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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A recent U.S. Public Health Service report compared the incidence of complications with 3 methods of midtrimester abortion. The comparison was based on a 4-year study of abortions done in 32 institutions. Major complications were least frequent with cervical dilatation followed by curettage or suction evacuation, more frequent with hypertensive saline injected into the amniotic sac, and most frequent with instillation of prostaglandin F2. By the second trimester, dilatation and evacuation is a difficult procedure. Major complications considered were: fever for 3 or more days; pelvic infections; pneumonia; thrombophlebitis; hemorrhage requiring transfusions; psychiatric hospitalization; hypernatremia; injury to bladder, ureter, or intestines; wound disruption; unintended major surgery; pulmonary embolism; convulsions; endotoxic shock; cardiac arrest; and death. The report is difficult to evaluate. Most medical letter consultants prefer intraamniotic administration of prostaglandin F2 or saline for midtrimester abortions.
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PMID:Phenformin. 84 55

We examined a group of 22 patients presented with the acute infective meningeal syndrome. Lumbar punction confirmed diagnosed purulent meningitis--meningoencephalitis, and bacteriologic liquor culture identified Streptococcus pneumoniae as a cause of the disease. Patients were mostly aged over 30. Clinical picture revealed signs of general infection and the meningeal syndrome. The severity of the disease was assessed on the basis of apparent signs of general infection, state of consciousness and endotoxic shock symptoms. Severe consciousness disorders were present in 16 (72.72%) patients. In our patients possible pneumococcus infection foci were: sinusitis, otitis media, pneumonia, mastoiditis and adnexitis. Lethal outcome occurred in 5 (22.72%) patients. In the therapy we used penicillin, chloramphenicol and ampicillin along with corticosteroid administration.
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PMID:[Pneumococcal meningitis from 1974 to 1984]. 134 70

During the last 15 years we have treated 147 patients with acute purulent mediastinitis (APM). According to the aetiology of the disease, 2 major groups were defined. The first group included the cases of oesophageal origin--112 patients (dilatation--38 patients, foreign body extraction--29 patients, lye injuries--11 patients, oesophagoscopy--8 patients, sharp foreign body--6 patients). The second group consisted of patients with mediastinitis of non-oesophageal origin--35 patients (tracheo-bronchial disease--21 patients, tooth infection--8 patients, cervical infection). Symptoms of the mediastinal infection were typical; nevertheless, early diagnosis (within first 12 h) was obtained in only 43.5% of cases. Therapy for all patients included general stabilisation, broad spectrum antibiotics and immunotherapy. In 86 patients, mediastinal drainage was performed with additional suture of the oesophageal wall or plication with a gastric or diaphragmatic patch in 9 cases. Oesophagectomy and delayed colon transplant was the method used in 61 patients. Mortality included 21 patients (14.3%). The cause was broncho-pneumonia in 9 patients, endotoxic shock in 7 and renal failure in 3 patients.
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PMID:Surgical treatment of acute purulent mediastinitis. 138 46

Leukemia inhibitory factor (LIF) has many biological actions which parallel those of IL-1, IL-6 and tumor necrosis factor-alpha, but its role in the pathogenesis of human disease is unknown. A specific radioreceptor competition assay capable of detecting LIF at concentrations above 1 ng/ml (45 pM) was developed. To identify disease states in which LIF might be involved, a cross-sectional survey of serum and body fluids from approximately 1,500 subjects with a variety of diseases was performed using the LIF radioreceptor competition assay. Serum LIF concentrations were transiently elevated (2-200 ng/ml) in six subjects with meningococcal or Gram-negative septic shock, and in a subject with idiopathic fulminant hepatic failure. Moderately elevated LIF concentrations (> 10 ng/ml) were detected in cerebrospinal fluid from subjects with bacterial meningitis, in effusions associated with pneumonia and peritonitis, and in amniotic fluid from a woman with chorioamnionitis. Low LIF concentrations (1-10 ng/ml) were present in synovial fluid from subjects with inflammatory arthritis, amniotic fluid from women in labor, and some reactive, chronic inflammatory and malignant effusions and cyst fluids, but rarely in transudates. These initial findings suggest that LIF might be involved in the pathogenesis of inflammation and septic shock.
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PMID:Leukemia inhibitory factor levels are elevated in septic shock and various inflammatory body fluids. 143 Feb 24

The availability of intravenous immunoglobulin preparations and human monoclonal antibodies has broadened the potential utility of antibody therapy to include treatment of viral infections such as cytomegalovirus and respiratory syncytial virus and prevention and treatment of serious bacterial infections such as endotoxic shock and pneumonia in children with acquired immunodeficiency syndrome. As new polyclonal and monoclonal immunoglobulin preparations are developed for specific organisms or clinical settings, immunoglobulin therapy is likely to become an increasingly important component of the clinician's armamentarium.
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PMID:Immunoglobulin therapy in older infants and children. 157 24

Infections remain the leading cause of death among patients admitted to intensive care units (ICU). Infections due to Gram-negative bacteria are both frequent and difficult to treat. The poor outcome of such infections has been attributed to the endotoxin. The high mortality rate related to Gram-negative sepsis has prompted the testing of new, adjunctive therapies to prevent and treat infections in critically ill patients. Immunotherapy or immunoprophylaxis have long been investigated in this context. Passive immunotherapy consists of the administration of immune plasma or serum, or standard or hyperimmune purified immune globulins. Several clinical studies using such preparations to treat critically ill patients are reviewed in this article. While two studies using hyperimmune plasma or serum appeared to be successful, two studies using hyperimmune globulin failed to show a beneficial effect in the treatment or the prevention of Gram-negative septic shock. Regarding the infusion of standard intravenous immune globulin (IVIG) two studies have demonstrated a substantial benefit in the prevention of severe infections; the reduction of nosocomial pneumonia recorded in both trials and the shortness of stay in ICU may also afford savings in hospital costs. The cost effectiveness of such prophylactic administration of IVIG is worthy of further investigation.
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PMID:Polyclonal intravenous immune globulin for prevention and treatment of infections in critically ill patients. 803 38

Eight patients with acute leukemia (AL) and invasive pulmonary aspergillosis (IPA) developing during previous antileukemic therapy underwent BMT (autologous in 6 cases and allogeneic 2). IPA was treated prior to BMT with full doses of amphotericin B, associated with surgical resection in three cases. One patient was treated with amphotericin B and itraconazole. Prior to BMT, seven patients had minimal residual pulmonary lesions. All patients received amphotericin B (0.5 mg/kg/day) during the aplastic period prior to engraftment. One patient died of Gram-negative septic shock before engraftment. Seven patients achieved complete hematological engraftment without any evidence of IPA reactivation. Amphotericin B was well tolerated with only minimal transient renal dysfunction in three patients. Later pulmonary complications related to IPA were observed in only one patient who developed a self-limited episode of hemoptysis. One patient died of CMV pneumonitis and two of leukemia relapse. Four patients survive disease-free and without complications related to IPA. We conclude that the reactivation of correctly treated IPA can be successfully prevented in BMT patients by use of prophylactic amphotericin B. With this approach, prior IPA is not a contraindication to BMT.
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PMID:Invasive pulmonary aspergillosis prior to BMT in acute leukemia patients does not predict a poor outcome. 824 83

The article analyses the 65 lethal cases by typhoid in the period 1980-1986 during an outbreak of infection among the servicemen of the 40-th Army. All the deceased had the age of 18-37, 79.8% of them were 18-20 years old. The most frequent complications were: myocarditis (84.6%), pneumonia (75.4%), hemorrhagic syndrome (50.8%), intestinal perforation (49.2%), intestinal ulcer hemorrhage (21.5%), pleuritis (20.0%), purulent complications (11.7%), endotoxic shock (12.3%). The structure of proximate causes of death was as following: perforative peritonitis (30.8%), pneumonia (20.0%), acute heart failure (13.8%), intestinal ulcer hemorrhage (12.3%), suprarenal hemorrhage (7.7%). The results obtained during this study prove the fact that this outbreak of epidemic infection had the features of classical typhoid.
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PMID:[Complications and the proximate causes of death in typhoid]. 848 36

The study aimed to establish an experimental model to investigate the pathogenesis of lung infection by Pasteurella multocida, an important cause of bovine respiratory disease. An experimental model is required to assist the development of an effective vaccine. Sixteen 8-week-old calves were challenged intratracheally with 10(9) or 10(10) colony forming units of P. multocida in either 60 or 300 ml saline in a 2 x 2 factorial experiment. All animals became dull within 2-6h post-infection (p.i.) and two calves were killed humanely because of suspected endotoxic shock. Remaining animals showed increased respiratory rates by 15-20 h p.i. and, at 23 h p.i., calves given the high dose, high volume challenge showed higher (P < 0.05) rectal temperatures. From 24 to 36 h p.i., clinical signs decreased in a majority of animals. Plasma haptoglobin concentrations increased (P < 0.05) in calves given the high volume challenge irrespective of the number of bacteria. At post-mortem examination (4d p.i.), lung lesions, mainly in the apical lobes, were found in all calves. Histopathological examination showed areas of purulent pneumonia with a tendency to abscessation and inflamed interlobular septa characterised by accumulation of neutrophils and oedema. The clinical and pathological responses described were typical of bovine pneumonic pasteurellosis.
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PMID:Experimental induction of pneumonic pasteurellosis in calves by intratracheal infection with Pasteurella multocida biotype A:3. 1220 5

60 cases of endotoxic shock in obstetrics and gynecology in a 7 year period, January 1974 to December 1980 in Nigeria are reviewed. The most common and causative conditions were septic abortion, puerperal sepsis and pyelonephritis in pregnancy. The commonest cultured organism was Eschericha Coli. There were 33 deaths, giving a mortality rate of 55%, which falls within the range reported in the literature. The mortality rate in the institution where this study was conducted has shown a downward trend. Early surgery is advocated in those cases with infected retained products of conception and pyoperitoneum, and more liberal use of steroids, hypertonic glucose solution and digoxin, especially in patients with cardiac decompensation. The patients of the sample met the following criteria: 1) the occurrence of hypotension with consistent reading of 80/50 mm Hg or less; 2) demonstrable evidence of infection as determined by fever, hematological and bacteriological studies; and 3) the presence of persistent tachycardia. Conditions related to pregnancy accounted for 50% of of all cases. A significant finding was that 14 out of 18 patients with induced abortion had it at 2 weeks before admission. A majority of the patients in this study had subnormal temperature. The presence of jaundice, pneumonia, persistent oliguria and hepatomegaly are ominous signs accompanied by high mortality. Pulmonary factors in shock are important in determining patient survival as well as lung functions afterwards. The mortality in endotoxic shock remains high despite widespread use of fluids, antibiotic and steroid therapy, indicating that eliminating bacteria and restoring blood pressure are not the only considerations in treating shock. Insufficient nutrition may contribute to cardiorespiratory deterioration in the acutely ill patient; important physiological variables are improved by administration of hypertonic glucose solution, which leads to increased clearance of E. Coli from the blood.
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PMID:Contribution of endotoxic shock to gynaecological and maternal morbidity and mortality. 1226 57


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