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

Nongonococcal septic arthritis can occur during the postpartum period. We report two cases, one involving the wrist and the sacroiliac joints and the other the pubic symphysis. The difficulty of initial diagnosis in the postpartum period is emphasized. This pathology is uncommon and may begin insidiously. The sacroiliac joint is particularly at risk for postnatal sepsis, but its deep localization hinders investigations. Besides the classical obstetrical infectious assessment (blood cultures, urine culture, vaginal sample, white blood cell count and CRP) and radiological investigations, joint puncture is needed to isolate the causal infectious agent. Joint immobilization in combination with major 3-month antibiotic therapy is usually successful, generally with no sequellae.
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PMID:[Postpartum septic arthritis. Two case reports]. 969 Jan 67

To assess the relationship between capillary leakage and inflammatory mediators during sepsis, blood samples were taken on hospital admission, as well as 24 and 72 h later, from 52 children (median age, 3.3 years) with severe meningococcal sepsis, of whom 38 survived and 14 died. Parameters related to cytokines (interleukin 6 [IL-6] IL-8, plasma phospholipase A2, and C-reactive protein [CRP]), to neutrophil degranulation (elastase and lactoferrin), to complement activation (C3a, C3b/c, C4b/c, and C3- and C4-CRP complexes), and to complement regulation (functional and inactivated C1 inhibitor and C4BP) were determined. The degree of capillary leakage was derived from the amount of plasma infused and the severity of disease by assessing the pediatric risk of mortality (PRISM) score. Levels of IL-6, IL-8, C3b/c, C3-CRP complexes, and C4BP on admission, adjusted for the duration of skin lesions, were significantly different in survivors and nonsurvivors (C3b/c levels were on average 2.2 times higher in nonsurvivors, and C3-CRP levels were 1.9 times higher in survivors). Mortality was independently related to the levels of C3b/c and C3-CRP complexes. In agreement with this, levels of complement activation products correlated well with the PRISM score or capillary leakage. Thus, these data show that complement activation in patients with severe meningococcal sepsis is associated with a poor outcome and a more severe disease course. Further studies should reveal whether complement activation may be a target for therapeutical intervention in this disease.
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PMID:Complement activation in relation to capillary leakage in children with septic shock and purpura. 978 43

Procalcitonin (PCT) levels increase in patients with systemic infections; the highest levels have been found in sepsis. This study tested whether plasma procalcitonin level was related to sepsis, CRP, burn size, inhalation injury or mortality in severely burned patients over the entire clinical course. In 27 patients with 51 (20-91)% TBSA, PCT was measured three times weekly from admission over the entire course of stay in a single ICU. Daily scoring by the "Baltimore Sepsis Scale" was performed. The patients were assigned to three groups depending on the clinical course and outcome: A = no septic complications, B = septic complications-survivors, C = septic complications non-survivors. PCT levels were elevated slightly at admission (mean 2.1 ng/ml) except in three patients who suffered electrical burns (mean 15.7 ng/ml). PCT peak levels correlated well with the Scoring values (r = 0.84) while CRP did not (r = 0.64). Peak PCT levels were significantly higher (p < 0.005) in septic patients (B and C) who averaged 49.8+/-76.9 ng/ml, than in non-septic patients (A) who averaged peak levels of 2.3+/-3.7 ng/ml. The highest PCT levels were found immediately before death (86.8+/-97 ng/ml). Seven patients had an inhalation injury 3rd degree. In these patients at 24 h postburn, there was no relationship between PCT levels and inhalation injury but during the later days postburn there were significant differences in PCT levels in patients with versus without inhalation injury. All patients with inhalation injury 3rd degree developed septic complications. There was no positive correlation between the PCT-admission-levels and the TBSA, but there was a positive correlation between the TBSA and the mean peak PCT levels during the later days postburn (r = 0.73; p < 0.05). The cut-off value of 3 ng/ ml we found reliable to indicate severe bacterial or fungal infection. PCT values over 10 ng/ml increasing over the following days were found only in life-threatening situations due to systemic infections. The individual course of PCT in one patient is more important than absolute values. PCT presented in this study as a useful diagnostic parameter in severely burned patients.
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PMID:Procalcitonin--a sepsis parameter in severe burn injuries. 991 76

The objective of this study was to evaluate the significance of preoperative dental treatment for the development of complications in the form of infections during the first postoperative weeks after heart valve surgery. In one group of patients (n = 149), oral health was examined and dental treatment performed 3-6 months prior to heart valve surgery. In a second group (n = 104), oral health was examined postoperatively and these patients did not receive any dental treatment before surgery. Infections were recorded for all patients during the first three weeks after surgery and correlated to the dental status at the time of surgery. Sepsis or endocarditis occurred in 5.4% of the first group and in 1.9% of the second group. Freedom from all infections for the two groups was 55% and 56%, respectively. The results did not reveal any significant differences between the groups regarding patients' oral health at the primary oral examination. The frequencies of postoperative complications such as focal infections, fever and increased CRP were also found to be similar for both groups. The combined scores of complications were 2.1% and 1.8%, respectively. Data from the present study do not support the suggestion that dental intervention will decrease the rate of early complications following heart valve surgery.
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PMID:The significance of oral health and dental treatment for the postoperative outcome of heart valve surgery. 1009 52

The aim of this study was to investigate the regulation and clinical significance of serum acute phase proteins. The patients were divided into three groups: group I consisted of 11 patients with less than 20% of TBSA; group II 10 patients with 20-50% of TBSA and group III 11 patients with more than 50% of TBSA. Blood samples were taken at 8, 24, 48 and 72 h postburn, and in group III additional blood samples were taken on the 7th, 14th, 21st day or in septic episode. The concentration of CRP and C3, Tf, PA were detected by rate nephelometry, agar immunodiffusion and rocket immunoelectrophoresis respectively. Compared with controls, the peak value of CRP was observed during 48-72 h (P < 0.01), C3 decreased at 8 h and lowest at 24 h. Tf was lowered at 48 h, PA and Tf shared the similar changes. However, all four variables had no marked difference during infection and sepsis. The results showed no correlation between C3 and CRP (r = 0.0885, P > 0.05). The results suggested that: 1. CRP mainly reflected the extent of injury but not sepsis; 2. increased CRP was not the causative factor of decreased C3. Tf reduction accelerated bacterial growth.
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PMID:[The changes and clinical significance of serum CRP, C3, Tf, and PA in the early postburn stage]. 1045 48

The influence of glutamine on human immune system is multidirectional but the exact changes still remain unclear. In this study the effect of total parenteral nutrition (TPN) enriched with glutamine on some selected immunological and nutritional parameters was examined in twelve surgical patients with sepsis and malnutrition. The reason for glutamine supplementation was lack of clinical improvement after standard TPN. All patients received TPN enriched with glutamine for 10 days. Phenotypic analysis of peripheral blood mononuclear subsets (CD4, CD8, CD16, CD56, HLA-DR) were measured before, during (on days 2, 4, 6) glutamine administration and two days after (day 12) glutamine withdrawal. Simultaneously some nutritional parameters were assessed. The number and percentage of CD4, CD16, CD56 mononuclear subsets increased significantly on day 2 and stayed on the same level during observation (with exception in CD4 on day 6, 12 and CD56 on day 4). No significant differences in CD8 and HLA-DR number and percentages were observed after TPN enriched with glutamine. BIA examination revealed on days 2 and 12 significant decrease of total body water and significant increase of body cell mass, intracellular water on day 12. It was correlated with significant higher total lymphocytes count and significantly higher total protein, serum albumin, transferrin, cholesterol and CRP concentration. Results demonstrated that TPN supplemented with glutamine improved rapidly some immunological and nutritional parameters in surgical, malnutrition patients with sepsis.
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PMID:[Cellular immunity changes after total parenteral nutrition enriched with glutamine in patients with sepsis and malnutrition]. 1096 19

We experienced 2 cases of septic children after open heart surgery. Both of them recovered by using exchange blood transfusion technique. We use irradiated and dialysed fresh blood for exchange blood transfusion. After this procedure, they recovered from sepsis, as the datas improving, white blood cell reduced from 19,700 +/- 3,710 to 8,200 +/- 2,360, CRP reduced from 5.46 +/- 1.65 to 1.89 +/- 0.70, T-Bil reduced from 7.61 +/- 2.66 to 3.02 +/- 0.89, and BUN reduced from 525.92 +/- 6.64 to 19.76 +/- 5.34. Furthermore, blood pressure and urine volume were stable between exchange blood transfusion, although after open heart surgery. Therefore this procedure has benefits for the compromised, septic patients, performed open heart surgery, because of its stability of the circulating circumstances. And using the irradiated and dialysed fresh blood provides stable condition eventhough under high dose catecholamine use.
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PMID:[Exchange transfusions in sepsis after the pediatric open heart surgery]. 1171 84

Leptin, an adipocyte-derived signaling factor, is a member of the IL-6 cytokine family. However there is no direct evidence of leptin stimulation of the acute phase protein (APP) synthesis which is typical for all other IL-6-like factors. The purpose of this study was to characterize the dynamics of circulating leptin in relation to ten APPs. We used postoperative septic patients as a model of cytokine network hyperstimulation and intensive APP reaction. The prospective study was performed on 22 patients with proven postoperative intraabdominal sepsis after large abdominal surgery. Plasma levels of leptin, TNF-alpha, IL-1beta, soluble IL-2 receptor (sIL-2R), IL-6 (ELISA analysis) and ten APPs (nephelometric analysis) were estimated. We have demonstrated a statistically significant elevation of plasma leptin concentrations in the septic group compared with healthy subjects (p<0.001). The correlation of plasma leptin and BMI during postoperative sepsis was diminished. The regression coefficient was the highest for leptin and CRP (r=0.48, p<0.05), and for leptin and alpha-1-antitrypsin (r=0.46, p<0.05) in the septic group. There was significant correlation between TNF-alpha and leptin (r=0.47, p<0.05) and between IL-6 and leptin (r=0.45, p<0.05) in septic patients. No significant correlation was found between leptin and "negative" APP and between leptin and IL-1beta. Leptin has thus been shown as an acute phase reactant with a potential hematopoietic, immunomodulatory and hepatocyte stimulating activity during the infectious and non-infectious stress response. The significant correlation between leptin and CRP and leptin and alpha-1-antitrypsin indicates that leptin can participate in APP synthesis regulation during a systemic inflammatory response.
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PMID:Serum leptin levels in septic men correlate well with C-reactive protein (CRP) and TNF-alpha but not with BMI. 1182 20

Between 1997-2000 there were 30 patients with bacterial sepsis treated at Department of Infectious Diseases of Silesian Medical University School in Bytom. Neisseria meningitidis (23.33%), Streptococcus pneumoniae (20%) and Staphylococcus aureus (3.33%) were most frequent etiological factors of the disease. The etiology of sepsis was not revealed in 53.34% of cases. Clinical state of patients was assessed using SSS and SAPS II score. All subjects were divided into two groups: group I--patients with septic syndrome symptoms (11 cases), group II--patients without septic syndrome symptoms (19 cases). The aim of the study was usefulness of plasma C-reactive protein estimation in the course of bacterial sepsis monitoring. Plasma CRP concentration was assessed by immunoturbidometric method (using RANDOX, UK kits). Blood samples were taken on th 1., 4. and 10. day of therapy. Plasma CRP levels were statistically significantly higher in patients of the group I in samples of the first and the second assay. CRP serum concentration correlated with severity of a patient's clinical state. Type of sepsis's etiological factor did not exert influence on plasma CRP level. In fatal cases high plasma CRP concentration was recorded during the whole time of hospitalization, whereas in cases of recovery fast decrease of this protein level was noted. The obtained result indicate, that estimation of plasma CRP concentration in patients with bacterial sepsis may be helpful in evaluation of clinical state severity, monitoring of the disease course as well as therapy efficacy.
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PMID:[Usefulness of plasma C-reactive protein (CRP) estimation in patients with bacterial sepsis]. 1198 62

We analysed the utility of procalcitonin (PCT) assay, either alone or in combination with 2 simple blood assays, for the diagnosis of culture-proven neonatal septicaemia. Tests for serum PCT concentration, serum CRP concentration and blood immature to total neutrophil leucocyte ratio all had reasonable (58-77%) sensitivity, reasonable (62-84%) specificity, good (94-97%) negative predictive value and poor (16-24%) positive predictive value for the diagnosis of sepsis. Algorithms combining various tests produced slight improvements in sensitivity or specificity. Although the PCT test appeared to be useful for the diagnosis of neonatal sepsis in this small study, it did not offer any significant advantages over traditional tests for the diagnosis of infection.
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PMID:Comparison of procalcitonin with CRP and differential white blood cell count for diagnosis of culture-proven neonatal sepsis. 1223 81


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