Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Daily prophylactic application of either 1.0% silver sulfadiazine cream or 0.1% gentamicin cream was compared for effectiveness in preventing bacterial colonization of burn wounds and sepsis. Pseudomonas aeruginosa colonized the wounds of 37% of the 38 patients treated with silver sulfadiazine and 30% of the 33 patients treated with gentamicin; gentamicin-resistant P. aeruginosa colonized the wounds of 21% of the patients treated with gentamicin. Staphylococcus aureus colonization occurred in 55% of the patients treated with silver sulfadiazine, whereas colonization with Candida species occurred in 58% of the patients treated with gentamicin. Although gentamicin-resistant organisms caused no deaths their repeated appearance resulted in discontinuation of prophylaxiz with gentamicin cream. The next year P. aeruginosa strains resistant to gentamicin were isolated from burn wounds of only two patients who had not previously received parenteral therapy with gentamicin or tobramycin. Gentamicin cream should be reserved for treating patients with wounds infected by gentamicin-sensitive P. aeruginosa and those allergic to sulfa drugs. For most patients with burn wounds silver sulfadiazine is safe and effective as an antibacterial agent for topical prophylaxis.
Can Med Assoc J 1978 Sep 09
PMID:Comparison of silver sulfadiazine and gentamicin for topical prophylaxis against burn wound sepsis. 9 23

A model was developed in the rhesus monkey to determine if the marked wasting of body proteins associated with sepsis could be prevented by an intravenous supply of various nutritional substrates. All monkeys were given a basic infusion of 0.5 gm of amino acid nitrogen/kg body weight via an indwelling catheter in the jugular vein. Three groups were given diets with no added calories, 85 calories/kg from dextrose or 85 calories from lipid. In each group, six monkeys were inoculated with 3 x 10(8) Streptococcus pneumoniae and four with heatkilled organisms. In the monkeys infused with the amino acids alone, pneumococcal sepsis resulted in a fourfold increase in loss of body proteins compared with calorie-restricted controls. Addition of 85 calories/kg/day of either dextrose or lipid reduced body wasting associated with infectious disease. The calories from lipid were utilized bythe septic host as a source of energy, with a slightly reduced efficiency when compared with the isocaloric infusion of dextrose. The nitrogen sparing of the fat emulsion could not be accounted for by its glycerol content. Therefore, the septic monkey seemed to utilize fatty acids as an energy substrate. It appears that the carbohydrate calories tend to favor the synthesis of peripheral proteins (associated mainly with skeletal muscle), while lipid calories favor synthesis of visceral proteins such as plasma albumin and acute-phase proteins.
JPEN J Parenter Enteral Nutr 1978 Sep
PMID:Protein-sparing therapy during pneumococcal infection in rhesus monkeys. 10 60

Skin tests (ST) in 1332 patients are associated with increased morbidity from sepsis. Patients with normal skin tests had a 7% major sepsis rate and 2% mortality rate. Thirty-six per cent of anergic (A) patients and 21% of relatively anergic (RA) patients died; 52% of A patients and 34% of RA patients had sepsis. These data include all patients studied and represent their worst skin test. Two studies were done. The first was a retrospective evaluation of effect of surgery upon 49 anergic patients with biliary tract disease, colon cancer, bowel obstruction, hypovolemia and visceral abscesses. The patients did not receive total parenteral nutrition (TPN). The data show that surgery without TPN can reverse the anergic state and did so in 84% of patients reported. The second study was a prospective, double-blind, randomized trial of the effect of levamisole on skin tests, neutrophil chemotaxis (CTX), sepsis and mortality iin 39 preoperative anergic patients. Major sepsis was significantly increased in placebo group (p less than 0.05). Mortality, minor sepsis, restoration of skin tests and chemotaxis were somewhat better in levamisole patients but not statistically so. These studies show that in addition to TPN, surgery and immunorestorative drugs are viable approaches to the management of selected anergic patients.
Ann Surg 1979 Sep
PMID:Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. 11 27

A 13-year-old boy with acute myelogenous leukemia resistant to conventional chemotherapy received a bone marrow transplant from his HL-A-identical, mixed lymphocyte culture-reactive sister. The recipient was prepared for transplantation with cyclophosphamide and total body irradiation. Despite cytogenetic evidence of engraftment, graft-versus-host disease was not observed. The patient died 38 days post-transplantation of Gram-negative bacteremia sepsis and recurrent leukemia of recipient origin.
Transplantation 1975 Sep
PMID:Bone marrow transplantation between mixed lymphocyte culture-reactive individuals. 12 39

The authors have treated 399 fractures of the femoral shaft by blind nailing with reaming following Kuntscher's technique. They fully describe the necessary technical details for a safe operation. They emphasize the importance of an adequate instrumentation and report peroperative complications and the way for avoiding them (poor reduction of the fractures, difficulty for bridging the fracture site, creating of additional fragments, blockage of reamers or nails in the medullary canal). Indications and results are described. I non-union, 15 malunions and 4 sepsis were reported.
Rev Chir Orthop Reparatrice Appar Mot 1975 Sep
PMID:[Blind nailing with reaming in fractures of the femoral shaft. Technique, indications, and results in 399 cases]. 13 51

Nine cases of sequestration of the lung were seen in children. Bronchopulmonary sequestration of the lung is a distinct congenital anomaly and clinical entity that can be distinguished from other congenital abnormalities of the lung. Such a congenital anomaly must be considered in children who, on roentgenologic examination, are found to have an opacity in the lower lung fields. Intralobar bronchopulmonary sequestration often is associated with recurrent pulmonary sepsis, whereas extralobar sequestration is less likely to be symptomatic and usually exhibits no abnormal physical findings. In a unique case, we found an extralobar sequestration associated with an esophageal duplication that communicated with the sequestered lobe but not with the esophagus. This situation represents a transitional stage in embryonic development of extralobar sequestration. Intralobar and extralobar forms of sequestration show many common characteristics indicating a common embryogenesis. Surgical excision, consisting of lobectomy or segmentectomy, is safe and effective and may be accomplished without morbidity or mortality.
Mayo Clin Proc 1976 Sep
PMID:Sequestration of the lung in children. 13 87

Primary failure of host defense mechanisms has been associated with increased infection and mortality. Anergy, the failure of delayed hypersensitivity response, has been shown to identify surgical patients at increased risk for sepsis and related mortality. The anergic and relatively anergic patients whose skin tests failed to improve had a mortality rate of 74.4%, whereas those who improved their responses had a mortality rate of 5.1% (P < 0.001). This study documents abnormalities of neutrophil chemotaxis, T-lymphocyte rosetting in anergic patients and the effect of autologous serum. These abnormalities may account for the increased infection and mortality rates in anergic patients. Skin testing with five standard antigens has identified 110 anergic (A) or relatively anergic (RA) patients in whom neutrophil chemotaxis (CTX) and bactericidal function (NBF), T-lymphocyte rosettes, mixed lymphocyte culture (MLC), cell-mediated lympholysis (CML), and blastogenic factor (BF) were studied. The MLC, CML and BF were normal in the patients studied, and were not clinically helpful. Neutrophil CTX in 19 controls was 117.5 +/- 1.6 u whereas in 40 A patients, neutrophils migrated 81.7 +/- 2.3 u and in 15 RA patients 97.2 +/- 3.8 u (P < 0.01). In 14 patients whose skin tests converted to normal, neutrophil migration improved from 78.2 +/- 5.4 u to 107.2 +/- 4.0 u (P < 0.01). Incubation of A or control neutrophils in A serum reduced migration in A patients from 93 +/- 3.7 u to 86.2 +/- 3.5 u (P < 0.01) and in normals from 121.2 +/- 1.6 u to 103.6 +/- 2.6 u (P < 0.001). The per cent rosette forming cells in 66 A patients was 42.5 +/- 3.1 compared to 53.6 +/- 2.8 in normal responders (P < 0.02). Incubation of normal lymphocytes in anergic serum further reduced rosetting by 30%. Restoration of delayed hypersensitivity responses and concurrent improvement in cellular and serum components of host defense were correlated with maintenance of adequate nutrition and aggressive surgical drainage.
Ann Surg 1977 Sep
PMID:Delayed hypersensitivity: indicator of acquired failure of host defenses in sepsis and trauma. 14 52

Dacron valved conduits or aortic allografts were placed between the right heart and the pulmonary artery for repair of various complex congenital cardiac anomalies in 56 patients (aged 15 days to 33 years; median, 11 years). Forty-four patients had a total of 56 previous palliative procedures, which contributed to postoperative morbidity and mortality. Six patients had a total of seven episodes of early or late sepsis involving the conduit. One patient, treated for early sepsis, again developed infection in the Hancock graft 1 year postoperatively and died. Three other patients, 2 with calcified allografts, developed infections 4 months to 7 years following repair and required graft replacement. Hemodynamic data 1 month to 5 years (mean, 1.6 years) following repair revealed mild to moderate obstruction (less than 45 mm Hg gradient) at the Hancock conduit valve ring in 13 of 19 patients, while 5 had large pressure gradients (greater than 75 mm Hg). All aortic allografts had severe obstruction and calcification necessitating graft replacement. It is anticipated that improved technique and appropriate timing of palliative and corrective operations will substantially reduce or eliminate these problems.
Ann Thorac Surg 1977 Sep
PMID:Experience with valved conduits for repair of congenital cardiac lesions. 14 50

Review of the coagulation laboratory records and medical records at Memorial Sloan-Kettering Cancer Center over a three year period (1971--1974) revealed 89 patients with disseminated intravascular coagulation (DIC). The diagnosis of DIC was made if laboratory studies showed evidence of quantitative and qualitative changes in fibrinogen and significant thrombocytopenia. The patients included 19 with leukemia (17 acute), 3 with multiple myeloma, 15 with lymphoma, 46 with metastatic solid tumors, (10 lung, 9 breast, 8 gastrointestinal, 12 genitourinary, 7 miscellaneous) 4 with vascular tumors, and 3 without tumor. Other conditions which might have precipitated or initiated DIC such as gram-negative sepsis, liver impairment, or mucin secreting tumors were present in the majority of patients. Bleeding occurred in 75% of the patients and was fatal in 36%. Thromboembolism occurred in 22.5%. Thirteen percent were asymptomatic. Serum lactic dehydrogenase was elevated in over 75% of the patients at the time of, or subsequent to the occurrence of DIC. Treatment with heparin was helpful in only three of twenty patients. Eighty percent of the patients died within one to over 30 days of the onset of DIC. Post mortem evidence of DIC was present in 18 of 43 autopsies. Results of this study indicate that DIC is a frequent complication of a wide variety of tumors and that its occurrence causes morbidity and mortality in a significant number of patients. Treatment with heparin is of little help unless remission is induced and the precipitating factor(s) are reversed.
Thromb Diath Haemorrh 1975 Sep 30
PMID:Disseminated intravascular coagulation: experience in a major cancer center. 17 94

Lumbar discovertebral abnormalities thought to be due to endogenous or subclinical trauma were evaluated in 22 cases. These consisted of predominantly lytic areas due to intrabody disc herniation in five cases, broad zones of vertebral body sclerosis due to reactive osteitis in 11, and destruction of the vertebral endplates surrounded by diffuse sclerosis in six. Spinal biopsy and negative bacterial cultures were consistent with the diagnosis in eight cases. Follow-up roentgenograms and further clinical evaluation in the remaining 14 showed either no progression or changes consistent with trauma. Only four cases had a history of exogenous trauma. Intrabody disc herniations usually affected the upper vertebral body with characteristic sparing of the adjacent endplate. The sclerotic lesions tended to occur in the anterior portion of the vertebral body, with the inferior aspect of L4 most frequently involved. These may be confused with osteoblastic metastases, particularly if adjacent disc narrowing is minimal. The lack of progressive vertebral fragmentation helps to distinguish this condition from neuroarthropathy. Lesions characterized by destruction of the vertebral endplates and reactive sclerosis simulate infection; absence of a soft tissue mass and clinical signs of sepsis as well as lack of progression are important differential features.
AJR Am J Roentgenol 1976 Sep
PMID:Traumatic lesions of the discovertebral junction in the lumbar spine. 18 33


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