• Title/Summary/Keyword: Sepsis-mortality

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Potential application of ginseng in sepsis: Applications of ginseng in sepsis

  • Fuxun Yang;Jiajia Li;Yunping Lan;Yu Lei;Fan Zeng;Xiaobo Huang;Xiaoxiu Luo;Rongan Liu
    • Journal of Ginseng Research
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    • v.47 no.3
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    • pp.353-358
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    • 2023
  • Sepsis and septic shock affect millions of people worldwide each year with high clinical mortality rates. At present, basic research on sepsis has emerged in an endless stream, but there are few effective clinical translation results. Ginseng, a medicinal and edible representative of Araliaceae plants, contains a variety of biologically active compounds including ginsenosides, alkaloids, glycosides, polysaccharides, and polypeptides. Neuromodulation, anticancer activity, blood lipid regulation, and antithrombotic activity have been linked to ginseng treatment. At present, basic and clinical research have suggested various applications of ginseng in sepsis. In view of the different effects of various ginseng components on the pathogenesis of sepsis, and in order to further understand and develop the possible value of ginseng in sepsis, this manuscript reviews the application of various components of ginseng in the treatment of sepsis in recent years.

Sepsis Developed from an Odontogenic Infection: Case Report (치성감염으로 인한 패혈증: 증례보고)

  • Kim, Moon-Seob;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Park, Jin-Ju;Jeong, Mi-Ae;Yang, Seok-Jin;Jung, Jong-Won;Kim, Jeong-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.445-448
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    • 2011
  • Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant microorganisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

Kupffer Cells Are Responsible for Producing Hepatic Microsomal Drug Metabolizing Dysfunction during Trauma and Sepsis

  • Lee, Sang-Ho;Kim, Joo-Young;Kim, Sung-Ho;Eum, Hyun-Ae;Lee, Sun-Mee
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.301.3-302
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    • 2002
  • Sepsis remains the leading cause of morbidity and mortality following trauma. Although hepatocellular dysfunction occurs during trauma and sepsis. the mechanism responsible for this remains unclear. We investigated the role of Kupffer cells in the alterations in microsomal drug metabolizing function during trauma and sepsis. Rats were subjected to trauma by femur fracture (FFx). After 72h, polymicrobial sepsis was induced by cecal ligation and puncture(CLP). (omitted)

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Effect of Ginkgo biloba extract on the survival rate in lipopolysaccharide-induced sepsis model mice (Lipopolysaccharide로 유도한 패혈증 모델에서 Ginkgo biloba extract 투여가 생존율에 미치는 영향)

  • Rhee, Ki-Jong;Kim, Hyeon-Cheol;Jung, Bae-Dong
    • Korean Journal of Veterinary Service
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    • v.35 no.3
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    • pp.191-195
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    • 2012
  • Accumulated evidence indicate that Ginkgo biloba extract (EGb 761) acts as an antioxidant and scavenger of free radicals as well as influencing apoptotis. Earlier studies have employed the inflammatory agent lipopolysaccharide (LPS) to induce severe sepsis. In the present study, we examined whether the intraperitoneal injection of EGb 761 increases the survival rate of mice in the LPS-induced severe sepsis model. The survival rate was significantly increased by 30% in mice administered with 100 mg/kg of EGb 761 but not in mice administered with 50 mg/kg EGb 761. In addition, pre-treatment with EGb 761 increased the survival rate (30%) but post-treatment with EGb 761 did not. These results suggest that EGb 761 may have clinical potential in preventing sepsis induced mortality.

Pathogens and Prognotic Factors for Early Onset Sepsis in Very Low Birth Weight Infants (극소 저체중 출생아에서 조기 패혈증의 원인균과 예후인자)

  • Kim, Yi-Sun;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Seo, Hyun-Ju;Choi, Seo-Heui;Park, Soo-Kyung;Jung, Yu-Jin;Kim, Myo-Jing;Jeon, Ga-Won;Koo, Soo-Hyun;Lee, Kyung-Hoon;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.163-171
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    • 2009
  • Purpose: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. Methods: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. Results: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. Conclusion: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.

Clinical Analysis of Ventilator-associated Pneumonia (VAP) in Blunt-chest-trauma Patients (흉부둔상환자에서 인공호흡기 관련 폐렴환자의 임상적 분석)

  • Oh, Joong Hwan;Park, Il Hwan;Byun, Chun Sung;Bae, Geum Suk
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.291-296
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    • 2013
  • Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.

Clinical Year in Review 2014: Critical Care Medicine

  • Lee, Jeong Moon;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.6-12
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    • 2014
  • Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

Interferon-β alleviates sepsis by SIRT1-mediated blockage of endothelial glycocalyx shedding

  • Suhong Duan;Seung-Gook Kim;Hyung-Jin Lim;Hwa-Ryung Song;Myung-Kwan Han
    • BMB Reports
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    • v.56 no.5
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    • pp.314-319
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    • 2023
  • Sepsis is a life-threatening multi-organ dysfunction with high mortality caused by the body's improper response to microbial infection. No new effective therapy has emerged that can adequately treat patients with sepsis. We previously demonstrated that interferon-β (IFN-β) protects against sepsis via sirtuin 1-(SIRT1)-mediated immunosuppression. Another study also reported its significant protective effect against acute respiratory distress syndrome, a complication of severe sepsis, in human patients. However, the IFN-β effect cannot solely be explained by SIRT1-mediated immunosuppression, since sepsis induces immunosuppression in patients. Here, we show that IFN-β, in combination with nicotinamide riboside (NR), alleviates sepsis by blocking endothelial damage via SIRT1 activation. IFN-β plus NR protected against cecal ligation puncture-(CLP)-induced sepsis in wild-type mice, but not in endothelial cell-specific Sirt1 knockout (EC-Sirt1 KO) mice. IFN-β upregulated SIRT1 protein expression in endothelial cells in a protein synthesis-independent manner. IFN-β plus NR reduced the CLP-induced increase in in vivo endothelial permeability in wild-type, but not EC-Sirt1 KO mice. IFN-β plus NR suppressed lipopolysaccharide-induced up-regulation of heparinase 1, but the effect was abolished by Sirt1 knockdown in endothelial cells. Our results suggest that IFN-β plus NR protects against endothelial damage during sepsis via activation of the SIRT1/heparinase 1 pathway.

Puerperal septic shock and necrotizing fasciitis caused by Staphylococcus caprae and Escherichia coli

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.248-252
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    • 2018
  • Puerperal sepsis is one of the leading causes of maternal morbidity and mortality worldwide. Postpartum pelvic infections can cause various complications, including wound infections and necrotizing fasciitis. Several microorganisms are known to cause such infections; however, no study has reported on Staphylococcus caprae, a coagulase-negative staphylococcus that is isolated frequently from animals and infrequently from human specimens, as a causative agent. Here, we report a rare case of septic shock complicated by necrotizing fasciitis after a cesarean section. This is the first report of a human isolate of S. caprae in association with puerperal sepsis and necrotizing fasciitis.

Result of Surgical Treatment for Infective Endocarditis (심내막염의 수술적 치료 성적에 관한 보고)

  • Kim, S.H.;Ahn, H.;Kim, C.W.
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.370-376
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    • 1990
  • From April, 1981, through March, 1989, 30 patients had received valve replacements and 1 patient had received foreign body removal for infective endocarditis at Seoul National University Hospital. There were 22 male and 9 female patients, ranged in age from 22 to 59 [mean 34.9] years. Twenty-three had native valve endocarditis, 7 had prosthetic valve endocarditis and 1 had infected transvenous permanent pacemaker electrode in right heart. Twenty-four required operation during active phase of disease and 7 during inactive phase. The infecting organism was Streptococcus in 10 patients, Staphylococcus in 5 patients, both Staphylococcus and Streptococcus in 1 patient, E. coli in 2 patients, and Candida in 1 patient. Indications for Surgery were congestive heart failure in 20, systemic emboli in 5, combination of both in 3, congestive heart failure with uncontrolled sepsis in 2, and complete heart block in 1 patient. Hospital mortality was 9.7% [3/31], and all were the patients who received emergency operation. There were 2 late mortality [7.7 %] due to acute myocardial infarction and recurrent endocarditis. This report suggests that the surgical treatment can be achieved with acceptable low mortality and morbidity in medically intractable congestive heart failure, emboli and sepsis.

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