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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Incidence of influenza, the most frequent infectious disease in Poland decreased 72% to 336,919 cases (882.4 per 100,000 population). Number of bacterial foodborne infections and intoxications remain high--19,870 cases (52.0 per 100,000). 79.6% of them were caused by Salmonella. In 17.0% of them etiologic factor was not found. Number of cases of diarrhea among children 0-2 (viral, bacterial and of unknown origin) was 16,361 (2,326 per 100,000). Among them 5,672 were viral. This number includes rotaviral infections as probably the dominant component. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (4.1 per 100,000) which'dropped to the level below the incidence of viral hepatitis C (5,6). Hepatitis A remains at the low level (0.25 per 100,000). Level of newly diagnosed cases of AIDS (170 cases, 0.45 per 100,000) is 19% higher then in the previous year. The major problem with HIV reporting is low fraction of reported risk factors. Infectious diseases caused 0.68 % of deaths. Mortality from infectious diseases was 6.5 per 100,000 population and was significantly higher among men (8.6) then among women (4.5). In urban settings mortality from infectious diseases was higher (7.0 per 100,000) then in the country (5.8). In particular districts (voivodeships) mortality indices remained in the range of 4.6 (kujawsko-pomorskie) to 9.8 (lubuskie). The highest number of deaths was caused by tuberculosis and its late sequels (34.2%). Attention should be given to the increased number of deaths due to sepsis (34.0%, without neonatal sepsis).
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PMID:[Infectious diseases in Poland in 2004]. 1724 56

This review summarizes the origins of the insight that excess production of pro-inflammatory cytokines caused a constellation of changes that contribute to pathophysiology of disease. This connection was made following the original 1975 TNF (tumor necrosis factor) publication from New York describing how activated macrophages kill tumors. The study caught the eye of a group in London who were trying to understand how the same in vivo macrophage activation would protect mice against the erythrocytic protozoan parasites that cause malaria and babesiosis. Based on collaborative research between these two groups, it was argued in 1981 that TNF and related cytokines initiated events that caused pathology, as well as parasite death within red cells in these infectious diseases. This proved to be a key conceptual advance. It was also argued that the pathology of bacterial sepsis logically had TNF origins. Once TNF was cloned in 1985, allowing its specific analysis in serum and neutralization in vivo, the involvement of this cytokine in infectious disease pathology was pursued by a number of groups. Some researchers found that once "their" cytokine was cloned and sequenced, they had been unwittingly expanding knowledge on TNF for several years. By the late 1980s excess TNF production was proposed to be central to acute systemic viral diseases. This family of cytokines is now at the centre of investigations to understand the mechanisms of acute systemic viral diseases, including influenza and the hemorrhagic viral diseases. With its implication as the master regulator of other inflammatory cytokines in the synovial membrane, TNF has also become the major cytokine in the pathogenesis of chronic inflammatory disease. Its neutralization has proven to be a potent treatment for rheumatoid arthritis and Crohn's disease.
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PMID:How TNF was recognized as a key mechanism of disease. 1749 63

Acute hypercytokinaemia represents an imbalance of pro-inflammatory and anti-inflammatory cytokines, and is believed to be responsible for the development of acute respiratory distress syndrome and multiple organ failure in severe cases of avian (H5N1) influenza. Although neuraminidase inhibitors are effective in treating avian influenza, especially if given within 48 h of infection, it is harder to prevent the resultant hypercytokinaemia from developing if the patient does not seek timely medical assistance. Steroids have been used for many decades in a wide variety of inflammatory conditions in which hypercytokinaemia plays a role, such as sepsis and viral infections, including severe acquired respiratory syndromes and avian influenza. However, to date, the results have been mixed. Part of the reason for the discrepancies might be the lack of understanding that low doses are required to prevent mortality in cases of adrenal insufficiency. Adrenal insufficiency, as defined in the sepsis/shock literature, is a plasma cortisol rise of at least 9 microg dl(-1) following a 250 microg dose of adrenocorticotropin hormone (ACTH), or reaching a plasma cortisol concentration of >25 microg dl(-1) following a 1-2 microg dose of ACTH. In addition, in the case of hypercytokinaemia induced by potent viruses, such as H5N1, systemic inflammation-induced, acquired glucocorticoid resistance is likely to be present. Adrenal insufficiency can be overcome, however, with prolonged (7-10 or more days) supraphysiological steroid treatment at a sufficiently high dose to address the excess activation of NF-kappaB, but low enough to avoid immune suppression. This is a much lower dose than has been typically used to treat avian influenza patients. Although steroids cannot be used as a monotherapy in the treatment of avian influenza, there might be a potential role for their use as an adjunct treatment to antiviral therapy if appropriate dosages can be determined. In this paper, likely mechanisms of adrenal insufficiency are discussed, drawing from a broad background of literature sources.
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PMID:A rationale for using steroids in the treatment of severe cases of H5N1 avian influenza. 1757 50

Complete Center for Disease Control death certificate records and Centers for Medicare and Medicaid Services 100% Standard Analytic File for hospice claims for 2002 were used to describe the whole population of hospice users and nonusers in the United States. The overall hospice utilization rate for persons 65 years and older was 28.6%. Hospice utilization varied by cause of death, and was highest for individuals with malignancies (65%), kidney disease and nephritis (55%), and Alzheimer's disease (41%). Hospice utilization was lowest for conditions leading to rapid or unexpected death, such as accidents and suicide (0%), influenza and pneumonia (3%), and sepsis (6%). Considerable geographic differences in hospice utilization existed, with hospice use higher in the South and the Southwest and lower in the Midwest and the Northeast. State-specific usage rates ranged from 8% in Alaska to 49% in Arizona. Our findings highlight opportunities for the hospice industry to provide more care, opportunities defined by diagnostic and geographic axes.
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PMID:Geographic variation in hospice use in the United States in 2002. 1759 May 66

A range of complications of pregnancy, abnormal fetal growth and development, and complications of delivery have been associated with increased risk of schizophrenia. Few studies have been able to adjust for a broad range of potential confounding factors. A national population nested case-control study based on Danish longitudinal registers was conducted to investigate the risk of schizophrenia associated with exposure to a range of obstetric events. The sample included 1039 first admissions to, or contacts with Danish psychiatric services with an ICD-8 or ICD-10 diagnosis of schizophrenia and 24, 826 individually matched controls. Adjusting for the other obstetric factors, family psychiatric history, and socio-economic and demographic factors, risk of schizophrenia was associated with maternal non-attendance at antenatal appointments (Incidence Rate Ratio (IRR) 2.08, 95% CI: 1.0, 4.4), gestational age of 37 weeks or below (IRR 1.51, 95% CI: 1.0, 2.2), maternal influenza (IRR 8.2, 95% CI: 1.4, 48.8), preeclampsia (IRR 2.72, 95% CI: 1.0, 7.3), threatened premature delivery (IRR 2.39, 95% CI: 1.4, 4.1), haemorrhage during delivery (IRR 2.43, 95% CI: 1.1, 5.6), manual extraction of the baby (IRR 2.15, 95% CI: 1.1, 4.4), and maternal sepsis of childbirth and the puerperium (IRR 2.91, 95% CI: 1.1, 7.9). There was no significant interaction between the obstetric factors and either sex or family psychiatric history. The data suggest a modest association between prematurity, indicators of hypoxia, maternal infections, and maternal behaviours and risk of the later development of schizophrenia after adjusting for a number of possible confounding factors.
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PMID:Obstetric conditions and risk of first admission with schizophrenia: a Danish national register based study. 1776 5

Although less common than influenza A, influenza B infections can cause significant mortality and morbidity in children who are immunocomprised and have underlying medical conditions. We report a preterm neonate with fatal influenza B virus pneumonia. This infant presented with signs and symptoms indistinguishable from any other cause of sepsis.
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PMID:Fatal influenza B virus pneumonia in a preterm neonate: case report and review of the literature. 1789 92

In 2005 numerous important modifications were introduced into surveillance of infectious diseases in Poland according to the requirements of European Union. The most important modification was introduction of European case definitions. Concerning list of infectious diseases, all positions recommended by EU are reported in Poland. Incidence of influenza, the most frequent infectious disease in Poland increased 117.7% to 733,234 cases (1921.4 /100,000). Number of cases of diarrhea among children 0-2 (viral, bacterial and of unknown origin) was 20,194 (2834.2 /100,000). Among them 6877 were viral. This number includes rotavirus infections as probably the dominant component. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (4.5 /100,000) which dropped to the level below the incidence of viral hepatitis C (7.8 /100,000). Hepatitis A remains at the low level (0.14 /100,000) Level of newly diagnosed cases of AIDS (146 cases, 0.38 /100,000) is 15.6% lower then in the previous year. The major problem with HIV reporting is low fraction of reported risk factors. Infectious diseases caused 0.70% of deaths. Mortality from infectious diseases was 6.8 per 100,000 population and was significantly higher among men (8.9) then among women (4.8). In urban settings mortality from infectious diseases was higher (7.0 per 100,000) then in the country (6.3). In particular districts (voivodeships) mortality indices remained in the range of 4.7 (podlaskie) to 10.2 (lubuskie). With the decreasing trend of deaths due to tuberculosis and increased numbers of deaths from sepsis, for the first time in 2005 number of deaths from sepsis (967; 2.5/100,000, without neonatal sepsis) was bigger than number of deaths from tuberculosis (834; 2.2).
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PMID:[Infectious diseases in Poland in 2005]. 1795 29

The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS).
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PMID:Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide survey. 1803 Feb 63

Infections constitute the most common and severe complication of immune deficiencies. The pattern of infections is strikingly dependent on the type of immune defect. Antibody deficiencies usually manifest with recurrent capsulated bacteria related-infections of the respiratory tract, due to pneumoccoci and Haemophilus influenza. The same bacteria are implicated in asplenic patients with frequent sepsis of devastating consequences. Complement deficiencies must be looked for in case of meningococcal infections. Neutropenia and defects in phagocytic cell functions favour bacteraemia and invasive fungal infections. Importantly, neutropenia can rapidly lead to septic shock. Cellular immune deficiencies are associated with opportunistic infections including viral infections due to Herpes viridae, fungal and parasitic infections (Pneumocystis jiroveci, Toxoplasma gondii) and mycobacterial infections. Most of the time, immune defects are combined, accounting for the variety and the complexity of clinical presentations and microbial investigations.
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PMID:[Infectious complications of immune deficiencies]. 1808 Apr 23

It is now broadly accepted for infectious disease in general that it is not the invading organism, but the body's unbridled response to it--the "cytokine storm"--that causes illness and pathology. Nevertheless, many researchers still regard the harmful effects of falciparum malaria as being governed by oligaemic hypoxia arising from parasitised erythrocytes obstructing blood flow through vulnerable organs, particularly the brain, and we summarise why these notions are no longer tenable. In our view, this harmful sequestration is readily accommodated within the cytokine storm perspective as one of its secondary effects. We approach these issues by examining aspects of malaria, sepsis and influenza in parallel, and discuss the insights that comparisons of the literature can provide on the validity of possible anti-disease therapies.
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PMID:Understanding the role of inflammatory cytokines in malaria and related diseases. 1834 78


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