Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fournier's gangrene is a necrotising soft-tissue infection of the scrotum and perineal region caused by gram-negative and gram-positive Enterobacteriaceae. The disease is characterised by its unique appearance, its speed of onset, and its high mortality. CASE REPORT. A 26-year-old male presented to the emergency room complaining of a painful, tremendously swollen scrotum and penis (Fig. 1) that had developed within the past 24 h. Later, slurred speech, pallor, and hypotension were recognised, leading to the patient's admission to the intensive care unit. Suspecting a severe internal haemorrhage, vigorous volume therapy was started using crystalloids and colloids until blood and fresh frozen plasma were available. One hour later, septic shock was presumed and therapy augmented by IV antibiotics, tracheal intubation, and mechanical ventilation. Despite all efforts, the patients condition deteriorated rapidly and he died a few hours later due to multiple organ failure in septic shock. Postmortem, a perforated external hemorrhoidal node was found to be the primary focus of sepsis. Microbiologic cultures revealed Escherichia coli in blood and tissue samples. DISCUSSION. Fournier's gangrene is a rare disease; nevertheless, its clinical picture has to be recognised immediately in order to provide appropriate treatment in time. It occurs predominantly in males after minor trauma, colorectal or urological disease, and perineal or abdominal surgery. Fournier's gangrene usually begins with itching and pain in the scrotal region followed by swelling and dark-blueish discolouration of the scrotum and penis, occasionally including the lower abdominal wall. Fever and chills are usually present. The illness progresses to severe prostation and septic shock with a mortality of 20%-50%. Tissue cultures mostly reveal E. coli, gram-positive enterococci, Pseudomonas, Proteus, and various anaerobes. The treatment should include immediate radical surgical debridement, i.v. administration of broad-spectrum antibiotics, and cardiopulmonary support. CONCLUSION. The dramatic course of Fournier's gangrene requires early recognition, extensive surgical debridement, as well as intensive care treatment in order to prevent irreversible septic shock.
 ...
PMID:[Fulminating E. coli sepsis in Fournier's gangrene]. 814 38

The experience with the first 100 hemodialysis sessions at the Owena Dialysis Centre of the University College Hospital, Ibadan (UCH) is hereby presented. A total of 9 patients were dialysed during a 7-month period. The femoral vein was the most often utilised vascular access route (53 episodes in 5 patients) while a forearm fistula was functional in only one patient. The dialyzer and blood lines were reused for each patient for a maximum of 5 times. Technical problems encountered were: power failure (12 episodes), ruptured dialyzer (3), water-pipe leakage (4) machine breakdown (2) and heparin pump failure (2). Clinical problems were: failure of fistula access (2), thrombosed femoral veins (2), clotted cannula (3), low arterial pressure (20); nausea and vomiting (2), pruritus (46), muscle cramps (5), Sepsis (8) and hypotension (2). Six patients discontinued treatment after less than 10 dialyses due to financial constraints. The high cost of hemodialysis remains the major setback to its use in the treatment of end-stage renal disease in developing countries; there is the need for acceptable improvisation to reduce the overhead cost so as to make it available to most patients requiring dialysis.
 ...
PMID:Hemodialysis in Ibadan: a preliminary report on the first 100 dialysis. 879 61

Progressive familial intrahepatic cholestasis (PFIC) occurs in many communities and races. A form of PFIC in five children from two consanguineous marriages in an Irish kindred is described. In addition, a review of clinical information from the records of three deceased members of the kindred strongly implies that they also suffered from PFIC. The children had a history of neonatal diarrhoea, sepsis, and intermittent jaundice that ultimately became permanent. They suffered intractable pruritus and growth retardation. Despite evidence of severe cholestasis, serum gamma-glutamyl transferase and cholesterol were normal in these children. Sweat sodium concentration were raised in three children. Liver histology showed severe intrahepatic cholestasis and hepatocellular injury. Urinary bile acid analysis revealed a non-specific pattern consistent with chronic cholestasis. These children suffer from a form of PFIC remarkably similar to that occurring in members of the Byler kindred.
 ...
PMID:Byler-like familial cholestasis in an extended kindred. 937 Sep 14

The main complications of endoscopic retrograde cholangiography and sphincterotomy are bleeding, pancreatitis, perforation and sepsis. Two cases of unexplained prolonged cholestatic jaundice in patients who underwent endoscopic retrograde cholangiography (ERC) for biliary obstruction due to choledocholithiasis are reported. The patients were admitted because of right upper quadrant pain, vomiting and jaundice. Laboratory tests showed increased levels of total and conjugated serum bilirubin and increased alkaline phosphatase. Ultrasound examination showed cholelithiasis and choledocholithiasis with bile duct dilatation. ERC with sphincterotomy was performed and gallstones obstructing the common bile duct were removed endoscopically. Following ERC and despite complete patency of the biliary tree, a progressive increase of total and conjugated bilirubin and of alkaline phosphatase was noted, associated with itching and total stool discoloration. The insertion of nasobiliary drain did not improve the jaundice. Prednisolone treatment for 12 days was associated with progressive restoration of serum bilirubin alkaline phosphatase to normal levels. It was postulated that the radiocontrast material used may have acted toxically on the liver with disruption of the canalicular plasma membrane. It is proposed that intrahepatic cholestasis should be added in the list of complications of endoscopic retrograde cholangiography.
 ...
PMID:Prolonged cholestatic jaundice after endoscopic retrograde cholangiography. 922 70

Intrahepatic cholestasis is characterized by a decrease in bile flow in the absence of overt bile duct obstruction, resulting in the accumulation of bile constituents in the liver and blood. Various etiological factors have been incriminated including drugs, total parenteral nutrition, sepsis, pregnancy, graft-versus-host disease and systemic disorders such as sarcoidosis, amyloidosis and Hodgkin's disease. The pathogenesis of cholestasis is unclear and several mechanisms have been hypothesized, without convincing evidence that any of these play a role in clinical cholestasis. Despite the uncertainty about the pathophysiology of intrahepatic cholestasis, several forms of therapy have been employed. Ursodeoxycholic acid may relieve pruritus and lethargy, and in some cases may modify disease progression. If cholestasis persists, supportive therapy is important to maintain optimal physical and nutritional well-being. In patients with advanced liver disease associated with hepatocellular failure, liver transplantation is the only viable option.
 ...
PMID:Intrahepatic cholestatic syndromes: pathogenesis, clinical features and management. 1043 57

Hemorrhoids are common, and a significant proportion of patients who have hemorrhoids experience symptoms such as bleeding, pain and itching. Endoscopic hemorrhoidal ligation is a safe and effective technique indicated for the treatment of grade 1 to 3 hemorrhoids, with a high success and low complication rate. Complications, when they occur, are minor and may include painful thrombosed prolapsed hemorrhoids, slippage of bands, minor rectal bleeding and chronic longitudinal ulcer. Rare, potentially life-threatening complications are massive hemorrhage and pelvic sepsis. A case of massive, life-threatening lower gastrointestinal hemorrhage following endoscopic hemorrhoidal rubber-band ligation is presented. Our patient ingested aspirin intermittently following the procedure. In a study documenting complications after hemorrhoidal band ligation, two of three individuals requiring transfusion for massive hemorrhage were taking aspirin on a regular basis. The risk of massive hemorrhage after hemorrhoidal rubber band ligation is probably increased by ingestion of nonsteroidal anti-inflammatory drugs. It may be wise to withhold such drugs soon after the procedure, if feasible.
 ...
PMID:Massive life-threatening lower gastrointestinal hemorrhage following hemorrhoidal rubber band ligation. 1251 Jul 9

The pharmacotherapy of burn care has evolved from the first topical antibiotics instituted > 30 years ago. These have helped greatly to reduce the incidence of burn wound sepsis, but a better understanding of the principles of burn care has resulted in earlier burn wound excision and complete coverage with autograft, cadaver skin, synthetic dressings, and amnion. This has markedly reduced septic complications and ameliorated the hypermetabolic response to burn injury. The hypermetabolic response, which is mediated by hugely increased levels of circulating catecholamines, prostaglandins, glucagon and cortisol, causes profound skeletal muscle catabolism, immune deficiency, peripheral lipolysis, reduced bone mineralisation, reduced linear growth, and increased energy expenditure. Supportive therapy and pharmacological manipulation, acutely and during rehabilitation, with growth hormone, insulin and related proteins, oxandrolone and propranolol can ameliorate the hypermetabolic response, improving survival and long-term outcome. Despite judicious use of topical and systemic antibiotics, opportunistic nosocomial bacterial resistance threatens to annul the improved survival of patients with severe burns. Patterns of emerging resistance encountered in burn units need to be considered, in light of a decreasing antibiotic armamentarium. A holistic approach to pharmacotherapy of severely burned patients including current practice in antimicrobial control, analgesia, sedation, and anxiety management is required. Current therapy of frequently encountered problems, such as post-burn pruritus, prophylaxis of deep venous thrombosis and peptic ulceration, and pharmacological manipulation of inhalation injury in the burned patient is described. Current pharmacotherapy to ameliorate psychosocial problems associated with burns such as acute stress disorder, depression and post traumatic stress disorder are discussed. Better analgesics, newer antibiotics and immune stimulating drugs are required to reduce mortality and morbidity in large burns.
 ...
PMID:Current pharmacotherapy for the treatment of severe burns. 1261 89

Vaginal infections, during reproductive period are frequent and although not life treating, they can affect their normal functions. They can also affect women's fertility as well as the course of pregnancy. The outcome of pregnancy can be endangered due to the possibility of infection of newborn while passing trough birth canal of the infected mother. As statistically shown, bacterial vaginosis is considerably more often found with the patients having precancerous changes on cervix, or diagnosed cancer of cervix, comparing with women with healthy cervix. It can also cause the appearance of postoperative pelvic cellulitis after hysterectomy. On the other side, the presence of S. agalactiae in vaginal secretion may cause very serious and lethal infections of the newborn such as meningitis, pneumonia and sepsis. As for protozoa T. vaginalis it has been shown that it could cause reduced fertility ability and that during pregnancy it could damage fetal membranes and bring to its premature rupture and premature birth. There is also increased risk of cervix cancer. During reproductive period of women especially if risk factors are existing such as hormone therapy, diabetes mellitus type 1 and applications of wide range antibiotics, vaginal fungal infections caused by Candida can frequently appear. These infection apart from the discomfort like itch and affluent secretion they can also mean diagnostic and therapeutical problem. Regular microbiological test of women are highly recommended during reproductive period as standard for bacterial vaginosis, fungal and trichomonas infections. If those results appear negative, further microbiological tests are necessary. Such tests which are more elaborate, more timely and more expensive are referring to tests on chlamydia, microplasma and some viruses that can also be the cause of vaginal secretion disbalance in women during reproductive period.
 ...
PMID:[Importance of microbiologic examination of vaginal secretions in the reproductive period]. 1522 66

Scabies is a disease of global proportions in both human and animal populations, resulting from infestation of the skin with the "itch" mite Sarcoptes scabiei. Despite the availability of effective chemotherapy the intensely itching lesions engender significant morbidity primarily due to secondary sepsis and post-infective complications. Some patients experience an extreme form of the disease, crusted scabies, in which many hundreds of mites may infest the skin causin severe crusting and hyperkeratosis. Overcrowded living conditions and poverty have been identified as significant confounding factors in transmission of the mite in humans. Control is hindered by difficulties with diagnosis, the cost of treatment, evidence for emerging resistance and lack of effective vaccines. Historically research on scabies has been extremely limited because of the difficulty in obtaining sufficient quantities of the organism. Recent molecular approaches have enabled considerable advances in the study of population genetics and transmission dynamics of S. scabiei. However, the most exciting and promising development is the potential exploitation of newly available data from S. scabiei cDNA libraries and EST projects. Ultimately this knowledge may aid early identification of disease, novel forms of chemotherapy, vaccine development and new treatment possibilities for this important but neglected parasite.
 ...
PMID:Scabies: new future for a neglected disease. 1550 41

The Sezary's syndrome is a lymphoproliferative disorder from the group of chronical lymphocytic leukaemia originated from the T-cell lineage. Authors are presenting the patient with Sezary's syndrome for the first time ever diagnosed in the Institute of Haematology. The patient, 58 years old got ill in summer 1989. with the symptoms of strong itch and erythematous papullas over the sin. In April 1990. he came to the Institute of Hematology where he was diagnosed as a Sezary's syndrome case on the evidence of generalized erythrodermia, identification of lymphocytes with cerebriform nucleus in peripheral blood and membrane-marker analysis that showed aberant post-thymic proliferation of T-lymphocytes in bone marrow. The patient wastreated with a polychemiotherapy and with "electron beam" therapy with temporary improvement, but died in January 1991 with sepsis and a hepathorenal syndrome.
 ...
PMID:[Sezary's syndrome (case report)]. 1629 36


<< Previous 1 2 3 4 5 Next >>