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

The number of implanted the cardiovascular implantable electronic device(s) (CIED(s))--pacemakers (PM) and implantable cardioverters defibrillators (ICD)--increases each year. The number of CIED(s) exchange procedures as well as changes in models of stimulation (upgrade to dual chamber pacemakers or three chamber cardiac resynchronization therapy devices) also grows. Also increases the inactive electrode left in the cardiovascular system. The risk of infection is higher during the exchange of devices than with their implantation. Treatments for patients with multiple electrode systems are becoming a potential source of infection. The incidence of damage defibrillator is greater than pacemaker leads. Intracardiac electrodes causes the growth of connective tissue, fibrosis in the venous system and may cause obstruction subclavian vein or brachiocephalic preventing implantation needed a new electrode. Damaged and broken electrodes may migrate to the cavities of the heart. This increases the risk of thrombosis, pulmonary embolism, tricuspid valve dysfunction and serious arrhythmias. All these facts presented lead to the conclusion that the growing need to remove the electrodes (both infected and inactive) pacemaker or cardioverter defibrillator. There are two classes of indications to remove the electrodes. Procedures for removing the benefits must outweigh the risks. Should be considered for each patient individually and take into account the experience of the operator and its results. Class I indications are: lead dependent endocarditis, sepsis, arrhythmias or embolism secondary to the presence of lead, venous occlusion prevents the implantation of new electrodes, interference between the electrodes, an implantable device infection box. Class II includes: chronic pain in the area and inactive pacemaker electrodes in young people. After removal must be individually examined whether there is a need to implant the new layout. It should not be implanted in a place that has previously been infected. The preferred area is the opposite, iliac vein, reaching epicardial implantation.
Pol Merkur Lekarski 2010 Mar
PMID:[Indications for the procedure for transvenous removing of electrodes based on the guidelines of U.S. societies]. 2081 63

A 28 year old woman with a specific phobia of being in hospital, three hours after having given birth to her baby, demanded to be discharged from the hospital, in spite of having been informed by the obstetrician that her life was threatened because of an intrauterine infection that might cause sepsis. The patient decided to stay in hospital after several long-lasting psychiatric consultations including psychotherapeutic interventions. The patient did not recognise that her fear was excessive and unreasonable, i.e., did not meet one of the criteria of specific phobia. She gradually regained criticism toward her symptoms within approximately one day. This indicates that patients with specific phobia confronted with a phobic situation may temporarily loose awareness that their fears are unreasonable and/or too intensive and may express beliefs similar to psychotic delusions. This situation faced the team of doctors with potential legal problems that might appear if the patient had definitely refused to stay in the hospital. Polish law does not allow to treat such patients against their will on non-psychiatric hospital wards. However, in the case ofa definite phobia diagnosis there is no legal way to hospitalise a patient against his or her will on a psychiatric ward.
Psychiatr Pol
PMID:[Specific phobia in early period of puerperium. Case report and its legal aspects]. 2091 9

Inadvertent lead implantation into the left ventricle (LV) is a rare but serious complication of permanent pacing and should be diagnosed as soon as possible. We report a case of a patient with a pacemaker pocket infection with sepsis and two ventricular leads - one old electrode abandoned in the right ventricle and another one unintentionally implanted via patent foramen ovale into the LV. Both leads were extracted percutaneously, although the procedure was complicated by a minor ischaemic stroke.
Kardiol Pol 2011
PMID:Transvenous extraction of a five year-old ventricular lead inadvertently implanted in the left ventricle. 2167 12

The use of immunoglobulins in the treatment of infectious diseases has a long tradition. Initially immunoglobulins from hyperimmunised animals were used for their antitoxic and antimicrobial activity. The development of preparations of human intravenous immunoglobulin (IVIG) and the observations of their long-term use enabled to assess their usefulness in the treatment of the diseases of proven or probable infectious etiology. In the treatment of infectious diseases IVIG are currently used as immunomodulating drugs or immunosuppressive therapy, more frequently than the specific antibodies against the viruses, bacteria or their toxins. In practice of the infectious ward IVIG are used as a drug of choice in the treatment of Kawasaki disease, in toxic epidermolysis and Stevens-Johnson syndrome. As adjunctive therapy IVIG are used in the infection with parvovirus B19, in hemophagocytic syndrome, for treatment of infections presenting with a severe toxemia caused by Clostridium difficile, Streptococcus pyogenes and Staphylococcus aureus. The rationale for the use of IVIG may be also serious infections caused by enteroviruses, particularly neuroinfections. The use of IVIG in the treatment of sepsis is controversial, since their effectiveness is not proven.
Pol Merkur Lekarski 2011 Jun
PMID:[The use of immunoglobulins in the treatment of infectious diseases]. 2175 56

Exudative pericarditis is found in 30-50% of the patients with rheumatoid arthritis (RA), particularly in later stages of the disease. Most cases present with no or few symptoms. We report a case of a 68 year-old male with a history of mild RA who developed exudative pericarditis leading to recurrent cardiac tamponade requiring repeated pericardiocenteses. Treatment with glucocorticosteroids, methotrexate and colchicine proved ineffective in preventing the recurrences. Immunosuppression contributed to the development of sepsis caused by Enterobacter cloacae and resulting in the patient's death.
Kardiol Pol 2011
PMID:[Recurrent cardiac tamponade and sepsis in a patient with rheumatoid arthritis]. 2192 8

In multiple gestation, premature rupture of fetal membranes (PROM) is an important risk factor for premature delivery and intrauterine infection. The incidence of PROM in twin gestations is threefold of that in singleton pregnancies. The incidence in triplets occurs even more frequently underlining the role of PROM as a leading cause of infant mortality and morbidity. Besides prematurity the complications of PROM include umbilical cord compression due to oligohydramnios, cord prolapse, placental abruption, and chorioamnionitis. Together with PROM, chorioamnionitis is held responsible for significant maternal and neonatal morbidity including endometritis and sepsis in the mother and early-onset sepsis, respiratory distress syndrome, inborn pneumonia, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular white matter injury in the neonate. Furthermore, in twin gestations, PROM remains an independent risk factor for long-term neonatal care. An uncommon situation develops when in multiple gestation PROM affects only one of the fetuses. In such cases, the co-existence in the uterine cavity of the properly developing fetus(es) can be a challenge for the process of medical decision-making. In the present work, limited world literature on the topic was critically reviewed in search of the best possible recommendations for clinical management.
Ginekol Pol 2011 Oct
PMID:[Premature rupture of membranes one fetus from a multiple pregnancy]. 2237 42

Cytokines trigger coagulant and fibrinolytic systems in sepsis to result in Disseminated Intravascular Coagulation (DIC) that is an important complication and leads to disseminated hemorrhages and multi-organ failure. High Mobility Group B1 DNA Binding (HMGB1) protein is a cytokine taking part in systemic inflammatory response. The objective of this study was to investigate HMGB1 levels in groups of septic patients with and without DIC.Twenty-one septic patients without DIC and 12 septic patients with DIC from the Intensive Care Unit (ICU) were included in the study. In addition, 20 patients admitted to the ICU without sepsis or DIC and 20 healthy volunteers served as controls. Levels of HMGB1, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, protein C, protein S, anti-thrombin III (ATIII), platelet (thrombocyte) and leukocyte count were determined. Levels of fibrinogen, protein C, ATIII and platelet count were significantly lower and D-dimer was significantly higher in the group with sepsis plus DIC compared to the group with sepsis without DIC. Levels of HMGB1 were higher in the group with sepsis and DIC compared to the group with sepsis; however, the difference was not statistically significant and the levels of HGMB1 of both groups were significantly higher compared to ICU and healthy control groups. HMGB1 levels were not significantly different in survivor and non survivor patients. HMGB1 levels did not differ in lower respiratory tract infection (LRTI) and urinary tract infection (UTI) in regard to the etiology of sepsis.
Acta Biochim Pol 2012
PMID:High mobility group B1 levels in sepsis and Disseminated Intravascular Coagulation. 2309 60

Critically ill patients are frequently affected by acute kidney injury accompanied by dysfunction of other systems and organs. Sepsis is common in this population and remains a major cause of multiorgan dysfunction syndrome, indicating a crucial role in efficient antibiotic treatment. However, such treatment is particularly difficult due to altered pharmacokinetic profile in these patients, dynamic changes in their clinical status and, in many cases, need for renal replacement therapy (RRT). Current guidelines concerning the dosing of antibiotics in this patient population are not particularly reliable because they are based on studies involving small and heterogeneous groups of patients, often treated with different RRT modalities. Our paper reviews the basic pharmacokinetic and pharmacodynamic parameters as well as other factors that should be considered while devising a proper therapeutic approach for this patient population.
Pol Arch Med Wewn 2012
PMID:Dosing of antibiotics in critically ill patients: are we left to wander in the dark? 2316 29

The biological importance of lipopolysaccharides (LPS), components of bacterial cell wall has not been explained sufficiently. The glycine present in these structures could play an important role in the immunological response after bacterial infections and during sepsis. In our studies we obtained synthetic and stable substituted glycinated 1-thioglycosides derivatives of monosaccharides, e.g., D-glucose or D-galactose as well as disaccharides, e.g., melibiose and lactose. The conditions of acylation reactions were validated and specific products were separated by using chromatography methods. Their structures were confirmed by NMR. These compounds were conjugated with carrier proteins e.g., bovine serum albumin and horse myoglobin. Prior to conjugation proteins were modified with glycidol to create the protein-diol intermediates and subsequent periodate oxidation of the glycol moieties to generate the reactive aldehyde functionalities. Modified and formylated carrier proteins were conjugated with acylated thioglycosides in the presence of sodium cyanoborohydride. Subsequently, the products obtained were analyzed in SDS-PAGE and separated by using HW-55S gel-filtration chromatography. The immunoreactivity of selected glycinated glycoconjugates were studied in ELISA assays with specific anti-aminoacylated glyconjugate antibodies obtained after rabbit immunization with Escherichia coli K12 C600 core oligosaccharide glycine-containing glycoconjugate. The differences in the immunoreactivity of different glycinated 1-thioglycosides were observed. The received glycine-acylated glycoconjugates could mimic the non-sugar substituents localized in various bacterial LPS. These synthetic compounds could be candidates for their use as glycoconjugate vaccines in protection against serious bacterial infections, e.g.. sepsis.
Acta Pol Pharm
PMID:Synthesis of glycinated glycoconjugates based on 1-thioglycosides and their preliminary studies as potential immunomodulatory factor. 2328 85

Bullous dermatitis in infants is a clinical term used for a number of disorders associated with primary neonatal pemphigus. The disease requires differentiation of autoimmune disorders such as pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid. These diseases are the result of pemphigus IgG antibodies that pass from the mother to the fetus through the placenta. The level of antibody titers in the pregnant woman and her clinical condition are not the markers of the severity of the disease in children, but, in case of a high level, a miscarriage premature birth, or even stillbirth, may occur. Staphylococcal syndrome exfoliative dermatitis (staphylococcal scalded skin syndrome - SSSS), the etiological agents of which are type A or B exfoliative toxins of Staphylococcus aureus, is most frequently observed. These toxins can activate as superantigens and cause T-cell activation. They induce proteolysis and separation of the granular layer of epidermis through direct binding of these antigens. Symptoms of the disorder regardless of the etiologic factors, are common: redness of the skin and formation of bubbles of various sizes filed with serous or serous-bloody content. Bursting bubbles patches peel off, leaving bare, sometimes oozing surface. Extensive damage to the skin is a gateway to infection and disturbs the function of regulating warmth and water-electrolyte balance. Early detection of the cause and appropriate general and local treatment effectively prevent the development of sepsis. The authors present a case of a full-term neonate (male, birthweight 3230 g, good overall condition, 5-min Apgar score: 10) born with dermatitis bullosa of unknown etiology Physical examination immediately after birth revealed multiple blisters filled with serous and serous-bloody content on the skin all over the neonatal body mostly in the area of both armpits, elbows, wrists, knees, ankles and fingers of both hands and feet. The course of pregnancy was uncomplicated. However detailed family history revealed pemphigus skin in the mother (from infancy up to the age of puberty) but the mother was not able to offer details on the diagnosis and treatment of this disease. Symptoms in the mother disappeared after her first menstrual period. Both, typical clinical symptoms presenting in the newborn and maternal pemphigus in the past initially suggested an autoimmune disorder However the examination of the levels of IgG antibody and anti-IgA in neonatal serum, as well as tissue examination by the immunofluorescence (IF) method to detect the presence of these antibodies, were negative and consequently the autoimmune disease was excluded. Negative results of bacteriological tests did not confirm the staphylococcal syndrome. It seems that the cause of cutaneous pemphigus observed in the newborn could be an intrauterine infection or hidden, undiagnosed collagen disease in the mother.
Ginekol Pol 2012 Oct
PMID:[Congenital epidermolysis bullosa--a case report]. 2338 68


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