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

There were 52 patients with sepsis, 61.6% were over 60 years of age (63.3% of patients had septicemia, 36.7% had septicopyemia). The disease was caused by ++pyo-inflammatory diseases of the vessels in 34.6% and the urinary system in 17.3% of cases. Microbial causative agents were isolated from the blood in 83.3% of patients (monoculture in 46.6%, associations of microorganisms in 36.6%; staphylococcus in 59.7%, gram-negative microflora in 46.7%). The most frequently encountered disorders of the immunological status were reduction of the number of lymphocytes and their T- (85%) and B-population (62.9%), increase of the level of immunoglobulins M (81.5%) and A (55.6%), decrease of the number of accessory T-cells (73.6%) and the ratio of accessory and suppressant T-cells (52.6%). Along with the application of antibacterial therapy, which relieved the microcirculatory blockage, and detoxication measures in the treatment of the purulent foci, much attention was paid to immunologic correction for the removal of primary and secondary insufficiency (endobulin, ++T-activin, isoprinosin). Blocking of the immunological reaction was relieved in 65.5% of patients by discrete plasmapheresis with compensation for the deficiency with endobulin, quick-frozen plasma, and rheopreparations. In the group of 52 patients 12 died (mortality 23.1%).
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PMID:[Diagnosis and treatment of septicemia]. 146 67

Coagulase-negative staphylococci (C-NS) are a frequent cause of bacteraemia in premature neonates. It is likely that the strains of C-NS causing bacterial sepsis in premature neonates have their origin on the patient's skin surface. We have studied the quantitative development of the skin microflora at eight sites on premature neonates. A swab wash method was used to sample and enumerate the cutaneous microflora of premature neonates admitted to an intensive care unit with respiratory distress syndrome. The numbers of bacteria present on the skin increased rapidly by 100-fold in the first week of life. The species of C-NS found on neonatal skin were similar to those found on adult skin. However, the bacterial population was 10(3) lower by comparison. There was considerable variation in numbers of bacteria and in the proportion resistant to antibiotics from day to day. There appeared to be no association between antibiotic usage and the proportion of isolates resistant to antibiotics, although the resident bacteria were in many cases resistant to a variety of antibiotics. C-NS were isolated from 92% of samples from which bacteria were isolated. Staphylococcus epidermidis was found at all sites and accounted for 82% of each colonial type of staphylococcus isolated. Other organisms isolated included Propionibacterium sp, alpha-haemolytic streptococci, aerobic spore-bearing bacilli, aerobic coryneforms, Candida albicans, Klebsiella oxytoca, Pityrosporum sp, Klebsiella pneumoniae, and Escherichia coli. The results of this study suggest that the skin of premature neonates is colonised with antibiotic resistant C-NS during the first week of life and that the chance of contamination of an intravascular catheter at insertion increases during this period.
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PMID:Development of cutaneous microflora in premature neonates. 151 78

A review of 391 children in the first decade of life admitted to a surgical ward with soft tissue infections revealed predisposing factors in 38.4% of cases, mainly trauma and adjacent skin sepsis. Superficial abscess formation occurred in 90% of cases, muscle abscesses in 9.5%, and necrotizing fasciitis in less than 1%. The most frequent organism isolated was the staphylococcus aureus which was found in 52.8% of the available cultures. Coliform organisms were found in 14.6%, and haemolytic streptococci in just over 10%. A study of the culture and sensitivity profiles obtained made it possible to formulate a programme for the empirical treatment of soft tissue infections based on the region of the body involved.
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PMID:Soft tissue infection in children in south Trinidad. 156 92

Localized bacterial skin infections are frequent. In furunculosis, a local treatment is usually sufficient. In case of frequent recurrence a possible staphylococcus aureus colonization should be looked for and eliminated. Erysipela is treated by systemic antibiotics in order to avoid complications such as streptococcal gangrena or parainfectious glomerulonephritis. Anaerobic cellulitis and gas gangrena are postoperative or posttraumatic infections of the soft tissues which require a combined surgical and antibiotic treatment. Systemic infections may be recognized by characteristic skin lesions. These skin lesions are the consequence of bacterial emboli, vasculitis, intravascular coagulation or toxins, respectively. Examples for such manifestations are lesions in endocarditis, purpura fulminans, ekthyma gangrenosum, disseminated candidemia and toxic shock syndrome.
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PMID:[Localized bacterial skin infections and dermatologic manifestations of systemic infections]. 161 60

We noticed coagulase positive staphylococcus is the most common pathogen in the neonatal sepsis in our neonatology unit. We followed 22 cases with neonatal sepsis. Blood cultures revealed coagulase staphylococcus in 9 cases, coagulase negative staphylococcus in 6 cases, Pseudomonas spp. in 5 cases, E. coli in 1 case, Klebsiella spp. in 1 case. The most common symptom was apnea. CRP positivity was noted in 15 cases (68.2%) while increase in immature/total neutrophil ratio was observed in 12 cases (54.5%). However, we detected leukopenia in 2 cases (9.1%). Also, the birthweight of the cases died due to neonatal sepsis were below 2000 gr.
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PMID:[Neonatal sepsis]. 176 91

In order to determine the sepsis induced by the practice of canalizing the deep venous sector in revascularized patients, 43 catheters removed from 43 patients were cultured; no sepsis induced by this practice was found and 13 catheters had positive cultures, which amounted to 30.3% of the sample under study; five catheters (38.4%) with positive cultures belonged to patients who showed no sepsis; eight catheters (61.5%) with positive cultures corresponded to patients who showed septic focci. The average stay was 4.07 days. The germ most frequently found was negative coagulase staphylococcus.
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PMID:[The risk of sepsis induced via the deep venous approach]. 184 21

Fourteen patients with Wegener's granulomatosis (WG) and severe renal and extrarenal involvement were studied (serum creatinine on admission 5.8 +/- 3.4 mg/dl). Renal histology showed a necrotizing, crescentic glomerulonephritis in all patients. Despite advanced renal disease on admission cyclophosphamide, steroids (in 13 patients) and plasma exchange (in 9 patients) caused a rapid and sustained improvement of renal function. Four patients required intermittent hemodialysis over a period of one week. After 2 weeks of treatment serum creatinine values below 2 mg/dl (n = 4) indicated a nearly complete recovery of renal function in the long-term follow up (mean serum creatinine achieved after 12 months therapy: 1.1 +/- 0.1 mg/dl (n = 4). Therefore serum creatinine values observed after 2 weeks of therapy, appear to be of prognostic value with regard to renal outcome. No relapse of active WG or progressive renal deterioration was observed during follow-up (22 +/- 13 months) except in one patient with persisting renal impairment. Three patients died (staphylococcus sepsis, intracerebral hemorrhage during hypertensive crisis, pulmonary embolism) during the first two months of therapy. The decline of serum creatinine seemed to be a better indicator of successful therapy than the decrease of anticytoplasmatic antibody (ANCA), erythrocyte sedimentation rate (ESR) and hematuria. On admission ANCA titer neither correlated with serum creatinine, the degree of renal involvement, nor was it of prognostic value. ANCA, serum creatinine and hematuria normalized within 2 to 8 months, whereas ESR and proteinuria remained elevated. Our data indicate a good prognosis of WG even with advanced renal involvement and generalized vasculitis provided aggressive treatment is performed early.
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PMID:Crescentic glomerulonephritis in Wegener's granulomatosis: morphology, therapy, outcome. 187 37

The clinical and immune modulatory effects of interleukin-2 (IL-2) and interferon (INF) alfa-2a were examined in a phase II study in patients with metastatic renal cell carcinoma (six patients) and melanoma (eight patients). Treatment consisted in IL-2 3 MU/m2 continuous infusion days 1-4 and INF alfa-2a 6 MU/m2 subcutaneously day 1 and 4, both given on alternate weeks. Tumour response was assessed after four cycles of treatment or earlier, if necessary. Patients with stable disease or response were to be continued for another nine cycles or up to disease progression. The 14 patients received a total of 60 cycles of treatment. Major toxicities (WHO Grade III/IV) were fever, capillary leak syndrome with hypotension, nausea and vomiting, erythema with pruritus, leuco- and thrombopenia and sepsis with staphylococcus aureus. Five of 14 patients (36%) developed a self limiting autoimmune thyroiditis with HLA-DR expression on thyrocytes. Long term treatment toxicity was moderate with an average weight loss of 5% and an average fall in Karnofsky index of 10% compared to baseline. No responses were seen in renal cell carcinoma, two patients with melanoma had a partial and two a minor response with a duration of 1-7 months. Serial measurements of immune modulatory parameters showed a functional response to treatment with an increase of NK- and LAK-activity during the first two cycles, followed by a plateau and decrease during the third and fourth cycles. These findings were paralleled by a successive decline in treatment induced INF gamma response. These findings suggest, that alternative weekly treatment with IL-2 and INF alfa-2a results in an exhaustion of lytic capacity of NK- and LAK-cells and an attenuation of secondary cytokine release.
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PMID:Clinical and immune modulatory effects of alternative weekly interleukin-2 and interferon alfa-2a in patients with advanced renal cell carcinoma and melanoma. 199 8

Sepsis is a serious situation in patients with chronic central venous access. The infections complications presented with totally implanted reservoirs are studied in this paper. Twenty five venous systems for chemotherapy, total parenteral nutrition, specific drugs and blood drawing, were placed in 24 patients ranging in age from three months to sixteen years. Catheter related sepsis was defined as simultaneous positive blood cultures drawn through the reservoir and peripheral vein. Five children (20 per 100) had septicemia with candida albicans (3), staphylococcus aureus (1) and staphylococcus epidermidis (1). Four systems was removed after unsuccessful antimicrobial therapy. Three symptomatic patients were studied by echocardiography, one of them showed thrombosis in superior vena cava and right atrium, this child underwent an open atriotomy. These data suggest that removal of implantable venous system is required for successful treatment in patients with catheter related sepsis.
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PMID:[Sepsis in children using venous implants with reservoir]. 204 29

Fifty-eight episodes of catheter-related sepsis in 21 patients receiving home parenteral nutrition were retrospectively studied. Of 81 organisms isolated from the blood, 59% were Gram-positive cocci, 25% were Gram-negative bacilli, and 16% were yeast. Attempts to treat bacterial infections at home with antibiotic therapy while the catheter remained in place were made; fungal isolation resulted in immediate hospitalization and catheter removal. Gram-negative infections more often resulted in eventual hospitalization (92%) and catheter removal (50%) than Gram-positive infections (57% hospitalization and 23% catheter removal). Empiric therapy with 1 g of cefazolin intravenously every 12 hr was successful in only 33% of episodes caused by coagulase-negative staphylococci, whereas vancomycin was successful in 62%. Sensitivity testing was not a reliable guide for antibiotic choice for treatment of these infections. Cefazolin, 1 g, intravenously every 12 hr was successful in only 25% of Gram-negative episodes treated empirically with this regimen. We conclude that our home parenteral nutrition patients should be hospitalized for a few days upon presentation with a catheter infection for clinical evaluation and aggressive antibiotic therapy. Vancomycin is the preferred drug for treatment of catheter-related infections caused by coagulase-negative staphylococcus.
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PMID:Antibiotic therapy of catheter infections in patients receiving home parenteral nutrition. 211 21


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