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2.
Anaerobe ; 53: 50-55, 2018 Oct.
Article de Anglais | MEDLINE | ID: mdl-29920342

RÉSUMÉ

The epsilon toxin (Etx) produced by Clostridium perfringens type B and D causes severe enterotoxaemia associated with a general edema and neurological alterations, leading to subsequent death and is listed as one of the most lethal toxins. Currently employed vaccines against C. perfringens epsilon toxin include toxoid based vaccines. Use of peptide vaccines has become an interesting approach for vaccination after the successful licensing of peptide vaccines against Haemophilus influenza, Neisseria meningitides and Streptococcus pneumonia that have demonstrated the potential and effectiveness of these vaccines. Therefore, the present study was undertaken to develop a peptide based vaccine against epsilon toxin. Peptides were selected on the basis of epitope mapping by making 35 overlapping peptides of 15 amino acid residues in length specific to the primary amino acid sequence of the toxin, with a 7 amino acid residues overlaps between sequential peptides. Chemically synthesized peptides that were recognised by the antibody against the full length epsilon toxin were further assessed for vaccine potential. The selected peptides were chemically conjugated to partially reduced tetanus toxoid (TT) using of N-succinimidyl-3(2-pyridyldithio) propionate. Immunization of BALB/c mice with TT-peptide conjugates by sub-cutaneous route induced sustained high level mixed immune response as analyzed by antibody isotyping. Immunoblot analysis and ELISA clearly indicated generation of Etx-specific antibodies. Further, neutralization studies with the antisera generated against the TT-conjugated peptide(s) demonstrated that the antisera were able to neutralize the lethal dose of epsilon toxin in vitro demonstrating its potential as a promising vaccine candidate against enterotoxaemia.


Sujet(s)
Adjuvants immunologiques/pharmacologie , Toxines bactériennes/immunologie , Vaccins antibactériens/immunologie , Anatoxine tétanique/pharmacologie , Toxémie/prévention et contrôle , Adjuvants immunologiques/composition chimique , Animaux , Anticorps antibactériens/sang , Anticorps neutralisants/sang , Antitoxines/sang , Toxines bactériennes/composition chimique , Toxines bactériennes/génétique , Vaccins antibactériens/administration et posologie , Vaccins antibactériens/synthèse chimique , Vaccins antibactériens/génétique , Infections à Clostridium/prévention et contrôle , Test ELISA , Femelle , Immunotransfert , Injections sous-cutanées , Souris de lignée BALB C , Tests de neutralisation , Anatoxine tétanique/composition chimique , Vaccins synthétiques/administration et posologie , Vaccins synthétiques/composition chimique , Vaccins synthétiques/génétique , Vaccins synthétiques/immunologie
3.
J Perioper Pract ; 24(6): 141-6, 2014 Jun.
Article de Anglais | MEDLINE | ID: mdl-25007476

RÉSUMÉ

Catheter related bloodstream infections (CR-BSIs) can lead to a number of serious conditions for the patient, including death. There is much recent evidence both in the UK and abroad which identifies the sources of CR-BSIs, yet they continue to occur. This article seeks to review some of the current evidence in relation to the prevention of CR-BSIs at insertion point.


Sujet(s)
Infections sur cathéters/prévention et contrôle , Cathétérisme veineux central/effets indésirables , Voies veineuses centrales/microbiologie , Infection croisée/prévention et contrôle , Prévention des infections/méthodes , Toxémie/étiologie , Toxémie/prévention et contrôle , Humains , Soins infirmiers périopératoires/méthodes , Guides de bonnes pratiques cliniques comme sujet , Royaume-Uni
4.
J Biol Chem ; 289(2): 885-94, 2014 Jan 10.
Article de Anglais | MEDLINE | ID: mdl-24225957

RÉSUMÉ

Shiga toxin type 2 (Stx2a) is clinically most closely associated with enterohemorrhagic E. coli O157:H7-mediated hemorrhagic colitis that sometimes progresses to hemolytic-uremic syndrome. The ability to express the toxin has been acquired by other Escherichia coli strains, and outbreaks of food poisoning have caused significant mortality rates as, for example, in the 2011 outbreak in northern Germany. Stx2a, an AB5 toxin, gains entry into human cells via the glycosphingolipid receptor Gb3. We have determined the first crystal structure of a disaccharide analog of Gb3 bound to the B5 pentamer of Stx2a holotoxin. In this Gb3 analog,-GalNAc replaces the terminal-Gal residue. This co-crystal structure confirms previous inferences that two of the primary binding sites identified in theB5 pentamer of Stx1 are also functional in Stx2a. This knowledge provides a rationale for the synthesis and evaluation of heterobifunctional antagonists for E. coli toxins that target Stx2a. Incorporation of GalNAc Gb3 trisaccharide in a heterobifunctional ligand with an attached pyruvate acetal, a ligand for human amyloid P component, and conjugation to poly[acrylamide-co-(3-azidopropylmethacrylamide)] produced a polymer that neutralized Stx2a in a mouse model of Shigatoxemia.


Sujet(s)
Diholoside/composition chimique , Conception de médicament , Antienzymes/composition chimique , Shiga-toxine-2/composition chimique , Animaux , Conformation des glucides , Séquence glucidique , Cristallographie aux rayons X , Diholoside/métabolisme , Antienzymes/métabolisme , Antienzymes/pharmacologie , Humains , Ligands , Souris , Souris de lignée C57BL , Souris transgéniques , Modèles moléculaires , Données de séquences moléculaires , Liaison aux protéines , Structure tertiaire des protéines , Shiga-toxine-2/antagonistes et inhibiteurs , Shiga-toxine-2/métabolisme , Analyse de survie , Toxémie/prévention et contrôle
5.
Hum Vaccin Immunother ; 9(11): 2386-92, 2013 Nov.
Article de Anglais | MEDLINE | ID: mdl-23835363

RÉSUMÉ

Clostridium perfringens epsilon toxin (ETX), one of the most potent toxins known, is a potential biological weapon; therefore, the development of an effective vaccine is important for preventing intoxication or disease by ETX. In this study, genetically detoxified epsilon toxin mutants were developed as candidate vaccines. We used site-directed mutagenesis to mutate the essential amino acid residues (His106, Ser111 and Phe199). Six site-directed mutants of ETX (mETX (H106P) , mETX (S111H) , mETX (S111Y) , mETX (F199H) , mETX (F199E) , mETX (S111YF199E) ) were generated and then expressed in Escherichia coli. Both mETX (F199E) and mETX (H106P) with low or non-cytotoxicity that retained their immunogenicity were selected to immunize mice 3 times, and the mouse survival data were recorded after challenging with recombinant wild-type ETX. mETX (F199E) induces the same protection as mETX (H106P) , which was reported previously as a promising toxin mutant for vaccine, and both of them could protect immunized mice against a 100× LD50 dose of active wild-type recombinant ETX. This work showed that mETX (F199E) is another promising candidate vaccine against enterotoxemia and other diseases caused by ETX.


Sujet(s)
Toxines bactériennes/immunologie , Vaccins antibactériens/immunologie , Clostridium perfringens/immunologie , Toxémie/prévention et contrôle , Animaux , Antigènes bactériens/génétique , Antigènes bactériens/immunologie , Antigènes bactériens/toxicité , Toxines bactériennes/génétique , Toxines bactériennes/toxicité , Vaccins antibactériens/administration et posologie , Vaccins antibactériens/effets indésirables , Vaccins antibactériens/génétique , Clostridium perfringens/génétique , Modèles animaux de maladie humaine , Chiens , Escherichia coli/génétique , Femelle , Expression des gènes , Humains , Cellules rénales canines Madin-Darby , Souris de lignée BALB C , Mutagenèse dirigée , Protéines mutantes/génétique , Protéines mutantes/immunologie , Protéines mutantes/toxicité , Analyse de survie , Vaccins synthétiques/administration et posologie , Vaccins synthétiques/effets indésirables , Vaccins synthétiques/génétique , Vaccins synthétiques/immunologie
6.
J Med Microbiol ; 61(Pt 10): 1380-1392, 2012 Oct.
Article de Anglais | MEDLINE | ID: mdl-22767539

RÉSUMÉ

Current vaccine approaches to combat anthrax are effective; however, they target only a single protein [the protective antigen (PA) toxin component] that is produced after spore germination. PA production is subsequently increased during later vegetative cell proliferation. Accordingly, several aspects of the vaccine strategy could be improved. The inclusion of spore-specific antigens with PA could potentially induce protection to initial stages of the disease. Moreover, adding other epitopes to the current vaccine strategy will decrease the likelihood of encountering a strain of Bacillus anthracis (emerging or engineered) that is refractory to the vaccine. Adding recombinant spore-surface antigens (e.g. BclA, ExsFA/BxpB and p5303) to PA has been shown to augment protection afforded by the latter using a challenge model employing immunosuppressed mice challenged with spores derived from the attenuated Sterne strain of B. anthracis. This report demonstrated similar augmentation utilizing guinea pigs or mice challenged with spores of the fully virulent Ames strain or a non-toxigenic but encapsulated ΔAmes strain of B. anthracis, respectively. Additionally, it was shown that immune interference did not occur if optimal amounts of antigen were administered. By administering the toxin and spore-based immunogens simultaneously, a significant adjuvant effect was also observed in some cases. Thus, these data further support the inclusion of recombinant spore antigens in next-generation anthrax vaccine strategies.


Sujet(s)
Maladie du charbon/prévention et contrôle , Antigènes bactériens/immunologie , Bacillus anthracis/immunologie , Vaccins antibactériens/immunologie , Toxémie/prévention et contrôle , Animaux , Anticorps antibactériens/sang , Antigènes de surface/immunologie , Test ELISA , Femelle , Cochons d'Inde , Immunoglobuline G/sang , Souris , Souris de lignée BALB C , Lapins , Spores bactériens/immunologie
7.
Vaccine ; 26(4): 469-76, 2008 Jan 24.
Article de Anglais | MEDLINE | ID: mdl-18093704

RÉSUMÉ

Escherichia coli O157:H7 produces Stx1 and Stx2 causing severe diseases. Their B subunits (StxBs) are useful for a vaccine but exhibit low immunogenicity, especially Stx2B. Nasal vaccination with StxBs plus cholera toxin induces only serum anti-Stx1B antibodies in mice. However, nasal administration of a mutant of E. coli enterotoxin and His-tagged Stx2B induced serum antibodies neutralizing Stx2 in vitro or in vivo and mucosal IgA antibodies in lungs. As His-tagged Stx2B showed five or three polymers in gel filtration chromatography, His-tagged Stx2B forms smaller tertiary structure than the native one and is effective for preventing Stx2 toxemia as a nasal vaccine.


Sujet(s)
Adjuvants immunologiques , Vaccins antibactériens/administration et posologie , Vaccins antibactériens/immunologie , Toxine cholérique/immunologie , Infections à Escherichia coli/immunologie , Escherichia coli/immunologie , Immunisation , Shiga-toxine-2/immunologie , Toxémie/prévention et contrôle , Animaux , Anticorps antibactériens/analyse , Anticorps antibactériens/immunologie , Spécificité des anticorps , Chromatographie sur gel , Entérotoxines/génétique , Escherichia coli/génétique , Femelle , Histidine , Calendrier vaccinal , Immunoglobuline A/analyse , Poumon/immunologie , Souris , Souris de lignée ICR , Muqueuse/immunologie , Mutation , Tests de neutralisation , Polymères , Sous-unités de protéines/composition chimique , Sous-unités de protéines/immunologie , Sous-unités de protéines/isolement et purification , Shiga-toxine-2/composition chimique , Shiga-toxine-2/génétique , Shiga-toxine-2/isolement et purification , Vaccins sous-unitaires/administration et posologie , Vaccins sous-unitaires/immunologie
8.
Pesqui. vet. bras ; 27(1): 29-38, jan. 2007. tab, ilus
Article de Portugais | LILACS | ID: lil-443326

RÉSUMÉ

O conhecimento das doenças dos animais domésticos, nas diferentes regiões do Brasil é importante para determinar formas eficientes de profilaxia e controle. Este trabalho tem como objetivo descrever a epidemiologia, sinais clínicos e patologia das enfermidades do sistema nervoso central (SNC) de caprinos e ovinos, que ocorreram de janeiro de 2000 a maio de 2006 no semi-árido, principalmente do estado da Paraíba. Durante o período, 365 casos ou surtos foram diagnosticados em caprinos e 270 em ovinos. Desses, 63 (9,92 por cento) eram doenças do SNC, sendo 34 (9,31 por cento) em caprinos e 29 (10,7 por cento) em ovinos. As principais enfermidades foram abscessos (19,04 por cento), tétano (15,9 por cento), raiva (9,52 por cento) intoxicação por Ipomoea asarifolia (7,93 por cento), listeriose (6,34 por cento), trauma (6,34 por cento), polioencefalomalacia (4,77 por cento), toxemia da prenhez (3,17 por cento), ataxia enzoótica (3,17 por cento) e meningite (3,17 por cento). Outras doenças diagnosticadas numa única oportunidade (1,59 por cento) foram intoxicações por Crotalaria retusa, Ipomoea carnea, Ipomoea sericophylla e Prosopis juliflora, otite com encefalite, malformação, linfossarcoma linfoblástico, meduloblastoma e necrose simétrica focal. Em 6,34 por cento dos casos o diagnóstico foi inconclusivo.


The knowledge of the diseases of domestic animals in the different Brazilian regions is important to determine measures for their control and prevention. The objective of this paper is to report the epidemiology, clinical signs and pathology of the diseases of the central nervous system (CNS) of goats and sheep in the Brazilian semiarid, mainly in the state of Paraíba, diagnosed at the Veterinary Hospital of the Federal University of Campina Grande, from January 2000 to May 2006. During the period, 365 cases or outbreaks were diagnosed in goats and 270 in sheep. From these, 63 (9.92 percent) were of diseases of the CNS, being 34 (9.31 percent) in goats and 29 (10.7 percent) in sheep. The main diseases were abscesses (19.04 percent), tetanus (15.9 percent), rabies (9.52 percent) poisoning by Ipomoea asarifolia (7.93 percent), listeriosis (6.34 percent), traumatism (6.34 percent), polioencephalo-malacia (4.77 percent), pregnancy toxemia (3.17 percent), enzootic ataxia (3.17 percent), and meningitis (3.17 percent). Other diseases diagnosed in only one opportunity (1.59 percent) were intoxications by Crotalaria retusa, Ipomoea carnea, Ipomoea sericophylla and Prosopis juliflora, otitis with encephalitis, malformation, lymphoblastic lymphosarcoma, medulloblastoma, and focal symmetric necrosis. In 6.34 percent of the cases diagnosis was unknown.


Sujet(s)
Capra , Ovis , Système nerveux central/anatomopathologie , Infections à Listeria/épidémiologie , Infections à Listeria/prévention et contrôle , Tétanos/épidémiologie , Tétanos/prévention et contrôle , Toxémie/épidémiologie , Toxémie/prévention et contrôle
9.
Infect Immun ; 73(12): 8362-8, 2005 Dec.
Article de Anglais | MEDLINE | ID: mdl-16299334

RÉSUMÉ

Passive immunization has been successfully employed for protection against bacterial and viral infections for over 100 years. Immunoglobulin Fc regions play a critical role in the clearance of bacterial pathogens by mediating antibody-dependent and complement-dependent cytotoxicity. Here we show that antibody fragments engineered to recognize the protective antigen component of the B. anthracis exotoxin with high affinity and conjugated to polyethylene glycol (PEG) for prolonged circulation half-life confer significant protection against inhalation anthrax despite their lack of Fc regions. The speed and lower manufacturing cost of bacterially expressed PEGylated antibody fragments could provide decisive advantages for anthrax prophylaxis. Importantly, our results suggest that PEGylated antibody fragments may represent a unique approach for mounting a rapid therapeutic response to emerging pathogen infections.


Sujet(s)
Maladie du charbon/prévention et contrôle , Anticorps antibactériens/usage thérapeutique , Antigènes bactériens/immunologie , Antitoxines/usage thérapeutique , Toxines bactériennes/immunologie , Immunisation passive , Région variable d'immunoglobuline/usage thérapeutique , Polyéthylène glycols/usage thérapeutique , Animaux , Anticorps antibactériens/administration et posologie , Anticorps antibactériens/composition chimique , Affinité des anticorps , Antitoxines/administration et posologie , Antitoxines/composition chimique , Bacillus anthracis/immunologie , Femelle , Cochons d'Inde , Fragments Fc des immunoglobulines/immunologie , Fragments d'immunoglobuline/administration et posologie , Fragments d'immunoglobuline/composition chimique , Fragments d'immunoglobuline/usage thérapeutique , Région variable d'immunoglobuline/administration et posologie , Région variable d'immunoglobuline/composition chimique , Polyéthylène glycols/administration et posologie , Polyéthylène glycols/composition chimique , Toxémie/prévention et contrôle
10.
Infect Immun ; 72(1): 602-5, 2004 Jan.
Article de Anglais | MEDLINE | ID: mdl-14688144

RÉSUMÉ

The anthrax toxin protective antigen precursor is activated by proteolytic cleavage by furin or a furin-like protease. We present here data demonstrating that the small stable furin inhibitor hexa-D-arginine amide delays anthrax toxin-induced toxemia both in cells and in live animals, suggesting that furin inhibition may represent a reasonable avenue for therapeutic intervention in anthrax.


Sujet(s)
Maladie du charbon/prévention et contrôle , Antigènes bactériens , Toxines bactériennes/toxicité , Antienzymes/administration et posologie , Furine/antagonistes et inhibiteurs , Peptides/administration et posologie , Toxémie/prévention et contrôle , Animaux , Lignée cellulaire , Macrophages alvéolaires/anatomopathologie , Mâle , Rats , Rats de lignée F344
11.
Circulation ; 106(16): 2104-10, 2002 Oct 15.
Article de Anglais | MEDLINE | ID: mdl-12379581

RÉSUMÉ

BACKGROUND: Simvastatin, a 3-hydroxy-methylglutaryl coenzyme A reductase inhibitor, has been shown to lower serum cholesterol levels in clinical use. Moreover, statins exert beneficial effects in vascular diseases by inhibition of leukocyte rolling, adherence, and transmigration. The aim of this study was to determine if pretreatment with simvastatin attenuates Staphylococcus aureus alpha-toxin-induced increase in leukocyte-endothelial interactions during exotoxemia. METHODS AND RESULTS: The effects of simvastatin on leukocyte-endothelial cell interactions were observed by intravital microscopy in the rat mesenteric microcirculation. Simvastatin (50 or 100 microg/kg) was administered 18 hours before the study. Activation of microcirculation was induced by bolus administration of 40 microg/kg S aureus alpha-toxin. Exotoxemia resulted in a significant and time-dependent increase in leukocyte rolling, adherence, and transmigration of leukocytes as well as P-selectin expression on the intestinal vascular endothelium. Pretreatment with simvastatin significantly inhibited exotoxin-induced leukocyte rolling from 71+/-10 to 14+/-4.7 cells/min (P<0.01) and adherence from 14+/-3.5 to 0.4+/-0.2 cells (P<0.01). In addition, simvastatin pretreatment significantly inhibited transmigration of leukocytes from 10.5+/-1.2 to 4.2+/-0.9 (P<0.05) cells. Immunohistochemical detection of endothelial cell adhesion molecule P-selectin showed a 50% decrease in endothelial cell surface expression after simvastatin treatment. Furthermore, simvastatin treatment resulted in enhanced expression of endothelial cell NO synthase III in the intestinal microcirculation. CONCLUSIONS: These results demonstrate that simvastatin interferes with exotoxin-induced leukocyte-endothelial cell interactions, which may be relevant in various infectious diseases. Statin treatment may offer a new therapeutic strategy for these clinical conditions.


Sujet(s)
Anti-inflammatoires non stéroïdiens/pharmacologie , Toxines bactériennes/antagonistes et inhibiteurs , Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase/pharmacologie , Simvastatine/pharmacologie , Toxémie/prévention et contrôle , Animaux , Adhérence cellulaire/effets des médicaments et des substances chimiques , Mouvement cellulaire/effets des médicaments et des substances chimiques , Techniques de culture , Endothélium vasculaire/effets des médicaments et des substances chimiques , Endothélium vasculaire/physiopathologie , Hémodynamique , Hémolysines , Immunohistochimie , Leucocytes/effets des médicaments et des substances chimiques , Leucocytes/immunologie , Mâle , Veines mésentériques/anatomie et histologie , Veines mésentériques/effets des médicaments et des substances chimiques , Veines mésentériques/physiopathologie , Vidéomicroscopie , Nitric oxide synthase/analyse , Nitric oxide synthase/immunologie , Nitric oxide synthase type III , Sélectine P/analyse , Sélectine P/immunologie , Rats , Rat Sprague-Dawley , Infections à staphylocoques/immunologie , Infections à staphylocoques/anatomopathologie , Infections à staphylocoques/prévention et contrôle , Toxémie/immunologie , Toxémie/anatomopathologie , Veinules/effets des médicaments et des substances chimiques , Veinules/physiopathologie
14.
Crit Care Med ; 24(4): 584-9, 1996 Apr.
Article de Anglais | MEDLINE | ID: mdl-8612407

RÉSUMÉ

OBJECTIVES: To determine the prevalence and clinical significance of hypolipidemia found in critically ill patients, and whether the addition of a reconstituted lipoprotein preparation could inhibit the generation of tumor necrosis factor-alpha (TNF-alpha) in acute-phase blood taken from these patients. SETTING: Surgical intensive care unit (ICU) of a large urban university hospital. DESIGN: Prospective case series. PATIENTS: A total of 32 patients with a variety of critical illnesses had lipid and lipoprotein concentrations determined. Six patients and six age- and gender-matched control subjects had whole blood in vitro studies of the effect of lipoprotein on lipopolysaccharide mediated TNF-alpha production. INTERVENTIONS: Blood samples were drawn on admission to the ICU and over a subsequent 8-day period. MEASUREMENTS AND MAIN RESULTS: Mean serum lipid and lipoprotein values obtained from patients within 24 hrs of transfer to the surgical ICU were extremely low: mean total cholesterol was 117 mg/dL (3.03 mmol/L), low-density lipoprotein cholesterol 71 mg/dL (1.84 mmol/L), and high-density lipoprotein cholesterol 25 mg/dL (0.65 mmol/L). Only the mean triglyceride concentration of 105 mg/dL (1.19 mmol/L), and the mean lipoprotein(a) concentration of 25 mg/dL (0.25 g/L) were within the normal range. During the first 8 days following surgical ICU admission, there were trends toward increasing lipid and lipoprotein concentrations that were significant for triglycerides and apolipoprotein B. Survival did not correlate with the lipid or lipoprotein concentrations, but patients with infections had significantly lower (p = .008) high-density lipoprotein cholesterol concentrations compared with noninfected patients. Lipopolysaccharide-stimulated production of TNF-alpha in patient and control blood samples was completely suppressed by the addition of 2 mg/mL of a reconstituted high-density lipoprotein preparation. CONCLUSIONS: Patients who are critically ill from a variety of causes have extremely low cholesterol and lipoprotein concentrations. Correction of the hypolipidemia by a reconstituted high-density lipoprotein preparation offers a new strategy for the prevention and treatment of endotoxemia.


Sujet(s)
Endotoxines/sang , Lipides/sang , Toxémie/sang , Adulte , Sujet âgé , Analyse de variance , Apolipoprotéines/isolement et purification , Apolipoprotéines/usage thérapeutique , Maladie grave , Femelle , Humains , Lipoprotéines/sang , Lipoprotéines HDL/isolement et purification , Lipoprotéines HDL/usage thérapeutique , Mâle , Adulte d'âge moyen , Études prospectives , Toxémie/traitement médicamenteux , Toxémie/prévention et contrôle , Facteur de nécrose tumorale alpha/analyse , Facteur de nécrose tumorale alpha/antagonistes et inhibiteurs
15.
Br J Surg ; 83(2): 181-4, 1996 Feb.
Article de Anglais | MEDLINE | ID: mdl-8689158

RÉSUMÉ

Forty patients with acute calculous cholangitis had successful endoscopic drainage. Bile from nasobiliary drains and venous blood was collected at 0, 12, 24, 36 and 48 h after endoscopy. Endotoxin levels were measured by the chromogenic Limulus Amoebocyte Lysate assay. There was a significant reduction in both bile and serum endotoxin levels after endoscopic drainage (P < 0.001). Endotoxaemia occurred when bile endotoxin reached 10(3) EU/ml and rose exponentially beyond this threshold. Significant association was demonstrated between both bile and serum endotoxins to the clinical features of cholangitis (P < 0.05). No correlation was evident between serum endotoxin and the parameters of white cell count, serum bilirubin and alkaline phosphatase (r = 0.53, 0.00 and 0.00 respectively). Endoscopic drainage is effective in lowering bile and serum endotoxin levels and clinical signs and symptoms reliably predict endotoxaemia.


Sujet(s)
Angiocholite/chirurgie , Lithiase biliaire/chirurgie , Drainage/méthodes , Toxémie/prévention et contrôle , Maladie aigüe , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Bile/composition chimique , Bile/microbiologie , Endoscopie digestive , Endotoxines/métabolisme , Escherichia coli/isolement et purification , Femelle , Humains , Mâle , Adulte d'âge moyen
16.
Am J Nephrol ; 16(1): 60-72, 1996.
Article de Anglais | MEDLINE | ID: mdl-8719767

RÉSUMÉ

Water treatment is a vital aspect of hemodialysis in which knowledge and technical skills are of utmost importance. The recognition that nontuberculous mycobacteria can be resistant to certain germicides spurred the establishment of the current safety microbiologic standards for dialyzer reprocessing. Monitoring the dialyzer membrane integrity is as important as meeting the standards for bacterial and endotoxin levels for dialyzer reprocessing. Ensuring the use of product water that meets the chemical and microbiologic standards of the Association for the Advancement of Medical Instrumentation is necessary to reduce the incidence of endotoxemia and chemical hazards associated with the use of water for hemodialysis. The pathogenesis of febrile reactions during hemodialysis remains controversial. The weight of evidence, however, favors transmission of endotoxin fragments across dialysis membranes to induce mononuclear cell cytokine production.


Sujet(s)
Défaillance rénale chronique/thérapie , Dialyse rénale/méthodes , Purification de l'eau/méthodes , Solutions de dialyse , Humains , Facteurs de risque , Toxémie/prévention et contrôle , Eau/composition chimique
18.
Antibiot Khimioter ; 41(9): 77-80, 1996.
Article de Russe | MEDLINE | ID: mdl-9005793

RÉSUMÉ

The experience with ofloxacin in the prophylaxis and treatment of infected burn wounds in 40 patients was investigated. High clinical and microbiological efficacy of the drug was stated (82.5 and 83 per cent respectively). The highest efficacy of ofloxacin was observed when the burned area did not exceed 25 per cent of the body surface. It was concluded that the prophylactic use of the drug during acute burn toxemia was not expedient.


Sujet(s)
Anti-infectieux/usage thérapeutique , Brûlures/complications , Ofloxacine/usage thérapeutique , Toxémie/traitement médicamenteux , Infection de plaie/traitement médicamenteux , Adulte , Sujet âgé , Femelle , Humains , Mâle , Tests de sensibilité microbienne , Adulte d'âge moyen , Toxémie/microbiologie , Toxémie/prévention et contrôle , Résultat thérapeutique , Infection de plaie/microbiologie , Infection de plaie/prévention et contrôle
20.
Br Vet J ; 151(5): 489-522, 1995.
Article de Anglais | MEDLINE | ID: mdl-8556312

RÉSUMÉ

Recent experimental findings indicate that endotoxin (i.e. lipopolysaccharide) interacts with specific membrane receptors localized to mononuclear phagocytic cells and neutrophils. Binding of endotoxin to these cells, together with endotoxin-induced activation of host vascular endothelium, initiates a series of signal transduction events that culminate in release of numerous biochemical mediators. The latter include cytokines, platelet-activating factor, thromboxane A2, prostaglandins, leukotrienes, nitric oxide, proteases, toxic O2 radicals, and vasoactive amines. These mediators orchestrate complex biological interactions and amplification signals that lead to cardiopulmonary dysfunction and multi-organ failure within 4-6 h of experimental infusion of endotoxin into animals. The pathophysiological changes include decreased cardiac output, systemic hypotension, decreased blood flow and O2 delivery to tissues, intense pulmonary vasoconstriction and hypertension, bronchoconstriction, increased permeability, pulmonary oedema, ventilation-to-perfusion inequalities, hypoxaemia, and haemoconcentration. Metabolic alterations include increased blood lactate and pyruvate, metabolic acidosis, hyperkalaemia and hypoglycaemia. Potential therapeutic modalities for treatment of endotoxaemia/septic shock include specific antagonists directed against lipopolysaccharide, cytokine, and platelet-activating factor receptors, monoclonal antibodies directed against cytokines and lipid A/core polysaccharides of endotoxin, antiproteases, and agents that block release of toxic O2 and arachidonic acid metabolites.


Sujet(s)
Bactériémie/médecine vétérinaire , Endothélium vasculaire/effets des médicaments et des substances chimiques , Endotoxines/sang , Médiateurs de l'inflammation/métabolisme , Maladies des porcs/physiopathologie , Toxémie/médecine vétérinaire , Animaux , Bactériémie/physiopathologie , Bactériémie/prévention et contrôle , Protéines du sang/métabolisme , Endotoxines/métabolisme , Endotoxines/toxicité , Monoxyde d'azote/métabolisme , Récepteurs de surface cellulaire/métabolisme , Suidae , Maladies des porcs/prévention et contrôle , Toxémie/physiopathologie , Toxémie/prévention et contrôle
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