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6��C or >38.3��C, tachycardia (>90 beats/minute), ventilatory frequency >20 breaths/minute or PCO2 <32 mmHg (unless the patient was mechanically ventilated), a white cell count ��12 �� 109 litre-1 or <4 �� 109 litre-1 or >10% immature Doxorubicin neutrophils. Severe sepsis was defined as sepsis with evidence of organ dysfunction and hypoperfusion, acute alteration of mental standing, elevated plasma lactate, unexplained metabolic acidosis (arterial pH <7.3), hypoxaemia, prolonged prothrombin time or a decrease in platelet count >50% or ��100 �� 109litre1, oliguria and hypotension defined as systolic arterial pressure <90 mmHg or a decrease of >40 mmHg. Septic shock was defined as hypotension (<90/60 mmHg) in addition to sepsis syndrome persisting despite adequate fluid resuscitation and requiring intropic support.
The SOFA score is composed of scores from six organ systems (respiratory (R), cardiovascular (C), hepatic (H), coagulation (Co), renal (Re), and neurological (N)) graded from 0 to 4 according on the degree of dysfunction/failure. The aggregate score (complete optimum SOFA score (TMS) is calculated, summing up the worst scores 17-DMAG (Alvespimycin) HCl for every from the organ programs (TMSorg) during the ICU remain .Blood samplingBlood samples were collected in glass tubes. Blood was processed within two hours. It had been centrifuged at 1,600 g for 15 minutes.IL-6 and TNF-�� determination applying ELISASerum levels of IL-6 and TNF-�� have been established by quantitative sandwich enzyme immunoassay (R&D Techniques, Inc., Minneapolis, MN, USA) in accordance to the manufacturer's instructions.
The intensity in the colour was measured at 490 nm for both IL-6 and TNF-��.Leptin determinationSerum leptin was established by quantitative sandwich enzyme immunoassay (Ray Biotech., Inc., Doxorubicin Minneapolis, MN, USA) in accordance on the manufacture's instructions. The intensity from the colour was measured at 450 nm.Statistical analysisParametric data were analyzed employing either ANOVA or Student's t-test while non-parametric data have been analyzed utilizing Mann-Whitney U and ��2-tests. Data have been presented as mean and standard deviation. A P-value of < 0.05 was considered significant.ResultsPatients' characteristicsA total of 106 patients (57 men and 49 women) were included in the study. Forty patients developed septic complications during their ICU stay (sepsis group), 12 developed septic shock, 18 developed severe sepsis, and 10 patients developed sepsis without any organ dysfunction.
Thirty-four patients developed manifestations of SIRS without proof of infectious organisms (SIRS group), ten developed non-septic complications from the form of disturbed hepatic or renal functions, electrolyte imbalance or acid-base disorders. Thirty-two medico-surgical patients showed no manifestation of SIRS (non-SIRS group). Eleven patients died, eight of whom had been in septic shock and the other three had been suffering from extreme sepsis.