive care unit from July 1977 to June 1979 were reviewed; only those who were on ventilators for 3 or more days (range 3-25) were included, but those ventilated after cardiac arrest with possible brainstem damage were excluded. Group A included 33 VP (22 surgical, 11 medical) who received a protein-free, energy-deficient routine IV diet (1650 kJ/day as dextrose in water or electrolyte solution); group B had 14 VP who received nutritional support as TPN or nasogastric tube feeding (8300-12600 kJ/day with optimum nitrogen). In group A, 18 (54.5%) of the 33 VP were able to be weaned off the ventilator compared to 13 (92.8%) of the 14 VP in group B (p less than 0.05). Of medical VP, 10 (90.9%) of 11 in group A were weaned compared with 3 (100%) of 3 in group B (not significant). However, of surgical VP, only 8 (36.3%) of 22 in group A were able to be weaned off mechanical ventilation compared with 10 (90.9%) of 11 in group b (p less tha 0.01); this was likely highly significant in surgical patients because of greater metabolic demand for wound healing and more severe sepsis.
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PMID:Effect of nutritional support on weaning patients off mechanical ventilators. 678 32

Dopamine, ethanol, and mannitol were investigated to determine if they could increase pulmonary blood flow and oxygen delivery without significantly increasing intrapulmonary shunt. These drugs were studied in adult patients with respiratory distress following trauma, operation, or sepsis. Intravascular pressure, cardiac output, oxygen consumption and delivery, and limb blood flow and peripheral oxygen delivery were measured in all patients. Hypotensive patients received dopamine in incremental doses of 2 mu g/kg/min until either mean arterial pressure increased 15 mm Hg or heart rate increased by more than 15 beats/min. Ethanol was given as 10% ethanol in 5% dextrose at 2 ml/kg/hr. Mannitol was given as 25 gm of a 25% solution in a single bolus followed by infusion of 8 to 25 gm of 20% solution (mean 10 +/- 2 gm) as a continuous intravenous drip over 1 hour. No drug produced a significant change in intrapulmonary shunt. Ethanol produced significant (p less than 0.05) increases in cardiac index, heart rate, oxygen consumption, and oxygen delivery. Dopamine significantly decreased pulmonary vascular resistance while increasing systemic blood pressure. Visceral blood flow apparently increased while the peripheral vascular response to ischemia remained intact. Mannitol increased oxygen delivery and consumption in both the total body and limb. Thus in patients with adult respiratory distress syndrome (ARDS), increases in pulmonary blood flow can be achieved with several distinct pharmacologic agents without significant increases in intrapulmonary shunt. These increases in flow are generally accompanied by increases in oxygen delivery without increased pulmonary vascular resistance.
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PMID:Effects of dopamine, ethanol, and mannitol on cardiopulmonary function in patients with adult respiratory distress syndrome. 678 9

Peripheral parenteral nutrition can provide perioperative nutritional support to patients with inadequate oral intake in whom total parenteral nutrition with hypertonic dextrose administered by a central vein cannot be undertaken because of sepsis, subclavian vein thrombosis, or lack of expertise and familiarity. Peripheral parenteral nutrition may be indicated in patients with marginal nutritional status whose postoperative course and period of starvation are unpredictable and in patients being started on a total enteral nutrition regimen. In patients with increased requirements because of stress or malnutrition who need full nutritional support by a peripheral method, the lipid system is indicated. In certain instances, large enough volumes can be infused to provide sufficient calories and protein for nutritional repletion. Protein-sparing therapy is indicated for nutritional maintenance in patients who do not clearly require full support by total parenteral nutrition but who are taking insufficient calories and protein orally. Peripheral parenteral nutrition avoids the risks of subclavian vein catheterization but requires that adequate peripheral veins are available. The metabolic complications are minimal compared with those of total parenteral nutrition, and the nutritional management of the diabetic patient is greatly simplified. Several techniques of preserving peripheral veins and prolonging their use have been discussed.
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PMID:Parenteral nutrition by peripheral vein. 678 74

The urinary excretion of 3-methylhistidine (3 MEH) has been shown to be a reliable index of muscle protein breakdown. It is decreased in protein-calorie malnutrition and increased during the hypercatabolic phase of sepsis and thermal trauma. Losses of 3 MEH after moderate to severe skeletal trauma in man and animals are reported as increased or unchanged. To clarify this response, 24 male and 6 female skeletal trauma patients were evaluated for 24 hr urinary losses of 3 MEH, nitrogen and creatinine. Eight of the 24 males also received a catabolic steroid for treatment of a head injury. In addition, 3 male and 1 female septic patients were similarly evaluated. Controls consisted of 10 volunteers on a meat free diet for 4 days and of 8 volunteers who were given only intravenous 5% dextrose in water for 3 days. The 3 MEH excretion for all control males was 3.6 mumole/Kg/day and for females was 2.8 Skeletal trauma produced a 280% increase for the males and a 225% increase for the females. Trauma with steroids caused a 325% increase. Sepsis induced a 227% increase in 3 MEH losses for males and 292% for females during the febrile episode. Creatinine excretion also increased significantly in response to trauma and sepsis but the magnitude of the increase was less than for 3 MEH. This was reflected in the 3 MEH to creatinine molar ratio increase from 0.018 for controls to 0.030-0.040 in sepsis and trauma. Patients with extensive body weight loss showed decreases in 3 MEH and creatinine excretion and a molar ratio similar to controls. The calculated contribution of muscle protein to whole body protein breakdown in the trauma and septic groups showed a twofold increase compared to the control group. The data indicate that the increased muscle protein catabolic response following stress of skeletal trauma and sepsis provides an insight on the origin of the large urinary nitrogen losses following such insults.
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PMID:Urinary excretion of 3-methylhistidine: an assessment of muscle protein catabolism in adult normal subjects and during malnutrition, sepsis, and skeletal trauma. 679 Sep 1

Branched-chain amino acids (BCAAs) may regulate muscle amino acid flux. Metabolic studies of both experimental animals and humans utilizing comparatively large amounts of BCAAs infused with hypocaloric glucose have shown that catabolism and proteolysis can be blunted. These studies suggested that the nitrogen-sparing properties of amino acid solutions used in postoperative trauma or sepsis might be improved by increasing the amount of BCAAs. This hypothesis was tested on ten patients undergoing operations of moderate severity utilizing a peripheral amino acid mixture with a branched-chain:non-branched-chain ratio of 45:55% given in 5% dextrose. The patients received 1.7 gm of protein equivalent/kg of ideal body weight in 5% dextrose-crystalloid solution with a concentration of 3.5% amino acids for the first 5 postoperative days. Nitrogen balance, 3-methylhistidine excretion, blood chemistries, and plasma amino acid profile tests were done daily. The results showed that nitrogen equilibrium was maintained for 5 postoperative days without any untoward effects on patients, their surgical wounds, or hepatic function. Plasma amino acids showed no significant changes from baseline with the exception of elevations of the BCAAs. We conclude that this 45% BCAA-enriched solution may be safely administered to patients with postoperative traumatic injury and results in nitrogen equilibrium over a 5-day period.
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PMID:The effect of a new branched chain--enriched amino acid solution on postoperative catabolism. 681 32

The authors report on a case of sepsis due to E. coli in a newborn baby with galactose intolerance. The immature immunological state of the newborn child in combination with a disorder of galactose metabolism obviously favour the development of bacterial infections. Galactose-free formulas should be applied quickly together with an adequate antibiotic therapy in the case of newborn babies with suspected bacterial infection. The prognosis may be influenced favourably by early clarification of the cause of severe impairment including jaundice, vomiting, loss of weight and somnolence in the first three weeks of life.
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PMID:[Sepsis due to E. coli in newborns with galactose intolerance (author's transl)]. 701 51

Hypertriglyceridemia commonly accompanies clinical sepsis and may be caused by increased hepatic production or decreased clearance of triglyceride from the bloodstream. In contrast, enhanced lipid clearing capacity is usually seen after uncomplicated trauma. The purpose of the study was to determine the role of lipoprotein lipase (LPL) in effecting the above changes. Enzyme activity was assayed in skeletal muscle and adipose tissue biopsy samples from 11 normal subjects and from 17 injured and 11 infected surgical patients. Normal subjects after 4 days of 5% dextrose infusion (D5) showed a significant decrease in adipose tissue LPL activity but no change in skeletal muscle activity. Trauma patients after several days of D5 had higher activity in adipose tissue and higher plasma insulin levels than diet-matched control subjects but showed no change in skeletal muscle activity. Infected patients with high plasma triglyceride levels had significantly decreased LPL activity in both tissues. A linear relationship was found between insulin concentration and adipose tissue LPL activity in normal subjects. We conclude that: (1) low tissue LPL activity in sepsis may result in diminished lipid clearance and contribute to hypertriglyceridemia, (2) after trauma, changes in tissue LPL activity as well as other factors such as altered hemodynamics play a role in determining in vivo lipid clearance, and (3) adipose tissue LPL activity is related to the plasma insulin concentration in normal subjects.
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PMID:Lipoprotein lipase activity in surgical patients: influence of trauma and infection. 702 Jan 40

Amino acids and dextrose infusion were given for short periods of time to a young man whose basal state is characterized in the previous paper in this series, and their effects were documented in terms of plasma concentrations and splanchnic extraction. The basal state measurements show in the acute trauma state and its subsequent starvation state a largely balanced splanchnic extraction of amino acids but at a decreasing rate. Amino acid (FreAmine) infusion at low rates on this background produced a large increase in extraction of a largely balanced mixture of amino acids but a minimal change in glucose release. The septic state is characterized in both the basal and amino acid infusion state by splanchnic extraction of an unbalanced mixture of amino acids which is deficient in branched-chain amino acids and in relative excess of glucogenic amino acids with increased glucose release and increased utilization of amino acids for gluconeogenesis. In early sepsis this state can largely be repaired by exogenous amino acid infusion but in late sepsis can only be partially repaired. The data suggest that the patient in late sepsis should have a branched-chain rich amino acid mixture and that the hepatic failure of sepsis is strongly associated with peripheral release of an unbalanced mixture of amino acids secondary to enhanced branched-chain catabolism. Infused glucose produces a large increase in the plasma glucose but also improves the balance of the splanchnic amino acids extracted. The statistical validity of the preceding statements are examined in detail in the manuscript.
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PMID:Multiple systems organ failure: II. The effect of infusion of amino acids and glucose. 721 85

Glycolytic intermediates in rat liver show similar changes in both endotoxic and peritonitis shock models suggesting a common etiology. To determine if this parallelism exists for other organs, adult rat hearts were analyzed 5 hours after E. coli endotoxin injection (2 mg/100 gm rat weight) or after sepsis produced by cecal incision. Tissue obtained by freeze-clamp biopsy was deproteinized and the metabolites were enzymatically assayed. Glucocorticoids were injected IV: 1 mg dexamethasone sodium phosphate (DMS) and 3 mg methylprednisolone sodium succinate (MPS) per 100 gm rat weight at time of operation. Glucose-6-phosphate (G6P) and fructose-6-phosphate (F6P) in septic hearts (N = 10) declined 36% and 37% from sham-operated control values (N = 11) of 640 nmole and 136 nmole per gm wet tissue. This finding is consistent with accelerated glycolysis. No changes of other metabolites indicative of severe hypoxic conditions were noted. A 2.5-fold increase in lactate was observed. This may reflect a shift to anaerobiosis in peripheral muscle and greater extraction by heart. Confirming earlier endotoxin rat heart data, glucocorticoids did not prevent decreases in G6P and F6P in septic hearts which declined 37% and 36% below sham controls (N = 10 for pooled glucocorticoid data). Hexose monophosphates in sham animals treated with GC alone were also found to be lowered. Glucocorticoids were synergistic with endotoxin in lowering beta-hydroxybutyrate in heart samples. It is concluded that endotoxin and sepsis produce identical responses on myocardial carbohydrate metabolites and that glucocorticoids do not counter these effects, which reflects the lack of gluconeogenic potential in this organ.
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PMID:Glucocorticoid effect on glycolytic intermediates in septic rat heart. 730 22


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