Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A controversy on the therapeutic effect of topical "moist ointment" in burns has been noticed recently. An experimental study is designed for the evaluation of its antibacterial and antiinfection effect. A 20% fullthickness burn wound is produced on SD rat back, and they are seeded with 10(9) CFU of Pseudomonas aeruginosa ATCC-27853. "Moist ointment", cream base, 1% silver sulfadiazine (Ag-SD) cream or 1.2% silver norfloxacin (Ag-FLX) cream is topically applied to the burn wounds at various time interval of 10 min, 8h, 24h, and 48h, after the inoculation of Pseudomonas aeruginosa. Topical therapy lasted for 48h, with dressing change once a day but twice a day for "moist ointment" therapy only. Bacterial counts of subeschar tissue and heart blood culture, and histopathologic study of the wounds are made as laboratory criteria. A modified agar well diffusion (AWD) test is performed as a bacterial inhibitory study using Pseudomonas aeruginosa ATCC-27853, E. coli ATCC-25922, or Staphylococcus aureus ATCC-25923. Results of the study show that Ag-FLX cream has a strong antibacterial effect and Ag-SD cream a moderate effect. However, "moist ointment" and cream base do not show antibacterial effect. Bacterial counts of subeschar tissue and histopathologic study of the infected burn wounds show that more than 70% of the animals in the "moist ointment" group have invasive wound infection, and the incidence of septicemia with Pseudomonas aeruginosa is 50% as determined by blood cultures. The above mentioned results indicate that "moist ointment" has no antibacterial and anti-infection effect.
 ...
PMID:[Experimental study of antiinfection effect of topical "moist ointment" in burn wound infection]. 808 81

Hyperganglionosis or neuronal intestinal dysplasias (NID) and hypoganglionosis (HO) are intestinal diseases of difficult diagnosis and treatment and diverse evolution, despite identical histologic findings. The aim of this study was to discuss the therapeutic problems derived from the patients differing clinical course. Retrospective review of 14 patients with regard to diagnosis, manometry and histology (hematoxylin-eosin, acetylcholinesterase activity, immunohistochemistry and Smith's silver stain) was done. Six patients presented intestinal occlusion or sub-occlusion from the first months of life with impeded oral feeding. Ileostomy was performed in 5 and total colectomy with anastomosis in 1. All patients required parenteral nutrition; cisapride was added in 2. Three died from sepsis (3 NID). Of the 3 survivors, 2 have ileostomies (2 NID) and the other ileo-rectal anastomosis (NID). Of the remaining patients, two presented aganglionism and the finding of proximal hyperganglionism occurred post-surgery. Surgery was repeated in one patient. The remaining 6 (1 HO, 5 NID) were diagnosed between 3 and 10 years of age because of constipation. Four are under treatment with cisapride and 2 required partial colic resection. No relationship can be established between histologic findings and clinical manifestations. In chronic clinical courses, treatment with cisapride and cleaning enemas should be tried first. Acute clinical pictures (occlusion-sub occlusion) should be treated by decompressive ileostomy. Partial colic resection may lead to new intestinal failure.
 ...
PMID:[Considerations regarding the treatment of non-aganglionic congenital intestinal neuropathies]. 820 35

Infection remains the major cause of morbidity and mortality following the shock phase in the burn patient. Measures to reduce the risk of wound infection and subsequent sepsis include early excision where possible, and the use of topical antimicrobial creams such as silver sulphadiazine. Studies from the USA and Europe suggest the addition of cerium nitrate to this commonly used agent may improve its efficacy. We present the findings of a pilot study which investigated the action of a commercial preparation of cerium nitrate/silver sulphadiazine mixture (Flammacerium, Duphar B. V. Holland) on 20 patients considered unsuitable for surgery. There were no episodes of cellulitis or septicaemia. Flammacerium was noted to produce an adherent eschar that was easy to shave and which received split skin grafts well.
 ...
PMID:The use of cerium nitrate-silver sulphadiazine as a topical burns dressing. 825 66

The ability of cefotaxime, ciprofloxacin, piperacillin and tobramycin to cause release of endotoxin was examined in vitro with cultures of Enterobacter cloacae and Escherichia coli. Endotoxin was measured by a quantitative limulus amoebocyte lysate assay and its presence was confirmed by silver staining of the lipopolysaccharide moiety following SDS-PAGE. The morphology of the bacteria during antibiotic exposure was examined by scanning electronmicroscopy. Cefotaxime, ciprofloxacin and piperacillin caused significant endotoxin release, correlating with their ability to affect cell-wall morphology, causing filamentation, wall breakage and cell lysis. In contrast, little endotoxin was released when bacteria were exposed to tobramycin and no morphological changes were observed when bacteria were exposed to bactericidal concentrations of this aminoglycoside. Its antimicrobial spectrum and bactericidal activity make tobramycin an appropriate agent for treatment of sepsis caused by gram-negative bacteria and its lack of propensity to elicit excessive release of endotoxin may avoid exacerbation of endotoxin-related shock in sepsis.
 ...
PMID:Antibiotic-induced release of endotoxin from bacteria in vitro. 828 10

Local infection and burn wound sepsis are one of the most severe problems in the treatment of thermally injured patients. Early surgical treatment and the use of topical antiseptics led to a decrease in the infection rate and significantly improved the survival rate of burns patients within the last twenty-five years. Many antiseptics are used in the treatment of burns. Silver nitrate, silver sulphadiazine, sulfamylon and povidone-iodine (PVP-I) are the most common substances used worldwide in burn care facilities. Clinical studies demonstrate that treatment with PVP-I is the most effective against bacterial and fungal infection. Several methodological problems however arise from direct comparison between these antiseptics, and local and systemic adverse effects can make the right choice difficult. Some case reports documented possible side effects in the treatment of patients with PVP-I, leading to general concerns about this treatment. Absorption of iodine and possible changes in thyroid hormones are well known, but evaluation of the clinical consequences is controversial. Reports of severe metabolic acidosis and renal insufficiency with lethal results have condemned the use of PVP-I in the treatment of extensive burns. The case reports, however, dealt with patients suffering from general morbidity and sepsis and therefore these single reports may not be generally valid. Local treatment of burns may cause further problems. The beneficial effect of a decrease of bacterial counts in deeper tissue may be confounded by other effects delaying wound healing, as shown in some experimental studies. Controlled clinical investigations on burn patients however are still missing. The paper will discuss these topics in detail referring to the treatment of burns with PVP-I. It is based on a critical review of the literature and the author's own experience in burns therapy.
 ...
PMID:Review of the use of povidone-iodine (PVP-I) in the treatment of burns. 829 Apr 64

A prospective study was undertaken to compare the silver-impregnated collagen cuff (Vitacuff) with the bedside tunneled catheter. Fifty patients were randomly assigned to three groups: group I received triple-lumen catheters with Vitacuff application and a semiocclusive dressing material; group II received triple-lumen tunneled catheters with a semiocclusive dressing; and group III received triple-lumen tunneled catheters with collodion as a dressing material. In patients suspected of having central venous catheter sepsis, blood cultures were obtained through the catheter, the catheter was removed, and the tip was cultured semiquantitatively. Central venous catheter sepsis was defined as a positive catheter-tip culture and blood culture for the same organism. No catheter-related sepsis was seen in either the Vitacuff or the tunneled catheters with collodion dressing. In the tunneled catheters with semiocclusive dressing, there was one case of catheter-related sepsis and one case of insertion-site infection. There was also one insertion-site infection in the Vitacuff group, but there was no statistical difference in infection rates between the three groups.
 ...
PMID:A prospective randomized trial comparing the silver-impregnated collagen cuff with the bedside tunneled subclavian catheter. 843 26

A 26-month-old boy sustained a scald injury covering 83 per cent of his total body surface area (TBSA). He also developed sepsis and multiorgan failure (MOF). Locally he was treated with Procel burn cover and silver sulphadiazine cream (SSD) for 23 days. By using Procel, the dressing-change time was shortened significantly. Procel burn cover controlled core and skin temperature more effectively compared to conventional dressing, and the staff acceptance increased because of its easy and fast use. Based on our observation, this material can be used successfully as a total body dressing with children with extensive partial thickness burns or temporarily in full thickness burns until wound excision can be performed.
 ...
PMID:Procel burn cover used as a total body dressing in burns. 854 Sep 86

Infection associated with the use of triple lumen catheters in hospitals is a frequent and serious complication. The prevailing hypothesis for the origin of catheter-related infection (CRI) is bacterial colonization and subsequent infection of the skin insertion site and catheter interface. The recently released ARROWgard catheter contains a bonded synergistic combination of silver sulfadiazine and chlorhexidine, which is thought to render the catheter resistant to bacterial colonization and subsequent sepsis. The purpose of this study is to compare the incidence of CRI and catheter-related sepsis (CRS) between a standard triple lumen catheter and ARROWgard antiseptic coated catheter in patients receiving total parenteral nutrition (TPN). A randomized, prospective clinical trial was conducted at a community referral center from January 1993 through April 1994. One-hundred-ninety-one patients with need for TPN were randomized to receive either the ARROWgard or a standard triple lumen catheter placed under a strict sterile protocol. CRI was defined as >/= 15 colony forming units by semiquantitative culture technique of the catheter tip or intracutaneous segment. CRS was defined as growth of the same organism on the catheter and at least one peripheral blood culture. All catheters were cultured. Ninety-two patients received the ARROWgard catheter, and 99 patients received the standard catheter. There were no differences between the average age, sex, length of hospital stay, days on TPN, number of catheters/patient, indications for TPN, primary diagnoses, or duration of the central line between the two groups. The overall rate of CRI was 11.5 per cent, and CRS was 8.4 per cent in this study. The rate of CRI for the ARROWgard was 10.9 per cent, compared with 12.9 per cent for the standard catheter (P = NS). The rate of CRS for the ARROWgard was 8.7 per cent, compared with 8.1 per cent for the standard catheter (P = NS). The coating of central venous catheters with silver sulfadiazine and chlorhexidine does not reduce the rate CRI or CRS when compared with standard central venous catheters in patients receiving TPN.
 ...
PMID:Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. 871 61

Catheter-related infection (CRI) is a serious complication of central venous catheterization. We have investigated the efficacy of a silver-coated polyurethane catheter (Pellethane, Fresenius AG, Germany) in preventing CRI in oncological patients receiving chemotherapy in a phase II study. From November 1992 through April 1994, 266 patients were assigned to receive single lumen catheters, either standard uncoated catheters (UC, n = 113) or silver-coated ones (SC, n = 120). Catheters were inserted into the internal jugular vein after institutional approval and informed consent. Duration of catheterization (UC vs. SC = 13.3 vs. 12.7 days) and leukopenia (< 1.0 x 10(9) WBC/l; 4.3 vs. 3.6 days) were similar in both groups demonstrating a comparable risk for infections. Skin reactions at the catheter entry site were recorded daily. CRI and colonization rates were studied by semiquantitatively culturing intradermal and intravascular segments. CRI were confirmed by blood cultures obtained via catheter and from peripheral veins in cases of suspected sepsis or at the end of catheterization. No adverse effects from the silver-coated catheter could be observed. The bacteriological results showed that SC were colonized (> 15 CFU) in 45.1% and UC in 44.2%. CRI developed in 21.2% of the UC patients but only in 10.2% of the SC patients (p = 0.011). We conclude that this new silver-coated central venous catheter is biocompatible and effective in reducing the incidence of catheter-related infections in oncological patients.
 ...
PMID:Prevention of catheter-related infections by silver coated central venous catheters in oncological patients. 882 13

B1 bradykinin receptors were visualized by using the B1 bradykinin receptor agonist [3H]des-Arg10-kallidin in receptor autoradiography experiments. Cryosections were prepared from arterial vessels from a healthy control pig, a pig with pre-existing inflammation and an animal with experimental sepsis induced by an infusion of bacterial lipopolysaccharide (LPS). Only diffusely scattered silver grains with no preference for a distinct tissue structure were detected on emulsion-coated coverslips above the cryosections from the healthy control animal. This indicates that under normal circumstances no or only minute amounts of B1 bradykinin receptors are present in these tissues. In contrast, a 3-fold increase in specific B1 bradykinin receptor binding was observed on both the corresponding preparations of the sick piglet and of that with experimentally induced sepsis. A similar enhancement of specific [3H]des-Arg10-kallidin binding occurred in preparations devoid of endothelium. By comparison with the stained cryosection on the slide the silver grains showed a preferential distribution above smooth muscle cells. Taken together our data are consistent with the hypothesis that B1 bradykinin receptors are induced in the muscle layer of large vessels not only after experimentally-induced sepsis but also in pre-existing inflammatory disease.
 ...
PMID:Autoradiographic visualization of B1 bradykinin receptors in porcine vascular tissues in the presence or absence of inflammation. 885 23


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>