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Query: UMLS:C0036690 (sepsis)
59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An infant with complete DiGeorge syndrome was treated with blood transfusions and fresh frozen plasma because of severe septicemia and anemia. 9 weeks after the first transfusion and 2 weeks after administration of fresh frozen plasma he died of acute graft-versus-host disease. The blood products were routinely irradiated with 25 gray, the fresh frozen plasma was not irradiated. The diagnosis of GvHD was confirmed on autopsy. All cellular blood products including fresh frozen plasma which are used in the treatment of immuno-deficient patients have to be irradiated to avoid GvHD. Currently 50 gray are recommended.
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PMID:[Graft versus host reaction in an infant with DiGeorge syndrome]. 278 42

The parents and grandparents of 100 pediatric patients hospitalized at the Hospital of the Gondar college of Medical Sciences were interviewed by means of a questionnaire containing personal data, methods of traditional medicine, treatment of 30 widespread diseases and disorders of children, views about probable causes, the diagnosis of the "local healer", and the effectiveness of his treatment. Most of those interviewed came from the Gondar region, and they had an 82% illiteracy rate. 85 of the 100 children had been treated by traditional medicine: 9 experienced improvement, but the condition of 15 worsened as a result. 68% of respondents thought that traditional medicine was more cautious and conservative, 46% cited easy access to it, and 6% the low cost as the reasons for using it. 62% vowed never to use it, though after their hospital experience, still 36% claimed they would turn to the local healer again. Over 80% had uvulectomy done to treat upper respiratory diseases, and circumcision of boys is almost 100% (it is also frequent among girls). Spirits healers are distinguished from local healers: they are Christian Orthodox clergymen who exorcise demons and ghosts. Amulets, arm rings, hair style, eye makeup is supposed to protect from the evil eye. Certain practices are dangerous: application of parts of a plant causing deep necrosis, Embelia shimperi and Hagenia abyssinia used for deforming can be deadly, phlebotomy for meningitis can cause extreme anemia, the use of red-hot iron to treat infections can not only result in scarification but also sepsis. Malnutrition and kwashiorkor is often neglected, as is tuberculosis when the local healer acts. 34 of the 100 patients had TB, 7 of whom had spondylitis. The improvement of hygiene and programs to educate the populace should be implemented.
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PMID:[Traditional medicine in Ethiopia in childhood diseases]. 279 27

This paper presents the results of experience in identifying maternal deaths through "networking." In a survey of child health in coastal Kenya, women of reproductive ages were asked about their knowledge of maternal deaths in the villages. Thirty-five maternal deaths were ultimately identified in the study area, which led to an estimate of maternal mortality of 6 to 7 per 1,000 live births. The leading causes of death were hemorrhage and anemia, followed by sepsis; and nulliparous women appeared to be at higher risks of dying. Special attention is given to the ethnomedical aspects of maternal mortality,which have important implications for strategies to reduce maternal mortality.
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PMID:Identifying maternal mortality through networking: results from coastal Kenya. 281 98

The presentation and subsequent course of respiratory syncytial virus (RSV) bronchiolitis may be atypical and unusually severe when simultaneous infection due to other pathogenic agents is present. During the past two years, nine of the 189 pediatric patients hospitalized with documented RSV infection were found to have the following simultaneous isolates from initial respiratory tract specimens: four adenovirus, four pneumococcus, one cytomegalovirus, and one Pneumocystis carinii. Noted complications attributable to the second pathogen included thrombocytopenia and anemia (cytomegalovirus), hepatitis and disseminated intravascular coagulation (adenovirus), and sepsis and osteomyelitis (pneumococcus). Three of the four patients with RSV and adenovirus died of severe respiratory failure despite mechanical ventilation; two of these patients received ribavirin therapy. Rapid identification of RSV is important but should not be a substitute for more comprehensive viral and bacterial evaluation.
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PMID:Simultaneous infection with respiratory syncytial virus and other respiratory pathogens. 283 76

The maternal mortality rate in 10 hospitals scattered all over Anambra State, Nigeria, in a 5-year period were studied. The hospitals covered urban, semi-urban and rural areas. The maternal mortality rate varied from 1.8 to 13/1000 with a mean of 4.97/1000. This mean is 45 times the rate in England in 1978 and also compared less favorably with some other figures from third world sources. Attributable causes included obstetric hemorrhage (23%), ruptured uterus (27.6%), obstructed labor (13%), sepsis (12.1%), eclampsia (7.9%), anemia (2.9%), septic abortion (2.1%) and other causes. 16.7% of deaths were among 16-20 year olds; 14.6% among 21-25 year olds, 27.2% among 26-30 year olds; 18.8% among 31-35 year olds; and 22.6% among women older than 35. 87.5% of the women were unbooked. Of the 239 cases, 51 delivered vaginally, 162 by cesarean section, 12 by breech, 5 by TOP and 5 by destruction. Parity and age were important influences; at highest risk were primigravida and the grandmultipara, especially between para 4 and para 5. All the major causes of death are avoidable--either by obtaining prenatal and intrapartal care or by anticipating fetopelvic disproportion or abnormal lie. Lack of access to health facilities, especially in the rural areas, poor transportation, great distances to nearest health facility, are all implicated in obstructed labor deaths. Most cases of hemorrhage are avoidable through early diagnosis and recognition of high risk cases, prophylactic measures and availablity of blood transfusion and surgical delivery. Lack of antibiotics and non-adherence to normal aseptic precautions were also problems, especially in the 5 deaths from illegal abortions. Changes in the mortality rate can be made by accurate data collection, improved health facilities, improved socioeconomic status and basic education.
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PMID:Maternal mortality in Anambra State of Nigeria. 290 99

In a 45-year-old woman with severe normochromic anemia (Hb 2.8 g%) an extensive myelofibrosis and infiltration of the bone marrow with small blasts was observed histologically. Cytochemical examination of the blasts showed a negative peroxidase and a strongly positive alpha-NE reaction. PAS reaction was slightly granular positive in the cytoplasmic protuberances of the blasts and in the platelets. Marker analysis yielded no evidence of lymphatic origin of the blasts. In flow-cytometric studies of 230,000 cells a homogeneous 2c blast population could be identified. Cytogenetic analysis revealed an abnormal pseudo-diploid karyotype characterized by 2 acrocentric marker chromosomes caused by a translocation of chromosomes 8 and 14, as usually seen in Burkitt type lymphoma. Finally the reaction product of platelet-specific peroxidase could be demonstrated in the perinuclear cisternae of the endoplasmic reticulum by electron microscopy. Highly elevated beta-thromboglobulin and platelet factor 4 plasma levels were also measured. Following an ineffective treatment with daunoblastine and ARA-C, the patient died of pseudomonas aeruginosa septicemia after having received high-dose ARA-C treatment.
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PMID:Acute myelofibrosis in megakaryoblastic leukemia with translocation between chromosomes 8 and 14. 296 71

Sera from 37 Nigerian men with Kaposi's sarcoma were examined for evidence of infection with human T-cell lymphotropic virus type III (HTLV-III), cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis A virus (HAV), and Candida albicans. For comparison purposes, sera from 30 patients with primary cell liver carcinoma and 150 health young adults were also assessed. The Kaposi's sarcoma patients were in poor general condition, with severe anemia and gross sepsis. In each case, cutaneous disease affected only the limbs-- a finding that is in contrast with the visceral organ involvement seen in most black African victims. The serologic testing provided clear evidence that tropical African Kaposi's sarcoma is not associated with HTLV-III infection; non of the 217 serum samples analyzed from the 3 study groups showed antibodies to this virus. A widespread pattern among the Kaposi's sarcoma and liver carcinoma patients was depression of peripheral blood monocyte chemotaxis and a diminished, delayed-type hypersensitivity reaction to tuberculin. All patients in these 2 groups demonstrated circulating antibodies to CMV, EBV, HBV, AND HAV. Candida albicans was isolated from 30 of the 37 Kaposi's sarcoma patients and all 30 liver carcinoma patients compared with none of the health controls. These findings suggest that endemic tropical African Kaposi's sarcoma is a different disease than the epidemic AIDS-linked Kaposi's sarcoma reported from the US, and it is probable that different etiologic agents are involved in each case.
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PMID:Kaposi's sarcoma and HTLV-III: a study in Nigerian adult males. 302 63

There were 37 maternal deaths among the 109,221 livebirths registered during the period 1977-86 in Bahrain, Arabian Gulf. The maternal mortality rate was 33.9/100,000 for the 10-year study period; however, disaggregation reveals a decline in this rate from 42.3/100,000 in 1977-81 to 26.9/100,000 in 1982-86. This decline presumably reflects streamlining of the Ministry of Health's maternity services, including a central maternity hospital with all modern facilities that serves as a referral center for all of Bahrain, 2 peripheral hospitals with provision for blood transfusion and surgical deliveries, and 3 maternity units managed by fully qualified midwives. About 80% of deliveries are covered by these maternity services; only 2.5% of deliveries occur in the home. Despite this highly developed maternity care system, 18 of the maternal deaths were due to direct obstetric cause: hemorrhage, 7; pre-eclampsia and eclampsia, 5; abortion septicemia, 2; bowel perforation during cesarean section, 1; thromboembolism, 2; and amniotic fluid embolism, 1. The causes of the 19 indirect maternal deaths were: pulmonary embolism, 5; infection, 7; cardiac failure, 2; cerebrovascular accident, 2; pulmonary hypertension, 1; and uncertain, 2. Of interest is the finding that sickle cell disease was the underlying cause of maternal death in 12 of the 37 deaths in this series. Sickle cell disease was implicated in 3 of the deaths from hemorrhage, all 5 deaths from pulmonary embolism, 2 deaths from septicemia, and the 2 cases of cardiac failure. In this series, 50% of the patients with sickle cell disease had thromboembolic crises following treatment of anemia with packed cell transfusion. Blood transfusion, especially of packed cells, should be given with caution to these patients since it may precipitate vaso-occlusive crisis by increasing blood viscosity. Since sickle cell disease represents a high risk during pregnancy in this Arab population, such patients should have frequent prenatal check-ups and deliver in a well-equipped hospital.
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PMID:Maternal mortality in Bahrain with special reference to sickle cell disease. 321 81

Terminal complement complex (TCC) and anaphylatoxin formation in 18 patients with sepsis and 20 patients with acute limb ischemia were studied before the start of treatment and seven days later. The septic or ischemic patients had elevated levels of plasma TCC before start of therapy. In successfully treated patients these concentrations were within the normal range one week later. Similarly, the plasma anaphylatoxin level was increased before therapy and returned to the normal range within seven days. Escherichia coli incubated in vitro in fresh human serum at body temperature started formation of TCC in a dose-related manner. As complement will induce cellular lysis via TCC and edema via anaphylatoxins, anemia and impaired respiration in these patients may be influenced by increased concentrations of terminal complement complexes and of C3a and C5a.
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PMID:Terminal complement complexes and anaphylatoxins in septic and ischemic patients. 327 84

Bone marrow necrosis is a poorly understood and frequently an unrecognized finding in routine bone marrow biopsies. Previous reports indicate the incidence of bone marrow necrosis ranges from 0.5 percent (rare) to approximately one-third of all bone marrow biopsies examined. Our studies indicate that the presence of bone marrow necrosis depends on the clinical condition of the patient. Overall, our incidence of bone marrow necrosis was 37 percent of the bone marrow biopsies examined. Of these, 26.4 percent was mild. 7.5 percent moderate, and 3.1 percent severe necrosis. The mechanism in most cases had an identifiable underlying etiology such as a malignancy, or vascular or cytotoxic damage, with a small percentage being unexplained. Bone marrow necrosis is seen across a wide range of conditions, including sickle cell diseases, AIDS, leukemia, lymphoma, metastatic carcinoma, anemia, sepsis, and other systemic diseases. Patients at the extremes of age, less than 20 years and greater than 70 years, usually demonstrate only small foci of necrosis (Grade I). Moderate (Grade II) and severe (Grade III) bone marrow necrosis are often associated with life threatening illnesses, with most of these being hematologic malignancies or bone marrow metastases. The prognosis associated with bone marrow necrosis seems to be dependent on the underlying primary clinical condition regardless of the degree of necrosis observed.
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PMID:Bone marrow necrosis: an entity often overlooked. 338 56


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