Secondary peritonitis--a balance between contamination and host defence mechanisms.
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Aged↗
Biomedical subjects
A Revhaug
Publications and source records attributed to A Revhaug.
Preoperative cutaneous hypersensitivity reaction related to postoperative complications following elective surgery.
Delayed cutaneous hypersensitivity testing (DCH) using the following antigens: Mumps, PPD, Candida and streptokinase/streptodornase was effectuated preoperatively in 339 surgical patients. DCH test results were evaluated as normal (N) when two or more antigens showed positive response (greater than 5 mm in diameter), relative anergic (RA) with one positive response and anergic (A) when no response was positive. Normal response was observed in 78%, RA in 13% and A in 9% of the patients. Complications in the 232 patients that were operated upon were seen in 51% of the A or RA patients while only 7.1% of the N patients developed complications. The mortality increased significantly from 2.2% in normal patients to 23.5% in the anergic group. Patients classified as anergic or relative anergic had significantly lower preoperative serum levels of prealbumin (p less than 0.001), retinolbinding protein (p less than 0.05) and albumin p less than 0.01) than the normal patients.
Adult↗
Splenic artery aneurysm with bleeding oesophageal varices.
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Aneurysm↗
The synergistic effect of trauma and infection on interleukin-1 but not tumor necrosis factor liberation during posttraumatic gram-negative septicemia.
The release profiles of interleukin 1 (Il-1) and tumor necrosis factor (TNF) were studied during experimental Escherichia coli septicemia and peritonitis with and without a preceding (-48 h) moderate trauma (femur marrow nailing). The trauma alone did not induce significant Il-1 or TNF liberation to plasma. During septicemia, a rapid IL-1-rise (+30 min) and subsequent normalization (+120 min) was seen. A previous trauma delayed (30 min), but accentuated (2x) and prolonged (> 4 h) the Il-1 response. During peritonitis, a delayed (30 min) but otherwise similar Il-1-response was observed. TNF levels rose rapidly (+30 min) in all animals, and remained high throughout the experimental period (6 h). The trauma did not influence the TNF response. We conclude that a synergism exists between trauma and infection with regard to the magnitude of the Il-1 response.
Animals↗
Effects of insulin-like growth factor 1 on neutrophil and monocyte functions in normal and septic states.
BACKGROUND: Insulin-like growth factor 1 (IGF-1) mediates anabolic actions in catabolic states and also influences the immune system. Endogenous IGF-1 production is suppressed in sepsis; replacement therapy is therefore a natural approach to obtain the protein anabolic and potentially immune-stimulating effects of IGF-1. METHODS: Twenty-two piglets were randomized to three groups: an IGF-1 group (n = 8) receiving a continuous infusion of 1.3 mg/h of IGF-1, a nontreated septic control group (n = 8), and a nonseptic control group (n = 6) receiving saline. Phagocytosis and respiratory burst in porcine neutrophils were evaluated by flow cytometry (FCM); tumor necrosis factor (TNF) levels were measured in serum during the septic period. In addition, human neutrophils and monocytes were primed in vitro with IGF-1 and subsequently were stimulated with phorbol myristate acetate (PMA) or Escherichia coli; phagocytosis and respiratory burst were evaluated by FCM. RESULTS: Under nonseptic conditions, pretreatment with IGF-1 suppressed the ability of neutrophils to ingest bacteria (ie, the level of phagocytosis) 43.4% +/- 2.7% (IGF-1-treated) vs 55.8% +/- 3.4% (nontreated septic controls) and 57.3% +/- 3.34% (nonseptic controls) (p = .01). When challenged by live E. coli infusion, phagocytosis increased in the IGF-1 group to the levels of the nontreated group. The respiratory burst showed a convincing priming effect of IGF-1. After 4 hours of sepsis, the mean fluorescence intensity was 63.1 +/- 6.9 in the IGF-1 group and 40.7 +/- 3.0 in nontreated septic controls. The serum levels of TNF-alpha in the nontreated septic control group were twice those in the IGF-1-treated group, ie, 65.7 +/- 13.1 pg/mL in the nontreated septic controls and 31.5 +/- 7.5 pg/mL in the IGF-1 group (p = .03). In vitro priming of human neutrophils and monocytes with IGF-1 and subsequent stimulation with PMA or E. coli demonstrated that IGF-1 enhanced both phagocytosis and respiratory burst. CONCLUSIONS: IGF-1 serves as a priming agent for biologic functions of leukocytes.
Animals↗
Polymorphonuclear leucocyte activation after trauma: evidence for increased generation of oxygen free radicals in response to in vitro endotoxin stimulation.
The effects of moderate bone trauma on the functional status of circulating polymorphonuclear neutrophil (PMN) leucocytes were studied over a 3-day period in a porcine model. Nine pigs were submitted to femur marrow nailings and six acted as controls. The PMNs were studied in regard to production of oxygen free radicals and locomotion. The trauma was followed by leucocytosis, dominated by granulocytosis. Oxygen free radical production by PMNs, measured by chemiluminescence, was significantly greater in the traumatized animals than in the controls. Stimulation of the PMNs with low concentrations of endotoxin disclosed intergroup differences until 48 hours post-trauma. No intergroup difference in PMN locomotion were demonstrated. The results indicated post-traumatic functional changes in the circulating PMNs, suggesting increased reactivity and sensitivity for gram-negative bacteria and their endotoxins during septicaemia.
Animals↗