Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Though the incidence, prevalence, and mortality of tuberculosis have decreased so quickly in last thirty years in Japan, we still have many persons suffering from so called tuberculosis sequelae who complain pulmonary symptoms, particularly respiratory failure. As I have been studying this problems for last many years as a part of tuberculosis treatment, I would like to summarize the present status of the problem. 1) Acute respiratory failure is observed in DIC followed by miliary tuberculosis and in far advanced cases. 2) Chronic respiratory failure is common in pulmonary tuberculosis sequelae. Sexual ratio, male to female is three to two and average age is 60.5. It is quite reasonable that advanced restrictive failure, %VC less than 40%, occurs in 70% of all cases, but obstructive disturbance, FEV1.0% less than 55%, was also observed in 40% of cases. It is still not so clear why tuberculosis sequelae shows obstructive ventilatory failure, but the response to obstruction with the administration of beta-stimulant is observed. Advanced hypoxemia, PaO2 less than 50 Torr, is observed in 30% and hypercapnea is observed in 70% of total cases. Clinical right heart disturbance is observed in 80% of cases. 3) Based on to calculation from the number of interval organ failure and questionnaire to hospitals, the number of persons suffering from respiratory failure is estimated at 20 per 100,000, and it is presumed that the prevalence of respiratory failure will begin to decrease in two to five years later. 4) Pulmonary hypertension, mPA 28.8 mmHg, and higher PVR, 402, are observed in 90 catheterized cases. alpha-NA Peptide in serum and ACT, RVET by echocardiogram are well related to the value of mPA. 5) Average accumulated survival rate is 50% after three years, and it related closely with PaO2. 6) Long term oxygen therapy is the most reasonable and practical treatment for not only to increase the life span but also to improve QOL of the patient. Exercise training is also effective. Almitrine (clinical trial base in Japan), Doxopram and other drugs are effective to recover hypoxemia and to improve pulmonary hypertension. Home mechanical ventilation just started in Japan, and two cases for tuberculosis sequelae are reported. In persons suffering from respiratory failure, special consideration should be made on the treatment of complications, for example abdominal surgery. 7) Social measures, for example, residence with sheltered workshop and vocational training center are quite important to care the respiratory failure due to tuberculosis sequelae. Profile and follow up study of the residence and the training center are reported.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Development and treatment of respiratory failure due to tuberculosis]. 265 73

Plasma antithrombin III (ATIII) levels decrease early during gram-negative septicemia, and even a moderate decrease in this major inhibitor of the coagulation system is associated with serious disseminated intravascular coagulation (DIC). Herein the efficacy of high-dose (at least 250 units/kg) ATIII supplementation in animal models of Escherichia coli endotoxemia or bacteremia is reported. An endotoxemic rat model demonstrated that: (1) DIC occurs very early, before the appearance of deleterious cardiovascular abnormalities; (2) ATIII prophylaxis attenuates DIC, metabolic dysfunction, and organ damage; (3) ATIII prophylaxis increases permanent survival; (4) ATIII treatment one hour after endotoxin challenge attenuates DIC, metabolic dysfunction, and organ damage, although not as well as when given prophylactically, and survival is not increased. An endotoxemic sheep pulmonary dysfunction model demonstrated that: (1) ATIII prophylaxis prevents the typical decrease in arterial oxygen partial pressure; (2) ATIII prophylaxis combined with alpha-1-proteinase inhibitor significantly attenuates indices of pulmonary dysfunction. An E. coli bacteremic baboon model demonstrated that ATIII prophylaxis and treatment significantly attenuate indices of DIC and organ damage and prevent death in an otherwise completely lethal dose bacterial challenge. In conclusion, prophylactic treatment with high doses of ATIII may be efficacious in disease states of impending disseminated intravascular coagulation, such as primary or secondary gram-negative septicemia.
 ...
PMID:Efficacy of antithrombin III supplementation in animal models of fulminant Escherichia coli endotoxemia or bacteremia. 267 67

A veterinarian dealing with critical and trauma patients must be proficient with techniques for tracheostomy, thoracostomy tube placement for chest drainage, diagnostic peritoneal lavage, and autotransfusion. The utilization of these techniques may be life-saving in the critical patient. A tracheostomy is indicated in any patient with upper airway obstruction that cannot be managed with supplemental oxygen and/or orotracheal intubation. A tracheostomy tube with an inner cannula is preferred. Tracheostomy tubes should be cleaned at 3- to 4-h intervals, and methods should be employed to decrease thick tracheal secretions and to remove them from the trachea. A patient with a tracheostomy tube should be monitored continuously. A thoracostomy tube is indicated in any patient with large and/or continuous accumulation of air, blood, fluid, or chyle in the pleural space. The thoracostomy tube should be at least the same size as the patient's main stem bronchus. The thoracostomy tube is placed aseptically at the seventh intercostal space at the junction of the upper one third and lower two thirds of the lateral chest wall. Fluid or air may be removed from the chest intermittently with a three-way stopcock attached to the thoracostomy tube and a 60-ml syringe. If continuous drainage is needed, a continuous underwater seal and suction system should be used. Diagnostic abdominal paracentesis and peritoneal lavage are useful techniques in the determination of abdominal trauma, hollow viscus rupture, peritonitis, hepatic trauma, and urinary system trauma. When a multiholed catheter and lavage are used, the accuracy of detecting abdominal trauma is 95 per cent. When only needle paracentesis is used, the accuracy drops to 47 per cent. Abdominal lavage fluid can be analyzed for bacteria, whole blood, white blood cells, free bilirubin, creatinine, blood urea nitrogen, amylase, alkaline phosphatase, and alanine aminotransferase. Large volumes of whole blood recovered from abdominal or thoracic paracentesis can be reinfused into the patient if needed, providing it is not contaminated or markedly hemolyzed. The blood should be collected aseptically into blood bottles or bags. If the bleeding is ongoing or the blood only a few hours old, anticoagulants should be used. If the hemorrhage is several hours old, then clotting and defibrination has already occurred and the blood can be collected into "dry" bags or bottles. Before use, abdominal blood should be analyzed for urine, bile or fecal contamination. Blood collected from the thoracic cavity is much less likely to be contaminated. Autotransfused blood is administered through a standard blood administration set.
 ...
PMID:Critical care surgical techniques. 268 82

A previously healthy 40-year-old woman was admitted with severe dyspnea, cough and slight fever. Chest X-ray film revealed bilateral widespread opaque infiltration with ground glass shadows around it. The laboratory examination showed moderate hepatic and muscular injury with disseminated intravascular coagulation. In addition her arterial blood gas showed severe hypoxemia (PaO2: 25 Torr under room air). Moreover, about 1 week prior to admission, 2 baby budgerigars she had been raising for half a year died. Because of this history and multi-organ injuries, this disease was considered to be acute pneumonia owing to fulminant psittacosis causing acute respiratory failure. On the first day of admission, she was intubated and ventilated mechanically with an oxygen concentration (FIO2) of 100%. Subsequently, treatment with intravenous minocycline (400 mg/day), heparin for D.I.C. and corticosteroid were started. Abnormal findings in both chest X-ray and several laboratory parameters improved gradually though fever continued for a week. On the 14th day of her hospital stay, she was weaned from the ventilator successfully and the administration of corticosteroid and heparin tapered. On the 41st day, she was discharged without any symptoms. Results of complement fixation (CF) antibodies against chlamydia on paired sera showed a significant rise from 1:32 to 1:256. Moreover, both IgG and IgM antibodies for Chlamydia psittaci with microplate immunofluorescent antibody technique (MFA) showed an 8 times' rise during 10 days after admission. The definitive diagnosis was made with positive isolation of C. psittaci from both the throat swab of this patient and the spleen and liver of the dead budgerigar by the cell culture method. Psittacosis should always be borne in mind as a possible cause of fulminant pneumonia with acute respiratory failure, and such a situation can be handled successfully if emergency care including mechanical ventilation is available.
 ...
PMID:[Successful treatment of a patient with fulminant psittacosis]. 269 84

Acute bilateral diffuse pulmonary shadowing complicates the resection of hydatid mole approximately 10% of the time. Etiologic factors include trophoblastic emboli, pulmonary emboli, high output congestive failure, and DIC. Prompt recognition and emergency oxygen therapy with PEEP are imperative for survival.
 ...
PMID:Acute bilateral diffuse pulmonary shadowing after evacuation of hydatid mole. 292 29

Neutrophil-mediated oxidative stress on the rat mesenteric microcirculation was studied in the experimental model of endotoxin-induced disseminated intravascular coagulation (DIC) by using an intravital fluorescent microscope equipped with a Silicon Intensifier Target Image Tube camera and luminol-dependent chemiluminescence (ChL) analysis. Leukocytes adhering to the venules were visualized by the injection of acridine orange, a fluorochrome tracer which shows high affinity to white cells. Endotoxin (E. coli, O-111 B4) was administered intravenously at a dose of 2 mg/kg/hour. After starting the infusion of endotoxin, the number of adherent cells gradually increased in the venular endothelium and was followed by a transient neutropenia. ChL activities from neutrophils were also significantly elevated, which may reflect the enhanced ability to generate oxygen-radicals. To elucidate the role of 5-lipoxygenase products in the locomotive and metabolic changes of neutrophils, the effects of AA-861, a specific inhibitor of 5-lipoxygenase was tested. In addition prednisolone and indomethacin were evaluated. AA-861 and prednisolone reduced neutropenia, leukocyte adhesion to the venular walls and ChL activities from neutrophils. It was concluded that 5-lipoxygenase may modulate neutrophil-mediated oxidative stress on microvasculature in endotoxin-induced DIC.
 ...
PMID:5-lipoxygenase inhibitor (AA-861) attenuates neutrophil-mediated oxidative stress on the venular endothelium in endotoxemia. 338 68

The prognosis for a patient with a severe head injury is dependent not only upon the location and the degree of this trauma, but also upon additional complications. For example, disseminated intravascular coagulation (DIC) can occur because of the thromboplastic activity of the damaged brain tissue that enters the circulation. The complement (C) system is activated by certain enzymes that cleave the clotting factors. Therefore, after head injuries we searched for C activation because it could result in the adult respiratory distress syndrome (ARDS). Patients and methods. We had two groups of patients: (1) 23 with large destruction and (2) 13 with little destruction of the brain tissue. Eighteen patients in group 1 and 8 in group 2 had isolated brain trauma. Blood samples were taken--upon arrival at the hospital and then 1, 3, 7, 12, 24, and 48 h later; after that we took weekly blood samples up to the completion of their treatment in the intensive care unit. We measured the total hemolytic serum C activity (CH50), activation of alternative pathway hemolysis (APH50), cleavage products C3a and C3d, and total protein. Furthermore, we studied the coagulation parameters of the extrinsic (prothrombin time) and intrinsic (partial thromboplastin time) pathways and fibrinogen content. From the patients records we extracted clinical parameters such as neurological status, intracranial pressure, pathological details on computer tomography hemoglobin and arterial-alveolar oxygen difference. Results. Figure 1 shows the different reactions of the C system in both groups: while patients of group 1 suffered from a decrease in total and alternative hemolytic activity, the other group increases in both parameters.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Complement activation following head and brain trauma]. 349 78

The diagnosis of hemorrhagic shock can be made on the basis of a good knowledge of the clinical picture of the bleeding patient. The necessary lab tests must be carried out over a period of time to establish their evolution and thus the degree of shock. At present, attention is being focused on the microcirculation. In shock, tissue is starved of oxygen and nutrients, resulting in the liberation by degenerating cell structures of numerous substances that have an effect on vascular tone. Decompensation is accompanied by consumption coagulopathy, which also has an influence on the microcirculation. The inhibitor potential is very important here. The patient must be out of shock before endoscopy can be considered.
 ...
PMID:The patient in shock--clinical picture and pathophysiology. 351 87

From 1981 through 1986, 8 newborns with congenital diaphragmatic hernia required herniorrhaphy in the first 8 hours of life. Extracorporeal membrane oxygenation (ECMO) was employed in 7 after they met local criteria predictive of 95% mortality. These criteria were an alveolar-postductal arterial oxygen gradient greater than 600 mm Hg for 12 hours or hemodynamic instability. Four of these 7 patients had unremitting hypoxemia after herniorrhaphy (no "honeymoon" period), 3 of whom survived. One additional patient died, producing a mortality of 29%. ECMO used for 68 to 241 hours (mean, 163 hours) provided reliable oxygenation in all. Deaths resulted from disseminated intravascular coagulation and bleeding, and bleeding and pulmonary failure after ligation of a patent ductus arteriosus. Complications occurred in 6 patients and included bleeding (3), hernia recurrence (3), and air embolism (1). Follow-up ranging from 1 year to 6 years after discharge of the 5 survivors shows normal growth and development in 4. The reported mortality without ECMO following congenital diaphragmatic herniorrhaphy in the first 8 hours of life ranges between 60 and 80%. While bleeding may present problems, survival of newborns with refractory hypoxemia after diaphragmatic repair has improved with ECMO.
 ...
PMID:Extracorporeal membrane oxygenation following repair of congenital diaphragmatic hernias. 363 9

Various biochemical and structural changes affecting the newborn's wellbeing develop as a result of perinatal asphyxia. Central nervous system abnormalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or massive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid electrolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out effective resuscitation measures on the depressed infant at the time of delivery.
 ...
PMID:Asphyxia neonatorum. 371 11


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>