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Query: UMLS:C0036690 (
sepsis
)
59,461
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Carcinoma
of the main hepatic duct junction tends to spread extensively along the hepatic ducts into the liver parenchyma. Therefore extensive resection of the bile ducts combined with hepatic resection is the procedure of choice. Between January 1973 and April 1989, 25 of 50 patients with this type of
carcinoma
underwent resection, a resectability rate of 50%. One patient died of staphylococcal
sepsis
on the postoperative day 42 after right trisegmentectomy and resection of the bile ducts, a hospital death rate of 4%. Twenty-four patients were discharged from the hospital. The 5-year actuarial survival rate calculated by the Kaplan-Meier method was 19%. Four patients lived longer than 5 years after surgery; the longest survival was 9 years after right trisegmentectomy and resection of the bile ducts. These four patients had clear margins at the resected bile ducts. This article was designed to clarify the point at issue by presenting our results in terms of indications, operative morbidity and mortality, and long-term survival.
...
PMID:Carcinoma of the main hepatic duct junction: indications, operative morbidity and mortality, and long-term survival. 787 48
Recombinant interferon alfa-2a (rIFN alpha-2a) synergistically augments the cytotoxic effects of the antimetabolite fluorouracil (5-FU) against two human colon cancer cell lines. A pilot clinical trial was initiated to determine whether this same combination of agents would show clinical utility greater than that expected with 5-FU alone in patients with advanced colorectal
carcinoma
. 5-FU was administered at 750 mg/m2/d for 5 days as a continuous intravenous infusion followed by weekly bolus therapy. rIFN alpha-2a was administered at 9 million units subcutaneously three times per week starting on day 1. Doses of 5-FU were modified for mucosal toxicities and myelo-suppression, and doses of rIFN alpha-2a were modified for fatigue and neurologic toxicities. Thirty-two previously untreated patients with advanced colorectal
carcinoma
were entered into a clinical trial. With the exception of one patient with a destructive lesion of the sacrum, all patients had metastases to visceral organs, abdominal wall, or pelvis. Twenty patients (63%) achieved a partial response, seven remained stable, and five had progressive disease. Mucosal toxicities limited delivery of full projected dose. Two patients died following episodes of watery diarrhea progressing to
sepsis
. A third died suddenly, secondary to an interstitial pneumonitis. The remainder of the toxicities were managed with dose reductions. At the median follow-up of 8 months, 23 of 32 patients remain alive. Nine are alive at 16 to 30+ months. The early results of this single-institution study are promising, but will require confirmation in a multi-institutional setting currently being conducted by the Eastern Cooperative Oncology Group.
...
PMID:Clinical update on the role of fluorouracil and recombinant interferon alfa-2a in the treatment of colorectal carcinoma. 240 91
Between October 1980 and December 1985, 471 patients with a resectable rectal
carcinoma
entered a randomized multicenter trial for comparison of pre- and postoperative irradiation. Two hundred thirty-six patients were allocated to receive high-dose fractionated preoperative irradiation (total dosage, 25.5 Gy in five to seven days) and 235 patients to receive postoperative irradiation to a very high dosage level with conventional fractionation (60 Gy in a total 8 weeks). The postoperative treatment was delivered only to a high-risk group of patients (Astler-Coller stages B2, C1, and C2). The preoperative irradiation was well tolerated, with no immediate irradiation-related complications and no increased postoperative mortality (3%, 7 of 217 patients, compared to 5%, 10 of 215 patients in the postoperatively irradiated group). More patients in the preoperative irradiation group had perineal wound
sepsis
after abdominoperineal resection and this prolonged the stay in hospital after surgery. In 50% of the patients the postoperative treatment could not be commenced until more than 6 weeks after surgery. The postoperative treatment was not as well tolerated as the preoperative one. The local recurrence rate was statistically significantly lower after preoperative than after postoperative radiotherapy (12% versus 21%; p = 0.02). In both groups more patients developed a local recurrence if the bowel was perforated at surgery or if the resection line was microscopically close to the tumor. To date, with a minimum follow-up of 3 years and a mean follow-up of 6 years, there is no difference in survival rates between the two groups.
...
PMID:Pre- or postoperative radiotherapy in rectal and rectosigmoid carcinoma. Report from a randomized multicenter trial. 240 93
At the instance of a female patient with obstructive jaundice due to inoperable
carcinoma
of the head of the pancreas is reported on the percutaneous transhepatic cholangiodrainage. With the help of this non-operative palliative drainage of the system of bile ducts in malignant tumors of the biliopancreatic area an at least transitory relief with regression of the jaundice and the excruciating pruritus is achieved. With regard to the relatively high complication rate of the percutaneous drainages performed without laparotomy (haemorrhage, cholangitis,
sepsis
) and to the possibly already early loss of function by occlusion or dislocation of the catheter the indication for such an approach is strictly to be made.
...
PMID:[Percutaneous transhepatic bile duct drainage (PTCD)]. 241 32
Percutaneous nephrostomies were used in 34 patients with ureteral obstruction caused by gynecologic diseases. Group 1 consisted of 12 patients with untreated cervical
carcinoma
; group 2 consisted of six patients with recurrent cervical
carcinoma
; group 3 consisted of seven patients with complications of urinary conduits, and group 4 consisted of eight patients with a variety of malignant and benign gynecologic diseases causing ureteral obstruction. One perinephric hematoma and one perinephric abscess (4%) occurred during primary percutaneous nephrostomy diversion of 53 renal units. One (3%) percutaneous nephrostomy-related death caused by
sepsis
was observed in 34 patients. Only four (12%) patients with significant intrinsic renal disease did not have effective normalization of renal function by percutaneous nephrostomy. Percutaneous nephrostomies allow rapid and reliable urinary diversion without the morbidity and mortality of operative techniques. Percutaneous nephrostomy should be considered for relief of ureteral obstruction in patients with untreated cervical
carcinoma
who may enjoy prolonged palliation or cure, in patients with complications of previous urinary conduits as a temporizing method of urinary diversion, and in patients with benign or chemotherapy-sensitive pelvic malignancies causing ureteral obstruction. The use of percutaneous nephrostomy in patients with recurrent carcinoma of the cervix should be individualized on the basis of expectations for prolonged functional palliation.
...
PMID:Percutaneous nephrostomy in gynecologic oncology patients. 245 17
For phase II studies in patients with solid tumors, the National Cancer Institute recommended that the starting dose of fludarabine phosphate be 20 mg/m2/day as a short intravenous infusion for 5 days every 21 days. Twenty-one patients with untreated, advanced, measurable colorectal
carcinoma
received fludarabine phosphate as a 30-minute infusion at a median dose of 25 mg/m2/day (range 15-35 mg/m2/day) for 5 consecutive days repeated every three weeks. Antitumor response was evaluated following two courses of therapy. No patient achieved complete or partial response. Minor regression of lung metastases occurred for less than 12 weeks in one patient. Therapy was generally well tolerated. Frequent toxicities included lymphopenia, mild nausea and vomiting, mucositis, and anorexia. One patient died of
sepsis
, bleeding, and progressive disease while she was severely myelosuppressed. Neurotoxicity was not observed in any patient. Fludarabine phosphate at this schedule and dose range is inactive against colorectal
carcinoma
.
...
PMID:Phase II study of fludarabine phosphate in patients with advanced colorectal carcinoma. 245 66
In a prospective study including 60 patients with esophageal
carcinoma
the nutritional status was evaluated by means of anthropometric, biochemical and immunological data. As a first measure of malnutrition the diminuation of each single parameter was estimated in a 10%-scale, according to this a linear rising number of points given and the sum for all 11 parameters expressed as a score (Gofferje and Fekl). Second the nutritional status was judged by the prognostic nutritional index (Buzby and Mullen). Both score and index were correlated with serious postoperative complications (wound infection, anastomotic leakage,
sepsis
, organ failure, death). The results show that it was not possible to assess the risk of esophagectomy preoperatively on the ground of nutritional parameters solely. The reason could be that the nutritional status was rather normal in most cases and its risk burden therefore low. In conclusion performing preoperative nutritional therapy routinely seems not to be justified.
...
PMID:[Nutritional status in esophageal cancer: assessment and significance for preoperative risk assessment]. 249 40
Twenty selected patients with advanced malignant tumour (11 women and 9 men; mean age 52.8 [17-83] years) were on home parenteral nutrition because of ileus and (or) shortintestine syndrome. Mean survival time after onset of total parenteral nutrition in hospital was 107 (23-467) days. Mean treatment period at home was 81 (13-376) days, in hospital 26 (3-91) days. The patients with the shortest survival time all had metastasizing gastric
carcinoma
. The most common complaint was physical fatigue. In one patient there was a treatment-related complication (catheter
sepsis
). The results document that total parenteral home nutrition of carefully selected patients with advanced malignant tumour makes it possible for the remaining period of life to be spent, in acceptable conditions, at home rather than in hospital.
...
PMID:[Home parenteral feeding in advanced tumor diseases]. 250 97
Septicemia
encountered at Kawasaki Municipal Hospital between 1985 and 1986 were studied clinically. Forty six patients had monomicrobial and 5 has polymicrobial infections, respectively. Out of these 46 patients with
septicemia
, 17 were due to Escherichia coli, 7 were due to Klebsiella pneumoniae and 4 were due to Staphylococcus aureus. Ten patients had hepatobiliary, 7 had hematological, 7 had malignant diseases as underlying diseases, respectively. Out of 10 patients complicated with septic shock, 7 died. Twenty three patients were community acquired infections. The age of most of the patients were over 50. The mortality rate of more than 65-year-old patients were higher than that of other patients. Our of 5 patients with
septicemia
due to polymicrobial infection, only 1 patient with erythroleukemia died. Fifty patients were treated mainly with beta-lactam antibiotics such as piperacillin or cefmetazole alone or in combination with aminoglycosides and so on. Three patients with infective endocarditis were encountered during this period. Two were due to alpha-streptococcus and 1 was due to Enterococcus. A 41-year-old patient with mitral valve insufficiency and metastatic gastric
carcinoma
to the bone marrow were complicated with disseminated intravascular coagulation. This patient, however, was successfully treated with a daily dose of 24 mega units of benzylpenicillin, and was given gabexate mesilate, concomitantly.
...
PMID:[Clinical studies on septicemia and infective endocarditis encountered between 1985-1986]. 250 8
A case of signet cell
carcinoma
associated with AIDS is presented. A 50-year old Japanese man with hemophilia A was suffering from human immunodeficiency virus (HIV) infection, the result of multiple injections of clotting factor concentrates. A diagnosis of signet cell carcinoma of the stomach was reached upon endoscopic and histological examinations. Opportunistic infections of esophageal candidiasis and candida
septicemia
occurred. The patient died of repeated gastrointestinal bleeding and cachexia. Although there is a possibility of the patient having a coincidential
carcinoma
along with AIDS, the HIV infection, perhaps, had a role in causing signet cell cercinoma.
...
PMID:Signet cell carcinoma of the stomach in a patient with acquired immunodeficiency syndrome: a case report. 253 9
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