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 diagnosis of clinical sepsis is the primary indication for administration of systemic antibiotics. Choices of antibiotics for sepsis, where cultures are unavailable, requires a knowledge of current strains in the unit where the patient resides and coverage for both Staphylococcus aureus and Pseudomonas. Dosage requirements are increased in burned patients and serum antibiotic levels must be monitored for maximal effectiveness and minimal toxicity. Localized foci of infection must be identified and eradicated with regional antibiotic therapy or surgery when possible. Gram-negative pneumonia in the patient with an inhalation injury poses special difficulties in therapy. Resistance to antibiotics must be constantly guarded against and isolation procedures followed to avoid its propagation in the burn unit. Combination drug regimens and plasmid-directed therapy may in the future slow down the acquisition of further antibiotic resistance and lead to improved salvage of severely burned patients.
Surg Clin North Am 1978 Dec
PMID:Use of systemic antibiotics in the burned patient. 25 20

A 37-year-old man with blastic crisis of chronic myelogenous leukemia was admitted for chemotherapy. After treatment with an infusion of vincristine, he became leukopenic and febrile. Two episodes of gram-negative septicemia were treated with prolonged courses of antibiotics; however, fever persisted, and the patient developed the superior vena cava syndrome. Despite therapy with amphotericin B, the patient died. At autopsy a thrombus of Aspergillus was found completely occluding the superior vena cava.
Chest 1978 Dec
PMID:Superior vena cava syndrome caused by invasive aspergillosis. 28 77

Sepsis is a frequent cause of morbidity following extensive bowel resection. It has been suggested that the lymphoid tissues of the gut may be essential to normal humoral immunity. This study evaluates: (1) the effect of endotoxin on mortality following selective massive bowel resection and jejunoileal bypass; (2) cellular immunity by skin allograft rejection and bypass, and (3) T and B cell lymphocyte subpopulations is mesenteric lymph nodes, intestine and appendix. Endotoxin increased mortality in rats with more distal bowel resection but not following bypass. Skin allograft rejection was similar in each group. Peyer's patches, mesenteric lymph nodes and appendices were evaluated for T & B cell subpopulations. These tissues had a greater percentage of B cells (53% lymph nodes, 63% appendix) with IgM the predominant immunoglobulin. Cellular immunity was not a factor. Lymphoid tissues of the distal bowel and mesentery contain abundant B cells and IgM that may contribute to humoral immunity. Massive bowel resection may increase the risk of morbidity from gram negative sepsis and/or endotoxin presumably due to decreased humoral immunity.
J Pediatr Surg 1979 Dec
PMID:Adverse effects of endotoxin following massive distal bowel resection. 31 29

Serial measurements of CH50, C3, C4, and factor B were performed on three newborn infants with group B streptococcal sepsis. Two of the septic infants had a colonized but noninfected identical twin. All three infants with group B streptococcal sepsis had hypotension, prolonged coagulation times, neutropenia, and respiratory failure. During the course of the sepsis, factor B was depressed 30% to 35%, C3 was depressed 40% to 60%, and CH50 was depressed by 100% when compared to their cord blood levels. Two of the infants also had a 50% to 70% depression of C4. In contrast, no significant decrease in complement levels occurred in the siblings of the twins or in two additional control infants. These data are characteristic of older patients with Gram-negative sepsis and strongly suggest that the group B Streptococcus has endotoxin-like properties.
Pediatrics 1977 Dec
PMID:Complement activation and group B streptococcal infection in the newborn: similarities to endotoxin shock. 34 Oct 69

The large mass of devitalized tissue that comprises the burn eschar is gradually becoming recognized as the principal source of complications in the burn patient. Clinical observations suggest that the topical agent silver sulfadiazine does not penetrate the eschar sufficiently to prevent bacterial infection from becoming established in the deeper levels of the wound but does penetrate to a depth of approximately 1.5 mm in bactericidal concentrations. A new technique that takes advantage of this fact, early laminar excision, has been developed at the Children's Hospital of Michigan Burn Center. The eschar is excised layer by layer with the electric dermatome under general anesthesia within the first 72 hr post burn, and the thickness of the devitalized tissue is reduced to a remnant of less than 1 mm. This is less than the depth to which silver sulfadiazine is capable of penetrating in bactericidal concentrations, and greatly enhanced control of burn wound sepsis is achieved. Early laminar excision of the eschar, combined with silver sulfadiazine dressings, aggressive resurfacing of the wound, and increased emphasis on nutrition, is an approach to management of the victims of thermal trauma that should significantly improve survival in patients with burn injuries greater than 60% body surface area.
J Pediatr Surg 1978 Dec
PMID:Early laminar excision: improved control of burn wound sepsis by partial dermatome debridement. 36 94

Ampicillin-sensitive or -resistant Staphylococcus aureus and Klebsiella strains were cultured in various nutrient media as prototypes of the agents of sepsis isolated in bacteriological routine analysis. In each case, 2 ml of defibrinated human blood containing 100 and 1000 cells, 8 gamma and 80 gamma ampicillin/1 ml blood respectively were added to 50 ml of nutrient medium. The following media were used. 1. casein soya-bean meal peptone broth (Oxoid), 2. tryptose-phosphate medium (Oxoid), 3. dextrose broth (Oxoid), 4. brain-heart-dextrose medium (Oxoid), 5. brain-heart infusion, autoclaved (Difco), 6. brain-heart infusion, after sterile filtration (Difco), 7. vacutainer culture bottles (BD) prepared medium, 8. micrognost blood culture bottles (Biotest) prepared medium. While the sensitive staphylococcus strain exhibited a slower growth than the sensitive Klebsiella strain in all nutrient media, the growth rate of the two resistant variants was approximately the same for an initial count of 100 cells per ml of blood. Among the resistant staphylococci the higher initial count of the inoculum resulted in an improved growth. After addition of 8 gamma or 80 gamma ampicillin/1 ml blood the sensitive staphylococcus strain did not show any grwoth irrespective of the inoculated number of cells while the sensitive Klebsiella strain multiplied irrespective of the initial number of cells. After 24 hours the resistant staphylococci and Klebsiella strains of which 1000 cells each had been used for inoculation exhibited growth in almost all media used.
Zentralbl Bakteriol Orig A 1978 Dec
PMID:[Experimental studies to culture bacteria from blood specimen with an addition of ampicillin in various nutrient media (author's transl)]. 37 22

Between 1965--78 118 newborns with septicemia have been treated in the Children's Hospital of the Free University Berlin. Microorganisms identified were streptococci in 32 cases, 27 of which were group B streptococci (increasing number since 1973). In 1978 group B streptococci were responsible for 44% of all the septicemia cases as well as for 12% of all newborn deaths. The incidence of group B streptococcal septicemia in newborn babies is 1/1000 live births for the Berlin region. 2 patients presented the late-onset type of group B streptococcal neonatal sepsis; both survived having neurological sequelae. 25 newborns belonged to the early-onset group, the mortality rate in this group is 56%. The clinical features, bacteriological findings and risk factors are summarized in table form. There could be an influence related to the maternal blood type. Histological examinations in 5 placentae revealed signs of amniotic infection.
Monatsschr Kinderheilkd 1979 Dec
PMID:[Group B streptococci: the most common cause of neonatal septicemia (author's transl)]. 39 Mar 70

Using steel intravneous needles obtained from patients with hematologic malignancies, the authors evaluated the efficacy of a semiquantitative method for culturing vascular cannulas on solid medium, comparing it with conventional broth culture. Of 148 needles studied, 140 (95%) were negative on semiquantitative culture (less than 15 colonies on the plate) although 38 produced growth in broth or on the plate; none of these needles caused septicemia. Eight needles were positive on semiquantitative culture (greater than or equal to 15 colonies), and two of these caused septicemia (P = .002). Positive semiquantitative cultures were associated with local inflammation (P = .02). Semiquantitative culturing was equal to the broth method in sensitivity (100%) in the diagnosis of needle-related septicemia; specificity (96% vs. 92%) and the predictive value of a positive needle culture (25% vs. 14%) were both enhanced with the semiquantitative method. The semiquantitative technic differentiates infection from contamination and offers other major advantages compared with the broth method, and is recommended for culturing steel needles as well as plastic catheters.
Am J Clin Pathol 1979 Dec
PMID:A semiquantitative culture technic for identifying infection due to steel needles used for intravenous therapy. 39 Oct 29

Neonatal susceptibility to overwhelming bacterial infection is commonly attributed to a relative deficiency in serum opsonic activity. However, few studies have compared the functional capacity of the classical complement pathway with that of the alternative complement pathway in the neonate. The opsonic activity of nine maternal infant serum pairs were studied by determining percent uptake of radiolabeled Escherichia coli. Seven mother-infant paired sera were studied using E. coli strains known to be opsonized via the alternative complement pathway: the mean percent uptake of E. coli opsonized in neonatal sera was 16.8%; of those opsonized in maternal sera, 54%; and of those opsonized in control sera, 45% (P less than 0.005). Two E. coli strains requiring the classical complement pathway for opsonization were phagocytized equally well in maternal and infant sera of seven mother-infant pairs. Determination of anti-O hemagglutination inhibition (HI) antibody titers in six maternal sera for one classical complement pathway activating and one alternative complement pathway strain showed no correlation between percent phagocytosis and HI antibody titer. These data would suggest that serum levels of classical pathway components are probably adequate for opsonization of E. coli via the classical pathway, but that low alternative complement pathway activity in neonatal sera may contribute to the newborn's increased susceptibility to bacterial sepsis.
Pediatr Res 1979 Dec
PMID:Deficient alternative complement pathway activity in newborn sera. 39 30

The clinical records of 180 pediatric patients who received Intralipid via peripheral veins at a single institution (1964-1977) were retrospectively analyzed, with particular reference to the complications of this form of therapy. Intralipid was used in a dose range of 2--4 g/kg/day in order to supply 40% of the daily calorie requirements. The patients were neonates, infants, children, and adolescents with a wide range of clinical diagnoses. Local complications associated with Intralipid therapy were minimal. Transient elevations in serum enzyme levels (SGOT, SGPT, and LDH) were observed in 4% of patients, but all of these returned to the normal range after cessation of therapy. Ten patients had histologic evidence of cholestasis, the significance of which is discussed. The lipid emulsion was employed in patients with preexisting hyperbilirubinemia with concomitant resolution of jaundice. Intralipid was administered to patients with known severe thrombocytopenia (secondary to sepsis or myelosuppression) with return of the platelet counts to normal levels during the course of infusion therapy. The use of Intralipid in patients with established sepsis did not delay its response to conventional surgical or antibiotic therapy. There were no instances of the "overloading" syndrome observed.
J Pediatr Surg 1977 Dec
PMID:Peripheral total parenteral nutrition employing a lipid emulsion (Intralipid): complications encountered in pediatric patients. 41 43


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