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

The authors evaluated the financial and health implications of treatment choices for three serious classes of infection: hospital-acquired pneumonia, intra-abdominal infection, and sepsis of unknown origin. Data were obtained from a systematic review of clinical literature and published data bases, by written questionnaire from a panel of infectious disease authorities, and from actual costs at a tertiary-care hospital. For pneumonia and sepsis, the third-generation cephalosporin evaluated (ceftizoxime) was found to be less expensive than other regimens, when costs of dose preparation and administration, monitoring, and toxicity were added to drug acquisition costs. The lowest-cost regimen for intra-abdominal infection was metronidazole plus gentamicin. Modest differences in efficacy would easily outweigh differences in toxicity, however, and could justify the use of more expensive regimens (e.g., mezlocillin plus gentamicin for hospital-acquired pneumonia, and cefoxitin plus gentamicin for intra-abdominal infection). If all regimens are assumed to be equally efficacious, then the third-generation cephalosporin was both lowest in cost and, owing to its low toxicity, greatest in net health benefit.
J Gen Intern Med
PMID:Cost-effective choice of antimicrobial therapy for serious infections. 309 40

The role of motility as a virulence factor in Pseudomonas aeruginosa burn wound sepsis was examined using mutants deficient in the Fla or Mot phenotype. Physiological profiles of parental strains and Fla- and Mot- mutants were similar with respect to antibiograms, O antigen types, growth rates, and proteolytic, exotoxin A and phospholipase activities, providing evidence for isogenicity. Lethality studies using a subcutaneous mouse burn model showed that three Fla- mutants and one Mot- mutant were much less virulent (10(2) to 10(5) times) than the parent wild-type. Topical challenges in the flame burn model showed that a Fla- mutant of strain M-2 was approximately tenfold less virulent. A reduction in virulence, although somewhat less than tenfold, was also observed in the scald burn model for M-2 Fla-, and Mot- strains. Tissue colonization experiments revealed a characteristic, rapidly systemic infection in burned mice challenged with wild-type organisms. Nonmotile mutants similarly proliferated in the burn wound, but the characteristic bacteraemia and systemic invasion were markedly absent. The infection remained localized in the skin wound and the mice survived. The pattern of infection by nonmotile mutants in the colonization studies was very similar to that obtained with Fla+ cells in burned animals passively treated with antiflagellar antibody. These results add substantial support to the concept of motility as a P. aeruginosa virulence factor in invasive infections.
J Gen Microbiol 1988 Jan
PMID:Flagella, motility and invasive virulence of Pseudomonas aeruginosa. 314 66

The incidence of nasal carriage of Staphylococcus aureus and the in vitro susceptibility of isolates to fusidic acid, penicillin, erythromycin, methicillin and tetracycline was determined in 204 patients who had been treated previously with a short course of a topical preparation of Fucidin for acute skin sepsis, and in an equal number of control subjects. Staphylococcus aureus was isolated from 36 per cent and 34 per cent of patients in the Fucidin and control groups respectively. Only one of the 144 isolates was resistant to fusidic acid. Short, single courses of topical therapy in general practice are unlikely to be epidemiologically hazardous in the long term. Evidence of possible cross-infection in general practice was obtained.
J R Coll Gen Pract 1984 May
PMID:Nasal carriage and antibiotic susceptibility of Staphylococcus aureus in general practice. 673 60

In conventional usage, "sepsis" denotes a clinical syndrome caused by excessive release of a variety of proinflammatory mediators, including tumor necrosis factor alpha, interleukin-1, and metabolites of arachidonic acid. Because this condition can be precipitated by infectious or noninfectious causes (eg, acute pancreatitis), a recent consensus conference has advocated replacing the term sepsis with the phrase systemic inflammatory response syndrome. Improvements in our understanding of the pathophysiologic basis for systemic inflammatory response syndrome have resulted in the development of a number of novel approaches for treating, preventing, or limiting its deleterious consequences. Although much of this work remains confined to the laboratory, several of these approaches are undergoing (or recently have undergone) clinical evaluation. Among these are the use of monoclonal antibodies against endotoxin, monoclonal antibodies against tumor necrosis factor, recombinant proteins that antagonize the effects of or bind to circulating interleukin-1 or tumor necrosis factor, and drugs that inhibit the enzyme cyclooxygenase, which is responsible for the formation of certain key metabolites of arachidonic acid.
Curr Opin Gen Surg 1993
PMID:Surgical infections: blocking the mediator cascade responsible for sepsis and septic shock. 758 65

Improvements in surgical management and intensive care therapy have enabled many patients to initially survive severe life-threatening trauma or major surgical procedures only to die after delayed bouts of sepsis. This paper reviews literature published within the past year on the effects of nutrient substitution on malnutrition, injury, and the host immune response. Topics discussed include immunodeficiencies in trauma and malnutrition, immunomodulation by nutrition, and parenteral versus enteral nutrition. We also discuss the roles of arginine, glutamine, omega-3 fatty acids, and dietary nucleotides in the host immune response.
Curr Opin Gen Surg 1993
PMID:Malnutrition, injury, and the host immune response: nutrient substitution. 758 22

The fish rhabdovirus infectious haematopoietic necrosis virus (IHNV) contains a non-virion (NV) gene between the glycoprotein (G) and polymerase (L) genes on its RNA genome. The present study investigated three other fish rhabdovirus genomes and found that the NV gene of hirame rhabdovirus is closely related to the NV of IHNV, whereas the viral haemorrhagic septicemia NV gene showed evidence of significant divergence. Most importantly, spring viraemia of carp virus, the only vesiculovirus-like fish rhabdovirus examined, did not have an NV gene at its genomic RNA G-L junction. These results suggest that the presence of an NV gene is characteristic of the unassigned fish rhabdovirus subgroup previously classified as lyssaviruses, and that the NV gene is not essential for replication in fish cells per se, since it is absent in a vesiculovirus-like fish rhabdovirus.
J Gen Virol 1997 Jan
PMID:Distribution and variation of NV genes in fish rhabdoviruses. 901 Feb 93

Septicemia in crustaceans may occur occasionally due to Gram-negative opportunistic bacteria, especially under conditions of intensive aquaculture. The lipopolysaccharide (LPS) endotoxin induces in mammals septic shock and the activation by LPS of hormone release through the hypothalamo-pituitary axis is well known. In crustaceans an increase in circulating Crustacean hyperglycemic hormone and hyperglycemia are reported to result from exposure to several environmental stressors but the metabolic and hormonal effects of LPS in vivo are undescribed. A sublethal dose of LPS (Sigma, Escherichia coli 0111:B4) was injected into at least five individuals of species representative of crustacean taxa and life habits: Squilla mantis (Stomatopoda); the Decapoda Crangon crangon and Palaemon elegans (Caridea), Nephrops norvegicus (Astacidea), Munida rugosa and Paguristes oculatus (Anomura), Pilumnus hirtellus, Macropipus vernalis, Parthenope massena, and Ilia nucleus (Brachyura). Within 3 hr an increase in blood sugar developed ranging from 26.00 +/- 8.37 sd mg/dl in M. rugosa to 201.50 +/- 95. 91 sd mg/dl in P. oculatus and a significant increase of 79% in M. rugosa up to 1300% in P. hirtellus over control levels was observed. The involvement of eyestalk hormones in this generalized response was tested on S. mantis, M. vernalis, and P. elegans; LPS injected into eyestalkless animals did not elicit a significant hyperglycemic response compared with saline-injected controls. Eyestalkless animals injected with one eyestalk equivalent homogenate in saline from untreated animals did show a change in color from red to normal likely due to red pigment concentrating hormone and a hyperglycemic response within 2 hr. Eyestalkless animals injected with homogenate from LPS-treated shrimps showed the change in color but not the hyperglycemic response. It is concluded that LPS directly, or cytokines circulated upon challenge by the endotoxin, may act on the medulla terminalis X-organ-sinus gland complex and release CHH selectively eliciting an hyperglycemic stress response, after which CHH stores become relatively depleted.
Gen Comp Endocrinol 1997 Dec
PMID:Lipopolysaccharide-induced hyperglycemia is mediated by CHH release in crustaceans. 940 16

Survivors of acute respiratory distress syndrome (ARDS) are at risk for long-lasting cognitive decline due to hypoxemia, sepsis and/or psychological sequelae associated with aggressive supportive care in the intensive care unit (ICU). We conducted an exploratory study to assess cognitive performance in long-term survivors of ARDS and to investigate how cognitive functioning is related to employment status and health-related quality of life (HRQOL). At median time of 6.0 years after ICU discharge, forty-six ARDS survivors were tested with SKT, a short cognitive performance test for assessing deficits of memory and attention. A measure of HRQOL (SF-36 Health Status Questionnaire) was also administered, and in a brief psychiatric interview, employment status was rated. 23.9% (n=11) of the patients showed cognitive impairments. However, no extreme and severe cognitive deficits were recorded. They primarily revealed low levels of cognitive function in various tasks assessing attention skills. Disability was found in 41.3% (n=19) of the patients. All ARDS survivors with cognitive deficits were disabled, whereas only 22.9% (n=8) of the cognitively not impaired patients gave evidence of disability. The SF-36 values of the ARDS survivors indicated impaired health status on seven out of eight domains when compared to normative population data. Patients with cognitive deficits described the lowest HRQOL with major limitations in the domains role-physical and social functioning when compared to patients without cognitive impairments. In conclusion, long-term ARDS survivors exhibit impaired health status and the presence of cognitive deficits is associated with disability and considerable impairments in HRQOL. More detailed psychiatric research is required to establish the etiology of these cognitive impairments.
Gen Hosp Psychiatry
PMID:The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: results of an exploratory study. 1131 77

There have been many reports of primary Vibrio vulnificus septicemia in Korea since 1987. This study was undertaken to determine the cellular fatty acid (CFA) compositions of 95 clinical strains of V. vulnificus isolated in Korea during 1985-1995. We compared these results with the CFA profile of V. vulnificus in the Microbial Identification System (MIS) (CLIN library version 3.9; Microbial ID Inc., Newark, DE, U.S.A.), and the grouping of V. vulnificus by CFA analysis was also performed. The relationship between groups and serotypes of V. vulnificus was described. Although most of the CFAs in V. vulnificus strains were similar to the CFA profile of V. vulnificus in the MIS, some distinctive differences were observed between the results of this study and the MIS CFA profile of V. vulnificus. First, the means of 2 major CFAs, 16 : 0 and 16 : 1w7c, were 22.16 and 18.26% in this study but 23.52 and 25.44% in the MIS, respectively. Second, all isolates had 11 : 0iso3OH, which was not present in the MIS. Of 95 strains, 10 strains (10.5%) showed 'NO MATCH' results by the MIS identification. Eighty five strains (89.5%) were identified as V. vulnificus by the MIS (the first choice identification), but they disclosed low SI values of <0.6 (not 'EXCELLENT MATCH') except 2 strains (2.1%). This showed that V. vulnificus strains isolated in Korea had different characteristics in CFA composition in comparison with the MIS V. vulnificus library. Nine groups comprising all the strains were obtained by cluster analysis and were further characterized by principal-component analysis. There was heterogeneity between the groups by CFA and serotypes of V. vulnificus. The same serovars were distributed into diverse groups.
J Gen Appl Microbiol 1997 Dec
PMID:Cellular fatty acid profiles of ninety-five strains of Vibrio vulnificus isolated from clinical specimens in Korea. 1250 2

The complete nucleotide sequences of three human echovirus (EV) 11 strains and one EV19 strain, all of which caused outbreaks of enterovirus uveitis (EU), a new infant disease first identified in 1980 in Siberia, were determined. One EV11 strain which caused an outbreak of sepsis-like disease in Hungary was also sequenced. All four EV11 strains were mosaic recombinants of the prototype EV11 strain Gregory, with their non-structural coding regions and 5' NTRs being more similar to other prototype enteroviruses (EV1, EV9). However, this finding is probably a feature of all circulating enterovirus strains and may not be related to their altered virulence. A full genome sequence comparison of the three subtypes of EU-causing strains excludes the role of recent recombination in their emergence, and points to their independent emergence.
J Gen Virol 2004 Feb
PMID:Recombination in uveitis-causing enterovirus strains. 1476 4


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