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Search Results: 1 - 10 of 14103 matches for " Sepsis syndrome "
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Correlation analysis of compromised immune function with perioperative sepsis in HIV-positive patient  [PDF]
Baochi Liu, Meng Wang, Jinsong Su, Yanzheng Song, Li Liu, Lei Li
Health (Health) , 2012, DOI: 10.4236/health.2012.44028
Abstract: Objective: To investigate the relationship between immune function and perioperative sepsis in HIV-positive patients. Methods: Retrospective analysis of 144 HIV-positive patients surgically treated from Oct 2008 to Dec 2010 in Shanghai Public Health Clinical Center. The patients were divided into four groups based on their CD4+ T cells counts in preoperative period: group A (0 – 99 cell/ul), group B (100 – 199 cell/ul),group C (200 – 349 cell/ul),group D (≥350 cell/ul). All patients had received standardized surgical procedures, careful surgical routines were applied. To reduce operational damage, conventional antibi-otics, anti-TB, anti-fugal, antiretroviral therapies were used to prevent infection and promptly treatment of complications. Results among 144 HIV-positive patients (male 133 and female 11, aged 42.6 ± 12.5), 80 patients got perioperative sepsis (14 cases in preoperative period and 66 cases in postoperative period). 64 cases did not get sepsis. The average CD4+ T cell count was 276.97 ± 137.91 in preoperative period of patients without sepsis, which was significant higher than the patients with preoperative sepsis (151.29 ± 110.64) and patients with postope- rative sepsis(161.14 ± 128.45) (F = 13.91, P < 0.05). There were statistic differences of perioperative sepsis among A group (82.6%), B group (69.8%), C group (40.5%) and D group (26.9%) (χ2 = 23.680, P < 0.01). Three cases died of MODS in group A , each one died of MODS in group B and group C. There was no death in group D. There was negative correlation between the incidence of sepsis and levels of CD4+T cells (r = –0.987, P = 0.013). Conclusions With the decrease of preoperative CD4+T cells, the risk of perioperative sepsis had notable increase. Complete evaluation of surgical risk and suitable perioperative treatments may obtain better effect for the patients infected HIV.
Procalcitonin interest to assess a septic state inducing the death  [PDF]
Nouredine Sadeg, Frédéric Tarlier, Laurence Veneau, Hafid Belhadj-Tahar
Forensic Medicine and Anatomy Research (FMAR) , 2013, DOI: 10.4236/fmar.2013.14014
Abstract: In this prospective study, we evaluated the use of PCT when collecting the body which was carried out. The chosen cut-off was set at 10 ng/mL because at this level, the PCT was associated to a multiorgan failure attributable to a septic shock.For 90 cases, two groups were stratified by their final diagnosis: 33 of for non violent deaths and 57 of violent deaths. There was no significant elevation of procalcitonin rate (PCT) in the group of violent deaths. We noted 6 elevations of PCT rate above 10 ng/mL for non violent deaths (15.4%) and in 3 cases there wasan evidence for an infectious context (recent anti- infectious treatments, chemotherapy in progress).Control of CRP performed on blood samples found initial elevations above 10 mg/L in 3 of the 6 cases (including 2 of 3 cases associated with an infectious context). There is no evidence of PCT rate increase for intermediate PMI (post mortem interval), long PMI and undefined PMI. This study found a PPV (positive predictive value) and clinical specificity of 100% for a cut-off set at 10 ng/mL. By taking this threshold, no significant PCT increase was observed in presence of death cases related to a violent origin as well as a fatal multiorgan failure due to malignant hyperthermia syndrome induced by neuroleptic use. The PCT appears to remain stable over time and whatever the conservation conditions of the body.
Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study  [PDF]
Shonali C. Pawar, Henry Rosenberg, Robert Adamson, Jennifer A. LaRosa, Ronald Chamberlain
Open Journal of Anesthesiology (OJAnes) , 2015, DOI: 10.4236/ojanes.2015.54013
Abstract: Purpose: To examine the use of intravenous dantrolene in hospitalized patients. Materials and Methods: Medical Records of patients treated with intravenous dantrolene between 2007 and 2012 at 6 teaching hospitals were reviewed. Temperature, muscle rigidity, creatine kinase levels, and mortality were assessed in association with dantrolene use. Results: Twenty-five patients received intravenous dantrolene, 9 patients with neuroleptic malignant syndrome (NMS), 8 with hyperthermia due to sepsis, 4 with NMS and sepsis, 2 for malignant hyperthermia (MH), and 2 with hypermetabolic syndrome associated with juvenile diabetic ketoacidosis. Dantrolene was administered as a bolus of 1 - 3 mg/kg. Core temperature decreased after dantrolene administration in all groups but significant only for MH, NMS cases (Pre 102.3 ± 0.9°F vs. Post 99.5 ± 0.9°F; p < 0.001), in Sepsis cases (Pre 104.3 ± 1.5°F vs. Post 100.6 ± 1.0°F; p < 0.001). Mean rigidity scores decreased in all groups but significant only for NMS cases, and mean CK did not change significantly in any group. Conclusion: Dantrolene was associated with reductions in temperature and rigidity in hyperthermia of diverse origins in patients admitted to Intensive care settings.
Severe sepsis epidemiology: sampling, selection, and society
Walter T Linde-Zwirble, Derek C Angus
Critical Care , 2004, DOI: 10.1186/cc2917
Abstract: In 1991 a consensus of international experts was reached that defined the syndrome of severe sepsis as the presence of infection, a systemic inflammatory response, and acute organ dysfunction [1]. Severe sepsis quickly became one of the defining 'diseases' of intensive care. An explosion in our understanding of the underlying pathophysiology led to a profusion of large multicenter trials of prospective agents in patients who met severe sepsis criteria. Entire tracks at national and international intensive care meetings were dedicated to sepsis, and, most recently, several intensive care professional societies launched a public and clinician educational effort, entitled the 'Surviving Sepsis' campaign http://www.survivingsepsis.org webcite[2-4].Despite this huge investment of time, funding, and expertise in severe sepsis, we were slower to understand some basic epidemiologic and health services research questions, such as population incidence, risk factors for the development and progression of disease, long-term outcomes, costs of care, and variation in practice patterns. This is now changing.Three new articles published in Critical Care [5-7] add to an expanding body of information on the epidemiology of severe sepsis. These studies, together with several others reported in the past few years, highlight several issues that are worthy of further comment.The three papers show the range of approaches to estimating severe sepsis incidence and the difficulties that arise in trying to compare results. The study conducted by van Gestel and coworkers [7] is a carefully crafted analysis of the prevalence of severe sepsis on 1 day (11 December 2001) in Dutch intensive care units (ICUs). Those investigators reported an incidence rate of 0.54 cases/1000 population, and found that 11% of ICU admissions have severe sepsis. The study nicely highlights the care required when generating annual estimates from a short observation period. Silva and colleagues [5] reported the results
Procalcitonin Role in Differential Diagnosis of Infection Stages and Non Infection Inflammation
Gholamali Ghorbani
Pakistan Journal of Biological Sciences , 2009,
Abstract: The aim of this study is evaluation of procalcitonin role in the diagnosis of infectious and non infectious inflammation. This cross-sectional study was conducted in one hundred patients in Baqiyatallah Hospital of Iran in 2008. Patients suspected to infection were recruited to study. They were divided to four groups as: systemic inflammatory response syndrome, sepsis, sepsis syndrome and septic shock. Procalcitonin quantitative was assayed by immunoluminometric kit manufactured in Germany. Procalcitonin level was divided to four groups in <0.5 ng mL-1 compatible for SIRS, 0.5-2 ng mL-1 for sepsis and 2-10 ng mL-1 for sepsis syndrome and >10 ng mL-1 for septic shock. Data was analyzed by SPSS 13 for window software; T student test, ANOVA and Chi-square were used. In this study 53(53%) of subjects were men with mean age of 56.16 ± 19.5 years old. The diagnosis was SIRS in 36%, sepsis in 38%, sepsis syndrome in 14% and septic shock in 12% of cases. Procalcitonin level was less than 0.5 ng mL-1 in 61% and more than 10 ng mL-1 in 10% of patients. Procalcitonin level showed significant association with septic shock, positive blood culture and mental dysfunction. Ultimately this study showed that high level of procalcitonin can differentiate septic shock from SIRS and other stages of infection. Dysfunction of mental status and high level of procalcitonin can determine septic shock.
La enfermedad por quemaduras como modelo de respuesta inflamatoria sistémica
Broche Valle,Félix; Céspedes Miranda,Ela M; Salda?a Bernabeu,Alberto; Cruz Pérez,Arturo L;
Revista Cubana de Investigaciones Biom??dicas , 1999,
Abstract: a body burn is a violent agression that modifies all the mechanisms of organic homeostasis and is also a problem facing the medical services in the contemporary society because of its clinical and social connotation. from the physiopathological viewpoint, a burned patient develops a systemic inflammatory response characterizaed by hyperactivation of all its defense mechanisms. the de-regulation of such mechanisms leads to damage of tissues which is expressed as morpho-functional modifications of all systems. regardless of the ethiology, initial evolution, therapeutic management and individual response, sepsis generally complicates the evolution of burn injuries. this paper sets forth the clinical and histopathological elements of burn-related diseases and comments on the molecular mechanisms of systemic inflammatory response, underlining the role of the intercellular signalling mediators.
Infección de prótesis de aorta ascendente: tratamiento con aseo quirúrgico, preservación de prótesis y transposición de colgajo muscular en dos casos
Zalaquett S,Ricardo; Vidal GH,Pedro; Irarrázaval Ll,Manuel J; Arroyo L,Carlos; Pérez C,Carlos; Labarca L,Jaime;
Revista médica de Chile , 2001, DOI: 10.4067/S0034-98872001000200012
Abstract: mediastinitis with graft infection is a serious complication of ascending aorta replacement. we report two cases of graft infection, treated with surgical cleaning, graft preservation and transposition of muscle flaps. a 62 years old male was admitted 34 days after an ascending aortic grafting due to a sternal dehiscence and mediastinitis. antimicrobial treatment was started and a surgical cleaning performed, leaving an open sternotomy. three days later, the thoracic cavity was closed with a rectus abdominis muscle flap. after 23 months of follow up, the patient is well and without evidence of infection. a 74 years old male was subjected to an aortic valve and ascending aorta replacement and a myocardial revascularization. in the postoperative period, the patient developed septic signs, and a purulent drainage. a cat scan showed a liquid collection surrounding the aortic graft. on tw sixteenth postoperative day, a surgical cleaning was performed and the thorax was closed with the pectoralis major muscle. after 10 months of follow up, the patient is in good condition and without evidence of infection (rev méd chile 2001; 129: 196-200).
Infección de prótesis de aorta ascendente: tratamiento con aseo quirúrgico, preservación de prótesis y transposición de colgajo muscular en dos casos Infection of ascending aortic graft. Treatment with surgical cleaning, graft preservation and transposition of muscle flaps.: Report of two cases
Ricardo Zalaquett S,Pedro Vidal GH,Manuel J Irarrázaval Ll,Carlos Arroyo L
Revista médica de Chile , 2001,
Abstract: Mediastinitis with graft infection is a serious complication of ascending aorta replacement. We report two cases of graft infection, treated with surgical cleaning, graft preservation and transposition of muscle flaps. A 62 years old male was admitted 34 days after an ascending aortic grafting due to a sternal dehiscence and mediastinitis. Antimicrobial treatment was started and a surgical cleaning performed, leaving an open sternotomy. Three days later, the thoracic cavity was closed with a rectus abdominis muscle flap. After 23 months of follow up, the patient is well and without evidence of infection. A 74 years old male was subjected to an aortic valve and ascending aorta replacement and a myocardial revascularization. In the postoperative period, the patient developed septic signs, and a purulent drainage. A CAT scan showed a liquid collection surrounding the aortic graft. On tW Sixteenth postoperative day, a surgical cleaning was performed and the thorax was closed with the pectoralis major muscle. After 10 months of follow up, the patient is in Good condition and without evidence of infection (Rev Méd Chile 2001; 129: 196-200).
Síndrome de disfun??o de múltiplos órg?os induzida por sepse: estudo experimental em ratos
Lima, Jo?o Batista de Area;Skare, Thelma Larocca;Malafaia, Osvaldo;Ribas-Filho, Jurandir Marcondes;Michaelis, Tiago;Ribas, Fernanda Marcondes;Macedo, Rodrigo de Almeida Coelho;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2011, DOI: 10.1590/S0102-67202011000200002
Abstract: background: the leading cause of death in patients with sepsis in surgery is syndrome of multiple organ dysfunction. thus, experimental models that simulate organic changes of sepsis in humans are required. aim: to present two models that induce the syndrome of multiple organ dysfunction and to compare, the changes induced, by intravenous injection of lipopolysaccharide or cell 36ue of viable escherichia coli in relation to mortality and survival, level of lipopolysaccharide, release of tumor necrosis factor alpha ; hematological, liver and kidney function. method: the study lasted seven days and it was used on it 50 male wistar rats divided into three groups: control, lipopolysaccharide and escherichia coli. the experimental groups were inoculated and divided into two subgroups, with inocuation with 24 or 48 hours. on the seventh day were proceeded blood collection and histopathologic analysis of liver, kidneys and lungs. results: there was a survival of ten animals in the control group; zero in bacteria group of 24 hours and six in 48 hours; ten of lipopolysaccharide in 24 hours and six in 48 hours. in the experimental groups, levels of endotoxin, tumor necrosis factor alpha, leukocytes, platelets, renal and liver levels were higher than the control group. there were histopathological changes in the bacterial group. conclusion: the two models of sepsis induced multiple organ dysfunction syndrome; yet the administration 36ue endotoxin every 48 hours could be utilized in advantage over the other for not induce death in significant numbers during the period of seven days.
Sepse na unidade de terapia intensiva: etiologias, fatores prognósticos e mortalidade
Zanon, Fernando;Caovilla, Jairo José;Michel, Regina Schwerz;Cabeda, Estevan Vieira;Ceretta, Diego Francisco;Luckemeyer, Graziela Denardin;Beltrame, Cássia;Posenatto, Naiana;
Revista Brasileira de Terapia Intensiva , 2008, DOI: 10.1590/S0103-507X2008000200003
Abstract: background and objectives: sepsis is the main cause of death in patients treated in intensive care units (icu). the aim of this study was to evaluate etiology, prognostic factors and mortality of septic patients treated in icu of passo fundo, brazil. methods: out of 971 consecutive patients prospectively evaluated from august 2005 to february 2006, 560 were selected due to presence of systemic inflammatory response syndrome (sirs) and followed for 28 days or until discharge or death. patients were categorized according with the etiology of sirs and further classified as having sirs, sepsis, severe sepsis and septic shock. prognosis was assessed by means of apache ii and sofa. mortality was compared in different etiologies of sepsis, apache ii and sofa scores, parameters. results: of the 971 patients admitted to the icu, 560 developed sirs (58%). the most frequent cause of internation was neurological disease (28.9%), the most frequent site of infection was the respiratory tract (71.6%), and the most prevalent pathogens were gram-negative bacilli (53.2%). mean apache ii score was 18 ± 9, and mean sofa score was 5 ± 4. median icu stay was 6 (3-11) days and overall mortality rate was 31.1%: 6.1% for non-infectious sirs, 10.1% for sepsis, 22.6% for severe sepsis, and 64.8% for septic shock. conclusions: sepsis is an important health problem that leads to an extremely high mortality rate in the icu of passo fundo, brazil.
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