Articles: sepsis.
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Editorial Review
Tumor necrosis factor in sepsis: mediator of multiple organ failure or essential part of host defense?
Tumor necrosis factor-alpha (TNF) exerts numerous influences which, in association with severe infection, subserve both detrimental as well as beneficial host responses. The current review addresses recent insights into the structure and function of this pleiotropic cytokine, with a particular emphasis upon cellular and organ system consequences of sepsis-induced TNF activity. A comparison of responses elicited by endotoxin or TNF administration are discussed as are mechanisms of endogenous TNF regulation, such as soluble receptors, anti-inflammatory cytokines, and counter-regulatory responses. A review of past and future clinical strategies for altering TNF activity during sepsis is also provided.
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In hospital settings in Africa the many other concerns of sanitary officials and the lack of available resources often make hospital hygiene and nosocomial infection secondary problems. To illustrate the importance of these issues in an African pediatric setting, this report describes a series of 32 cases of nosocomial septicemia that occurred within a 2-month period in the Pediatric Department of Principal Hospital in Dakar. There were 10 deaths. ⋯ Klebsiella Pneumoniae was identified in 16 cases, Escherichia coli in 5, and an association of both bacteria in 5. A profile of beta-lactamase enzymes with a classic epidemiologic spectrum was observed in 15 of 21 strains of Klebsiella pneumoniae and in 3 of 10 strains of Escherichia coli. The authors discuss the conditions that may have encouraged the outbreak of septicemia, regret the lack of a service to monitor hospital hygiene, and propose prophylactic measures using laboratory tests that are feasible in a hospital setting in Africa.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Clostridium perfringens septicemia associated with foodborne toxic infection and abortion].
A 32-year-old pregnant woman with poor life and hygiene conditions presented with premature labour, fever and diarrhoea. After admission she gave birth to a stillborn child. ⋯ The outcome was favourable after an adapted antibiomicrobial therapy. This case illustrates the potential severity of Clostridium perfringens foodborne toxi-infection which can lead to abortion and septicaemia with massive haemolysis.
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Rev Gastroenterol Peru · Jan 1995
Review Comparative Study[Intra-abdominal sepsis: surgical management].
Intraabdominal sepsis is a frequent clinical disorder in inpatients with severe consequences as septic shock and multisystem organic failure. It starts with the presence of germs or toxins from the abdominal cavity either intra or retroperitoneal. Pathophysiology is not yet totally understood. ⋯ Treatment is based in the administration of antibiotics, nutritional support, ventilatory and hemodynamic aids. The keystone of the management is surgery. This review details the main technics and strategies of the surgeon in the operative room.