***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background / Aims : We investigated whether urinary podocytes are present in septic patients with methicillin-resistant Staphylococcus aureus (MRSA)-associated glomerulonephritis and whether polymyxin B-immobilized fiber ( PMX-F ) treatment affects proteinuria and urinary podocyte excretion in these patients . Methods : Twenty septic patients with MRSA-associated glomerulonephritis ( mean age : 63.7 years ) and 80 septic patients whose MRSA infection was not followed by glomerulonephritis ( mean age : 60.5 years ) were included in this study . All septic patients were treated with fosfomycin sodium , β-lactams , arbekacin sulfate , and teicoplanin , or a combination of these . Twenty septic patients with MRSA-associated glomerulonephritis were r and omly assigned to one of two treatments : PMX-F treatment ( group A , n = 10 ) and conventional treatment ( group B , n = 10 ) . PMX-F treatment was repeated twice . Results : Urinary podocytes and urinary protein excretion were not detected in MRSA septic patients without glomerulonephritis . However , urinary podocytes ( 1.7 ± 0.6 cells/ml ) and proteinuria ( 2.6 ± 0.6 g/d ) were detected in the 20 septic patients with MRSA-associated glomerulonephritis . Plasma endotoxin levels were decreased from 13.6 ± 4.6 pg/ml to 6.6 ± 2.2 pg/ml ( p < 0.05 ) in group A. Levels in group B , however , showed little difference after treatment . Urinary podocytes were reduced in group A ( from 1.8 ± 0.6 cells/ml to 0.4 ± 0.2 cells/ml , p < 0.01 ) as was urinary protein excretion ( from 3.0 ± 0.5 g/d to 0.8 ± 0.4 g/d , p < 0.01 ) but urinary podocytes and protein excretion levels showed little difference after treatment in group B. Conclusion : PMX-F treatment may be effective in reducing urinary protein and urinary podocyte excretion in septic patients with MRSA-associated glomerulonephritis Introduction The objective of this study was to clarify the efficacy and mechanism of action of direct hemoperfusion with an immobilized polymyxin B fiber column ( DHP-PMX ) in patients with acute lung injury or acute respiratory distress syndrome caused by sepsis . Method Thirty-six patients with sepsis were included . In each patient a thermodilution catheter was inserted , and the oxygen delivery index and oxygen consumption index were measured . DHP-PMX was performed in patients with a normal oxygen delivery index and oxygen consumption index ( > 500 ml/minute per m2 and > 120 ml/minute per m2 , respectively ) . The Acute Physiology and Chronic Health Evaluation II score was used as an index of the severity of sepsis , and survival was assessed after 1 month . The humoral mediators measured were the chemokine IL-8 , plasminogen activator inhibitor-1 , and neutrophil elastase ( NE ) . These mediators were measured before DHP-PMX treatment , and at 24 , 48 , and 78 hours after the start of treatment . The arterial oxygen tension (PaO2)/fractional inspired oxygen ( FiO2 ) ratio was measured before DHP-PMX treatment and at 24 , 48 , 72 , 92 , and 120 hours after the start of treatment . Results All patients remained alive after 1 month . Before DHP-PMX treatment , the Acute Physiology and Chronic Health Evaluation II score was 24 ± 2.0 , the IL-8 level was 54 ± 15.8 pg/ml , plasminogen activator inhibitor-1 was 133 ± 28.1 ng/ml , and NE was 418 ± 72.1 μg/l . These three humoral mediators began to decrease from 24 hours after DHP-PMX treatment , and the decline became significant from 48 hours onward . The PaO2/FiO2 ratio was 244 ± 26.3 before DHP-PMX treatment but improved significantly from 96 hours onward . There were significant negative correlations between the PaO2/FiO2 ratio and blood levels of NE and IL-8 . Conclusion The mechanism of action of DHP-PMX is still not fully understood , but we report the following findings . The mean blood levels of plasminogen activator inhibitor-1 , NE , and IL-8 were significantly decreased from 48 hours after DHP-PMX treatment . The mean PaO2/FiO2 ratio was significantly improved from 96 hours after DHP-PMX treatment . Improvement in the PaO2/FiO2 ratio appeared to be related to the decreases in blood NE and IL-8 levels OBJECTIVE the aim of the present study was to determine whether serum neopterin and soluble interleukin (IL)-2 receptor levels were related to the development of septic shock and whether polymyxin B-immobilized fibre ( PMX-F ) treatment affects these levels . METHODS we examined 24 patients admitted to our intensive care unit with Gram-negative septic shock .  Serum neopterin and soluble IL-2 receptor levels were measured using commercially available test kits . Patients were treated with direct hemoperfusion using PMX-F columns . RESULTS fifteen out of 24 patients ( 63 % ) survived and were discharged from our hospitals within 30 days after PMX-F treatment .  Blood endotoxin levels decreased significantly from 49.2+/-8.6 pg/ml to 13.2+/-4.4 pg/ml after PMX-F treatment . The pretreatment serum concentrations of neopterin and IL-2 receptor were significantly higher in the nine non-surviving patients with septic shock than in the 15 surviving patients ( P<0.01 ) and 20 control subjects ( P<0.001 ) . Serum concentrations of neopterin and IL-2 receptor in patients with septic shock decreased significantly after PMX-F treatment ( P<0.01 ) . CONCLUSIONS these data suggest that serum neopterin and IL-2 receptor concentrations may be prognostic indicators in patients with septic shock . PMX-F treatment may be effective for reducing serum neopterin and IL-2 receptor concentrations Background : CD16 + CD14 + monocytes dramatically increase in number in patients with severe infection .  Hemoperfusion with PMX-F ( direct hemoperfusion with polymyxin B immobilized fibers ) has been reported to be a safe and effective treatment for patients with septic shock , although the molecular mechanism that accounts for its effectiveness is still unclear . The purpose of this study was to quantify the number of CD16+CD14 + monocytes in patients with an intra-abdominal infection and to evaluate the effects of PMX-F treatment on clinical parameters and leukocyte surface antigen expression in these patients . Material s and Methods : Seventeen septic patients who had an intra-abdominal infection were enrolled in this study ; 7 of these patients received PMX-F treatment . Peripheral blood sample s were obtained immediately after admission , and were also collected from the above 7 patients before , during , and immediately after their PMX-F treatment . The expression of CD14 , CD16 , and Toll-like receptor (TLR)-4 on these patients ' monocytes was evaluated using flow cytometry . In addition , lipopolysaccharide (LPS)-induced production of TNF-α and IL-1β by these cells was measured by ELISA . Results : Monocytic expression of CD16 and TLR-4 was significantly greater in septic patients than in healthy controls , and their proportion of CD16+CD14 + monocytes was similarly elevated . LPSinduced production of TNF-α and IL-1β by peripheral blood mononuclear cells ( P BMC s ) of septic patients was significantly reduced compared to controls . Furthermore , there was a reduction in the proportion of CD 16+CD 14 + monocytes  during PMX-F treatment , and in the expression of TLR-4 on monocytes after PMX-F treatment . Conclusions : These results showed that the number of peripheral blood CD16+CD14 + monocytes and monocytic TLR-4 expression were markedly increased , and the production of pro-inflammatory cytokines in response to LPS significantly reduced in patients with sepsis . PMX-F treatment was found to be effective in reducing the number of CD 16+CD 14 + monocytes and in decreasing the monocytic expression of TLR-4 in patients with septic shock Objective To analyze the effects of polymyxin B-immobilized fiber ( PMX-F ) on bone resorption in septic patients . Design and setting Observational prospect i ve study in intensive care units of a general hospital . Patients and participants 25 patients with severe sepsis and 20 healthy controls . Measurements and results Septic patients were r and omly assigned to two groups : PMX-F treatment group ( n=15 ) and conventional treatment group ( n=10 ) . Total pyridinium crosslink pyridinoline ( PYD ) and deoxypyridinoline ( DPD ) in urine were determined by modified high-performance liquid chromatography . Nitric oxide production was assessed by measuring the ratio of the nitric oxide breakdown products to urinary creatinine ( NOx/Cr ) . Plasma endotoxin levels were determined by endospecy test . The blood albumin , ionized calcium , and parathyroid hormone were also measured . PMX-F treatment was performed twice separated by 24 h. Urinary NOx/Cr , PYD/Cr , and DPD/Cr were significantly increased in septic patients compared with those in healthy controls . Blood ionized calcium in septic patients was lower than in healthy controls , while parathyroid hormone levels in septic patients were higher than in healthy controls ( P<0.01 ) . PMX-F treatment reduced plasma endotoxin , urinary NOx/Cr , PYD/Cr , DPD/Cr , and serum parathyroid hormone levels and increased blood ionized calcium significantly ; however , conventional treatment did not affect these levels . Conclusions Septic patients increased nitric oxide production and bone resorption , and PMX-F treatment is effective in reducing nitric oxide levels and bone resorption markers Endotoxin is an important pathogenic trigger for sepsis . The polymyxin B-immobilized endotoxin removal hemoperfusion cartridge , Toraymyxin ( hereafter PMX ) , has been shown to remove endotoxin in pre clinical and open-label clinical studies . In a multicenter , open-label , pilot , r and omized , controlled study conducted in the intensive care unit in six academic medical centers in Europe , 36 postsurgical patients with severe sepsis or septic shock secondary to intra-abdominal infection were r and omized to PMX treatment of 2 h ( n = 17 ) or st and ard therapy ( n = 19 ) . PMX was well tolerated and showed no significant side effects . There were no statistically significant differences in the change in endotoxin levels from baseline to 6 to 8 h after treatment or to 24 h after treatment between the two groups . There was also no significant difference in the change in interleukin (IL)-6 levels from baseline to 6 to 8 h after treatment or to 24 h after treatment between the two groups . Patients treated with PMX demonstrated significant increases in cardiac index ( CI ; P = 0.012 and 0.032 at days 1 and 2 , respectively ) , left ventricular stroke work index ( LVSWI , P = 0.015 at day 2 ) , and oxygen delivery index ( DO2I , P = 0.007 at day 2 ) compared with the controls . The need for continuous renal replacement therapy ( CRRT ) after study entry was reduced in the PMX group ( P = 0.043 ) . There was no significant difference between the groups in organ dysfunction as assessed by the Sequential Organ Failure Assessment ( SOFA ) scores from day 0 ( baseline ) to day 6 . Treatment using the PMX cartridge is safe and may improve cardiac and renal dysfunction due to sepsis or septic shock . Further studies are needed to prove this effectiveness The aim of the present study was to determine whether treatment with polymyxin B-immobilized fibre ( PMX-F ) haemoperfusion , teicoplanin , or both in combination is effective in patients with methicillin-resistant Staphylococcus aureus ( MRSA ) sepsis . Sixty patients with MRSA sepsis were r and omly assigned to one of four treatments : ( A ) PMX-F treatment ( N=15 ) , ( B ) teicoplanin treatment ( N=15 ) , ( C ) PMX-F and teicoplanin in combination ( N=20 ) and ( D ) conventional therapy ( N=10 ) . PMX-F treatment was repeated twice . Teicoplanin was administered by intravenous injection . Plasma endotoxin levels were determined by endospecy test . Plasma endotoxin levels were reduced in groups A and C ( P<0.05 ) . Survival rates were 53 , 47 , 90 , and 20 % in groups A , B , C and D , respectively ( group C versus group A , P<0.05 ; group C versus group B , P<0.01 ; group C versus group D , P < 0.001 ) . The mean duration of stay was 44 , 42 , 28 and 56 days in groups A , B , C and D , respectively . Our data suggest that combination therapy with PMX-F and teicoplanin is effective for sepsis caused by MRSA Objective : To find out whether polymyxin B- 
    Output:
    
Conclusion Based on this critical review of the published literature , direct hemoperfusion with PMX-F appears to have favorable effects on MAP , dopamine use , PaO2/FiO2 ratio , and mortality .