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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many factors influence the incidence of sepsis following cesarian section. In Zimbabwe all cesarians probably warrant prophylactic antibiotics. These should be given parenterally in high doses, starting post-operatively. Single doses have been found to be effective. An overall 26% incidence of infection was found in 46 consecutive cesarians at Hwange. Ruptured membranes for 6 hours or more, duration of operation 60 minutes or more, and post-operative hemoglobin 9.5g% were significantly associated with infection. A prolonged post-operative course of benzylpenicillin plus streptomycin appeared to have no advantage over 3 perioperative doses of chloramphenicol. The results support the contention that antibiotic prophylaxis for cesarian section should be perioperative, ensuring a high plasma concentration of antibiotic during the operation. Further study is needed to determine the best drug or combination and the optimum number of doses. Prophylaxis needed may vary with the degree of risk, but at present this cannot be reliably assessed.
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PMID:Infection following caesarean section: a study of the literature and cases with emphasis on prevention. 248 12

During gram-negative sepsis it is known that endotoxin activates complement by the alternate pathway. The complement anaphylatoxin C5a, a result of this activation, is thought to play a key role in attracting and activating neutrophils in the lungs, leading to the adult respiratory distress syndrome. Complement levels were measured in primates made septic by Escherichia coli infusions. Anti-human C5a antibodies were administered to study their effect on neutrophil-mediated lung injury. Control (I), septic (II) and septic + anti-C5a antibody (III) groups (n = 4) were studied. The antibody-treated group (III) demonstrated a significant attenuation of septic shock and pulmonary edema as has been previously reported. All complement profiles were corrected for varying hemoglobin concentrations. C3, C4, and C5 levels were measured by radial immunodiffusion and were depleted in both septic groups. Once the levels were depleted from the plasma, they did not recover. The depletion of C4 indicates that classical pathway activation also occurred. C3a, C4a, and C5a levels were measured by radioimmunoassay. Significantly increased peak levels were reached in the septic groups 15 min after initiation of the E. coli infusion. There were no significant differences in early peak C3a and C4a levels between groups II and III. However, the mean peak C5a level in group III (anti-C5a antibodies) was 42% lower than that in group II, and after this early peak, C5a levels were not elevated above control levels in group III. The antibody to human C5a was thus shown to be cross-reactive with primate C5a and was specific since C3a and C4a levels were not decreased in group III.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Complement levels in septic primates treated with anti-C5a antibodies. 249 31

A patient with a large necrotic pancreatic carcinoma underwent ERCP and percutaneous biopsy of the cancer and of a suspected hepatic metastasis. On the second day, she developed a massive hemolysis with a 50% drop of hemoglobin level and a rise of serum bilirubin level from 1.3 to 37.5 mg%. Gas was noted on followup CT scan of the pancreas. Clostridium perfringens was found by needle aspiration of the pancreas and on multiple blood cultures. Death resulted from sepsis on the fourth day. Since ERCP and percutaneous needle biopsy of the pancreas are being done with increasing frequency, and since this complication has not been previously described, this case report is presented.
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PMID:Fatal clostridial pancreatitis following ERCP and percutaneous needle biopsy. 255 May 63

Oxygen delivery (DO2) and related variables were studied in eight dogs during severe untreated peritonitis induced by cecal ligation and perforation. The development of peritonitis was accompanied by abdominal fluid sequestration and significant increases in hemoglobin (Hgb), arterial oxygen content (CaO2), and P50. Changes in mixed venous PO2 (P-vO2), mixed venous saturation (S-vO2), DO2, oxygen uptake (VO2), cardiac index (CI), and arteriovenous O2 difference (C[a--v]O2) were not significant. When blood volume was returned to normal levels with dextran, CI rose and C(a--v)O2 decreased; P-vO2 increased and Hgb returned to baseline levels. In this animal model, sepsis and fluid sequestration produced an increase in blood O2 capacity and CaO2, which sustained DO2 and VO2. No changes were observed in P-vO2 or S-vO2. The hyperdynamic state of severe sepsis became evident only after reversing hemoconcentration by colloid infusion. The increase in P-vO2 and S-vO2 after volume loading is possibly related to primary septic mechanisms and/or to changes in DO2.
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PMID:Early physiologic changes in canine fecal peritonitis. 258 Jun 65

A number of Saudi children (31) with sickle cell disease and thalassemia underwent splenectomy: 12 for frequent blood transfusions, 15 for chronic hypersplenism (most of whom were also the recipients of periodic blood transfusion) and 4 for splenic abscess. The mean age of splenectomy was 8.8 years (8 months-18 years). Eight patients had sickle cell disease, 14 beta-thalassemia and 9 had sickle cell thalassemia. All patients received prophylaxis against pneumococcal infection. There was one postoperative death most probably due to sepsis. Sixteen of those who required frequent preoperative blood transfusions needed no more transfusions, while in 7 the need for transfusions decreased significantly (p less than 0.05). For those with hypersplenism, there was a significant postoperative increase in total hemoglobin (P less than 0.001), RBC (P less than 0.001) and platelet counts (p less than 0.02); and a substantial decrease in reticulocyte counts (p less than 0.05). The common post splenectomy complications were chest infection and a brief episode of pyrexia, but without undue morbidity. The study establishes a definite place for splenectomy in a selected population of children with sickle cell disease and thalassemia.
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PMID:Splenectomy in children with sickle cell disease and thalassemia. 263 77

Two cases of leaking atherosclerotic abdominal aortic aneurysm are presented. The leakage caused fever and leukocytosis, combined with signs of peritoneal irritation. Blood hemoglobin levels were reduced. Both patients were initially treated for sepsis but within hours the cause was identified; both died in the operating theater. The experience of others is reviewed and the mechanism of fever caused by leaking aneurysm is discussed.
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PMID:Fever caused by leaking atherosclerotic abdominal aortic aneurysm. 267 96

A spontaneous complete remission of 5 month's duration was observed in a 70 year-old man with acute myeloblastic leukemia complicated with severe pneumonia. The remission occurred after severe pancytopenia. He was treated only with antibiotics and blood transfusions. On admission, the leukocyte count was 6.4 x 10(3)/microliters with 98% myeloblasts. The hemoglobin level was 9.9 g/dl and platelet count was 1.5 x 10(4)/microliters. Marrow aspirate was hypercellular with 98.5% myeloblasts, which weakly showed Ia like antigen and myeloid related antigen. On relapse after five weeks' complete remission, leukemic cells were more immature, peroxidase negative and showed no surface markers. Chromosomal abnormalities were detected. During remission induction therapy he died of severe bacterial and fungal sepsis. Such cases of spontaneous complete remission have been rarely reported, previous adult cases were summarized and the role of etiologic factors were discussed.
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PMID:[Spontaneous complete remission in a 70 year-old man with acute myeloblastic leukemia with severe pneumonia]. 268 8

To determine the effects of blood transfusions on splenic function in older patients with sickle cell anemia, we investigated splenic function in 12 patients who had had cerebrovascular accidents and who were being treated at two collaborating centers using different transfusion protocols. Splenic function was assessed by radionuclide scan and pocked erythrocyte count. Patients were 6 to 18 years of age and had been receiving transfusions for 7 months to 10 years (median 4.2 years). Of the 12 children, five had normal or increased splenic size and function (normal scan and normal or minimally elevated pocked erythrocyte count). All were receiving intensive transfusion therapy, with the aim of maintaining the hemoglobin S level at less than 20%. The other seven patients had abnormal splenic function (absent radionuclide uptake and elevated pocked erythrocyte count); each was receiving less intensive transfusion therapy, with the pretransfusion hemoglobin S level usually at 30% to 40%. No patient developed bacterial septicemia while receiving hypertransfusion therapy. We conclude that splenic function during a long-term transfusion program is variable, depending in part on the "intensity" of transfusion therapy. Apparent splenic involution and fibrosis may be a reversible event in some patients.
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PMID:Splenic phagocytic function in children with sickle cell anemia receiving long-term hypertransfusion therapy. 279 47

A patient with T-polyagglutinable red cells and a severe coagulopathy provided an opportunity to observe the results of plasma transfusion in the face of T-activation. The patient was a 52-year-old Navajo Indian with a perforated gall bladder and related sepsis due to Clostridium perfringens. The gall bladder was removed surgically. Postoperatively, he had severe thrombocytopenia, and prolonged partial thromboplastin and prothrombin times. The patient's red cells were agglutinated by Arachis hypogaea and Glycine soja lectins but were unagglutinated by extracts of Salvia horminum, Salvia sclarea, and Bandeiraea simplicifolia. No untoward reactions or any evidence of hemolysis were observed when the patient was given platelet concentrates and 4 units of single-donor plasma. Serial plasma hemoglobin and haptoglobin levels documented that there was no hemolysis. His coagulopathy responded, and he had a successful surgical re-exploration and recovery. This case documents that serious adverse consequences do not necessarily follow transfusion of plasma in a recipient with T-activated red cells. T-activation is a relative but not absolute contraindication to plasma transfusion.
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PMID:Uneventful administration of plasma products in a recipient with T-activated red cells. 286

There is poor correlation between the MICs and zone sizes obtained for erythromycin against Haemophilus influenzae. The effect of two media, Mueller-Hinton medium supplemented with 3% lysed horse blood and 10 micrograms of NAD per ml (MHA + LYHB) and Mueller-Hinton agar supplemented with 1% bovine hemoglobin and 1% IsoVitaleX (MHA + HGB), on the MICs and zone sizes of erythromycin against H. influenzae was determined. The effect of three different methods for inoculum preparation on the susceptibility of H. influenzae was also determined. The MICs were independent of the method of inoculum preparation, but the zone sizes were smaller if the inoculum was carefully adjusted to contain approximately 10(8) CFU/ml. MICs were higher and zone sizes were smaller when MHA + HGB was used instead of MHA + LYHB. Good correlation was found when MHA + LYHB was used for determining the MIC and MHA + HGB was used for determining susceptibility by the disk method. When the inoculum was adjusted to match a McFarland 0.5 standard, the viable counts had to be approximately 10(8) CFU/ml for good correlation between MICs and zone sizes. A-56268, a new macrolide antibiotic, was tested against H. influenzae, and its MICs and tentative breakpoints against this organism were determined. The MICs obtained by various methods were correlated with in vivo efficacy by using a mouse septicemia model. MICs obtained on MHA + HGB or MHA + LYHB incubated without a 5% CO2 atmosphere showed the best correlation with in vivo efficacy.
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PMID:Susceptibility testing of macrolide antibiotics against Haemophilus influenzae and correlation of in vitro results with in vivo efficacy in a mouse septicemia model. 295 54


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