11 research outputs found
Kinetics of progenitor hemopoetic stem cells in sepsis: Correlation with patients survival?
BACKGROUND: Current theories underline the crucial role of pro-inflammatory mediators produced by monocytes for the pathogenesis of sepsis. Since monocytes derive from progenitor hemopoetic cells, the kinetics of stem cells was studied in peripheral blood of patients with sepsis. METHODS: Blood was sampled from 44 patients with septic syndrome due to ventilator-associated pneumonia on days 1, 3, 5 and 7 upon initiation of symptoms. Concentrations of tumour necrosis factor-alpha (TNFα), interleukin (IL)-6, IL-8 and G-CSF were estimated by ELISA. CD34/CD45 cells were determined after incubation with anti-CD45 FITC and anti-CD34 PE monocloncal antibodies and flow cytometric analysis. Samples from eight healthy volunteers served as controls. RESULTS: Median of CD34/CD45 absolute count of controls was 1.0/μl. Respective values of the total study population were 123.4, 112.4, 121.5 and 120.9/μl on days 1, 3, 5 and 7 (p < 0.0001 compared to controls). Positive correlations were found between the absolute CD34/CD45 count and the absolute monocyte count on days 1, 5 and 7. Survival was prolonged among patients with less than 310/μl CD34/CD45 cells on day 1 compared to those with more than 310/μl of CD34/CD45 cells (p: 0.022). Hazard ratio for death due to sepsis was 5.47 (p: 0.039) for CD34/CD45 cells more than 310/μl. Median IL-6 on day 1 was 56.78 and 233.85 pg/ml respectively for patients with less than 310/μl and more than 310/μl CD34/CD45 cells (p: 0.021). CONCLUSION: Stem cells are increased in peripheral blood over all days of follow-up compared to healthy volunteers. Patients with counts on day 1 less than 310/μl are accompanied by increased survival compared to patients with more than 310/μl
Early changes of CD4-positive lymphocytes and NK cells in patients with severe Gram-negative sepsis
Introduction Our aim was to define early changes of lymphocytes and of
NK cells in severe sepsis and to correlate them with serum levels of
soluble triggering receptor expressed on myeloid cells-1 (sTREM-1).
Methods Blood was sampled from 49 patients with proven highly suspected
infection by Gram-negative pathogens, within 12 hours of the advent of
severe sepsis, and was also sampled from six healthy volunteers. White
blood cells were targeted with monoclonal antibodies and were analyzed
by flow cytometry. The concentrations of sTREM-1 were estimated by
ELISA.
Results The presence of CD3/CD4 cells was significantly lower ( P <
0.0001) and that of NK cells significantly higher among patients with
sepsis compared with controls ( P = 0.011). The proportions ( median +/-
standard error) of ANNEXIN-V/CD4/ CD3-positive cells, of
ANNEXIN-V/CD8/CD3-positive cells and of ANNEXIN-V/CD14-positive cells of
the patient population were 7.41 +/- 2.26%, 7.69 +/- 3.42% and 1.96
+/- 4.22%, respectively. Patients with NK cells > 20% survived longer
compared with those patients with NK cells <= 20% ( P = 0.041), and
patients with sTREM-1 concentrations > 180 pg/ml survived longer
compared with those patients with sTREM-1 concentrations <= 180 pg/ ml (
P = 0.042). A negative correlation was found between the percentages of
ANNEXIN-V/CD4/CD3-positive cells and of CD3/CD4 cells (r(s) = - 0.305, P
= 0.049), and a positive correlation was found between the serum sTREM-1
concentration and the percentage of NK cells (r(s) = + 0.395, P =
0.014). NK cells isolated from two healthy volunteers released sTREM-1
upon triggering with endotoxins.
Conclusion Early severe sepsis is characterized by CD4-lymphopenia and
increased NK cells, providing a survival benefit for the septic patient
at percentages > 20%. The survival benefit resulting from elevated NK
cells might be connected to elevated serum levels of sTREM-1
In vitro postantibiotic effect of colistin on multidrug-resistant Acinetobacter baumannii
Infections by multi drug-resistant Acinetobacter baumannii constitute an
increasing threat for critically ill patients. Colistin is often the
only antimicrobial retaining activity against these strains. The
postantibiotic effect (PAE) of colistin was studied on 19 isolates of A.
baumannii resistant to ampicillin/sulbactam, ciprofloxacin, and
carbapenems with the viable count method. The mean PAEs of I X MIC and 4
x MIC concentrations of colistin on the tested isolates were 3.90 and
4.48 h, respectively, indicating that a modified dosage scheme with
increased dosing intervals might retain activity whereas minimizing the
incidence of adverse effects. (c) 2007 Elsevier Inc. All rights
reserved
Oleuropein: A novel immunomodulator conferring prolonged survival in experimental sepsis by Pseudomonas aeruginosa
Oleuropein, a novel immunomodulator derived from olive tree, was
assessed in vitro and in experimental sepsis by Pseudomonas aeruginosa.
After addition in monocyte and neutrophil cultures, malondialdehyde,
TNF-alpha, IL-6, and bacterial counts were estimated in supernatants.
Acute pyelonephritis was induced in 70 rabbits after inoculation of
pathogen in the renal pelvis. Intravenous therapy was administered in
four groups postchallenge by one multidrug-resistant isolate (A,
controls; B, oleuropein; C, amikacin; D, both agents) and in three
groups postchallenge by one susceptible isolate (E, controls; F,
oleuropein; G, amikacin). Survival was recorded; bacterial growth in
blood and organs was counted; endotoxins (LPS), malondialdehyde, total
antioxidant status, and TNF-alpha in serum were estimated. TNF-alpha and
IL-6 of cell supernatants were not increased compared with controls when
triggered by LPS and P. aeruginosa. Counts of multidrug-resistant P.
aeruginosa were decreased in monocyte supernatants. Median survival of
groups A, B, C, D, E, F, and G were 3.00, 6.00, 2.00, 10.00, 1.00, 5.00,
and 1.00 days, respectively. Bacteria in blood were lower at 48 h in
groups B and D compared with A and in groups F and G compared with E.
Total antioxidant status decreased steadily overtime in groups A, C, D,
and G, but not in groups B and F. TNF-alpha of groups B, C, and D was
lower than A at 48 h. Tissue bacteria decreased in group F compared with
E. Oleuropein prolonged survival in experimental sepsis probably by
promoting phagocytosis or inhibiting biosynthesis of proinflammatory
cytokines
Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
Objectives: Multiple pregnancies sustain the high pace of extreme
prematurity. Little evidence is available about triplet gestation given
the evolution in their management during the last decades. The aim of
the study was to compare the neonatal outcomes of triplets with those of
matched singletons in a cohort study. Methods: An observational
retrospective cohort study of triplets and matched singletons born
between 2004 and 2017 matched by gestational age was conducted.
Additionally, the investigation performed in regard to data from the
overall Greek population of interest. The primary outcome was mortality
or severe neonatal morbidity based on pregnancy type. Results: A total
of 237 triplets of 24-36 weeks’ gestation and 482 matched singletons
were included. No differences in the primary outcome between triplets
and singletons were found. Rates of severe neonatal morbidities did not
differ significantly between triplets and singletons. A threshold of
1000 gr for birthweight and 28 weeks’ gestation for gestational age
determined survival on triplets [OR: 0.08 (95% CI: 0.02-0.40,
p=0.0020) and OR: 0.13 (95% CI: 0.03-0.57, p=0.0020) for gestational
age and birthweight respectively]. In Greece stillbirths in triplets was
8 times higher than that of singletons (OR: 8.5, 95% CI: 6.9-10.5).
From 3,375 triplets, 94 were stillborn, whereas in singletons, 4,659 out
of 1,388,273. In our center 5 times more triplets than the expected
average in Greece were delivered with no significant difference in
stillbirths’ rates. Conclusions: No significant differences were
identified in mortality or major neonatal morbidities between triplets
and matched singletons highlighting the significance of prematurity and
birthweight for these outcomes