Sepsis

Publication Title: 
American Journal of Physiology. Endocrinology and Metabolism

Arginine is derived from dietary protein intake, body protein breakdown, or endogenous de novo arginine production. The latter may be linked to the availability of citrulline, which is the immediate precursor of arginine and limiting factor for de novo arginine production. Arginine metabolism is highly compartmentalized due to the expression of the enzymes involved in arginine metabolism in various organs. A small fraction of arginine enters the NO synthase (NOS) pathway. Tetrahydrobiopterin (BH4) is an essential and rate-limiting cofactor for the production of NO.

Author(s): 
Luiking, Yvette C.
Ten Have, Gabriella A. M.
Wolfe, Robert R.
Deutz, Nicolaas E. P.
Publication Title: 
Current Opinion in Clinical Nutrition and Metabolic Care

PURPOSE OF REVIEW: The purpose of this review is to highlight recent publications examining nitric oxide production in health and disease and its association with clinical nutrition and alterations in metabolism. RECENT FINDINGS: The role of the cofactor tetrahydrobiopterin in nitric oxide production and its relation with arginine availability is indicated as an important explanation for the arginine paradox. This offers potential for nitric oxide regulation by dietary factors such as arginine or its precursors and vitamin C.

Author(s): 
Luiking, Yvette C.
Engelen, MariÎlle P. K. J.
Deutz, Nicolaas E. P.
Publication Title: 
Journal of Clinical Pathology
Author(s): 
Preston, F. E.
Malia, R. G.
Sworn, M. J.
Blackburn, E. K.
Publication Title: 
Journal of Clinical Pathology

Eight patients with E. coli septicaemia had oliguric renal failure which was associated with haematological evidence of intravascular coagulation. Five of these patients also had the characteristic blood picture of microangiopathic haemolytic anaemia. In an attempt to prevent further deposition of fibrin, intravenous heparin was administered to six patients, three of whom recovered fully and three died. The diagnosis of intravascular coagulation was subsequently confirmed by histological examination of necropsy material and it is suggested that some of the complications of E.

Author(s): 
Preston, F. E.
Malia, R. G.
Sworn, M. J.
Blackburn, E. K.
Publication Title: 
Joint Commission Journal on Quality and Patient Safety

BACKGROUND: Eliminating nosocomial infections was identified as one of eight priorities for action for Ascension Health. St. John Hospital and Medical Center (SJHMC), and St. Vincent's Hospital (STV), designated alpha sites, developed best practices for the prevention of catheter-related blood stream infections (CR-BSIs) and ventilator-associated pneumonia (VAP), respectively.

Author(s): 
Berriel-Cass, Dorine
Adkins, Frank W.
Jones, Polly
Fakih, Mohamad G.
Publication Title: 
Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists

BACKGROUND: Sepsis is characterized by an increase in nitric oxide (NO) production, hemodynamic dysfunction and multiple organ failure. Propofol, a commonly used anesthetic in the intensive care unit for sedation and hypnosis, is thought to exert a protective effect on NO overproduction by inhibiting the expression of inducible NO synthase (iNOS) in sepsis.

Author(s): 
Liu, Yen-Chin
Chan, Julie Y. H.
Tsai, Yu-Chuan
Publication Title: 
Antimicrobial Agents and Chemotherapy

In the present study artemisinin (ART) was found to have potent anti-inflammatory effects in animal models of sepsis induced by CpG-containing oligodeoxy-nucleotides (CpG ODN), lipopolysaccharide (LPS), heat-killed Escherichia coli 35218 or live E. coli. Furthermore, we found that ART protected mice from a lethal challenge by CpG ODN, LPS, or heat-killed E. coli in a dose-dependent manner and that the protection was related to a reduction in serum tumor necrosis factor alpha (TNF-alpha).

Author(s): 
Wang, Jun
Zhou, Hong
Zheng, Jiang
Cheng, Juan
Liu, Wei
Ding, Guofu
Wang, Liangxi
Luo, Ping
Lu, Yongling
Cao, Hongwei
Yu, Shuangjiang
Li, Bin
Zhang, Lezhi
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

We enrolled 382 patients at two hospitals in Uganda in a prospective observational study of severe sepsis. Because artemisinins improve survival in murine sepsis models, we performed a post hoc analysis of the association between the use of artemether-lumefantrine (A-L) and mortality in patients with or without malaria. In patients with negative malaria smears (N = 328 of 379), Kaplan-Meier curves revealed decreased combined inpatient and 30-day mortality among patients receiving A-L versus those who did not (20.6%, SE = 10.6 versus 48.8%, SE = 3.2; Log rank chi(2) = 3.93, P = 0.048).

Author(s): 
Moore, Christopher C.
Jacob, Shevin T.
Pinkerton, Relana
Banura, Patrick
Meya, David B.
Reynolds, Steven J.
Kenya-Mugisha, Nathan
Mayanja-Kizza, Harriet
Scheld, W. Michael
Promoting Resource-Limited Interventions for Sepsis Management in Uganda (PRISM-U) Study Group
Publication Title: 
Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie

AIM: Excessive production of inflammatory mediators during invasive infection plays a key role in the pathogenesis of sepsis. In an attempt to improve survival of patients with this lethal syndrome, agents were developed to selectively inhibit mediators in this inflammatory response. Ulinastatin (UTI), a human protease inhibitor, inhibits the enhanced production of pro-inflammatory molecules. However, it is unknown if Ulinastatin treatment could result in protective effects for sepsis. The aim of this study was to investigate the role of Ulinastatin on septic rats.

Author(s): 
Cao, Yi-zhan
Tu, Yan-yang
Chen, Xiang
Wang, Bo-liang
Zhong, Yue-xia
Liu, Ming-Hua
Publication Title: 
Journal of Immunology (Baltimore, Md.: 1950)

We examined the effect of modulating phosphoinositide 3-kinase (PI3K) activity in a murine model of cecal ligation and puncture-induced polymicrobial sepsis. Inhibition of PI3K activity with wortmannin increased serum cytokine levels and decreased survival time in septic mice. We have reported that an immunomodulator, glucan phosphate, induces protection in murine polymicrobial sepsis. We observed that glucan stimulated tissue PI3K activity, which positively correlated with increased survival in septic mice.

Author(s): 
Williams, David L.
Li, Chuanfu
Ha, Tuanzhu
Ozment-Skelton, Tammy
Kalbfleisch, John H.
Preiszner, Johanna
Brooks, Lynne
Breuel, Kevin
Schweitzer, John B.

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