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Opsarini, Safitri Febriana, Respatiwulan, and Muhammad Bayu Nirwana. "COMPARISON OF CONTINUOUS TIME MARKOV CHAIN (CTMC) SIRS AND SIQRS EPIDEMIC MODEL SIMULATION RESULTS ON THE SPREAD OF MONKEYPOX DISEASE." Proceedings of International Conference on Education 2, no. 1 (April 1, 2024): 694–705. http://dx.doi.org/10.32672/pice.v2i1.1347.
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The uncontrolled spread of infectious diseases over a long period of time can cause epidemic. The pattern of spread of an infectious disease can be described through a mathematical model called an epidemic model. The development of the SIR epidemic model which assumes that recovered individuals have temporary immunity so that they can be re-infected is called the SIRS epidemic model. Quarantine is an effort to restrict movement to prevent the transmission of disease among individuals in a society. The SIQRS epidemic model is a modification of the SIRS model which assumes a quarantine phase for infected individuals. The SIQRS epidemic model that follows the Markov process and changes in the number of individuals are viewed in continuous time is the SIQRS continuous time Markov chain (CTMC) epidemic model. Monkeypox or monkeypox is an infectious disease that has hit several countries in Central and West Africa. The aims of this research are to explain the CTMC SIQRS epidemic model and compare the simulation results between the CTMC SIQRS and CTMC SIRS epidemic models on the spread of monkeypox. The research’s method is literature study by discussing relevant theories and previous research. The results of this research are the CTMC SIQRS model in the form of transition probabilities. The simulation of CTMC SIRS epidemic model on the spread of monkeypox shows that the end of epidemic occur at days years, whereas in the CTMC SIQRS model, the end of epidemic occur at days years. Therefore, it was concluded that the quarantine phase can speed up the end of the epidemic.
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Longtine, M. S., S. Enomoto, S. L. Finstad, and J. Berman. "Telomere-mediated plasmid segregation in Saccharomyces cerevisiae involves gene products required for transcriptional repression at silencers and telomeres." Genetics 133, no. 2 (February 1, 1993): 171–82. http://dx.doi.org/10.1093/genetics/133.2.171.
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Abstract Plasmids that contain Saccharomyces cerevisiae TG1-3 telomere repeat sequences (TRS plasmids) segregate efficiently during mitosis. Mutations in histone H4 reduce the efficiency of TRS-mediated plasmid segregation, suggesting that chromatin structure is involved in this process. Sir2, Sir3 and Sir4 are required for the transcriptional repression of genes located at the silent mating type loci (HML and HMR) and at telomeres (telomere position effect) and are also involved in the segregation of TRS plasmids, indicating that TRS-mediated plasmid segregation involves factors that act at chromosomal telomeres. TRS plasmid segregation differes from the segregation of plasmids carrying the HMR E silencing region: HMR E plasmid segregation function is completely dependent upon Sir2, Sir3 and Sir4, involves Sir1 and is not influenced by mutations in RAP 1 that eliminate TRS plasmid segregation. Mutations in SIR1, SIN1, TOP1, TEL1 and TEL2 do not influence TRS plasmid segregation. Unlike transcriptional repression at telomeres, TRS plasmids retain partial segregation function in sir2, sir3, sir4, nat1 and ard1 mutant strains. Thus it is likely that TRS plasmid segregation involves additional factors that are not involved in telomere position effect.
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Doraz, Walter E. "Sirs." Nutrition Today 20, no. 6 (November 1985): 33. http://dx.doi.org/10.1097/00017285-198511000-00018.
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Munro, Nancy. "Sirs." Nutrition Today 20, no. 6 (November 1985): 33–34. http://dx.doi.org/10.1097/00017285-198511000-00019.
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Schnaper, H. W., and T. M. Aune. "Suppression of immune responses to sheep erythrocytes by the lymphokine soluble immune response suppressor (SIRS) in vivo." Journal of Immunology 137, no. 3 (August 1, 1986): 863–67. http://dx.doi.org/10.4049/jimmunol.137.3.863.
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Abstract Soluble immune response suppressor (SIRS) is a protein produced by activated suppressor T lymphocytes which inhibits division by tumor cells and plaque-forming cell (PFC) responses in vitro. Although this lymphokine has been fairly well characterized in vitro, little is known about its effects in vivo. Purified murine SIRS, 10(3) to 10(4) U injected i.p., suppressed murine PFC responses to sheep erythrocytes (SRBC) in vivo. Suppression occurred when SIRS was injected into mice 5 days before assay, and also occurred when SIRS activated with 10(-6) M H2O2 was injected 24 hr before assay. These kinetics are similar to those observed in tissue culture, where suppression of PFC responses requires the addition of SIRS 4 to 5 days before assay unless SIRS is activated to SIRSox by H2O2. Levamisole, an inhibitor of SIRS-mediated suppression in vitro, also blocked suppression by SIRS in vivo. Delayed-type hypersensitivity reaction to footpad injection of SRBC was also inhibited by SIRS. Suppression of PFC responses by recombinant immune interferon (IFN-gamma), which activates lymphocytes to produce SIRS in vitro, was blocked by injection of levamisole or monoclonal anti-SIRS antibodies. These results show that SIRS suppresses immune responses in vivo, and suggest that suppression of PFC responses by IFN-gamma may be largely mediated by SIRS. These findings indicate that SIRS could contribute to the development of suppressed immunity in vivo.
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Webb, D. R., K. Mason, G. Semenuk, T. M. Aune, and C. W. Pierce. "Purification and analysis of isoforms of soluble immune response suppressor (SIRS)." Journal of Immunology 135, no. 5 (November 1, 1985): 3238–42. http://dx.doi.org/10.4049/jimmunol.135.5.3238.
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Abstract Soluble immune response suppressor (SIRS) isolated from the T cell hybrid 393D2.6 was originally reported to exist as at least two m.w. forms and to migrate on reverse-phase high-performance liquid chromatography columns as three separate species. In experiments presented here, a further analysis of the different chromatographic forms of SIRS has been carried out. SIRS-alpha elutes from C-18 reverse-phase columns in 20% propanol. When SIRS-alpha is subjected to isoelectric focusing, three biologically active species are isolated at approximately pH7, approximately pH6, and approximately pH5 (SIRS-alpha 7, SIRS-alpha 6, and SIRS-alpha 5, respectively). SIRS-beta elutes in 30% propanol, and on isoelectric focusing the biologic activity is found only at approximately pH7 (SIRS-beta 7). Both the alpha and beta forms of SIRS have nearly identical m.w. when subjected to molecular sieve chromatography and migrate with a m.w. of 11,000. The molecular basis for these isoforms is not yet clear but is consistent with earlier studies showing two separate messenger RNA species coding for SIRS.
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Side, Syafruddin, Ahmad Zaki, and Nurwahidah Sari. "Analisis Model Matematika Penyebaran Demam Berdarah Dengue dengan Fungsi Lyapunov." Journal of Mathematics, Computations, and Statistics 1, no. 2 (May 19, 2019): 125. http://dx.doi.org/10.35580/jmathcos.v1i2.9188.
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Abstrak. Artike lini adalah penelitian teori dan terapan. Artikelini bertujuan untuk membahas mengenai model matematika SIRS untuk penyebaran Demam Berdarah Dengue. Data yang digunakanadalah data sekunder jumlah penderita penyakit Demam Berdarah Dengue dari Side pada tahun 2014. Pembahasan di mulai dari membangun model matematika SIRS penyakit Demam Berdarah Dengue, menentukan eksistensi model SIRS menggunakan fungsi Lyapunov, penentuan titik ekuilibrium, kemudian mencari analisis kestabilan titik ekuilibrium menggunakan fungsi Lyapunov, menentukan nilai bilangan reproduksi dasar , membuat simulasi model, dan menginterpretasikannya. Dalam artikel ini diperoleh model matematika SIRS untuk penyakit Demam Berdarah Dengue, eksistensi model SIRS, dua titik ekuilibrium bebas penyakit dan endemik dari model SIRS, kestabilan global keseimbangan bebas penyakit dan endemik dari model SIRS dengan nilai bilangan reproduksi dasar , ini menunjukkan bahwa penyakit Demam Berdarah Dengue berstatus epidemik.Kata Kunci: Model Matematika, Penyebaran Penyakit, Demam Berdarah Dengue, Model SIRS, Fungsi LyapunovAbstract. This paper is theorethical and applied research. This paper aims to discus about SIRS mathematical models for the spread of dengue fever. The data used is a secondary data about the number of people with dengue fever disease from Side (2014). The discussion start from constructing SIRS models of dengue fever disease, determining the existence of SIRS models using Lyapunov function, determining equilibrium point, then looking for stability analysis of equilibrium point using Lyapunov function, determining reproduction number , making models simulation, and interpreting it. In this paper, we obtained mathemathical models of SIRS for dengue fever disease, existence of SIRS models, disease-free and endemic equilibrium points of SIRS models, global stability of disease-free and endemic equilibrium of SIRS models with basic reproduction number , it shows that dengue fever disease is epidemic status. , This shows that Dengue Hemorrhagic Fever is an epidemic.Keyword: Mathematical Model, Spread of Disease, Dengue Fever, SIRS Model, Lyapunov Function
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Nocera, Irene, Francesca Bonelli, Valentina Vitale, Valentina Meucci, Giuseppe Conte, Eduard Jose-Cunilleras, Luis Alfonso Gracia-Calvo, and Micaela Sgorbini. "Evaluation of Plasmatic Procalcitonin in Healthy, and in Systemic Inflammatory Response Syndrome (SIRS) Negative or Positive Colic Horses." Animals 11, no. 7 (July 6, 2021): 2015. http://dx.doi.org/10.3390/ani11072015.
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Colic horses show systemic inflammatory response syndrome (SIRS) clinical signs. Procalcitonin (PCT) showed increased circulating levels in sick horses. This study compares plasma PCT concentrations in healthy vs. SIRS negative/positive colic horses over time, and evaluates PCT and SIRS score potential correlation, to verify the usefulness of PCT for the evaluation of SIRS severity. Ninety-one horses were included; 43/91 were healthy, on basis of physical examination, blood work and SIRS score (score = 0), while 48/91 were sick colic horses, classified as SIRS-negative (score < 2) and positive (score ≥ 2). Moreover, a 0–6 point-scale SIRS score was calculated (assessing mucous membrane color and blood lactate concentration). PCT was evaluated at admission, and at 24, 48, 72 and 96 h, using a commercial kit for equine species. We verified by the ANOVA test PCT differences between healthy vs. colic horses, healthy vs. SIRS-negative or SIRS-positive colic horses, at all sampling times, and the correlation between the SIRS score at admission with the SIRS score. Statistically significant differences were detected between healthy vs. all colic horses and between healthy vs. SIRS-positive or negative horses at all sampling times. No correlation was observed between the SIRS score at admission and PCT values. PCT was statistically higher in colic horses compared to the healthy ones, suggesting a role as a biomarker for colic.
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McNelis, Francis L. "Dear Sirs." Laryngoscope 95, no. 8 (August 1985): 1012. http://dx.doi.org/10.1288/00005537-198508000-00028.
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Joseph, David L. "Dear Sirs." Laryngoscope 95, no. 8 (August 1985): 1012. http://dx.doi.org/10.1288/00005537-198508000-00029.
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PICKETT, R. D., A. WRIGHT, and H. C. SHEPPARD. "Dear Sirs." Nuclear Medicine Communications 16, no. 5 (May 1995): 417. http://dx.doi.org/10.1097/00006231-199505000-00070.
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Nelson, Timothy J., and Peter R. Almond. "Dear Sirs:." Medical Dosimetry 13, no. 2 (1988): 105. http://dx.doi.org/10.1016/0958-3947(88)90051-9.
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Borgonovo, Ariane, Caroline Baldin, Dariana C. Maggi, Livia Victor, Emilia T. O. Bansho, Juliana Piedade, Letícia M. Wildner, et al. "Systemic Inflammatory Response Syndrome in Patients Hospitalized for Acute Decompensation of Cirrhosis." Canadian Journal of Gastroenterology and Hepatology 2021 (April 25, 2021): 1–9. http://dx.doi.org/10.1155/2021/5581587.
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Background. Although recently challenged, systemic inflammatory response syndrome (SIRS) criteria are still commonly used in daily practice to define sepsis. However, several factors in liver cirrhosis may negatively impact its prognostic ability. Goals. To investigate the factors associated with the presence of SIRS, the characteristics of SIRS related to infection, and its prognostic value among patients hospitalized for acute decompensation of cirrhosis. Study. In this cohort study from two tertiary hospitals, 543 patients were followed up, up to 90 days. Data collection, including the prognostic models, was within 48 hours of admission. Results. SIRS was present in 42.7% of the sample and was independently associated with upper gastrointestinal bleeding (UGB), ACLF, infection, and negatively related to beta-blockers. SIRS was associated with mortality in univariate analysis, but not in multiple Cox regression analysis. The Kaplan–Meier survival probability of patients without SIRS was 73.0% and for those with SIRS was 64.7%. The presence of SIRS was not significantly associated with mortality when considering patients with or without infection, separately. Infection in SIRS patients was independently associated with Child-Pugh C and inversely related to UGB. Among subjects with SIRS, mortality was independently related to the presence of infection, ACLF, and Child-Pugh C. Conclusions. SIRS was common in hospitalized patients with cirrhosis and was of no prognostic value, even in the presence of infection.
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Rudner, Adam D., Brian E. Hall, Tom Ellenberger, and Danesh Moazed. "A Nonhistone Protein-Protein Interaction Required for Assembly of the SIR Complex and Silent Chromatin." Molecular and Cellular Biology 25, no. 11 (June 1, 2005): 4514–28. http://dx.doi.org/10.1128/mcb.25.11.4514-4528.2005.
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ABSTRACT Budding yeast silent chromatin, or heterochromatin, is composed of histones and the Sir2, Sir3, and Sir4 proteins. Their assembly into silent chromatin is believed to require the deacetylation of histones by the NAD-dependent deacetylase Sir2 and the subsequent interaction of Sir3 and Sir4 with these hypoacetylated regions of chromatin. Here we explore the role of interactions among the Sir proteins in the assembly of the SIR complex and the formation of silent chromatin. We show that significant fractions of Sir2, Sir3, and Sir4 are associated together in a stable complex. When the assembly of Sir3 into this complex is disrupted by a specific mutation on the surface of the C-terminal coiled-coil domain of Sir4, Sir3 is no longer recruited to chromatin and silencing is disrupted. Because in sir4 mutant cells the association of Sir3 with chromatin is greatly reduced despite the partial Sir2-dependent deacetylation of histones near silencers, we conclude that histone deacetylation is not sufficient for the full recruitment of silencing proteins to chromatin and that Sir-Sir interactions are essential for the assembly of heterochromatin.
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Hou, Yan-song, Hua Wang, Hao Chen, Ling-feng Wu, Lin-feng Lu, and Yi He. "Pathfast Presepsin Assay for Early Diagnosis of Systemic Inflammatory Response Syndrome in Patients with Nephrolithiasis." BioMed Research International 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/792572.
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It is relatively difficult to diagnose bacterial sepsis in nephrolithiasis patients. The aim of the study is to evaluate the diagnostic ability of presepsin in the differential diagnosis including SIRS, infection, or sepsis and to compare its diagnostic value with other markers, mainly as CRP, procalcitonin (PCT), and white blood cell (WBC) in patients of nephrolithiasis presenting with SIRS. 39 patients of nephrolithiasis who were diagnosed as SIRS were prospectively investigated. Plasma presepsin was detected by Pathfast presepsin assay system; CRP and PCT were measured as well. Additionally, 25 nephrolithiasis patients without SIRS were included. At all timing samples, patients were classified as SIRS or non-SIRS group. Median plasma presepsin levels were significantly increased in the SIRS group compared with non-SIRS group (452 pg/mL versus 178 ng/mL,P<0.001), and presepsin was markedly elevated even in the early stage of SIRS (584 pg/mL 6 h, 660 pg/mL 24 h versus 452 pg/mL,P<0.001). According to the receiver-operating characteristic (ROC) analysis, presepsin demonstrated a high diagnostic value compared with either PCT or CRP. In the early stage of SIRS, presepsin remained a highly sensitive (74.7%) and specific (88.4%) diagnostic marker compared with either PCT, CRP, or WBC. Moreover, the areas under the curve (AUCs) of presepsin (84.6%) were also superior to those seen in either PCT (79.6%) or CRP (71.8%). Thus plasma presepsin levels have comparable performance in SIRS for patients with nephrolithiasis.
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Schnaper, H. W., T. M. Aune, and R. K. Roby. "A role for histamine type II (H-2) receptor binding in production of the lymphokine, soluble immune response suppressor (SIRS)." Journal of Immunology 139, no. 4 (August 15, 1987): 1185–90. http://dx.doi.org/10.4049/jimmunol.139.4.1185.
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Abstract Soluble immune response suppressor (SIRS) is an immunosuppressive protein produced by human and murine suppressor cells activated by a variety of agents. Because histamine has been reported to activate suppressor cells, the possibility that it also induced SIRS production was investigated. Human lymphocytes treated with 10(-4) M histamine for less than 1 hr released a suppressive substance into culture supernatants that was physically, functionally and antigenically similar to human SIRS. Cimetidine and ranitidine, structurally distinct histamine type II (H-2) receptor antagonists, prevented histamine-induced SIRS production. In further experiments, suppression of human polyclonal IgM PFC responses by Con A and interferons, substances that activate the SIRS pathway, was inhibited by H-2 receptor antagonists. Activation of lymphocytes to produce SIRS by Con A or interferons was blocked by cimetidine or ranitidine. These data demonstrate that production of SIRS is induced by histamine, and raise the possibility that H-2 receptor binding may play a role in the SIRS pathway.
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Connelly, Jessica J., Peihua Yuan, Hao-Chi Hsu, Zhizhong Li, Rui-Ming Xu, and Rolf Sternglanz. "Structure and Function of the Saccharomyces cerevisiae Sir3 BAH Domain." Molecular and Cellular Biology 26, no. 8 (April 15, 2006): 3256–65. http://dx.doi.org/10.1128/mcb.26.8.3256-3265.2006.
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ABSTRACT Previous work has shown that the N terminus of the Saccharomyces cerevisiae Sir3 protein is crucial for the function of Sir3 in transcriptional silencing. Here, we show that overexpression of N-terminal fragments of Sir3 in strains lacking the full-length protein can lead to some silencing of HML and HMR. Sir3 contains a BAH (bromo-adjacent homology) domain at its N terminus. Overexpression of this domain alone can lead to silencing as long as Sir1 is overexpressed and Sir2 and Sir4 are present. Overexpression of the closely related Orc1 BAH domain can also silence in the absence of any Sir3 protein. A previously characterized hypermorphic sir3 mutation, D205N, greatly improves silencing by the Sir3 BAH domain and allows it to bind to DNA and oligonucleosomes in vitro. A previously uncharacterized region in the Sir1 N terminus is required for silencing by both the Sir3 and Orc1 BAH domains. The structure of the Sir3 BAH domain has been determined. In the crystal, the molecule multimerizes in the form of a left-handed superhelix. This superhelix may be relevant to the function of the BAH domain of Sir3 in silencing.
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Hidayanto, Achmad Nizar, Dian Setia Hartana, and Ika Chandra Hapsari. "STRATEGI MANAJEMEN PERUBAHAN UNTUK MENDUKUNG IMPLEMENTASI SISTEM INFORMASI RUMAH SAKIT STUDI KASUS: RSUD RAA SOEWONDO PATI." Jurnal Sistem Informasi 6, no. 2 (July 15, 2012): 108. http://dx.doi.org/10.21609/jsi.v6i2.283.
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Seiring dengan perkembangan rumah sakit dan teknologi informasi, Sistem Informasi Rumah Sakit (SIRS) RAA Soewondo dirasa tidak mampu lagi memenuhi kebutuhan informasi. Keterbatasan tersebut membuat pihak manajemen berencana mengganti SIRS mereka. Agar implementasi SIRS yang baru dapat berhasil, perlu dilakukan strategi manajemen perubahan yang tepat pada rumah sakit. Penelitian ini bertujuan untuk merumuskan strategi manajemen perubahan untuk implementasi SIRS di RAA Soewondo. Penelitian dilakukan menggunakan pengambilan data melalui kuesioner, wawancara, dan observasi. Tindakan perubahan didapat dengan analisis SWOT, kemudian dikelompokan ke dalam metode manajemen untuk membuat strategi manajemen perubahan. Metode manajemen perubahan yang digunakan adalah Anderson dan Anderson Nine Phase Model. Dari hasil penelitian, didapatkan hasil bahwa faktor resistensi karyawan relatif kecil. Tindakan perubahan yang sesuai dengan manajemen perubahan adalah dukungan pimpinan untuk implementasi perubahan SIRS, membuat persamaan visi dan misi ke semua bagian rumah sakit tentang perubahan SIRS, merancang keadaan perubahan yang diinginkan dengan memerhatikan divisi yang terpengaruh oleh perubahan SIRS ini, melakukan penggantian dengan metode pararel cutover, memberikan penghargaan kepada karyawan yang ikut menyukseskan program ini, serta membuat kebijakan baru agar kebijakan yang sudah berjalan menjadi permanen. Hasil akhir menunjukkan secara umum karyawan rumah sakit setuju akan perubahan SIRS saat ini. Along with the development of hospitals and information technology, the Soewondo RAA Hospital Information System (SIRS) felt unable to meet the information needs. These limitations make the management of SIRS plans to replace their SIRS. In order for successful implementation of new SIRS, change management strategy needs to be done right at the hospital. This study aims to formulate strategies for implementing change management in the RAA Soewondo SIRS. The study was conducted using data collection through questionnaires, interviews, and observation. Action changes obtained with SWOT analysis and then grouped into a management method for making the change management strategy. Change management method that had been used is Anderson and Anderson Nine Phase Model. The study shows that the staff’s resistance is relatively small. Action changes according that related to change management is leadership support for implementation of changes to SIRS, making equality vision and mission to all parts of the hospital about the change of SIRS, designing state of the desired changes with respect to the division that is affected by changes in SIRS, do the replacement with parallel cutover method , presents awards to employees who make this program succeed, and create new policies to estabilish policies that are already running to be permanent. The final results shows: in general, the employees agreed to change the current SIRS.
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Ivy, J. M., A. J. Klar, and J. B. Hicks. "Cloning and characterization of four SIR genes of Saccharomyces cerevisiae." Molecular and Cellular Biology 6, no. 2 (February 1986): 688–702. http://dx.doi.org/10.1128/mcb.6.2.688-702.1986.
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Mating type in the yeast Saccharomyces cerevisiae is determined by the MAT (a or alpha) locus. HML and HMR, which usually contain copies of alpha and a mating type information, respectively, serve as donors in mating type interconversion and are under negative transcriptional control. Four trans-acting SIR (silent information regulator) loci are required for repression of transcription. A defect in any SIR gene results in expression of both HML and HMR. The four SIR genes were isolated from a genomic library by complementation of sir mutations in vivo. DNA blot analysis suggests that the four SIR genes share no sequence homology. RNA blots indicate that SIR2, SIR3, and SIR4 each encode one transcript and that SIR1 encodes two transcripts. Null mutations, made by replacement of the normal genomic allele with deletion-insertion mutations created in the cloned SIR genes, have a Sir- phenotype and are viable. Using the cloned genes, we showed that SIR3 at a high copy number is able to suppress mutations of SIR4. RNA blot analysis suggests that this suppression is not due to transcriptional regulation of SIR3 by SIR4; nor does any SIR4 gene transcriptionally regulate another SIR gene. Interestingly, a truncated SIR4 gene disrupts regulation of the silent mating type loci. We propose that interaction of at least the SIR3 and SIR4 gene products is involved in regulation of the silent mating type genes.
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Ivy, J. M., A. J. Klar, and J. B. Hicks. "Cloning and characterization of four SIR genes of Saccharomyces cerevisiae." Molecular and Cellular Biology 6, no. 2 (February 1986): 688–702. http://dx.doi.org/10.1128/mcb.6.2.688.
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Mating type in the yeast Saccharomyces cerevisiae is determined by the MAT (a or alpha) locus. HML and HMR, which usually contain copies of alpha and a mating type information, respectively, serve as donors in mating type interconversion and are under negative transcriptional control. Four trans-acting SIR (silent information regulator) loci are required for repression of transcription. A defect in any SIR gene results in expression of both HML and HMR. The four SIR genes were isolated from a genomic library by complementation of sir mutations in vivo. DNA blot analysis suggests that the four SIR genes share no sequence homology. RNA blots indicate that SIR2, SIR3, and SIR4 each encode one transcript and that SIR1 encodes two transcripts. Null mutations, made by replacement of the normal genomic allele with deletion-insertion mutations created in the cloned SIR genes, have a Sir- phenotype and are viable. Using the cloned genes, we showed that SIR3 at a high copy number is able to suppress mutations of SIR4. RNA blot analysis suggests that this suppression is not due to transcriptional regulation of SIR3 by SIR4; nor does any SIR4 gene transcriptionally regulate another SIR gene. Interestingly, a truncated SIR4 gene disrupts regulation of the silent mating type loci. We propose that interaction of at least the SIR3 and SIR4 gene products is involved in regulation of the silent mating type genes.
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SINGH, L. KIPJEN, M. K. PATRA, G. K. MISHRA, A. C. SAXENA, U. K. DE, S. K. SINGH, H. KUMAR, and N. KRISHNASWAMY. "Effect of systemic inflammatory response syndrome (SIRS) on prostaglandin metabolite and oxidative stress in canine pyometra." Indian Journal of Animal Sciences 90, no. 4 (September 1, 2020): 569–73. http://dx.doi.org/10.56093/ijans.v90i4.104199.
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Pyometra, either open or closed cervix, inevitably progresses to systemic inflammatory response syndrome (SIRS), if ovariohysterectomy is not done timely. The aim of the study was to investigate the effect of pyometra led SIRS on certain serum biochemical and prostaglandin metabolite, 13,14-dihydro-15-keto PGF2 alpha (PGFM) and oxidative stress indices in the canine. The pyometra positive bitches were categorized as SIRS+ (n=29) and SIRS- (n =16) based on temperature (<100.5 or >102.5°F), respiration rate (>20/min), heart rate (>102/min), and total leukocytes count (<6×103 or >16×103 per μL). The SIRS+ bitches showed hypoalbuminemia, hyperglobulinemia, elevated blood urea nitrogen and creatinine, decreased super oxide dismutase (SOD) activity with moderate increase in the lipid peroxidation. Further, the SIRS+ bitches had significantly higher serum PGFM concentration (6.83±0.7 vs. 4.12±0.4 ng/mL) than SIRS- and the level was influenced by cervical patency. It was concluded that elevated serum PGFM along with hyperglobunemia, blood urea nitrogen, creatinine would be useful in diagnosis and monitoring of pyometra led SIRS in bitch.
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Karnawat, Anand Vinay, Vijayakumar Chellappa, Balasubramanian Gopal, Rajkumar Nagarajan, and Krishnamachari Srinivasan. "Systemic inflammatory response syndrome as a predictor of poorer outcomes in diabetic foot infection: a prospective analytical study." International Surgery Journal 7, no. 6 (May 26, 2020): 1830. http://dx.doi.org/10.18203/2349-2902.isj20202391.
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Background: This study was done to diagnose the severity of infection in a group of hospitalized diabetic foot infection (DFI) patients based on the presence or absence of systemic inflammatory response syndrome (SIRS) and compare the outcomes.Methods: This was a single-center cohort study, in which 50 consecutive DFI patients having SIRS and 50 consecutive patients not having SIRS were included. Patients were followed for the duration of the hospital stay; parameters for glycaemic control, minor and major amputation, microbial culture, duration of hospital and ICU stay and mortality was recorded.Results: The relative risk of major amputation among the patients of DFI who presented with SIRS was 2.66 times higher compared to who was not having SIRS at presentation (95% CI, 1.56-4.55). The presence of polymicrobial infection also had a statistically significant association with the incidence of major amputation. The duration of hospital stay was ~9.5 days longer in the DFI patients who presented with SIRS compared to who was not having SIRS at the time of presentation [8.00 (4.00-20.50) days versus 17.50 (10.75-38.25) days]. DFI patients with SIRS required a significantly prolonged ICU.Conclusions: SIRS can be used as objective criteria to predict poorer outcomes in the diabetic foot infection patient and also to classify it.
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Hyak, Jonathan M., Mayar Al Mohajer, Daniel Musher, and Benjamin Musher. "198. Clinical Prediction of Bacteremia and the Need for Early Antibiotic Therapy in Solid Tumor Cancer Patients." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S103—S104. http://dx.doi.org/10.1093/ofid/ofaa439.242.
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Abstract Background Cancer patients (pts) frequently receive empiric antibiotics without clear indication. This retrospective study investigated the relationship between the systemic inflammatory response syndrome (SIRS), early antibiotic (Anb) use, and bacteremia in solid tumor pts presenting to the emergency department (ED). Methods We extracted data from the electronic medical records of adults with solid tumors admitted to a tertiary care hospital through the ED for any reason over a 2 year period. Pts with neutropenic fever, organ transplant, trauma, or cardiopulmonary arrest were excluded. Rates of SIRS and bacteremia among pts receiving early Anb (eAnb, within 8 hours of admission) were compared to all others using χ 2. Binomial regression and receiver operator curves assessed predictors of bacteremia. Results Of 3580 eligible pts, 1344 pts were SIRS positive (≥ 2 criteria) and 2236 were SIRS negative; 501 (37%) and 493 (22%), respectively, received eAnb (p< 0.001). eAnb use increased with additional SIRS criteria (Fig 1). Of SIRS positive pts, 860 (64%) had BCs drawn within 48 hrs of presentation, of which 19% were positive. Of SIRS negative pts, 826 (37%) had cultures drawn within 48 hrs of presentation, of which 14% were positive (19% vs 14%, p=0.004). Of pts who had BCs drawn, the proportion of positive BCs among those who received eAnb and those who did not was identical (16% in each group; p=1). Of 276 pts ultimately proven to have bacteremia within 48 hrs, only 59% were SIRS positive, and only 49% received eAnb in the ED. By regression, only two SIRS components predicted bacteremia, fever (OR 1.8 ± 0.39, p=0.01) and tachycardia (1.4 ± 0.22, p=0.03), and SIRS criteria as a whole were poorly predictive of bacteremia (AUC 0.57, Table 1). A more robust model, which included additional labs and vital signs, was only marginally better (AUC 0.61, Table 2). Figure 1: Proportion of patients receiving early antibiotics by SIRS score Table 1: SIRS as a predictor of bacteremia Table 2: Best predictive model of bacteremia Conclusion Clinicians still use SIRS criteria to determine the need for eAnb. However, SIRS criteria are poor predictors of bacteremia in solid tumor pts, who frequently manifest them due to complications of cancer or cancer-directed therapy rather than infection. Furthermore, patients who are SIRS negative may be bacteremic. More reliable models are needed to guide judicious use of Anb in the solid tumor population. Disclosures All Authors: No reported disclosures
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Goossens, Evy, Jianhui Li, Chana Callens, Nathalie Van Van Rysselberghe, Hannele Kettunen, Juhani Vuorenmaa, Natalia Garcia Garcia Gonzalez, Claude Libert, Richard Ducatelle, and Filip Van Van Immerseel. "Acute Endotoxemia-Induced Respiratory and Intestinal Dysbiosis." International Journal of Molecular Sciences 23, no. 19 (October 1, 2022): 11602. http://dx.doi.org/10.3390/ijms231911602.
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Systemic inflammatory response syndrome (SIRS) is a severe condition characterized by systemic inflammation, which may lead to multiple organ failure, shock and death. SIRS is common in burn patients, pancreatitis and sepsis. SIRS is often accompanied by intestinal dysbiosis. However, the mechanism, role and details of microbiome alterations during the early phase of acute SIRS are not completely understood. The current study aimed to characterize the dynamic alterations of both the intestinal and respiratory microbiome at two timepoints during the early phase of acute SIRS (4 and 8 h after LPS) and link these to the host response in a mouse model of a LPS-induced lethal SIRS. Acute SIRS had no effect on the microbiome in the large intestine but induced a rapid dysbiosis in the small intestine, which resembled the microbiome alterations commonly observed in SIRS patients. Later in the disease progression, a dysbiosis of the respiratory microbiome was observed, which was associated with the MMP9 expression in the lungs. Although similar bacteria were increased in both the lung and the small intestine, no evidence for a gut-lung translocation was observed. Gut dysbiosis is commonly observed in diseases involving inflammation in the gut. However, whether the inflammatory response associated with SIRS and sepsis can directly cause gut dysbiosis was still unclear. In the current study we provide evidence that a LPS-induced SIRS can directly cause dysbiosis of the small intestinal and respiratory microbiome.
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Rogers, Richard, Sarah F. Velsor, and Margot M. Williams. "A Detailed Analyis of SIRS Versus SIRS-2 Critiques." Psychological Injury and Law 13, no. 3 (June 6, 2020): 275–83. http://dx.doi.org/10.1007/s12207-020-09379-6.
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Hei, Ziqing, Xinjin Chi, Nan Cheng, Gangjian Luo, and Shangrong Li. "Upregulation of TLR2/4 Expression in Mononuclear Cells in Postoperative Systemic Inflammatory Response Syndrome after Liver Transplantation." Mediators of Inflammation 2010 (2010): 1–7. http://dx.doi.org/10.1155/2010/519589.
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Background. To explore the relationship between Toll-like rpheral blood mononuclear cells (PBMC) and systemic inflammatory response syndrome (SIRS) in postoperative patients of liver transplantation (LT).Methods. Blood samples of 27 patients receiving LT were collected at T1 (after induction of anaesthesia), T2 (25 minutes after the beginning of anhepatic phase), T3 (3 hours after graft reperfusion), and T4 (24 hours after graft reperfusion). The expression of TLR2/4 on PBMC and serum concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-8 were measured. The patients were divided into SIRS group (n=12) and non-SIRS group (n=15) for analysis.Results. Blood loss and transfusion were higher in the SIRS group than in the non-SIRS group. Both the preanhepatic and anhepatic phase were significantly longer in the SIRS group. The TLR2/4 expression on PBMC as well as serum TNF-α, IL-1β, and IL-8 were significantly higher at T3 and T4 than that at T1 and T2 in the SIRS patients. The expression of TLR4 on PBMC is positively correlated to serum TNF-α, IL-8. Expression of TLR2/4 on PBMC and serum concentrations of TNF-α, IL-1β, did not differ among the 4-time points in non-SIRS patients.Conclusions. Upregulation of TLR2/4 expression on PBMC may contribute to the development of postoperative SIRS during perioperative period of LT.
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Marcinek, Mateusz, Michał Tkocz, Kamil Marczewski, Robert Partyka, Leszek Kukulski, Krystyna Młynarek-Śnieżek, Bogumiła Sędziak-Marcinek, Paweł Rajwa, Adam Berezowski, and Danuta Kokocińska. "Evaluation of Parameters Affecting the Occurrence of Systemic Inflammatory Response Syndrome in Patients Operated on Due to Kidney Tumors." Biomedicines 11, no. 8 (August 4, 2023): 2195. http://dx.doi.org/10.3390/biomedicines11082195.
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The application and prognostic nature of systemic inflammatory reaction syndrome (SIRS) is still being researched, as using SIRS parameters to predict patient status is cheap, efficient, fast, and easy. The study aimed to determine SIRS markers and postoperative complications occurrence in patients undergoing kidney tumor surgery, and to verify if SIRS occurrence depends on age, sex, BMI (body mass index), comorbidities, patients’ general condition before the surgery, type of surgery, intraoperative blood loss, or intraoperative ischemia time. Body temperature, heart rate, respiratory rate, and leukocyte count were measured in patients (n = 285) operated on due to a kidney tumor on the first (T0) and third (T3) postoperative day. Univariable and multivariable logistic regression were used to analyze the factors affecting postoperative SIRS and complications occurrence. T0: SIRS developed in patients with higher BMI, >2 ASA points, and more substantial intraoperative blood loss. T3: SIRS developed in obese or overweight patients, with >2 ASA points, significantly higher relative HR change, lower relative body temperature change, respiratory rate, and leukocyte count. BMI values, preoperative general health status, and the amount of intraoperative blood loss in patients undergoing surgery due to a kidney tumor can contribute to SIRS occurrence. Patient’s sex, age, tumor size, type of surgery, operated side, and time of intraoperative ischemia do not affect SIRS occurrence.
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Mignot-Evers, Lisette, Vivian Raaijmakers, Gerba Buunk, Steffie Brouns, Lorenzo Romano, Thijs van Herpt, Arvind Gharbharan, Jeanne Dieleman, and Harm Haak. "Comparison of SIRS criteria and qSOFA score for identifying culture-positive sepsis in the emergency department: a prospective cross-sectional multicentre study." BMJ Open 11, no. 6 (June 2021): e041024. http://dx.doi.org/10.1136/bmjopen-2020-041024.
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ObjectiveTo compare the daily practice of two emergency departments (ED) in the Netherlands, where systemic inflammatory response syndrome (SIRS) criteria and quick Sequential Organ Failure Assessment (qSOFA) score are used differently as screening tools for culture-positive sepsis.DesignA prospective cross-sectional multicentre study.SettingTwo EDs at two European clinical teaching hospitals in the Netherlands.Participants760 patients with suspected infection who met SIRS criteria or had a qualifying qSOFA score who were treated at two EDs in the Netherlands from 1 January to 1 March 2018 were included.MethodsSIRS criteria and qSOFA score were calculated for each patient. The first hospital treated the patients who met SIRS criteria following the worldwide Surviving Sepsis Campaign protocol. At the second hospital, only patients who met the qualifying qSOFA score received this treatment. Therefore, patients could be divided into five groups: (1) SIRS+, qSOFA−, not treated according to protocol (reference group); (2) SIRS+, qSOFA−, treated according to protocol; (3) SIRS+, qSOFA+, treated according to protocol; (4) SIRS−, qSOFA+, not treated according to protocol; (5) SIRS−, qSOFA+, treated according to protocol.Primary and secondary outcome measuresTo prove culture-positive sepsis was present, cultures were used as the primary outcome. Secondary outcomes were in-hospital mortality and intensive care unit (ICU) admission.Results98.9% met SIRS criteria and 11.7% met qSOFA score. Positive predictive values of SIRS criteria and qSOFA score were 41.2% (95% CI 37.4% to 45.2%) and 48.1% (95% CI 37.4% to 58.9%), respectively. HRs were 0.79 (95% CI 0.40 to 1.56, p=0.500), 3.42 (95% CI 1.82 to 6.44, p<0.001), 18.94 (95% CI 2.48 to 144.89, p=0.005) and 4.97 (95% CI 1.44 to 17.16, p=0.011) for groups 2–5, respectively.ConclusionqSOFA score performed as well as SIRS criteria for identifying culture-positive sepsis and performed significantly better for predicting in-hospital mortality and ICU admission. This study shows that SIRS criteria are no longer necessary and recommends qSOFA score as the standard for identifying culture-positive sepsis in the ED.Trial registration numberNL8315.
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Kesani, Anil K., Jennifer C. Urquhart, Nathan Bedard, Pittavat Leelapattana, Fawaz Siddiqi, Kevin R. Gurr, and Christopher S. Bailey. "Systemic inflammatory response syndrome in patients with spinal cord injury: does its presence at admission affect patient outcomes?" Journal of Neurosurgery: Spine 21, no. 2 (August 2014): 296–302. http://dx.doi.org/10.3171/2014.3.spine13784.
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Object The object in this study was to determine whether the presence of systemic inflammatory response syndrome (SIRS) in patients with traumatic spinal cord injury (SCI) on admission is related to subsequent clinical outcome in terms of length of stay (LOS), complications, and mortality. Methods The authors retrospectively reviewed the charts of 193 patients with acute traumatic SCI who had been hospitalized at their institution between 2006 and 2012. Patients were excluded from analysis if they had insufficient SIRS data, a cauda equina injury, a previous SCI, a preexisting neurological condition, or a condition on admission that prevented appropriate neurological assessment. Complications were counted only once per patient and were considered minor if they were severe enough to warrant treatment and major if they were life threatening. Demographics, injury characteristics, and outcomes were compared between individuals who had 2 or more SIRS criteria (SIRS+) and those who had 0 or 1 SIRS criterion (SIRS−) at admission. Multivariate logistic regression (enter method) was used to determine the relative contribution of SIRS+ at admission in predicting the outcomes of mortality, LOS in the intensive care unit (ICU), hospital LOS, and at least one major complication during the acute hospitalization. The American Spinal Injury Association Impairment Scale grade and patient age were included as covariates. Results Ninety-three patients were eligible for analysis. At admission 47.3% of patients had 2 or more SIRS criteria. The SIRS+ patients had higher Injury Severity Scores (24.3 ±10.6 vs 30.2 ±11.3) and a higher frequency of both at least one major complication during acute hospitalization (26.5% vs 50.0%) and a fracture-dislocation pattern of injury (26.5% vs 59.1%) than the SIRS− patients (p < 0.05 for each comparison). The SIRS+ patients had a longer median hospital stay (14 vs 18 days) and longer median ICU stay (0 vs 5 days). However, mortality was not different between the groups. Having SIRS on admission predicted an ICU LOS > 10 days, hospital LOS > 25 days, and at least one complication during the acute hospitalization. Conclusions A protocol to identify SCI patients with SIRS at admission may be beneficial with respect to preventing adverse outcomes and decreasing hospital costs.
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Yoon, Jaechul, Dohern Kym, Jun Hur, Yong Suk Cho, Wook Chun, and Dogeon Yoon. "Validation of Sepsis-3 using survival analysis and clinical evaluation of quick SOFA, SIRS, and burn-specific SIRS for sepsis in burn patients with suspected infection." PLOS ONE 18, no. 1 (January 3, 2023): e0276597. http://dx.doi.org/10.1371/journal.pone.0276597.
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Purpose Sepsis-3 is a life-threatening organ dysfunction caused by dysregulated host responses to infection; and defined using the Sepsis-3 criteria, introduced in 2016, however, the criteria need to be validated in specific clinical fields. We investigated mortality prediction and compared the diagnostic performance of quick Sequential Organ Failure Assessment (qSOFA), systemic inflammatory response syndrome (SIRS), and burn-specific SIRS (bSIRS) in burn patients. Methods This single-center retrospective cohort study examined burn patients in Seoul, Korea during January 2010–December 2020. Overall, 1,391 patients with suspected infection were divided into four sepsis groups using SOFA, qSOFA, SIRS, and burn-specific SIRS. Results Hazard ratios (HRs) of all unadjusted models were statistically significant; however, the HR (0.726, p = 0.0080.001) in the SIRS ≥2 group is below 1. In the adjusted model, HRs of the SOFA ≥2 (2.426, <0.001), qSOFA ≥2 (7.198, p<0.001), and SIRS ≥2 (0.575, p<0.001) groups were significant. The diagnostic performance of dichotomized qSOFA, SIRS, and bSIRS for sepsis was defined by the Sepsis-3 criteria. The mean onset day was 4.13±2.97 according to Sepsis-3. The sensitivity of SIRS (0.989, 95% confidence interval [CI]: 0.982–0.994) was higher than that of qSOFA (0.841, 95% CI: 0.819–0.861) and bSIRS (0.803, 95% CI: 0.779–0.825). Specificities of qSOFA (0.929, 95% CI: 0.876–0.964) and bSIRS (0.922, 95% CI: 0.868–0.959) were higher than those of SIRS (0.461, 95% CI: 0.381–0.543). Conclusion Sepsis-3 is a good alternative diagnostic tool because it reflects sepsis severity without delaying diagnosis. SIRS showed higher sensitivity than qSOFA and bSIRS and may therefore more adequately diagnose sepsis.
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Y, Eka Yulia Fitri, Tri Wahyu Murni, and Ai Mardhiyah. "HUBUNGAN ANTARA KADAR GLUKOSA DARAH DENGANSYSTEMIC INFLAMMATORY RESPONSE SYNDROME PADA PASIEN POST KRANIOTOMI." Vol. 7 No. 2 (2020) 7, no. 2 (July 2, 2020): 64–75. http://dx.doi.org/10.32539/jks.v7i2.15246.
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Tujuan: Setiap tindakan operasi akan mencetuskan terjadinya respon stres. Pada pasien yang menjalani kraniotomi respon stres yang terjadi adalah hipermetabolisme dan katabolisme, perubahan pada sistem endokrin dan metabolik sehingga mendorong terjadinya peningkatan kadar glukosa darah. Hiperglikemia dapat merusak fungsi imunitas tubuh, mengurangi proliferasi limfosit dan menurunkan aktivitas bakterial intraseluler, sehingga merusak respon inflamasi normal dan terjadi inflamasi secara sistemik (SIRS). Penelitian ini bertujuan untuk mengetahui hubungan antara kadar glukosa darah dengan derajat SIRS pada pasien post kraniotomi yang dirawat di intensive care unit. Metode: Penelitian ini merupakan analitik korelasi dengan desain observasional dan pendekatan kohort prospektif. Pengambilan sampel menggunakan consecutive sampling dengan jumlah 20 orang pasien trauma kepala yang menjalani kraniotomi dan memenuhi kriteria inklusi. Penelitian dilakukan pada September sampai November 2013 dengan menilai kadar glukosa darah dan derajat SIRS pada 24 jam dan 72 jam post kraniotomi. Hasil: 90% responden mengalami peningkatan kadar glukosa baik pada 24 jam dan 72 jam post kraniotomi, 60% responden mengalami SIRS ringan pada 24 jam post kraniotomi dan 55% responden tidak mengalami SIRS pada 72 jam post kraniotomi. Uji korelasi Rank Spearman menunjukkan tidak terdapat hubungan antara peningkatan kadar glukosa darah dengan beratnya derajat SIRS (Rs= -0,112, p= 0,640 dan Rs=0,257, p= 0,274). Tidak terdapat hubungan antara peningkatan kadar glukosa darah dengan beratnya derajat SIRS pada pasien post kraniotomi yang dirawat intensive care unit. Simpulan: Perawat mempunyai peran dalam mengidentifikasi SIRS dan faktor lain yang mempengaruhi SIRS selain kadar glukosa darah.
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Chen, Bo, Shenxu Bao, Yimin Zhang, and Ruwei Zheng. "Ultrasound-assisted synthesis of N235-impregnated resins for vanadium (V) adsorption." Royal Society Open Science 5, no. 4 (April 2018): 171746. http://dx.doi.org/10.1098/rsos.171746.
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N235-impregnated resins were prepared using XAD-16HP macroporous adsorption resins as support with and without ultrasonic irradiation to evaluate the effects of ultrasound impregnation (UI) on the preparation and adsorption characteristics of the resins. The results show that the impregnation ratio of the solvent-impregnated resins (SIRs) prepared by ultrasound impregnation method (SIRs-UI) increases obviously but their adsorption capacity for V(V) just slightly increases and the utilization rate of the extractant decreases with the augmentation of ultrasound power. This may be caused by the fact that more extractant can enter into the deeper pores of the resins under high ultrasound intensity, but these extractants cannot effectively react with V(V). The impregnation equilibrium time of SIRs-UI can be obviously shortened in comparison to that of the SIRs prepared by conventional impregnation method (SIRs-CI) (3 min versus 240 min) due to the cavitation effect evoked by ultrasound. Ultrasonic irradiation may cause more N235 desorbed from the pores of the resin at low N235 content, resulting in lower adsorption capacity for V(V) than that of SIRs-CI, but the adsorption capacity is inverse at higher N235 content. N235 may be distributed more homogeneously in the pores of XAD-16HP with ultrasonic irradiation, thus, SIRs-UI presents higher adsorption capacity and stronger stability than SIRs-CI. This study manifests that ultrasound-assistant impregnation method may be a potential and promising technique for the preparation of SIRs.
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Zhang, Kaiming, Liqin Ping, Xueqi Ou, Meiheban Bazhabayi, and Xiangsheng Xiao. "A Systemic Inflammation Response Score for Prognostic Prediction of Breast Cancer Patients Undergoing Surgery." Journal of Personalized Medicine 11, no. 5 (May 14, 2021): 413. http://dx.doi.org/10.3390/jpm11050413.
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Background: Systemic inflammatory response is related to the occurrence, progression, and prognosis of cancers. In this research, a novel systemic inflammation response score (SIRS) was calculated, and its prognostic value for postoperative stage I-III breast cancer (BC) patients was analyzed. Methods: 1583 BC patients were included in this research. Patients were randomly divided into a training cohort (n = 1187) and validation cohort (n = 396). SIRS was established in the training cohort based on independent prognostic hematological indicator, its relationship between prognosis and clinical features was analyzed. Then, a nomogram consisted of SIRS and clinical features was established, its performance was examined by calibration plots and receiver operating characteristic curve analysis. Results: The SIRS was an independent prognostic indicator for BC patients, and a high-SIRS was related to multifocality, advanced N stage, and worse prognosis. Incorporating SIRS into a nomogram could accurately predict the prognosis of BC patients, the results of receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of nomogram was up to 0.806 in training cohort and 0.905 in the validation cohort. Conclusion: SIRS was associated with the prognosis of patients with breast cancer. Nomogram based on SIRS can accurately predict the prognosis of breast cancer patients.
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Akkas, Fatih. "The Effect of the Duration between Preoperative Bladder Urine Culture and Semirigid Ureteroscopic Lithotripsy on the Rate of Systemic Inflammatory Response Syndrome Postoperatively." Urology Open Access Open Journal 2, no. 2 (May 5, 2021): 65–69. http://dx.doi.org/10.33169/uro.uoaoj-2-118.
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Purpose The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome (SIRS) after semirigid ureteroscopic lithotripsy (SUL), and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods A retrospective review was conducted including patients who underwent SUL in our center between June 2015 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results The entire study included a cohort of 572 patients. The rate of SIRS following SUL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SUL when comparing the SIRS group with the other group. Conclusion The duration between PBUC and SUL is not efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issue as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture.
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Aune, T. M., G. L. Freeman, and D. G. Colley. "Production of the lymphokine soluble immune response suppressor (SIRS) during chronic experimental schistosomiasis mansoni." Journal of Immunology 135, no. 4 (October 1, 1985): 2768–71. http://dx.doi.org/10.4049/jimmunol.135.4.2768.
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Abstract Chronic schistosomiasis mansoni is a helminthic infection characterized by cell-mediated anti-egg granulomatous reactions and a variety of associated immunoregulatory phenomena. Soluble immune response suppressor (SIRS) is a lymphokine produced by activated suppressor T lymphocytes in various experimental settings. This report demonstrates the presence of SIRS in the sera of mice with chronic schistosomiasis mansoni (at least 20 wk of infection), but not in the sera of mice with earlier infections. Also, cultures of isolated, intact, hepatic, egg-focused granulomas from chronically infected mice released detectable levels of SIRS. These are the immunomodulated lesions characteristic of this infection. Large, intense, unmodulated granulomas obtained from acutely infected mice did not release SIRS. There is, therefore, a strong association between the presence of SIRS in the serum, the production of SIRS by intact lesions, and the chronic, immunomodulated stage of schistosomiasis mansoni.
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Soe, Minn, Allan Nkwata, Jonathan R. Edwards, Margaret Dudeck, and Daniel Pollock. "Assessing The Impact of The National Healthcare Safety Network’s (NHSN’s) New Baseline on Acute Care Hospital Standardized Infection Ratios (SIRs)." Open Forum Infectious Diseases 4, suppl_1 (2017): S49—S50. http://dx.doi.org/10.1093/ofid/ofx162.117.
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Abstract Background To more accurately measure the progress of healthcare-associated infection (HAI) prevention efforts, the CDC’s National Healthcare Safety Network (NHSN) surveillance system updated risk-adjustment models for computation of updated Standardized Infection Ratios (SIRs), the primary HAI summary measure by NHSN. This study sought to examine how the updated SIRs varied from the previous SIRs calculated using older baselines for acute care hospital HAIs. Methods We analyzed NHSN data for healthcare facility-onset laboratory-identified Clostridium difficile [CDI] and methicillin-resistant Staphylococcus aureus [MRSA] bacteremia reported in accordance with the CMS’ inpatient quality reporting program requirement. The unit of analysis was CMS certification number (CCN) facility reporting in 2015. We compared overall distributions of CCN-level SIRs (CCN-SIRs) between new risk-adjustment models using a 2015 baseline (SIR_NEW) and old models using a 2011 baseline (SIR_OLD) and tested location shift (median away from null) of pairwise differences. We also examined the magnitude of shift in SIR from old to new baseline. Results For each HAI, the national pooled mean SIR of the new baseline was ~1.0. For CDI, the overall distributions of CCN SIR_NEW and CCN-SIR_OLD were different, and the median of pairwise difference was away from null with CCN-SIR_NEW slightly higher. For MRSA, the SIR differences were not significant. Most CCN-SIRs (83% for CDI, 93% for MRSA) remained in the same significance category across the old and new baselines (“worse,” “better, ‘not different from national benchmark’), and few CCN-SIRs were reclassified to a less favorable category. For 75% of CCN-SIRs, their relative position in the quartile distributions of SIR_NEW and SIR_OLD remained the same. The discrepancies between SIR_NEW and SIR_OLD tended to be larger among CCNs with high SIRs. Conclusion The updated national pooled mean SIRs were close to 1.0, validating the potential use of new risk adjustment models and baseline as updated benchmarks for tracking CDI and MRSA prevention progress. The shifts in CCN-level SIRs between old and new baselines were not large, indicating a modest impact of new baselines at the CCN level, except among hospitals with high SIRs. Disclosures All authors: No reported disclosures.
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Bose, Partha Pratim, Mitali Haldar, Ashokananda Konar, and Subhrojyoti Bhowmick. "Prevalence of Sepsis and Role of Prophylactic Antibiotics in Acute Liver Failure." Indian Journal of Emergency Medicine 4, no. 2 (June 15, 2018): 77–83. http://dx.doi.org/10.21088/ijem.2395.311x.4218.1.
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Sepsis is a major cause of death in ALF accounting for 24- 49% of death in Indian patients which is in fact more common than renal failure or GI bleed. We aimed to study the prevalence of sepsis in ALF and the role of prophylactic antibiotics in limiting the incidence of infections in ALF and improving related mortality. 46 patients of ALF were stratified into 2 main groups with SIRS>=2 and SIRS<2 on admission based on the number of SIRS components. Patients with SIRS>=2 were studied for the prevalence of sepsis in ALF. Patients with SIRS<2 were studied for the incidence of sepsis and the role of prophylactic antibiotics in ALF dividing them further into control group who received prophylactic antibiotics and the Test group who were given antibiotics only on worsening due to sepsis or there were evidence of infection. SIRS was documented regularly and on every episode of worsening. Prevalence of sepsis was studied by observing day1 infections. Role of prophylactic antibiotics was studied by documenting subsequent infections and related mortality in control group and comparing with the test group without prophylactic antibiotics. 70% of infected patients expressed more than 2 SIRS components whereas 27.3% infected patients never expressed more than 1 SIRS component. 50% infection rate was noted with expression of more than 2 SIRS components as compared to 14.3% who remained SIRS<2 without deterioration. Prevalence of sepsis was 64%. Mortality in the infected was 69% compared to 30% in the non infected. 71.4% infections with 40% related mortality was observed in the control group on prophylactic antibiotics whereas in the test group without antibiotic prophylaxis 75% infection were observed with 66.7% related mortality. This prospective evaluation points to SIRS being closely associated with infections. Use of prophylactic antibiotics may limit the incidence of infection and reduce sepsis related mortality in ALF.
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Hostler, Christopher, Rebekah W. Moehring, Arthur W. Baker, Becky Smith, Linda Adcock, Brittain Wood, Evelyn Cook, et al. "The Effect of National Healthcare Safety Network (NHSN) Rebaselining on Community Hospital SIRs." Open Forum Infectious Diseases 4, suppl_1 (2017): S50—S51. http://dx.doi.org/10.1093/ofid/ofx162.119.
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Abstract Background The NHSN recently updated risk adjustment models and “rebaselined” Standardized Infection Ratios (SIRs) for healthcare-associated infections. The CDC expected that hospital SIRs would generally increase. However, the impact of rebaselining on individual hospitals’ SIRs was unknown. Accordingly, we assessed the impact of rebaselining on SIRs in a network of community hospitals. Methods We analyzed 2016 SIR data for CAUTI, MRSA LabID events, CDI LabID events, colon SSIs (COLO), and abdominal hysterectomy SSIs (HYST) from 38 hospitals in the Duke Infection Control Outreach Network (DICON). SIRs calculated using the old and new baselines were compared. Wilcoxon signed rank test was performed to determine whether hospitals’ SIRs changed significantly following rebaselining. Hospitals were ranked by SIR for each metric, and change in rank following rebaselining was determined. Meaningful change in rank was defined as increase or decrease by ≥4 places (greater than a decile). Hospitals that did not have an SIR calculated for a given metric were excluded from that metric’s analysis. Results Median hospital SIRs for CAUTI and CDI increased significantly after rebaselining (0.587 vs 0.307, P < 0.001; and 0.825 vs 0.783, p = 0.04, respectively). Median MRSA SIRs increased (0.903 vs 0.797, P = 0.5), and COLO and HYST SIRs decreased (0.457 vs 0.586, P = 0.1; and 0 vs 0.489, P = 0.4); however, these changes were not statistically significant (Figure 1). For all metrics, a minority of hospitals had meaningful change in SIR rank following rebaselining (Figure 2). Conclusion SIRs increased following rebaselining for CAUTI and CDI but did not change significantly for MRSA, COLO, or HYST. The majority of hospitals’ SIR rank did not change meaningfully following rebaselining. Disclosures D. Sexton, Centers for Disease Control and Prevention: Grant Investigator, Grant recipient; Centers for Disease Control and Prevention Foundation: Grant Investigator, Grant recipient; UpToDate: Collaborator, Royalty Recipient
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Glinge, Charlotte, Sára Rossetti, Louise Bruun Oestergaard, Niels Kjær Stampe, Thomas Hadberg Lynge, Regitze Skals, Bo Gregers Winkel, et al. "Risk of Sudden Infant Death Syndrome Among Siblings of Children Who Died of Sudden Infant Death Syndrome in Denmark." JAMA Network Open 6, no. 1 (January 25, 2023): e2252724. http://dx.doi.org/10.1001/jamanetworkopen.2022.52724.
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ImportanceSudden infant death syndrome (SIDS) remains a leading cause of death during the first year of life. The etiology of SIDS is complex and remains largely unknown.ObjectiveTo evaluate whether siblings of children who died of SIDS have a higher risk of SIDS compared with the general pediatric population.Design, Setting, and ParticipantsThis register-based cohort study used Danish nationwide registers. Participants were all infants (&lt;1 year) in Denmark between January 1, 1978, and December 31, 2016, including siblings of children who died of SIDS. Siblings were followed up from the index cases’ date of SIDS, date of birth, or immigration, whichever came first, and until age 1 year, emigration, developing SIDS, death, or study end. The median (IQR) follow-up was 1 (1-1) year. Data analysis was conducted from January 2017 to October 2022.Main Outcomes and MeasuresStandardized incidence ratios (SIRs) of SIDS were calculated with Poisson regression models relative to the general population.ResultsIn a population of 2 666 834 consecutive births (1 395 199 [52%] male), 1540 infants died of SIDS (median [IQR] age at SIDS, 3 [2-4] months) during a 39-year study period. A total of 2384 younger siblings (cases) to index cases (first sibling with SIDS) were identified. A higher rate of SIDS was observed among siblings compared with the general population, with SIRs of 4.27 (95% CI, 2.13-8.53) after adjustment for sex, age, and calendar year and of 3.50 (95% CI, 1.75-7.01) after further adjustment for mother’s age (&lt;29 years vs ≥29 years) and education (high school vs after high school).Conclusions and RelevanceIn this nationwide study, having a sibling who died of SIDS was associated with a 4-fold higher risk of SIDS compared with the general population. Shared genetic and/or environmental factors may contribute to the observed clustering of SIDS. The family history of SIDS should be considered when assessing SIDS risk in clinical settings. A multidisciplinary genetic evaluation of families with SIDS could provide additional evidence.
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Ruan, Hailin, Dianshan Ke, and Dalin Liao. "Prognostic Accuracy of qSOFA and SIRS for Mortality in the Emergency Department: A Meta-Analysis and Systematic Review of Prospective Studies." Emergency Medicine International 2022 (May 5, 2022): 1–11. http://dx.doi.org/10.1155/2022/1802707.
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Objective. This meta-analysis aimed to determine the prognostic performance of quick sequential organ failure assessment (qSOFA) score in comparison to systemic inflammatory response syndrome (SIRS) in predicting in-hospital mortality in the emergency department (ED) patients. Methods. Eligible studies comparing the performance of qSOFA and SIRS in predicting in-hospital death of ED patients were identified from searching PubMed, Embase, and Cochrane. Raw data were collected, and the pooled sensitivity and specificity were calculated for qSOFA and SIRS. The summary receiver operating curve was also plotted to calculate the area under the curve. Results. A total of 16 prospective studies with 35,756 patients and 2,285 deaths were included. The pooled sensitivity was 0.43 (95% CI: 0.32–0.54) and 0.8 (95% CI: 0.73–0.86) for qSOFA and SIRS, respectively. The pooled specificity was 0.89 (95% CI: 0.84–0.93) and 0.39 (95% CI: 0.3–0.5) for qSOFA and SIRS, respectively. The area under the summary receiver operating curve was 0.76 (95% CI: 0.72–0.8) and 0.67 (95% CI: 0.62–0.72) for qSOFA and SIRS, respectively. A significant heterogeneity was observed for both qSOFA and SIRS studies. Conclusion. The present meta-analysis suggested that qSOFA had a higher specificity but a lower sensitivity as compared with SIRS in predicting in-hospital mortality in the ED patients. qSOFA appeared to be a more concise and simple way to recognize patients at high risk for death. However, the use of SIRS in the ED cannot be completely replaced since the sensitivity of qSOFA was relatively lower.
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Gori, Eleonora, Alessio Pierini, Ilaria Lippi, George Lubas, and Veronica Marchetti. "Leukocytes Ratios in Feline Systemic Inflammatory Response Syndrome and Sepsis: A Retrospective Analysis of 209 Cases." Animals 11, no. 6 (June 1, 2021): 1644. http://dx.doi.org/10.3390/ani11061644.
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Sepsis is a challenging condition in which hematological prognostic and diagnostic markers in cats are limited. The aims of this study were to test if there are any differences in leukocyte ratios (NLR, BLR and BNLR) between healthy, SIRS and septic cats (sick cats), and if, within sick cats, NLR, BLR and BNLR may be prognostic markers. A retrospective medical database study included 76 healthy cats (blood-donors), 54 SIRS and 79 septic cats. SIRS group was defined if cats fulfilled SIRS criteria. Sepsis was confirmed with an infectious focus on cytology or a positive culture for bacterial infection. Leukocyte ratios were compared among the three study groups and between survivors and non-survivors in sick cats. NLR resulted significantly higher in the sick group compared to healthy cats (p < 0.0001), although NLR was not different between SIRS and sepsis. An NLR > 4.53 had a sensitivity of 76% and a specificity of 93.4% to detect SIRS/sepsis (OR 44.8 95%CI 17–107). Only BLR and BNLR were significantly different between SIRS and sepsis. NLR was associated with mortality in the sick group (p = 0.04). Although NLR resulted higher in sick cats than healthy, BLR and BNLR demonstrated as promising tools in differentiating SIRS from sepsis. NLR was associated with mortality in sick cats.
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Milić, Ljiljana, Ilijana Grigorov, Slobodan Krstić, Miljan S. Ćeranić, Bojan Jovanović, Jelena Stevanović, and Predrag Peško. "Serum Level of HMGB1 Protein and Inflammatory Markers in Patients with Secondary Peritonitis: Time Course and the Association with Clinical Status." Journal of Medical Biochemistry 36, no. 1 (January 1, 2017): 44–53. http://dx.doi.org/10.1515/jomb-2016-0016.
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SummaryBackground:Intra-abdominal infection in secondary peritonitis drives as excessive production of inflammatory mediators and the development of systemic inflammatory response syndrome (SIRS) or sepsis. Finding a specific marker to distinguish SIRS from sepsis would be of immense clinical importance for the therapeutic approach. It is assumed that high-mobility group box 1 protein (HMGB1) could be such a marker. In this study, we examined the time course changes in the blood levels of HMGB1, C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) in patients with secondary peritonitis who developed SIRS or sepsis.Methods:In our study, we evaluated 100 patients with diffuse secondary peritonitis who developed SIRS or sepsis (SIRS and SEPSIS group) and 30 patients with inguinal hernia as a control group. Serum levels of HMGB1, CRP, PCT, and SAA were determined on admission in all the patients, and monitored daily in patients with peritonitis until discharge from hospital.Results:Preoperative HMGB1, CRP, PCT and SAA levels were statistically highly significantly increased in patients with peritonitis compared to patients with inguinal hernia, and significantly higher in patients with sepsis compared to those with SIRS. All four inflammatory markers changed significantly during the follow-up. It is interesting that the patterns of change of HMGB1 and SAA over time were distinctive for SIRS and SEPSIS groups.Conclusions:HMGB1 and SAA temporal patterns might be useful in distinguishing sepsis from noninfectious SIRS in secondary peritonitis.
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Amory, Hélène, Carla Cesarini, Lorie De Maré, Clémence Loublier, Nassim Moula, Johann Detilleux, Marc Saulmont, Mutien-Marie Garigliany, and Laureline Lecoq. "Relationship between the Cycle Threshold Value (Ct) of a Salmonella spp. qPCR Performed on Feces and Clinical Signs and Outcome in Horses." Microorganisms 11, no. 8 (July 30, 2023): 1950. http://dx.doi.org/10.3390/microorganisms11081950.
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The objective of this retrospective study was to evaluate the clinical significance of fecal quantitative real-time polymerase chain reaction (qPCR) Salmonella results when taking the cycle threshold values (Ct) into account. The study included 120 Salmonella qPCR-positive fecal samples obtained from 88 hospitalized horses over a 2-year period. The mean Ct of the qPCR test was evaluated in regard to (1) clinical outcome and (2) systemic inflammatory response syndrome (SIRS) status (no SIRS, moderate SIRS, or severe SIRS) of the sampled horses. An ROC analysis was performed to establish the optimal cut-off Ct values associated with severe SIRS. The mean ± SD Ct value was significantly lower in samples (1) from horses with a fatal issue (27.87 ± 5.15 cycles) than in surviving horses (31.75 ± 3.60 cycles), and (2) from horses with severe SIRS (27.87 ± 2.78 cycles) than from horses with no (32.51 ± 3.59 cycles) or moderate (31.54 ± 3.02 cycles) SIRS. In the ROC analysis, the optimal cut-off value of Ct associated with a severe SIRS was 30.40 cycles, with an AUC value of 0.84 [95% confidence interval 0.76–0.91] and an OR of 0.64 [0.51–0.79]. Results suggest that including the Ct value in the interpretation of fecal qPCR results could improve the diagnostic value of this test for clinical salmonellosis in horses.
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Sant' anna, Marcos Cezar, Luiz Guilherme Corsi Trautwein, Lucienne Garcia Pretto Giordano, Rebeca Cordeiro Justino, Karina Keller Marques da Costa Flaiban, and Maria Isabel Mello Martins. "The importance of Gram positive bacteria as the cause of canine pyometra." Semina: Ciências Agrárias 38, no. 2 (May 2, 2017): 1077. http://dx.doi.org/10.5433/1679-0359.2017v38n2p1077.
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E. coli is the main bacteria isolated from infected uterus and bacterial endotoxin can lead to fatal endotoxic shock. Systemic inflammatory response syndrome (SIRS) precedes the endotoxic shock. Thus, early recognition of SIRS is important for patient treatment and prognostic. In Brazil, Gram positive bacteria are responsible for approximately 20% of all pyometra cases, and there is limited information about pathophysiology of shock and tissue injury. The aim of this study was to investigate the capacity of Gram positive bacteria to cause SIRS in bitches with pyometra. A prospective follow-up of 67 bitches with pyometra was performed, which were classified as SIRS + and SIRS- on admission. All bitches were surgically treated (ovariohysterectomy), uterine contents were collected in a sterile manner and the material was submitted to microbiological evaluation. Were identified in 55.2% of bitches E. coli (G1), 23.9% other Gram negative bacteria (G2) and 20.9% Gram positive bacteria (G3). The leukocyte profile, serum biochemistry and prevalence of SIRS were similar between the groups. It is concluded that Gram positive bacteria have the capacity to promote tissue damage and can lead the patient to death after SIRS and shock, as well as by E. coli and other Gram negative.
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Kartheek, Kiran, Baliga B. S., Subodhshetty, Prasanna Mithra, and Charu Yadav. "Nutrient deficiencies (Copper, Zinc, Iron, Magnesium) among children with SIRS/sepsis-a hospital based cross sectional study." International Journal of Contemporary Pediatrics 4, no. 3 (April 25, 2017): 933. http://dx.doi.org/10.18203/2349-3291.ijcp20171701.
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Background: In developing countries sepsis is a major etiological factor contributing to 60-80 % of annual mortality. SIRS/sepsis rates are high among children admitted to hospitals particularly in intensive care units. Oxidative stress plays important role in etio-pathogenesis of SIRS/sepsis. Nutrients with antioxidant activity enhance immune system there by decreasing severity of SIRS/sepsis. Estimation of such nutrient levels might establish relationship with oxidative stress in children with SIRS/sepsis.Methods:A hospital based cross-sectional study was done on consecutive samples of 96 children diagnosed with SIRS/sepsis. Serum copper, iron zinc, magnesium levels of children diagnosed with sepsis/SIRS included in the study were estimated, data were represented as median with inter quartile range and proportions. Mann Whitney u test and Karl Pearson’s correlation tests were used to see correlation between clinical paramaters.Results: Zinc and magnesium deficiency were seen in 68.8% and 59.4% children with SIRS/sepsis. Median serum magnesium levels were 1.24mg/dL in children with illness <1 week and 1.51mg/dL with illness >1week duration prior to hospitalization (p=0.017). Hospital acquired infections were higher with zinc (P=0.001) and copper deficiency(P=0.002). Zinc deficiency correlated with need for longer hospitalization (P= 0.017). Mortality due to SIRS/sepsis increased as number of nutrient deficiencies increased (P =0.009).Conclusions:Significant number of children with SIRS/sepsis had nutrient deficiencies. These deficiencies correlated significantly with duration of illness prior to hospitalization. Children with nutrient deficiency had higher incidence of hospital acquired infections. Children with normal nutrient levels have decreased length of hospitalization. Children with multiple nutrient deficiency had higher risk of death.
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Harrell, Shelley. "SIRS Issues Researcher." Charleston Advisor 17, no. 4 (April 1, 2016): 44–46. http://dx.doi.org/10.5260/chara.17.4.44.
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Baue, Arthur E. "MOF/MODS, SIRS." Shock 5 (June 1996): S1–5. http://dx.doi.org/10.1097/00024382-199606001-00002.
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Baue, Arthur E. "MOF/MODS, SIRS." Shock 6, Supplement (October 1996): S1—S5. http://dx.doi.org/10.1097/00024382-199610001-00002.
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Rodby, Roger A. "Hemofiltration for SIRS." Critical Care Medicine 26, no. 12 (December 1998): 1940–42. http://dx.doi.org/10.1097/00003246-199812000-00007.
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Marshall, John C. "SIRS AND MODS." Shock 14, no. 6 (December 2000): 586–89. http://dx.doi.org/10.1097/00024382-200014060-00002.
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