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

Each year between 71,000 and 142,000 cases of septic shock are estimated to occur. Shock is a derangement in the homeostatic mechanisms of the body secondary to decreased tissue perfusion. The proper treatment of septic shock is based on complete understanding of the altered physiologic events, and, consequently, adequate therapy for shock should be approached from the standpoint of applied physiology in the clinical setting. Currently, sepsis is seen in the patients suffering multiple trauma or burns, undergoing immunosuppressive therapy for cancer or connective tissue disease, or who have undergone organ transplants. The initial therapy needs to consider carefully whether subtle clinical parameters are consistent with sepsis. Time and effort should be given to the prevention of septic shock. Good drainage procedures, proper nutritional therapy, and hydration needs to be maintained at all times. An early aggressive approach with regard to diagnosis can beneficially influence the outcome of infection by reducing the duration and complexity of therapy. Focus is on bacteriology and antimicrobial therapy, hemodynamic and fluid therapy, metabolic and nutritional aspects, complications, and steroids. 4 major complications of sepsis are abnormalities in the clotting pathway and changes in the renal, pulmonary, and cardiovascular systems. Steroids have been recommended for septic shock, for they are stabilizing to the lysosomal membranes in the splanchnic circulation. Experimentally, this has led to a decreased production of myocardial depressant factor. To use steroids properly large doses should be administered early in the shock state.
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PMID:Therapy for septic shock. 10 43

Over a 7 1/2-year period, 94 cancer patients presenting considerable operative risk were managed by total parenteral nutrition (TPN). All were nutritionally depleted, had obstruction to the gastrointestinal tract or had postoperative complications such as enterocutaneous fistulas, evisceration or intra-abdominal sepsis, which left TPN as the only means of achieving anabolism. When TPN was started preoperatively and continued post-operatively (28 patients--Group 1), no deaths or significant complications occurred. When TPN was first started after life-threatening complications had occurred (58 patients--Group 2), the mortality was 17.2%, so that a high incidence of recovery was achieved. When TPN was used in inoperable cachectic patients (8 patients--Group 3) to enable them to tolerate radiotherapy or chemotherapy, the mortality was 37.5%. This latter group is small, but TPN is worthwhile in selected patients where significant palliation and improvement in the quality of life can occur. With careful technique, risk of sepsis with TPN was no greater than in noncancer patients.
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PMID:Specialized nutritional support and cancer. 10 33

Cancer cachexia should no longer be a contraindication to adequate antineoplastic treatment. Current methods of nutritional assessment allow one to identify malnutrition and to follow the nutritional status of the patient throughout the cancer-management program. Enteral nutritional repletion and maintenance remain the ideal course of action, but the gastrointestinal tract is not always readily available or advisable for use; in such circumstances, intravenous hyperalimentation (IVH) may be indicated. The properly nourished patient better tolerates cancer therapy, experiences fewer complications of malnutrition (e.g., sepsis and poor wound healing), and has a better-functioning immune system than does his malnourished counterpart. This article reviews methods of nutritional assessment, delineates indications and techniques for nutritional repletion, and summarizes the results obtained.
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PMID:Nutritional concepts in the treatment of head and neck malignancies. 11 11

Upon the plasmin digestion of human fibrinogen, an early cleavage product, which has been designated as fragment A, was isolated, and to study the action of plasmin in the circulation, radioimmunoassay for fragment A was carried out. This assay used rabbit immune serum obtained by injection of fragment A mixed with complete Freund's adjuvant, and fragment A was labeled with 125I using the Chloramin-T method. In 20 normal healthy donors its serum level was 3.57 +/- 1.62 microgram/ml (mean +/- SD), and it was increased significantly in certain diseases, such as acute leukemias, cardiovascular disorders, malignancies, renal failure, systemic lupus erythematosus and sepsis.
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PMID:Radioimmunoassay of an early plasmin degradation product of human fibrinogen, "fragment A", and its clinical application. 14 16

Cats with naturally occurring leukemia and lymphoma had low or negative humoral antibody titers to the feline oncornavirus-associated cell membrane antigen (FOCMA). Geographic differences were seen in the relative frequencies of various forms of lymphoproliferative neoplasms. Lymphatic leukemia and thymic lymphoma were most common in Boston, whereas alimentary lymphoma was most frequent in Glasgow. No significant differences were found in geometric mean FOCMA antibody titers for the various forms of leukemia-lymphoma or for feline leukemia virus (FeLV)-positive as compared to FeLV-negative cats. Approximately 70% of 76 Boston cats with nonregenerative anemias were FeLV gs antigen (gsa) positive; this was similar to the percentage with leukemia-lymphoma from the same population that was positive. Fifty-five to 62% of the Boston cats with other infectious diseases, such as peritonitis and septicemia, were gsa positive. We postulate that this is due to a predisposition to infectious diseases by the immunosuppressive action of FeLV. Young cats from the Boston population that developed lymphoma, infectious peritonitis, and certain other diseases were more likely to be FeLV gsa positive than older cats with the same diseases.
J Natl Cancer Inst 1975 Aug
PMID:Feline oncornavirus-associated cell membrane antigen. IV. Antibody titers in cats with naturally occurring leukemia, lymphoma, and other diseases. 16 77

Review of the coagulation laboratory records and medical records at Memorial Sloan-Kettering Cancer Center over a three year period (1971--1974) revealed 89 patients with disseminated intravascular coagulation (DIC). The diagnosis of DIC was made if laboratory studies showed evidence of quantitative and qualitative changes in fibrinogen and significant thrombocytopenia. The patients included 19 with leukemia (17 acute), 3 with multiple myeloma, 15 with lymphoma, 46 with metastatic solid tumors, (10 lung, 9 breast, 8 gastrointestinal, 12 genitourinary, 7 miscellaneous) 4 with vascular tumors, and 3 without tumor. Other conditions which might have precipitated or initiated DIC such as gram-negative sepsis, liver impairment, or mucin secreting tumors were present in the majority of patients. Bleeding occurred in 75% of the patients and was fatal in 36%. Thromboembolism occurred in 22.5%. Thirteen percent were asymptomatic. Serum lactic dehydrogenase was elevated in over 75% of the patients at the time of, or subsequent to the occurrence of DIC. Treatment with heparin was helpful in only three of twenty patients. Eighty percent of the patients died within one to over 30 days of the onset of DIC. Post mortem evidence of DIC was present in 18 of 43 autopsies. Results of this study indicate that DIC is a frequent complication of a wide variety of tumors and that its occurrence causes morbidity and mortality in a significant number of patients. Treatment with heparin is of little help unless remission is induced and the precipitating factor(s) are reversed.
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PMID:Disseminated intravascular coagulation: experience in a major cancer center. 17 94

The clinical and pathologic findings of four cases of cystic nephroma (so-called "renal multilocular cyst") in four infants nephrectomized with the diagnosis of Wilms' tumor are presented. Each lesion consisted of an encapsulated mass composed of cysts separated by thin septa. Histologically the cysts were lined by epithelium, and the septa contained foci of immature metanephric blastema (abundant in one case and sparse in another). rhabdomyocytes and mature tubules. Neither embryonic ducts nor cartilage were seen. One cystic lesion was adjacent to a nephroblastoma which formed a separate nodule. No recurrences of metastases developed, and the only death was due to postoperative sepsis. These lesions are considered by some authors to be dysplasia, while others interpret them as benign neoplasms. Our findings and a review of the literature probably represent the differentiated counterpart of nephroblastoma.
Cancer 1977 Mar
PMID:Cystic nephroma. 19 49

A review was made of the presentation, treatment, and follow-up of 20 patients with adenoid cystic carcinoma and 12 patients with mucoepidermoid carcinoma of the bronchus who were seen at the Mayo Clinic during the 50 year period 1927 through 1977. Three forms of therapy were employed: complete surgical resection, radiation therapy alone, and radiation therapy after endoscopic removal of tumor tissue. Superior results were obtained in the group with adenoid cystic carcinoma, when complete resection was possible. Significant survival and palliation of sepsis was achieved with subtotal resection. The mucoepidermoid carcinomas in this series were classified on the basis of histologic differentiation. Mucoepidermoid carcinoma of Grade 1 was managed by conservative pulmonary resection. Mucoepidermoid carcinoma of Grades 2 and 3 showed a greater propensity for malignancy. Widespread dissemination caused death with unresectable high-grade mucoepidermoid carcinomas of Grades 2 and 3.
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PMID:Adenoid cystic carcinoma (cylindroma) and mucoepidermoid carcinoma of the bronchus. Factors affecting survival. 21 Mar 33

Aminoglutethimide is an investigational agent of proven benefit in the treatment of metastatic breast carcinoma. We report herein a case of aminoglutethimide-induced pancytopenia complicated by bleeding and gram-negative septicemia. Severe pancytopenia is a rare but important side effect of this new drug and is rapidly reversible when the agent is withdrawn.
Cancer Treat Rep 1978 Oct
PMID:Pancytopenia induced by aminoglutethimide in the treatment of breast cancer. 21 92

The authors studied the skin disorders in 50 patients who have undergone renal transplantation. They observed: -- Viral infections (herpes simplex, herpes Zoster, warts) in 56% of the patients. -- Bacterial infections in 36%, resulting in septicemia in 8% of the cases. -- Fungal infections in 26% of the patients. These infections appeared more severe than usual and recurred frequently. The occurence of several infections processes in the same patient was not uncommon. The clinical aspect and high incidence of various infections is related to immunosuppresive therapy. However, there is no clear-cut correlation between the type of infection and the type of treatment used. -- Squamous cell carcinoma occured in one patient. A high incidence of malignancies is known to occur in immunosuppressed patients. -- Skin signs related to hemodialysis (pruritus, hypermelanosis, skin dryness, vascular disturbances) regressed. -- The incidence of adverse reactions to drugs was high. -- 4 cases of ulcerations of the oral mucosa probably related to Azathioprine were observed.
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PMID:[Skin manifestations in renal transplants]. 21 59


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