Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between January 1981 and December 1990, 690 patients over the age of 80 years underwent gastrointestinal surgery. These operations were performed for diseases of the biliary tract in 248 cases (28%), colon or rectum in 238 cases (27%), stomach or duodenum in 130 cases (15%), small bowel in 32 cases (1.6%), oesophagus in 16 cases (1.8%), and for peritoneal carcinologic dissemination in 26 cases (3%). Emergency operation was performed in 43% of patients. Surgery was considered to be curative in 61% of patients. Overall postoperative mortality was 23%. The six following factors were associated with increased mortality: age over 85 years, ASA categories 3, 4, 5; surgery for malignant disease, peritonitis, palliative surgery, emergency surgery.
 ...
PMID:[Digestive surgery in patients over 80 years of age. Apropos of 690 operations]. 130 Sep 5

In 90 patients who, between 1.1.1986 and 31.12.1991, underwent surgery for a perforated gastric/duodenal ulcer, the importance of age, sex, ulcer history, ulcer site, free/covered perforation, extent of peritonitis, duration of history and the pre-operative risk assessment (ASA classification) was analysed with respect to the risk of dying of the perforated ulcer. The univariate analysis showed the following to be prognostically relevant factors: time interval between onset of acute symptoms and surgery (less than or equal to 24 hours: mortality rate 12%, greater than 24 hours: mortality rate 21%; p = 0.006); physical status of the patient as reflected in the ASA category prior to surgery (mortality: ASA II 0%, ASA III 8%, ASA IV 32%; p = 0.009), and the presence of a spontaneous pneumoperitoneum (free perforation 21% mortality, covered perforation 5% mortality; p = 0.049). Investigation of the overall influence of the univariate relevant factors in the logistic model showed a relative risk of 4.9 for duration of history, and of 5.4 for the ASA classification. The mortality risk for a patient who is operated on more than 24 hours after onset of the acute symptoms is 4.9 times that of a patient operated on within 24 hours. In the ASA classification, the mortality risk increases by 5.4 from one category to the next higher one.
 ...
PMID:[Perforation of gastroduodenal ulcer: a risk analysis]. 140 71

Analysis of 156 records relating to patients at the age of 15 to 85 years with extended purulent peritonitis of the surgical and gynecological genesis (the toxic phase, VI category ASA) showed that combination of programmed sanitation laparotomy and intensive antibacterial therapy performed as short-term courses before, during and after the operation with an account of the information on the nature of the microbial associations and antibioticograms was an efficient procedure in treatment of severe peritonitis. It was indicated in treatment of patients with polyorgan deficiency. When the surgical treatment was adequate early antibiotic therapy allowed to decrease the number and intensity of postoperative complications: the frequency of abscessing in the abdominal cavity and formation of intestinal fistulas lowered 2 and 1.5 times respectively. Such a decrease was also observed in asthenic patients with lowered protective reactions to development of new infectious foci in the abdominal cavity complicating the peritonitis process. It was also possible to prevent with that procedure the infection generalization and development of peritoneal sepsis. With application of the procedure to such patients (20 per cent) lethality lowered 2-fold.
 ...
PMID:[Antibacterial therapy in disseminated purulent peritonitis]. 281 88

We have prospectively studied all cholecystectomies performed in one year in our clinic in two groups: 190 cases performed laparoscopically and 98 open. We used standardized records and the EPI 5 program on an IBM compatible computer. There were no significant differences between groups regarding weight, sex and proportion of cases with acute cholecystitis. There were however major differences regarding age, type of habitat, ASA score and association with acute pancreatitis, obstructive jaundice and angiocholitis. Conversion of laparoscopic cholecystectomy to open procedure was imposed in 17 cases (not included in statistical analysis) due to technical difficulties (12 cases), haemorrhagic accidents (6 cases), injury of the common bile duct (1 case), stones lost in the abdominal cavity (3 cases), local peritonitis (5 cases). Laparoscopic cholecystectomy lasted a mean of 74 minutes. We encountered 3 specific complications: one CBD injury recognized intraoperatively and managed by Kehr's procedure (one CBD injury in the open cholecystectomy group), one small bowel perforation and one of biloma. Mortality averaged 0.5% in the LC group (one case of late postoperative stroke considered not related to the procedure) and 1% in the open cholecystectomy group. The hospital admission period was significantly reduced in the LC group (5 days vs. 12 days). LC appears as a safe procedure with a low complication rate. Conversion to open procedure is not a complication. Our study recommend LC as the method of choice in the treatment of gallbladder lithiasis.
 ...
PMID:[The value of laparoscopic cholecystectomy in the treatment of gallbladder pathologies]. 945 51

Surgery remains the ideal emergency treatment for biliary lithiasis in elderly subjects despite perioperative morbidity and mortality. Minimally invasive techniques appear promising but require assessment. The aim of this work was to determine the usefulness of these techniques and evaluate outcome in a series of 157 patients over 75 years of age who were hospitalized in an emergency setting of complicated biliary lithiasis from January 1990 to December 1996. There were 103 women and 54 men, mean age 82 years. The patients' general status was evaluated according to the ASA classification; 66% of the patients were ASA III, IV or V. Diagnoses at admission were acute cholecystitis (n = 71, 45%), angiocholitis (n = 50, 31%) subintrant hepatic colic (n = 17, 10.8%), pancreatitis (n = 10, 6%), isolated jaundice (n = 2), peritonitis (n = 2) and occlusion (n = 5). Within 24 hours of admission, 7 patients underwent emergency surgery, and the 150 others were given medical treatment. Among these 150 patients, cure was considered to have been achieved with medical treatment alone in 41 (subsequent surgery being required in only one 6 months later), semi-emergency was performed in 17, and a minimally invasive procedure was performed in the 92 others (echo-guided percutaneous cholecystostomy in 42, endoscopic sphincterotomy in 50) followed by a subsequent operation in 29. In the 103 patients (65.5%) in this series who did not undergo surgery, mortality was 3.8% and in the 54 patients (34.5%) who did, mortality was 15%, but this rate was only 6.9% when the open procedure followed a minimally invasive technique. Surgical treatment of complicated biliary disease remains the ideal therapy but indications should be carefully weighed in these elderly fragilized subjects. Under surgical observation, abstention from surgery or use of minimally invasive techniques can play an important role in the therapeutic strategy aimed at lowering perioperative mortality.
 ...
PMID:[Comments on emergency treatment of biliary lithiasis in patients over 75 years of age. Apropos of 157 cases]. 968 57

Aspirin (ASA) triggers the formation of 15-epi-lipoxins (15-epi-LXs or ATL [ASA-triggered LX]), which are potent bioactive eicosanoids that may contribute to the therapeutic impact of ASA. To elucidate the role of these new compounds in vivo, it is essential to establish quick and sensitive detection methods. To this end, we prepared an enzyme-linked immunosorbent assay specific for 15-epi-LXA4 that proved to be highly sensitive (IC50 approximately 50 pg, minimum detection approximately 3.5 pg) and stereoselective. The amounts of 15-epi-LXA4 generated by human neutrophils from peripheral blood of healthy volunteers using this enzyme-linked immunosorbent assay were in agreement with those values obtained by liquid chromatography. Formation of 15-epi-LXA4 was cell ratio-dependent during THP-1 (a monocytic leukemia cell line)-neutrophil interactions with ASA-treated cells, and 15-epi-LXA4 was not detected with either cell type alone. Generation of 15-epi-LXA4 was also examined in murine peritonitis with ASA administration. Exudates from ASA-treated mice showed increased production of 15-epi-LXA4 that was diminished by indomethacin, a blocker of ASA-dependent acetylation of prostaglandin G/H synthase. A cytochrome P450 inhibitor administered in the presence of ASA did not prevent 15-epi-LXA4 formation, which suggests that P450 does not significantly contribute to formation of 15-epi-LXA4 in this murine model. These results indicate that the new enzyme-linked immunosorbent assay is both sensitive and selective for 15-epi-LXA4 and that 15-epi-LXA4 is produced by human leukocyte-leukocyte interactions. In addition, 15-epi-LXA4 is generated by inflammatory exudates when ASA is administered during murine peritonitis and when prostaglandin G/H synthase is upregulated and acetylated. This assay should provide rapid means to investigate 15-epi-LXA4 generation in both cellular and animal models.
 ...
PMID:Aspirin-triggered 15-epi-lipoxin A4 (ATL) generation by human leukocytes and murine peritonitis exudates: development of a specific 15-epi-LXA4 ELISA. 980 10

The objective of the present investigation was to study the evolution of untreated inflammatory disease of the colon as compared to disease treated with an elemental diet plus glutamine, with 5-ASA and with a combination of the three. A total of 120 female Wistar-Tecpar rats aged 180 days and weighing on average 290 g were studied. Inflammatory disease of the colon was induced with 10% acetic acid and the animals were divided at random into four groups of 30 rats each. Group A, which received a standard diet and no type of treatment, was used as control. Group B received an elemental diet supplemented with glutamine. Group C received a standard diet and daily 5-ASA enemas, 15 mg/ml. Group D received an elemental diet supplemented with glutamine plus daily 5-ASA enemas. Ten animals were picked at random from each group and sacrificed on the 7th, 14th and 21st days of treatment after intravenous injection of Evans blue for visualization of the damaged areas. Changes in weight and the macroscopic aspects of the abdominal cavity and the colon were evaluated and the involved segment was resected for macroscopic and microscopic analysis. The highest weight loss occurred in group D animals on the 14th and 21st days. The number of complications was larger in group A animals, with intestinal perforation, peritonitis and death (P = 0.0053). Complications were of equal intensity in groups B and C and no complications were detected in group D. Macroscopic evaluation showed a lower frequency of ulcers on the 7th day in group B (P = 0.0113) and D (P = 0.0294). Group D animals showed a significantly reduced frequency of ulcers on the 14th day (P = 0.0140). Microscopic examination showed a better evolution in groups B (P = 0.0113) and D (P = 0.0294) on the 7th day and in group D on 14th day (P = 0.0105) compared to A. We conclude that the combination of an elemental diet containing glutamine and treatment with 5-ASA leads to more rapid healing of the colon lesions induced by 10% acetic acid in rats.
 ...
PMID:[Comparative study of the evolution of inflammatory colitis treated with an elemental diet, glutamine and 5-ASA. An experimental study in rats]. 981 77

Aspirin (ASA) is unique among current therapies because it acetylates cyclooxygenase (COX)-2 enabling the biosynthesis of R-containing precursors of endogenous antiinflammatory mediators. Here, we report that lipidomic analysis of exudates obtained in the resolution phase from mice treated with ASA and docosahexaenoic acid (DHA) (C22:6) produce a novel family of bioactive 17R-hydroxy-containing di- and tri-hydroxy-docosanoids termed resolvins. Murine brain treated with aspirin produced endogenous 17R-hydroxydocosahexaenoic acid as did human microglial cells. Human COX-2 converted DHA to 13-hydroxy-DHA that switched with ASA to 17R-HDHA that also proved a major route in hypoxic endothelial cells. Human neutrophils transformed COX-2-ASA-derived 17R-hydroxy-DHA into two sets of novel di- and trihydroxy products; one initiated via oxygenation at carbon 7 and the other at carbon 4. These compounds inhibited (IC(50) approximately 50 pM) microglial cell cytokine expression and in vivo dermal inflammation and peritonitis at ng doses, reducing 40-80% leukocytic exudates. These results indicate that exudates, vascular, leukocytes and neural cells treated with aspirin convert DHA to novel 17R-hydroxy series of docosanoids that are potent regulators. These biosynthetic pathways utilize omega-3 DHA and EPA during multicellular events in resolution to produce a family of protective compounds, i.e., resolvins, that enhance proresolution status.
 ...
PMID:Resolvins: a family of bioactive products of omega-3 fatty acid transformation circuits initiated by aspirin treatment that counter proinflammation signals. 1239 Oct 14

In 73 cases of perforated gastroduodenal ulcers in which operation was done at St. Joseph's Hospital, San Francisco, during the ten-year period July 1939 to July 1949, the death rate was 13.7 per cent. In all but three of the cases, simple closure of the perforation was carried out. In 46 cases there were postoperative complications. Of this number, peritonitis and its sequelae comprised 35 per cent and pulmonary complications, 37 per cent. The mortality rate in the group in which these complications occurred was 35 per cent.
 ...
PMID:Perforated gastric and duodenal ulcers; an analysis of 73 cases. 1482 21

The established model for the mechanism of action of aspirin is the inhibition of prostaglandin synthesis. However, this has never fully explained aspirin's repertoire of antiinflammatory properties. We found in acute pleuritis that aspirin, but not salicylate, indomethacin, or piroxicam, increased plasma nitric oxide (NO), which correlated with a reduction in inflammation. Inhibiting aspirin-elicited NO pharmacologically in this model nullified the antiinflammatory effects of aspirin. Moreover, aspirin was not antiinflammatory in either constitutive (eNOS) or inducible NO synthase (iNOS) knockout mice with IL-1beta-induced peritonitis. It transpires that aspirin generates NO through its unique ability to trigger the synthesis of 15-epi-lipoxin A(4). Aspirin and 15-epi-lipoxin A(4) were shown to inhibit leukocyte trafficking in an NO-dependent manner using intravital microscopy on IL-1beta-stimulated mouse mesentery. Not only did aspirin inhibit leukocyte-endothelial interaction in a manner similar to NO in wild-type mice but both aspirin and 15-epi-lipoxin A(4) had markedly reduced effects on leukocyte-endothelial cell adherence in eNOS- and iNOS-deficient mice compared with wild type. Collectively, these data suggest that aspirin triggers the synthesis of 15-epi-lipoxin A(4), which increases NO synthesis through eNOS and iNOS. This aspirin-elicited NO exerts antiinflammatory effects in the microcirculation by inhibiting leukocyte-endothelium interactions.
 ...
PMID:15-epi-lipoxin A4-mediated induction of nitric oxide explains how aspirin inhibits acute inflammation. 1523 6


1 2 3 Next >>