Articles: sepsis.
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Eur. J. Clin. Invest. · Mar 1996
Elevated serum neopterin level: its relation to endotoxaemia and sepsis in patients with major burns.
The present study was conducted to determine the relationship between levels of neopterin and endotoxin in the circulation, and whether the neopterin level was related to the development of severe sepsis after extensive burns. This prospective study included 35 patients with burn size greater than 30% (30-98%), and 22 healthy volunteers who served as a comparison group. Neopterin levels increased in most patients on day 3 post-burn, but they were not significantly correlated with the extent of the burn surface (P > 0 center dot 05). ⋯ These results suggest that thermal injury can lead to an elevation of serum neopterin independent of the burn surface area. The initial increase in the neopterin level may be a part of the acute-phase response to tissue injury itself, whereas the endotoxin release in the circulation may be responsible for the continuous induction of neopterin during the late stage. In addition, the presence of a constant high neopterin level is associated with a critical event in the development of severe burn sepsis.
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To describe the definitions for sepsis proposed by ACCP/SCCM Consensus Conference and to evaluate its capacity to classify children with severe meningococcal infection in homogeneous risk groups. ⋯ Definitions proposed for severe sepsis and septic shock are a valuable tool to classify children with acute meningococcal infection in homogeneous risk groups.
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Rev Hosp Clin Fac Med Sao Paulo · Mar 1996
[Mechanisms and evaluation of multiple organ and system failure after trauma].
Multiple organ failure (MOF) is a major cause of death of ICU trauma patients. Despite intensive clinical and experimental investigation, the exact physiopathology of this syndrome is unclear. ⋯ In this article the authors discuss recent results of this investigation. They present recently published criteria for MOF quantification, and focus on the mechanisms and mediators of MOF syndrome, emphasizing the role of sepsis, the intestinal ischemia/reperfusion MOF model, the role of polymorphonuclear neutrophil, and the relationship between adult respiratory distress syndrome (ARDS) and the development of MOF syndrome.
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The management of pediatric oncology patients with fever and neutropenia assumes that all patients are at risk for bacteremia, and therefore generally involves hospitalization and broad-spectrum parenteral antibiotics for all patients. The determination of which patients are at low risk for having positive blood cultures and for developing complications related to bacteremia is of potential benefit. ⋯ Children hospitalized for fever and neutropenia who have persistent fever and an ANC of less than 100 after 48 hours are at high risk for morbidity and are more likely to require antibiotic changes and antifungal therapy. Children who initially lack signs of sepsis, are afebrile, and have an ANC of 100 or higher after 48 hours are at low risk for complications and could be selectively discharged on antimicrobials after a 48-hour period of inpatient hospitalization.