scholarly journals Early heat shock protein 72 and 90α intracellular and extracellular responses in patients with severe sepsis or systemic inflammatory response syndrome

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P41
Author(s):  
K Apostolou ◽  
K Vardas ◽  
E Briassouli ◽  
K Psara ◽  
D Goukos ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Heat Shock ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Heat Shock Protein ◽  
Systemic Inflammatory Response ◽  
Heat Shock Protein 72

scholarly journals Οι πρωτεΐνες καταπληξίας και η γλουταμίνη στην ανοσολογική απόκριση ασθενών με σήψη

2016 ◽  
Author(s):  
Ευφροσύνη Μπριασούλη
Keyword(s):  
Severe Sepsis ◽  
Heat Shock ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Heat Shock Protein ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells

Σε αυτή την μελέτη, σε μονοπύρηνα κύτταρα περιφερικού αίματος (peripheral blood mononuclear cells (PBMC)) ασθενών με σοβαρή σήψη (severe sepsis (SS)) συγκριτικά με ασθενείς με SIRS (systemic inflammatory response syndrome) που προκλήθηκε από τραύμα και υγιείς μάρτυρες, ερευνήσαμε την δράση της Gln πριν ή μετά από διέγερση με θερμικό σοκ ή με λιποπολυσακχαρίτη (lipopolysaccharide (LPS)). Συγκεκριμένα, ελέγχθηκε το ενδεχόμενο να ασκεί τροποποιητική δράση στην απάντηση της heat shock protein-72 (HSP72) και της heat shock protein-90α (HSP90α), τόσο ενδοκυττάρια και εξωκυττάρια όσο και σε επίπεδο γονιδιακής έκφρασης. Επίσης μελετήθηκε η επίδραση που έχει στις αναφερόμενες συνθήκες διέγερσης σε διάφορες φλεγμονώδεις και αντιφλεγμονώδεις κυτταροκίνες σε εξωκυττάριο επίπεδο στις προαναφερθείσες ομάδες ασθενών και υγιών μαρτύρων.Όσο αναφορά τα βασικά επίπεδα στα PBMCs ενδοκυττάριας HSP72 καθώς και έκφρασης του mRNA της HSP72 , στους ασθενείς σε κρίσιμη κατάσταση ήταν υψηλότερα και αυξήθηκαν ακόμα περισσότερο με το HS, αλλά όχι με το LPS. Τα επίπεδα της ενδοκυττάριας HSP72 και τα επίπεδα του mRNA της HSP72 έχουν θετική συσχέτιση με της κυτταροκίνες στο ορό των ατόμων της μελέτης, αλλά αρνητική συσχέτιση με τις κυτταροκίνες του υπερκειμένου των κυτταροκαλλιεργιών, δεν φάνηκε να επηρεάζονται από HSP72-πολυμορφισμούς,τα επίπεδα κορτιζόλης ή τη βαρύτητα της ασθένειας. Η Gln μπορεί να μειώνει τα επίπεδα της ενδοκυττάριας l/mHSP72 μετά την έκθεση σε LPS και να τα αυξάνει μετά από το HS, αλλά δεν ασκεί στατιστικά σημαντική διαφορά στην σχετική έκφραση του mRNA HSP72 στις δύο ώρες. Η έκφραση και η ενδοκυττάρια συγκέντρωση της HSP90α στα PBMC’s βρέθηκε αυξημένη στην οξεία φάση της φλεγμονής. Σε αντίθεση με την μεγάλη αύξηση της ενδοκυττάριας HSP90α μετά από έκθεση στο HS, την οποία παρουσιάζουν τα PBMCs των υγιών μαρτύρων, τα μονοκύτταρα και λεμφοκύτταρα των βαρέως πασχόντων δεν είχαν παρόμοια ανταπόκριση, το οποίο ενδεχομένως να υποδηλώνει μη ικανοποιητική ανταπόκριση στον πυρετό στη σοβαρή νόσο.

scholarly journals Antimicrobial utilization pattern in Systemic Inflammatory Response Syndrome positive septicemia: a prospective study in an apex hospital in South Delhi

2019 ◽  
Vol 8 (3) ◽  
pp. 557
Author(s):  
Anwer Habib ◽  
Razi Ahmad
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
High Risk Patient ◽  
Systemic Inflammatory Response ◽  
Early Initiation ◽  
Source Of Infection ◽  
Sepsis And Septic Shock ◽  
Sirs Criteria

Background: Despite significant advances in critical care, mortality and morbidity in severe sepsis and septic shock remain high, this may be explained by the fact that in sepsis bacterial infection triggers the innate immune response, setting in motion a cascade of pro-inflammatory and anti-inflammatory cytokines leading to what we recognize as the systemic inflammatory response syndrome (SIRS). It has been thought that this self-propagating cascade drives the progression to severe sepsis and septic shock with increasing degrees of cellular injury and end-organ dysfunction, therefor early initiation of empirical antimicrobial agent is crucial and life-saving atleast in high risk patient. This study aimed to see the outcome (recover or mortality) of patients diagnosed by using SIRS criteria.Methods: Total of 105 patients of suspected sepsis fulfilling SIRS criteria (SIRS ≥2), were included in study. Study population were administered appropriate empirical antimicrobial depending on the source of infection and followed till the final outcome (complete recovery or death).Results: Out of 105 patients included in study based on SIRS criteria, 87 (82.85%) were confirmed to be having septicemia on further evaluation. In majority of patient primary source of infection were respiratory tract (44.76%) and most commonly employed and effective empirical antimicrobial were a combination piperacillin with tazobactum and amikacin (40%). 92.39% patients recovered with empirical antimicrobial, with total in-hospital mortality rate of 7.61%.Conclusions: Early initiation of appropriate antimicrobial by using SIRS as an indicator for the early diagnosis of septicemia is crucial in the management of septicemia and prevention of development of severe sepsis, septic shock.

Sepsis in adult leukemia patients.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 133-133
Author(s):  
Jan Garza
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Quality Improvement ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Hematologic Malignancies ◽  
Systemic Inflammatory Response ◽  
Improvement Project ◽  
Post Test ◽  
Sepsis And Septic Shock

133 Background: Sepsis is estimated to affect 16.8% of the cancer population with hematologic malignancies leading to significant mortality. The incidence may be higher in elderly leukemia patients with concurrent comorbidities. Results of case scenario questionnaires presented to leukemia nurses during a quality improvement project revealed a potential to increase recognition of systemic inflammatory response syndrome, commonly used to identify patients who are at high risk for sepsis, severe sepsis, and septic shock, by 20% among leukemia nurses. Earlier recognition of the systemic inflammatory response syndrome by clinicians is thought to possibly reduce the mortality among those with leukemia. The purpose of this poster is to present the pre-test/post-test results of an educational intervention aimed at increasing earlier recognition of SIRS and consequent sepsis, severe sepsis, and septic shock by 20% among 65 nurses on the leukemia units at a major cancer center. Methods: A multidisciplinary team Pharmacists from ICU and Leukemia and ICU MERIT Team-Leader, led by 2 APNs from ICU and Leukemia, developed and presented an educational program to nurses on the leukemia units to support proposed changes in practice. Pre-test and post-tests were used to determine nurses’ knowledge prior to and after the educational intervention. Results: Analysis of pre- and post-test scores revealed 61% increase in recognition of SIRS, sepsis, severe sepsis, and septic shock. There were no cases of systemic inflammatory response syndrome identified among the 29 leukemia patients by nurses prior to the intervention compared to 9 out of 16 post intervention. Conclusions: Education of nurses on leukemia units revealed an increase in their knowledge base and improvement in recognition of SIRS, sepsis, severe sepsis and septic shock. Implications for nursing include a need to incorporate this education to all nurses who are assigned to units caring for hematologic malignancies to include lymphoma, stem-cell transplant, and myeloma. Our quality improvement project showed the need for on-going healthcare provider education to recognize the symptoms early which may save lives and reduce costs of healthcare.

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