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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In urosepsis endotoxins usually deriving from gram-negative bacteria can initiate primary disturbances of hemostasis by activation of coagulation up to clinically manifest consumption coagulopathy. The reaction is triggered by an endotoxin induced alteration of granulocytes, endothelial cells, and platelets, thereby releasing procoagulant activities that possibly cause diffuse intravascular coagulation with impairment of vital organs. Additional negative effects on hemostasis can be caused by secondary hyperfibrino(geno)lysis. Secondary disturbances of hemostasis occur in urosepsis as a consequence of an impairment of liver (hypoproduction of coagulation factors, decrease of the clearance of activated coagulation factors) and kidney function (thrombocytopathy by uremic toxins). Disturbances of hemostasis induced by the treatment of urosepsis are the K-hypovitaminosis in parenteral feeding accompanied by antibiotics affecting the intestinal bacterial growth and the alteration of platelet function and fibrin formation by carbenicillin.
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PMID:[Septic shock in the urologic patient. II. Pathomechanisms of hemostatic disorders (author's transl)]. 89 44

The hemostasis system has been assessed in 42 patients in the age range of 18 to 60 years with secondary urosepsis. All patients had been operated for upper urinary tract obstruction or suppurative destructive renal and retroperitoneal lesions. Hemostasis was examined before and after the operation using coagulation screen. Middle-molecular peptides were assayed in the patients before and after plasmapheresis. Revealed hemostatic disorders were treated with heparin, antibacterial agents and infusion of fresh frozen plasma. Plasmapheresis is indicated in patients who are unresponsive to antibacterial therapy and surgical drainage of suppurative lesions. Postoperative hemostatic disorders presented as both hypo- and hypercoagulation, with thrombinemia in most cases. The patients with urosepsis showed latent hypercoagulation phase of DIC. By removing acute phase proteins, plasmapheresis prevented fibrinolytic failure. Exfusion of small volumes of plasma did not affect antithrombin III levels and produced a coagulation-anticoagulation balance. Declining levels of middle-molecular peptides after plasmapheresis were indicative of detoxication, presenting as better clinical status and improvement of laboratory findings.
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PMID:[The treatment of the disseminated intravascular coagulation syndrome in urosepsis patients]. 227 53

Clinical, laboratory and pathomorphological investigations evidence for close relationships between acute infectious inflammatory conditions of the prostate and thrombohemorrhagic complications arising both locally and systemically. All these postoperative complications manifesting clinically as acute prostatitis, epididymo-orchitis, urosepsis, bacteriotoxic shock, bleeding, thrombosis and embolism, latent or marked DIC syndrome have underlying local infectious-inflammatory process (postoperative acute prostatitis). Preoperative detection of local infection (concomitant chronic prostatitis), monitoring of hemocoagulation, antibacterial and antiinflammatory therapy of chronic prostatitis and normalization of blood rheology improve surgical outcomes in prostatic adenoma and lead to less frequent occurrence of both acute inflammatory and thrombohemorrhagic complications.
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PMID:[The relationship of postoperative thrombotic-hemorrhagic complications to the local acute inflammatory process in patients with prostatic adenoma]. 754 Mar 39

1,000 hysterectomies are reported by the author in a space of 20 years in four hospitals of ISSSTE. Some clinic-pathological parameters were analyzed, morbi-mortality, etc. The obtained results are informed using a simplification on the surgical techniques. The most frequent symptoms were menstrual disorders, and the most frequent diagnosis was myomatosis with (61.2%) average age between 35-45 years old. All were total hysterectomies, intrafascial 92.6% and abdominal 74.8%. Attention is called upon the fact that 7.2% of the patients presented pelvic congestion post tubaric occlusion and the association of adenomyosis. The overall morbidity was 12.2% being urosepsis the most frequent. Mortality was in one case of giant interligamentary myoma and DIC. Blood transfusion was needed just in 4.2%. We think that the surgical simplification here announced offer more safety, less morbidity, less bleeding and brief surgical time. More over, a critical analysis was made about use and abuse of this kind of surgical intervention.
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PMID:[Analysis of 1,000 hysterectomies. Technical simplifications and reflections. ISSSTE hospitals]. 818 71

The paper presents the results of plasmapheresis inclusion into a combined therapy of pyelonephritis. Out of 79 patients treated, 42 had urosepsis, 25 developed pyelonephritis in pregnancy, 12 had complicating chronic renal failure. Uroseptic patients were examined for hemostasis, the rest for immune status. There were symptoms of DIC syndrome in the former and immunity suppression in the latter. After the combined therapy with plasmapheresis, latent hypercoagulation and intoxication disappeared, uroseptic manifestations reduced. The above treatment of pregnancy pyelonephritis stopped inflammation, promoted activation of the immune system. In patients with chronic renal failure adjuvant plasmapheresis enhanced cellular and humoral immunity, neutrophil function, the number of middle-size molecules in the blood diminished. The latter improved renal function in decreasing uremia.
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PMID:[The use of plasmapheresis in treating urology patients]. 829 44

A patient with acute leukemia is presented in whom the leukemic cells, as seen by light microscopy were typical promyelocytes. The cells had normal or slightly invaginated nuclei with typical cytoplasmic granules and the diagnosis was confirmed by cytochemistry. The clinical course was rapid and the patient died of disseminated intravascular coagulation and urosepsis within a few days of diagnosis. However, electron microscopic examination showed cells with extremely convoluted and lobulated nuclei with nuclear pockets and cytoplasmic bridges as well as the complete absence of cytoplasmic granules in the majority of the cells. Furthermore, the urine lysozyme (muramidase) was elevated. These findings suggest that the leukemia in this patient may be classified as a hypogranular variant of acute promyelocytic leukemia (APL), with monocytoid ultrastructural appearances.
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PMID:Ultrastructural observations on a variant of acute promyelocytic leukemia. 834 79

At Asama General Hospital, we experienced six cases of urosepsis with septic shock during a period of five years between 1989 and 1993. All six patients, whose average age was 74 years old, recovered. In four patients, the condition was caused by obstructive uropathy. The remaining two cases were caused by renal inflammatory disease, which was complicated by diabetes mellitus. One of them was renal abscess with renal papillary necrosis, and the other was emphysematous pyelonephritis. The patients, who exhibited symptoms such as gram-negative bacteremia, severe hypotension, tachycardia, decrease of urine volume and mental disturbance, were diagnosed with urosepsis with septic shock. In all cases, symptoms such as a high fever of over 39 degrees C, hypoxemia and thrombocytopenia were observed. Renal dysfunction was found in 67%, and both liver dysfunction and disseminated intravascular coagulation (DIC) were found in 50% of the cases. Since no patients suffered from adult respiratory distress syndrome, a high survival rate was apparent. Anti-shock therapy and anti-coagulation therapy were ineffective for the patients who had septic shock due to urinary tract obstruction. Urinary tract drainage was required to treat the latter patients. Nephrectomy could not be avoided in renal parenchymatous inflammatory disease. In the future, what might be essential in therapeutics against urosepsis with septic shock, particularly to avoid nephrectomy, are the treatments such as immunotherapy against endotoxins and their mediators, and hemoperfusion for the removal of endotoxins.
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PMID:[Clinical study on 6 cases of urosepsis associated with septic shock]. 989 24

A 70-year-old man with bladder cancer received a total cystectomy and an ileal conduit 64 months before he visited our hospital with complaints of lower abdominal pain, shaking and chilliness. Bilateral hydronephrosis due to an ileal conduit obstruction were observed on the ultrasonography. Bacterial culture from blood and urine samplings revealed E. coli. Under the diagnosis of urosepsis, the administration of anti-biotics and bilateral percutaneous nephrostomy were performed. However, he suffered from septic shock and disseminated intravascular coagulation (DIC). Therefore, the treatments for DIC were done, and they were effective. The obstruction of the ileal conduit was cured spontaneously. No recurrence or metastases were found on ultrasonography and computed tomographic scan for 12 months after these treatments.
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PMID:[A case of septic shock due to ileal conduit obstruction]. 1141 Nov 7

While a ureteral stone is a common disease, it occasionally causes urosepsis and septic shock. We analyzed 6 cases of septic shock due to urosepsis caused by a ureteral stone from August 1998 to September 2001. All patients were female, ranging in age from 38-76 years old (63.8 +/- 15.3). Stones ranged from 4 to 12 ml in size. The results of analysis of bacterial culture from blood and urine revealed E. coli in 4 cases, K. pneumoniae in 1 case and P. mirabilis in 1 case. Treatment, including intravenous transfusion, the administration of vasopressor drugs and antibiotics, and anti-disseminated intravascular coagulation (DIC) treatments were performed. Percutaneous nephrostomy in 4 cases and ureteral stent indwelling in 1 case were also used for the management of urinary tract. Extracorporeal shock wave lithotripsy (ESWL) was performed in 4 patients after improvement of general condition. Furthermore, the 3 most recent patients had also received therapy to remove endotoxins. All patients were diagnosed in a stone-free condition after a combination of these therapies. The mean recovery interval from shock condition to shock-free status seemed to be shorter in the patients that received the endotoxin removal therapy.
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PMID:[Analysis of patients with septic shock due to urosepsis brought on by ureteral calculi]. 1262 72

Severe urinary tract infection occasionally causes urosepsis and disseminated intravascular coagulation (DIC). We experienced six cases of DIC with severe urinary tract infection from July 2009 to January 2011. Patients comprised two men and four women, ranging in age from 67-84 years old. In all cases, urinary tract infection was caused by pyelonephritis. The results of analysis of bacterial culture from blood and urine revealed E. faecalis in 2 cases, E. coli in 1 case, P. mirabilis in 1 case and Candida tripicalis in 1 case. Percutaneous nephrostomy in 1 case and ureteral stent indwelling in 3 cases and ureteral stent exchange in 2 cases were used for the drainage of the origin of infection. Under the diagnosis of DIC, the administration of antibiotics and anti-DIC treatment with recombinant thrombomodulin (rTM) were performed. rTM isa new drug for the treatment of DIC. rTM binds to thrombin to inactivate coagulation, and the thrombinrTM complex activates protein C to form activated protein C. Therefore, rTM actsasa negative feedback regulator of blood coagulation. Treatment with rTM improved in 5 of the 6 patients.
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PMID:[Experience in the treatment with recombinant thrombomodulin on disseminated intravascular coagulation with severe urinary tract infection]. 2245 Aug 31


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