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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reflux nephropathy is the term now used to describe the irregular segmental scarring and contraction of the kidney which may occur in association with persistent vesicoureteric reflux. The condition is recognized as an important cause of renal failure and hypertension in children and young adults. Current evidence suggests that bacterial infection plays a dominant role in the initiation of scar formation, but other factors may contribute to progressive renal damage. The possibility has also been raised that sterile reflux may be harmful to the kidney.
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PMID:Reflux nephropathy. 724 11

Pulmonary gangrene, a rare form of suppurative lung lesion, is the result of bacterial infection associated with vascular thromboses. It is one of the few affections that produce a meniscus image delimiting the pulmonary sequestrum. A case is reported of a woman with pulmonary venous hypertension from mitral disease who developed gangrene limited to Fowler's segment. Recovery occurred after antibiotic therapy and percutaneous drainage.
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PMID:[Meniscus and sequestrum images during pulmonary suppuration. A case of pulmonary gangrene (author's transl)]. 729 25

The leukocyte glycoprotein L-selectin mediates an early step in the recruitment of leukocytes to sites of inflammation. L-Selectin surface expression is rapidly down-regulated by inflammatory signals in vitro. In a prospective study, we found L-selectin expression on umbilical cord blood granulocytes and monocytes to be significantly decreased in newborn infants with acute bacterial infection compared with controls (p < 0.01). A significantly reduced L-selectin expression of both granulocytes and monocytes was also found to be associated with an increased neutrophil immature/total ratio (p < 0.01) but not with other laboratory markers of neonatal sepsis. There was no apparent impact of prematurity, low birth weight, gestational hypertension, or gestational diabetes on L-selectin expression. Although the mode of delivery did not affect granulocyte L-selectin expression, umbilical cord blood monocytes showed an increased L-selectin expression after emergency cesarean delivery compared with samples obtained after elective cesarean or vaginal delivery (p < 0.01). We conclude that acute systemic inflammation results in down-regulation of granulocyte and monocyte L-selectin expression in vivo similar to that observed in vitro.
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PMID:L-selectin is down-regulated in umbilical cord blood granulocytes and monocytes of newborn infants with acute bacterial infection. 753 4

The evaluation of a neutropenia first must document its etiology. Besides the particular etiological aspects in the newborn, neutropenia in a child may be 1) acquired, 2) constitutional, part of a complex genetic disease, 3) constitutional, isolated. Primary acquired neutropenia, also called benign chronic neutropenia, is the most frequent cause of chronic neutropenia in children; it is usually well tolerated and has a frequent favorable outcome in 12-14 months. Many complex genetic diseases include a neutropenia, among which several immunologic disorders that must be ruled out before considering the diagnosis of isolated constitutional neutropenia. Infantile agranulocytosis is the main primary constitutional neutropenia. It may be sporadic or hereditary (autosomal recessive or dominant inheritance) and is present at birth. It is profound, usually < 0.5 G/l (< 500/mm3) and exposes to severe pyogenic and fungal infections. In the neonatal period neutropenia must primarily suggest a bacterial infection, although other etiologies have to be known, particularly neonatal neutropenia caused by passive transfer of maternal antibodies and neutropenia related to gravidic maternal hypertension. The treatment of severe chronic neutropenia is directed towards the prevention of infections. It includes prophylactic antibiotherapy, the most commonly used one being the trimetroprim-sulfamethoxazole association, and granulocyte colony stimulating factor (G-CSF). G-CSF has considerably improved the condition of patients; it is usually well tolerated, but secondary effects have been reported (hypersplenism, glomerulonephritis, osteoporosis, vasculitis), and a potential leukemogenic risk has been evoked.
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PMID:[Acquired and constitutional neutropenia in children]. 784 76

However, side-effects such as severe infections, hypertension and electrolyte imbalance have been found, assumed to be related to hypercortisolism induced by chronic ACTH treatment. The authors treated 18 patients with infantile spasms with non-depot ACTH(1-24). The therapeutic effect of non-depot ACTH was comparable to that of depot ACTH, with no severe bacterial infection or sepsis. The incidence of hypertension was significantly lower in the non-depot ACTH group, and persistent hypercortisolaemia was not found. Non-depot ACTH(1-24) appears to be as effective as ACTH(1-24) depot therapy in the treatment of infantile spasms, and its side-effects are mild. It would appear that the effect of non-depot ACTH is not mediated by hypercortisolism, but by a direct neurotropic effect on the brain.
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PMID:The effect of non-depot ACTH(1-24) on infantile spasms. 825 87

A review and analysis of 5,001 neonatal venoarterial (VA) extracorporeal membrane oxygenation (ECMO) cases showed that bacterial and fungal infection occurred in 147 (2.9%) and 26 (0.6%) patients, respectively, with an overall incidence of 3.5%. Bivariate analysis was used to compare infected infants with controls, bacterial versus fungal groups, and bacterial subgroups with respect to patient demographics, primary diagnosis, mechanical complications, patient complications, duration of the ECMO course, and hospital mortality. Logistic regression models were constructed using variables that were statistically significant from the bivariate comparisons. Variables that remained significant after multivariate analysis included primary diagnosis of pneumonia/sepsis, mechanical complications of oxygenator failure, rupture of raceway or tubing, clots, and patient complications of hypertension and hyperbilirubinemia. The infection group had significantly longer mean total hours on bypass and higher hospital mortality. Infants with fungal infection had a significantly higher hospital mortality rate compared with those with bacterial infection. We conclude that infection during ECMO, especially fungal infection, carries an increased risk of hospital mortality and that mechanical complications are associated with an increased risk of infection, Key Words: Extracorporeal membrane oxygenation-Nosocomial-Bacterial infection-Fungal infection-Extracorporeal membrane oxygenation outcome.
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PMID:Bacterial and fungal infection in neonates undergoing venoarterial extracorporeal membrane oxygenation: an analysis of the registry data of the extracorporeal life support organization. 869 90

Lung transplantation is now an accepted modality for treating end-stage lung disease. To better understand the factors limiting the survival of these patients, we reviewed the autopsy findings in 37 patients who received lung transplants. Between 1986 and 1995, 131 patients have undergone lung transplantation at our institution, including 4 patients with repeat transplantations. Of these, 48 (36.6%) died, 37 (77%) of whom had an autopsy. The autopsied patients were divided into three groups on the basis of post-transplantation interval: early (< 30 d), intermediate (31-365 d), and late (> 365 d). Of the 12 patients in the early group, 6 died of intra- and postoperative complications and 6 of bacterial infection with pneumonia in the transplanted lung. There were 18 patients in the intermediate group, of whom 11 died of infection (5 of cytomegalovirus, 5 of nonviral infections of the transplanted lung, and 1 of encephalomyelitis), 3 of post-transplantation lymphoproliferative disorder, 3 of chronic airway rejection, and one of unrelated cause. Of the seven patients in the late group, four died of chronic airway rejection, two of unrelated causes, and one of bacterial infection. Native lungs examined in 23 patients showed, in addition to the primary disease, bacterial pneumonia in 5, post-transplantation lymphoproliferative disorder in 3, cytomegalovirus in 2, and aspergillosis in 1. In this series of 37 autopsied patients, chronic rejection was the cause of death in 7 and was concomitantly seen in 3 patients (27%). In summary, the most common cause of death was infection (48%), followed by chronic rejection (19%), surgical complications (19%), post-transplantation lymphoproliferative disorder (7%), and unrelated causes (7%); rejection was not a major cause of death in the early and intermediate post-transplantation periods; in 30% of native lungs, significant pathologic findings were present in addition to the primary disease; and in the intermediate post-transplantation period, significant left ventricular hypertrophy occurred, which may be attributable to cyclosporine-induced hypertension but which needs to be further studied.
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PMID:Postmortem findings in lung transplant recipients. 883 58

Take special care when recommending a product to people with a pre-existing medical condition (e.g., high blood pressure, stomach problems, asthma). It is safer to advise them to consult their pharmacist or doctor if there is a possibility of adverse drug interaction. Be aware of the possibility of overdosage (e.g., some patients take a large number of remedies simultaneously and may unwittingly be taking too much paracetamol, aspirin or ibuprofen). Green or yellow sputum suggests the patient has a bacterial infection in addition to a cold, and consulting a doctor is advisable. Enquire whether a cough is productive ("loose" or "chesty") or non-productive "dry, "tricky" or "irritating") so that you can advise on appropriate product. Productive coughs are helped by expectorants. Dry coughs are helped by suppressants. Cough preparations often contain antihistamine which may cause drowsiness, so be aware of this when advising a patient. For young children a paediatric formulation is advisable. Many of the main brands of cough and cold medicines have infant or junior varieties. Vapour products, often using substances like menthol placed on a tissue near the child but out of reach, can be very effective for blocked noses. Sugar-free preparations should be used for children (and adults) where possible, to avoid the risk of tooth decay. If patients suffer from repeated colds and coughs, and complain of feeling "run down", questioning may reveal that they have a poor diet. In that case, recommending a vitamin supplement or tonic and advice on a healthier diet may be appropriate. A persistent cough should receive medical attention.
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PMID:Coughs and colds: advising on what to take. 934 70

This study describes the social context of maternal mortality (MM) and morbidity among the Hausa of Northern Nigeria. The analysis is based on a literature review and anthropological field research conducted in southern Katsina in 1975-77, 1994, and 1996. A study during 1975-79, at Ahmadu Bello University Teaching Hospital in Hausaland, found that the most common causes of MM were bacterial infection, pregnancy-induced hypertension and consequences, hemorrhage, anemia, and obstructed labor. The most common pattern was the interaction of two or more complications. Case fatality rates were high among teenage girls with complications; women older than 30 years with eclampsia; and women with uterine rupture. MM was highly correlated with maternal age, total number of pregnancies, absence of prenatal care, lack of formal education, and Hausa-Fulani ethnicity. The MM ratio among Hausa-Fulani was 3180 deaths/100,000 live births. Obstetric fistulas may affect nearly 250,000 women in northern Nigeria. Many other related problems occur. Estimated obstructed labor cases were 1238/100,000 births. The social context that contributes to high mortality and morbidity includes Islamic culture that undervalues women; control of women by men; seclusion of wives that limits access to medical care; female illiteracy; early marriage and pregnancy; high rates of obstructed labor; directly harmful traditional medical beliefs and practices; inadequate facilities to treat obstetric emergencies; a declining economy; and a corrupt, inefficient political culture. Men need to be educated about the reproductive health of Hausa women.
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PMID:Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. 991 29

Even though Mg is by far the least abundant serum electrolyte, it is extremely important for the metabolism of Ca, K, P, Zn, Cu, Fe, Na, Pb, Cd, HCl, acetylcholine, and nitric oxide (NO), for many enzymes, for the intracellular homeostasis and for activation of thiamine and therefore, for a very wide gamut of crucial body functions. Unfortunately, Mg absorption and elimination depend on a very large number of variables, at least one of which often goes awry, leading to a Mg deficiency that can present with many signs and symptoms. Mg absorption requires plenty of Mg in the diet, Se, parathyroid hormone (PTH) and vitamins B6 and D. Furthermore, it is hindered by excess fat. On the other hand, Mg levels are decreased by excess ethanol, salt, phosphoric acid (sodas) and coffee intake, by profuse sweating, by intense, prolonged stress, by excessive menstruation and vaginal flux, by diuretics and other drugs and by certain parasites (pinworms). The very small probability that all the variables affecting Mg levels will behave favorably, results in a high probability of a gradually intensifying Mg deficiency. It is highly regrettable that the deficiency of such an inexpensive, low-toxicity nutrient result in diseases that cause incalculable suffering and expense throughout the world. The range of pathologies associated with Mg deficiency is staggering: hypertension (cardiovascular disease, kidney and liver damage, etc.), peroxynitrite damage (migraine, multiple sclerosis, glaucoma, Alzheimer's disease, etc.), recurrent bacterial infection due to low levels of nitric oxide in the cavities (sinuses, vagina, middle ear, lungs, throat, etc.), fungal infections due to a depressed immune system, thiamine deactivation (low gastric acid, behavioral disorders, etc.), premenstrual syndrome, Ca deficiency (osteoporosis, hypertension, mood swings, etc.), tooth cavities, hearing loss, diabetes type II, cramps, muscle weakness, impotence (lack of NO), aggression (lack of NO), fibromas, K deficiency (arrhythmia, hypertension, some forms of cancer), Fe accumulation, etc. Finally, because there are so many variables involved in the Mg metabolism, evaluating the effect of Mg in many diseases has frustrated many researchers who have simply tried supplementation with Mg, without undertaking the task of ensuring its absorption and preventing excessive elimination, rendering the study of Mg deficiency much more difficult than for most other nutrients.
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PMID:The multifaceted and widespread pathology of magnesium deficiency. 1142 81


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