Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative fever is a common dilemma faced by neurosurgeons. To study this problem, we prospectively collected patients who developed fever after spine surgery during the academic year 2007-2008 for whom the internist's consultation was requested. Eighty-five (85) patients were identified, of which 17 had an identifiable infectious cause for their febrile reaction (20%) - fever was attributed to urinary tract infection in 8 cases, pneumonia in 5 cases, wound infection in 3 cases (all lumbar), and cholecystitis in 1 case. The remaining 68 patients (80%) had no definitive diagnosis and fever was attributed to a peripheral venous line which, in this case, was replaced or discontinued. In 32 (37.6%) of the patients, the fever developed on postoperative day (POD) 2 or later. There was no statistically significant relationship between day of fever appearance and whether the fever was due to definite infection (P = 0.737). Comparing the basic group with another group of 456 spine surgery patients from 2006-2007 who might or might not have developed fever postoperatively using ANOVA, we found a significant difference in age (P = 0.011) and a very significant difference in hemoglobin level (P = 0.000) and HbA1c level (P = 0.000), but not in body mass index (BMI) (P = 0.289). Thus, most of the postoperative fever cases after spine surgery have no identifiable infectious focus and develop mainly in older patients with anemia and inadequately controlled HbA1c. A meticulous investigation of the source of fever including laboratory and radiological studies remains essential. Early mobilization is recommended for individuals undergoing lower spine surgery in order to decrease bacterial contamination from the gluteal cleavage.
 ...
PMID:Causes and risk factors for postoperative fever in spine surgery patients. 1920 24

The use of external beam radiation therapy for primary treatment of hepatocellular carcinoma (HCC) has been limited by the low radiation tolerance of the non-tumoral liver. However, technical advances allowing partial liver volume external irradiation have resulted in consistently high response rates. Internal radiation therapy, also called (90)Y radioembolization ((90)Y-RE), consists in delivering implantable microspheres labeled with (90)Y into the arteries that feed liver tumors in order to provide a high dose of radiation to tumor nodules irrespective of their number, size and location, while preserving the non-tumoral liver tissue from receiving a harmful level of radiation. Among patients with HCC, (90)Y-RE is used for those that have a preserved liver function and unresectable tumors that cannot be treated with percutaneous ablation. Although (90)Y-RE is by and large well tolerated, it may produce relevant toxic effects as a result of radiation of non-target organs including cholecystitis, gastrointestinal ulceration, pneumonitis, and most importantly, liver toxicity. A significant effect on tumor growth in the treated lesions is consistently observed with disease control rates in excess of 80%. Also, (90)Y-RE may allow downstaging large or multiple lesions to radical treatments with curative intent. When compared with the survival of HCC patients in advanced stage either not treated or treated with ineffective systemic agents, survival after (90)Y-RE is encouraging and warrants future clinical trials. Clinical research in combining the cytotoxic effect of (90)Y with the cytostatic mechanism of targeted therapies is currently in progress and will provide valuable safety and toxicity data that may translate into improved clinical outcome and overall survival.
 ...
PMID:Treatment of hepatocellular carcinoma by radioembolization using 90Y microspheres. 1954 55

A young, previously healthy and immunocompetent patient was transferred to our hospital to recover a suspected Ascaris worm from his gall bladder. Although the diagnosis of Ascaris infection could not be confirmed, the patient suffered from cholecystitis. To our surprise, the respiratory situation of the patient deteriorated within 24 h under antibiotic therapy and he had to be transferred to the intensive care unit for mechanical respiration. Human cytomegalovirus (HCMV) was isolated directly from a bronchoalveolar lavage (BAL) sample, and Mycoplasma pneumoniae DNA was detected by PCR in an enrichment culture of the same BAL sample. Serology for HCMV and M. pneumoniae clearly supported a primary/post-primary infection for both agents (IgM detection, increase of IgG titres and, in the case of HCMV, a low avidity index of only 22 %). Therefore, we assumed that a rare HCMV and M. pneumoniae coinfection was the aetiology of the fulminant pneumonia. Under broad antibiotic and antiviral treatment, the situation of the patient improved only very slowly.
 ...
PMID:Life-threatening pneumonia caused by human cytomegalovirus and Mycoplasma pneumoniae coinfection in a young, immunocompetent patient. 2046 42

Infections are usually detected in diabetes mellitus. They may be divided into: common infections such as fungal infections, pulmonary tuberculosis, pneumonia, bacteraemia, urinary tract infections, and diabetic foot infections and specific infections. The latter occur almost exclusively in diabetes and include rhinocerebral mucormycosis, malignant external otitis, emphysematous pyelonephritis, perirenal abscess, emphysematous cystitis and emphysematous cholecystitis. Radionuclide tests are decisive in the diagnosis and localisation of foot osteomyelitis, as well as the distinction of osteomyelitis from other conditions, notably Charcot osteoarthropathy. Technetium-99m methylene disphosphonate and labelled leukocyte bone scans are the main imaging techniques employed, while emerging techniques include single-photon emission tomography/computed tomography (CT) and positron emission tomography/CT. Nuclear medicine is also useful in the diagnosis and follow-up of specific infections in diabetes like, malignant external otitis, rhinocerebral mucormycosis, acute pyelonephritis, renal papillary necrosis and cholecystitis. The main indications of nuclear medicine tests are diabetic foot osteomyelitis, malignant external otitis, rhinocerebral mucormycosis and renal infections.
 ...
PMID:The role of nuclear medicine in the diagnosis of common and specific diabetic infections. 2080 89

We report a case of Q fever-related antiphospholipid syndrome in a patient presenting with acalculous cholecystitis and pneumonia. Serial laboratory tests indicated that the previous serological tests suggesting hepatitis C virus and Mycoplasma pneumoniae infections were false-positives. The patient's fever persisted despite treatment with doxycycline, but disappeared 1 day after initiation of steroid treatment. To avoid incorrect diagnosis and subsequent delays in appropriate treatment of Q fever patients, the possibility that Q fever can masquerade as other infections or as an autoimmune disease should be kept in mind.
 ...
PMID:Acute Q fever presenting as antiphospholipid syndrome, pneumonia, and acalculous cholecystitis and masquerading as Mycoplasma pneumoniae and hepatitis C viral infections. 2211 35

Patients in intensive care units (ICUs) frequently have multiple infections or persistent fever despite management. The aim of this study was to evaluate the diagnostic contribution of gallium-67 scintigraphy in ICU patients with suspected occult sepsis. One hundred and seventeen patients (>18 years) who had undergone gallium-67 scintigraphy in the ICU of our medical center over a 3-year period were retrospectively reviewed and analyzed. Patients were categorized into Group 1 (n = 84), those with a known infectious source, but who still had persistent fever or sepsis despite antibiotic treatment or abscess drainage; or Group 2 (n = 33), those without an evident infectious source after clinical, physical, and imaging studies. Among the 117 patients, 19 (16.2%) had a new diagnosis. In Group 1, 12 patients (14%) had a new infection, including pneumonia (4 patients), bed sore infection (2 patients), pulmonary tuberculosis (2 patients), leg cellulitis (1 patient), psoas muscle abscess (1 patient), osteomyelitis (1 patient), and infective endocarditis (1 patient). In Group 2, seven patients (21.2%) had a new infectious source, including septic arthritis (3 patients), osteomyelitis (2 patients), neck abscess (1 patient), and cholecystitis (1 patient). Significant differences were not observed between patients with positive and negative findings on gallium-67 scintigraphy in characteristics, underlying diseases, laboratory data, and outcomes. Gallium-67 scintigraphy helped to detect new or additional infectious sites, particularly bone, joint, and soft tissues. However, differences in hospital stay and mortality were not observed between patients with positive and negative findings.
 ...
PMID:Role of gallium-67 scintigraphy in the evaluation of occult sepsis in the medical ICU. 2216 45

Ceftriaxone is a commonly used antibiotic due to some of its advantages. Reversible gallbladder (GB) sludge or stone has been reported after ceftriaxone therapy. Most of these patients have no symptom, but the GB sludge or stone can sometimes cause cholecystitis. We experienced two patients who had newly developed GB stones after ceftriaxone therapy for diverticulitis and pneumonia, and this resolved spontaneously 1 month after discontinuation of the drug. Awareness of this complication could help to prevent unnecessary cholecystectomy.
 ...
PMID:Gallbladder pseudolithiasis caused by ceftriaxone in young adult. 2220 45

Scrub typhus is widely distributed across the Asia-Pacific region, Taiwan included. The clinical manifestations and complications of scrub typhus vary and the illness ranges in severity from mild to fatal. The etiology of facial nerve palsy varies and infectious agents have been associated with this condition. Rickettsiae species have, however, rarely been reported as the causative agents. We report the case of a 49-year-old man who had fever, malaise, headache, oligouria and tea-colored urine. Bilateral pneumonitis, acute renal failure, acalculous cholecystitis and aseptic meningitis were diagnosed after a series of examinations. The patient recovered after doxycycline treatment but he developed bilateral facial palsy during the convalescent phase, which improved after the administration of a steroid. The diagnosis of infection with Orientia tsutsugamushi was confirmed by the Taiwan Center of Disease Control and the tests for Leptospira, Rickettsia typhi and Coxiella burnetii were all negative. This case indicates that scrub typhus needs to be included in the differential diagnoses of cases of bilateral and simultaneous facial nerve palsy, particularly in areas where the disease is endemic.
 ...
PMID:Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review. 2220 41

A man in his fifties was admitted to our hospital because of syncope and hypotension. In the emergency room he reported abdominal pain, but focused assessment with sonography for trauma (FAST) was negative. His systolic blood pressure varied between 60 and 90 mmHg and an arterial blood gas revealed lactic acidosis with normal haemoglobin, which still might indicate acute bleeding. An ECG did not indicate myocardial infarction. In the absence of an obvious bleeding focus, the patient was urgently transported to a CT lab nearby, to identify possible bleeding and rule out other causes of circulatory shock, such as cardiac tamponade. Before radiologic scanning was initiated, the patient lost consciousness and displayed pulseless electrical activity. Resuscitation was initiated and pericardiocentesis was resultless. On vital indication and clinical suspicion of cardiac tamponade, an emergency median sternotomy was performed and a haematoma was evacuated from the pericardial space. The patient was stabilised and immediately taken to the operation theatre where a ruptured ascending aortic aneurysm was identified. The operation was successful, but following serious hypoperfusion, the patient suffered acute kidney failure requiring dialysis for several months, gram-negative septicaemia caused by a central venous catheter, cerebral infarction leading to hemiparesis and impaired vision, ventilator-associated pneumonia/acute lung injury and acalculous cholecystitis. This case report describes the findings on admission, the diagnostic process including surgical resuscitation and a complicated course of multi-organ failure. After almost 5 months, the patient was discharged from our hospital to another institution for further rehabilitation. He now has minimal sequelae and lives at home. Our take-home message is that seriously ill patients require fast, resolute and broad examination; they may need immediate surgical treatment including emergency intervention; and a good clinical outcome may be achieved in spite of serious complications.
 ...
PMID:[A man in his fifties with syncope and hypotension]. 2251 Oct 95

The analysis was applied concerning distribution of patients' flow depending on nosology forms of diseases and departments of hospital. The integrated value included number of treated patients and duration of treatment. The study established that the main groups of diseases determining the load on corresponding departments of hospital are cerebro-vascular diseases in neurologic department; diabetes mellitus in endocrinology department; pneumonia, chronic bronchitis and asthma in pulmonology department; urolithiasis in urology department; abnormal bleedings of female genitals in gynecology department; trauma of femur in traumatology department; cholelithiasis and cholecystitis in general surgery department. The developed differentiation of patients' flows makes it possible to determine the demand of diagnostic and treatment technologies in the particular hospital.
 ...
PMID:[About the formation of patients' flow in multi-type hospital]. 2363 10


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