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)

To evaluate the nutritional, metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids (fish oil) supplementation in immunocompromised patients, we performed a prospective study on the effect of immune formula administered to 11 severe trauma patients (average ISS = 24), 10 burn patients (average % TBSA = 48) and 5 cancer patients. Daily calorie and protein administration were based on the patient's severity (Stress factor with the range of 35-50 kcal/kg/day and 1.5-2.5 g/kg/day, respectively) Starting with half concentration liquid immune formula through nasogastric tube by continuous drip at 30 ml/h and increasing to maximum level within 4 days. The additional energy and protein requirement will be given either by parenteral or oral nutritional support. Various nutritional, metabolic, immunologic and clinical parameters were observed on day 0 (baseline), day 3, 7, and 14. Analysis was performed by paired student-t test. Initial mean serum albumin and transferrin showed mild (trauma) to moderate (burn and cancer) degree of malnutrition. Significant improvement of nutritional parameters was seen at day 7 and 14 in trauma and burn patients. Significant increase of total lymphocyte count (day 7, P < 0.01), CD4 + count (day 7, p < 0.01), CD8 + count (day 7, p < 0.0005 & day 14, p < 0.05), complement C3 (day 7, p < 0.005 day 14, p < 0.01), IgG (day 7, and 14, p < 0.0005), IgA (day 7, p < 0.0005 & day 14, p < 0.05), in all patients. C-reactive protein decreased significantly on day 7 (p < 0.0005) and day 14 (p < 0.005). 3 cases of burn wound infection, one case of UTI and one case of sepsis were observed. Two cases of hyperglycemia in burn, 3 cases of hyperbilirubinemia in trauma, 10 cases of elevated LFT (5 trauma/5 burn), and one case of hyponatremia in cancer patients were observed. Two cases of nausea, 4 cases of vomiting, 5 cases of diarrhea (< 3 times/day), 2 cases of abdominal cramp, 1 case of distension were observed. The feeding of IMMUNE FORMULA was well tolerated and significant improvement was observed in nutritional and immunologic parameters as in other immunoenhancing diets. Further clinical trials of prospective double-blind randomized design are necessary to address the so that the necessity of using immunonutrition in critically ill patients will be clarified.
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PMID:Metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients. 962 33

A short version of the UTI Guidelines elaborated by the Urinary Tract Infection Working Group of the Health Care Office of the European Association of Urology is presented. The topics include classification, diagnosis, treatment and follow-up of uncomplicated UTI, UTI in children, UTI in diabetes mellitus, renal insufficiency, renal transplant recipients and immunosuppression, complicated UTI due to urological disorders, sepsis syndrome, urosepsis, urethritis, prostatitis, epididymitis, orchitis and principles of perioperative prophylaxis in urology.
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PMID:EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). 1175 70

Acute pyelonephritis is frequent. Its usual signs and symptoms comprise renal pain, fever, inflammation, and pyuria. Simple acute E. coli pyelonephritis is frequent in the young female and in most cases is a benign condition. A typical pyelonephritis may be painless, or without high fever, or lacking bacterial growth in the urine due to previous inappropriate treatment. Severe, complicated pyelonephritis is mainly observed in diabetic, alcoholic or immunocompromised patients. In occasional cases, a common form of pyelonephritis may progress to formation of a renal abscess requiring drainage. When secondary to urinary tract abnormalities, pyelonephritis may be complicated with septicemia and can induce early and severe renal tissue damage. This form warrants emergency urologic treatment. Simple pyelonephritis of the young female without febrile UTI history requires little imaging. Conversely, extensive imaging workup is mandatory in the male, the elderly, when treatment is not rapidly effective or in case of early relapse. In some cases, acute pyelonephritis leads to the development of cortical scars, the long-term prognosis of which remains to be determined.
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PMID:[Acute pyelonephritis]. 1470 20

Proteus mirabilis is a common cause of catheter-associated urinary tract infection (C-UTI). It blocks indwelling urethral catheters through the formation of extensive crystalline biofilms. The obstruction of urine flow can induce episodes of pyelonephritis, septicemia, and shock. P. mirabilis exhibits a type of motility referred to as swarming, in which multicellular rafts of elongated, hyperflagellated swarmer cells form and move rapidly in concert over solid surfaces. It has been suggested that swarming is important in the pathogenesis of C-UTI. In this study we generated a set of stable transposon mutants deficient in swarming and used them to assess the role of swarming in the migration of P. mirabilis over urinary catheters. Swarming was found to be essential for migration over all-silicone catheters. Swarming-deficient mutants were attenuated in migration over hydrogel-coated latex catheters, but those capable of swimming motility were able to move over and infect these surfaces. A novel vapor fixation technique for the preparation of specimens and scanning electron microscopy were used to resolve the ultrastructure of P. mirabilis multicellular rafts. The flagellar filaments of P. mirabilis were found to be highly organized during raft migration and were interwoven in phase to form helical connections between adjacent swarmer cells. Mutants lacking these novel organized structures failed to swarm successfully. We suggest that these structures are important for migration and formation of multicellular rafts. In addition, the highly organized structure of multicellular rafts enables P. mirabilis to initiate C-UTI by migration over catheter surfaces from the urethral meatus into the bladder.
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PMID:Ultrastructure of Proteus mirabilis swarmer cell rafts and role of swarming in catheter-associated urinary tract infection. 1521 38

Group B Streptococcus (GBS) is widely recognized as a leading cause of neonatal sepsis and meningitis. Recently, GBS infections in older children have been increasingly noted. This retrospective study investigated the clinical features, distribution of serotypes, and antimicrobial susceptibility of GBS isolates in a tertiary care center in southern Taiwan over a 12-year period. GBS isolates recovered from various infected sites in 54 children treated from June 1991 through December 2002 were studied. These children were divided into those with disease onset of up to 3 months of age (group 1) and those with disease onset after 3 months of age (group 2). Patients in group 1 were subdivided into early-onset disease (EOD, <7 days of age, 7/30) and late-onset disease (LOD, > or =7 days to 3 months of age, 23/30). Sepsis (90% vs 8%; p<0.01) and meningitis (40% vs 4.2%; p<0.01) were observed more frequently in group 1, whereas urinary tract infection (UTI; 45.8% vs 6.7%; p<0.01) and acute tonsillitis (33.3% vs 0%; p<0.01) were noted more frequently in group 2. Underlying conditions were more common in group 2 than in group 1 (50% vs 10%; p<0.01), especially in patients with UTI. The most frequently encountered serotype was serotype III (56%). Patients in group 1, especially those with LOD, and those who had meningitis or sepsis, were prone to develop serotype III infections (p<0.05). All isolates were susceptible to penicillin G and cephalothin. About 50% of isolates were susceptible to erythromycin, azithromycin, and to clindamycin. In conclusion, GBS infection in children has different characteristics in different age groups. Serotype III is the most prevalent serotype in children. GBS isolates in southern Taiwan are still very susceptible to penicillin G.
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PMID:Group B streptococcal infections in children in a tertiary care hospital in southern Taiwan. 1522 Oct 37

Inter-alpha inhibitor proteins (IaIp) are a family of structurally related serine protease inhibitors found in relatively high concentrations in human plasma. Recent studies have implicated a role for IaIp in sepsis, and have demonstrated their potential as biomarkers in sepsis and cancer. For characterization of isolated IaI proteins and contaminating proteins during the last steps of the purification process, SELDI-TOF MS and HPLC-ESI-MS/MS were used. After separation by SDS-PAGE or 2-DE, polypeptide bands of 80, 125 and 250 kDa were excised from gels and digested by trypsin. The tryptic peptides were analyzed by both MS methods. The main contamination during the purification process, a band of 80 kDa, contains mainly IaIp heavy chain (HC) H3. HC H1 and H2 were also found in this band. In addition, some vitamin K-dependent clotting factors and inhibitors and other plasma proteins were identified. The 125-kDa band, representing the pre-alpha inhibitor, was found to contain both bikunin and HC H3. The presence of other HC H1, H2 and the recently described HC H4 was also detected by SELDI-TOF MS. The presence of HC H1, H2, and H3 in the 125-kDa band was confirmed by ESI-MS/MS, but not the presence of the H4. Three polypeptides, H1 and H2 together with bikunin, were identified in the 250-kDa band, representing the ITI, by both MS techniques. Once again, the presence of H4 was detected in this band only by SELDI-TOF MS, but the number of corresponding peptides was still not sufficient for final identification of this polypeptide. The importance of the application of proteomic methods for the proper evaluation of therapeutic drugs based on human plasma is discussed.
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PMID:Proteomic characterization of inter-alpha inhibitor proteins from human plasma. 1659 6

Leuconostoc is a gram-positive cocci, quite ubiquitous in nature. It is used in wine industry, and for aroma and texture of dairy products. Occasionally it has been isolated from humans in cases of bacteremia, catheter associated infections, sepsis, meningitis, pneumonia, UTI, osteomyelitis and hepatic dysfunction. Short bowel syndrome, patients with CVC and patients with gastrostomy undergoing enteral feeding, are described amongst the factors associated with this infection. The isolation of a gram-positive cocci, that does not hydrolyze arginine and that is resistant to vancomycin leads to this diagnostic possibility. Antibiotic treatment: penicillin or ampicillin.
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PMID:[Leuconostoc infections in patients with short gut syndrome, parenteral nutrition and continuous enteral feeding]. 1718 82

Several studies on the economic aspect of HAI have two major limitations: (1) the lack of distinction between resources attributable to the management of HAI and resources absorbed by the main clinical problem for which the patient was hospitalized, and (2) the lack of an adequate method for calculating the relative costs. The aim of the study was to test a cost modelling method that could overcome these limitations by applying Appropriateness Evaluation Protocol (AEP) to the medical charts and by using cost-centre accounting. Two types of HAI were chosen: UTI and sepsis. The data analysis showed that using this system the extra-length of stay can be cut down to nil in General Surgery and Intensive Care for sepsis and in Intensive Care for the UTI. Moreover it becomes clear that the weight of the cost for the bed, or for the diagnostic services, or again for the pharmacological treatment, varied widely depending on the site of the HAI and the ward where the patient was hospitalized. Comparing cost of HAI calculated on the basis of the main total cost per day of hospitalization attributable to the HAI we have finally seen that some cases do not produce any costs, whereas others account costs due not to HAI (operating room) or more expensive costs than the really HAl-treatment-attributable ones, as sepsis in Urology ward (Euro 988.18 versus Euro 747.41) or UTI in General Surgery ward (Euro 603.77 versus Euro 479.30), in Neurology (Euro 4242.91 versus Euro 2278.48) and in Orthopedics (Euro 2328.99 versus Euro 1332.81).
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PMID:[A method to determine hospital costs associated with nosocomial infections]. 1793 30

Renal transplantation is the optimal treatment for children with ESRD. We undertook this study to establish the outcome of pediatric renal transplants in a resource-constrained environment in a developing country. A retrospective analysis on 90 pediatric renal transplants (age at transplant </=18 yr) done at our center over a 15 yr period was analyzed. The mean age of the recipients was 15 yr (range 6-18 yr) accounting for 6.1% of all the renal transplants done at our center (90/1472). Ninety-six percent of patients received kidneys from live-related donors. The major causes of ESRD were glomerulonephritis (28%) and urological abnormalities (17%), while the etiology was unknown in 50%. Immunosuppression was based on a triple drug regimen consisting of prednisolone, CsA and azathioprine in 98% of children. Amongst complications, any acute rejection episodes (46.7%), UTI (26.7%) and CMV disease (16.7%) predominated. The mean duration of follow-up was 42 +/- 33 month (range 3-159 month). Graft loss occurred in nine (10%) children at a mean duration of 25 +/- 22 month (range 6-70 month). Overall 1-, 5-, and 10-yr graft survival was 98%, 84% and 76%. Overall 1-, 5-, and 10-yr patient survival was 95%, 87%, and 79%. The significant predictors of graft loss were CMV disease (p = 0.018) and >2 rejection episodes (p = 0.05), while sepsis (p = 0.01) was the most important contributor to patient loss. Pediatric renal transplantation in India can be accomplished successfully. The graft and patient survival in our study, the largest from India, is comparable to those published from developed countries and is encouraging given the limited resources.
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PMID:Pediatric renal transplantation--a single center experience of 15 yr from India. 1797 18

Differentiation of serious bacterial infection (SBI) from self-limiting viral illness in febrile infants younger than three months is a significant challenge for clinicians. We aimed to assess the risk factors for SBI in febrile infants. Data were obtained from 221 infants younger than three months who visited a single community referral hospital for fever and underwent a complete sepsis workup between August 2003 and July 2006. The causes of fever were febrile illness without a documented cause (FISDC, 65%), urinary tract infection (UTI, 12%), aseptic meningitis (12%), bacteremia (4%), bacterial meningitis (2%). Cerebrospinal fluid enterovirus polymerase chain reaction was positive in 28% of FISDC and 48% of aseptic meningitis cases. When UTI was excluded, the risk factors for SBI were 1) C-reactive protein (CRP) level of > or =1.87 mg/dL and 2) fevers of > or =38.9 degrees C. The specificity and negative predictive values of risk factors 1) and 2) for the diagnosis of SBI were 94% and 95%, respectively. We concluded that enteroviral infection may be a major cause of febrile episodes in infants younger than three months. If UTI could be excluded, the presence of CRP levels > or =1.87 mg/dL and fevers of > or =38.9 degrees C can be used as criteria to rule out SBI in these infants.
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PMID:Risk factors for serious bacterial infection in febrile young infants in a community referral hospital. 1979 81


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