High circulating levels of interleukin-6 in patients with septic shock: evolution during sepsis, prognostic value, and interplay with other cytokines
Article Abstract:
Interleukin-6 (IL-6) is a cytokine, or factor that regulates growth, and is released by monocytes (a type of white blood cell), macrophages (a natural defense cell), endothelial cells (which line many internal surfaces, including the heart and vessels), and fibroblasts (from which connective tissue forms). IL-6 has many other physiologic effects. It can cause fever; alter the liver production of acute-phase proteins, which are released during disease; activate immune B and T lymphocytes; and stimulate the production of blood cells. Studies suggest that IL-6 may also play a role in defense against bacterial infection, and is increased by endotoxin, a toxic substance produced by bacteria. The blood levels of IL-6 were measured in 70 patients with septic shock, or inadequate blood flow associated with bacterial infection of the blood. Since the cytokines known as tumor necrosis factor (TNF), interleukin-1beta (IL-1beta), and interferon-gamma (IFN-gamma) can activate the production of IL-6, their interactions with IL-6 in patients with septic shock were also assessed. The percentage of patients with detectable IL-6 levels decreased from 64 percent at the onset of septic shock to 18 percent at day 1 and 2 percent of patients at day 10. Patients who died of rapidly progressing septic shock had higher IL-6 levels compared with patients who had experienced a brief recovery from shock, but later died after relapse of the disease. Although the levels of IL-6 could not predict patient outcome, IL-6 levels at the start of the study were related to the duration of survival and levels of TNF. These findings show that most patients with septic shock have detectable levels of IL-6 at the onset of the disease, but these levels diminish within 24 hours. Although IL-6 levels at the onset of the disease are related to TNF levels and length of survival, IL-6 levels are not a useful indicator of outcome in patients with septic shock. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose
Article Abstract:
Constipation is a common problem that increases after the age of 65 years. It is treated by increasing dietary fiber and fluids, adding a bulk-forming agents to the diet such as psyllium, or laxative therapy. However, long-term therapy with laxatives may not be appropriate for elderly patients because of potential adverse side effects. Although lactulose, a glucose compound, is an effective laxative with few adverse side effects, it is very expensive. Sorbitol is another glucose compound with laxative effects that less expensive. The use of sorbitol as an alternative to lactulose for treating constipation in the elderly was assessed. Lactulose treatment and 70 percent sorbitol treatment were each given for four-week periods to 30 men aged 65 to 86 years with chronic constipation. Sorbitol caused 6.71 bowel movements per week, with an average of 5.23 days per week with bowel movements. Lactulose caused 7.02 bowel movements per week, with an average of 5.31 days per week with bowel movements. Eleven patients preferred sorbitol, 12 patients preferred lactulose, and seven patients had no preference. The severity of constipation, the amount of normal bowel movements, frequency and severity of symptoms such as bloating, cramping, excessive flatulence, and overall health status were similar for sorbitol and lactulose treatments. Nausea occurred more often during treatment with lactulose compared with sorbitol. These findings show that there are no clinical differences in the laxative effects between sorbitol and lactulose. Thus, sorbitol can serve as a cost-effective alternative to lactulose in treating chronic constipation in the elderly. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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