Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ceftazidime (CAZ) was administered to 34 full-term and premature infants aged 0-27 days with various bacterial infections in a dose of 10 or 20 mg/kg by intravenous bolus injection, and plasma concentrations and urinary recovery rates in these subjects during recovery periods were studied. Because of the small number of the cases recruited, neonates were not divided into the full-term and the premature group, but into 3 groups based on day-age: 0-3 days, 4-7 days, and 8 days or older. Concentrations and rates of transfer of CAZ into cerebrospinal fluid (CSF) were determined in 2 cases, and biliary concentrations in another case. A clinical evaluation of CAZ was performed in 12 male and 6 female infants aged 1 day to 4 months and 19 days, including 2 each with purulent meningitis, pneumonia and pyelonephritis, 3 with septicemia, 1 each with septicemia suspected, cholangitis, osteomyelitis, bronchopneumonia, staphylococcal scaled skin syndrome, and acute enterocolitis and 3 for prophylactic use. Plasma concentrations and urinary recovery rates of CAZ The intravenous bolus injection at 10 mg/kg. Peak plasma concentrations of CAZ were obtained at the first collection (30 minutes) of blood samples or 1 hour in all 3 groups, ranging from 23.3 to 26.9 micrograms/ml with no significant variations, plasma concentrations then slowly decreased, and were still 6.04-9.88 micrograms/ml even at 6 hours after the administration. The half-lives of CAZ in plasma tended to be shorter in older day-age neonates, with mean half-lives being 3.59, 2.50 and 2.50 hours for the youngest. The intravenous bolus injection at 20 mg/kg. Peak concentrations were obtained at the first collection of blood samples in all 3 groups (0-3 days: 15 minutes, the others: 30 minutes), being 54.8, 39.9 and 43.8 micrograms/ml, respectively, then slowly decreased and were still 10.4-15.7 micrograms/ml even at 6 hours after the administration. Inter-age differences in half-lives were marked, i.e., 3.6 hours in 0-3-day group, 3.48 hours in 4-7-day group and 2.75 hours in 8-day or older group. Urinary recovery rates were about 40-60% without reference to day-age neonates. CSF concentrations About 50 mg/kg of CAZ was given to each of 2 cases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Fundamental and clinical studies on ceftazidime in neonates and premature infants]. 354 Mar 45

Ascariasis lumbricoides is one of the most common helminthic infections in developing countries. Biliary ascariasis presents with recurrent cholangitis and sometimes with liver abscesses. We report the case of a young Philippino worker in Saudi Arabia who presented with obstructive jaundice, cholangitis and liver abscesses secondary to biliary tract ascariasis. The diagnosis was made at endoscopic retrograde cholangio-pancreatography (ERCP) and the obstructing worms were removed with a Dormia basket after endoscopic sphincterotomy at this procedure. Full resolution of the biliary and hepatic sepsis followed. Urgent ERCP and endoscopic decompression of the biliary system in biliary ascariasis is recommended.
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PMID:Endoscopic treatment of ascariasis causing acute obstructive cholangitis. 354 73

Microbiologic aspects of hepatobiliary tracts are reviewed. The gallbladder, the common duct and the liver are discussed separately. Special attention is paid to bacteriologic sampling technique. Factors associated with bactibilia are surveyed. The relation between biliary bacteria and stone formation is evaluated. The etiology of acute calculous and acalculous cholecystitis, cholangitis and pyogenic liver abscess is discussed from a microbiological point of view. The importance of new imaging techniques, such as ultrasound, radionuclide scanning and computerized tomography, in the diagnosis and treatment of biliary obstruction or hepatic abscess is recognized. The type of bacteria and their incidence in bile was strongly associated with the underlying condition and various host factors. The flora in acute cholecystitis closely resembled that of the small intestine, while cholangitis and hepatic abscess specimens grew species often found in the colon. In addition, 'microaerophilic streptococci' were especially abundant in hepatic abscess. Nonetheless, coliforms predominated at all loci. Depending on selection criteria of the study population, bacteria of biliary origin played varying roles in the development of postoperative sepsis. Principles of perioperative antibiotic prophylaxis and treatment of manifest infection are outlined.
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PMID:Microflora of the biliary tree and liver--clinical correlates. 354 64

Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis. Over a 5-year period 625 liver transplants in 477 patients were performed at the University Health Center of Pittsburgh. Fifty-three patients (56 transplants) underwent 70 PTCs. Complications diagnosed by PTC included biliary strictures, bile leaks, bilomas, liver abscesses, stones, and problems associated with internal biliary stents. Thirty-two percutaneous transhepatic biliary drainage procedures were performed. Ten transplantation patients underwent balloon dilatation of postoperative biliary strictures. Interventional radiologic techniques were important in treating other complications and avoiding additional surgery in many of these patients.
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PMID:Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience. 354 17

Forty-two patients with acute cholangitis, as evidenced by fever (95%), jaundice (86%), and right upper quadrant pain (67%), were treated with fluid and electrolyte resuscitation, broad spectrum antibiotic coverage, and initial percutaneous transhepatic biliary drainage (PTD). Despite a 17% incidence of nondilated ductal systems, drainage was established in all patients using a 22-gauge "skinny" needle and "accordion" catheter. No attempt was made at definitive cholangiogram; only 1-2 mL of contrast were injected to confirm placement of the catheter. Sepsis began to resolve in all patients within 24 hours of PTD, after which definitive cholangiogram was performed. PTD was accompanied by a 7% (3/42) complication rate, none of which contributed to subsequent morbidity and mortality. Two patients in severe septic shock had PTD but died within 8 hours of admission, constituting a 5% mortality rate. Definitive therapy after resolution of sepsis included: surgical (16 patients), internal/external drainage (14 patients), balloon dilatation (10 patients), mono-octanoin infusion (1 patient), and ampullary dilatation (1 patient). The surgical morbidity rate was 18%. There was no mortality. PTD is effective in providing decompression as initial therapy for acute cholangitis with minimal morbidity. Accurate diagnosis provided by the definitive cholangiogram obviates the need for multiple surgical procedures. PTD provides a portal to the biliary tract for alternative procedures (i.e., internal/external drainage, balloon dilatation), especially in patients with medical contraindications to surgery.
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PMID:The treatment of acute cholangitis. Percutaneous transhepatic biliary drainage before definitive therapy. 356 75

Endoscopic sphincterotomy is an accepted treatment for retained common bile duct stones, but there is little specific information available regarding its application in acute suppurative obstructive cholangitis with sepsis due to choledocholithiasis. Thirteen patients with this condition were referred to the authors for consideration of urgent endoscopic common bile duct decompression. All had been judged to be poor surgical candidates. Pus was released from the common bile duct by sphincterotomy within 24 hours of admission in all 13. Stones were removed endoscopically in 10 patients (77%) without complications. After endoscopic stone removal, symptoms, signs, and abnormal laboratory values returned to normal rapidly; follow-up endoscopic retrograde cholangiography did not show retained stones. Three patients whose large stones precluded endoscopic removal underwent operative choledocholithotomy. Urgent endoscopic sphincterotomy offers an important alternative in the treatment of acute suppurative obstructive cholangitis secondary to choledocholithiasis.
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PMID:Acute suppurative obstructive cholangitis due to stones: treatment by urgent endoscopic sphincterotomy. 359 86

A prospective study to determine the safety and effectiveness of choledochoscopy in acute cholangitis and acute suppurative cholangitis due to common bile duct stones was conducted on 70 patients. Common bile duct pressures determined on the first 20 patients showed that choledochoscopy was unlikely to cause cholangiovenous reflux. Laboratory and clinical parameters revealed that choledochoscopy did not cause septicemia, worsen cholangitis, or provoke acute pancreatitis. There was no iatrogenic injury during choledochoscopy, and the choledochoscopic views were minimally affected by cholangitis. Choledochoscopy detected overlooked stones after conventional methods of exploration of common bile ducts in 14.3% of patients and it helped to remove impacted stones in 2.9% of patients. As a result, the incidence of retained stones after choledochoscopy was 1.4%. Time spent in choledochoscopy was short, and the total postoperative septic complication rate was only 10%. There was no operative mortality. It is concluded that choledochoscopy is safe and effective in cholangitis.
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PMID:A scientific evaluation of operative choledochoscopy in acute cholangitis. 360 39

Percutaneous Transhepatic Biliary Drainage (PTHBD) was performed in 56 consecutive patients with severe acute cholangitis, during a period of one year. An immediate decompression effect with a "good" response was achieved in 46 (82.2%), who usually became afebrile within 18 to 24 hours, and "poor" response in 10 (17.8%). Five died (8.93%) in a subsequent operation. No mortality was associated with the use of PTHBD. Complications related to the procedure occurred in 12 of the 56 patients (21.4%). Hemobilia was the major complication. The other complications were intraabdominal hemorrhage, bleeding from the puncture site, transient hypotension, catheter occlusion and/or dislodgement, bile leak, pneumothorax and hemothorax. Two with hemobilia, one with intraabdominal hemorrhage and the other with bile leak required an emergency operation. PTHBD procedures can be lifesaving in biliary sepsis. Once infection and hyperbilirubinemia are controlled, rational subsequent therapy can be formulated for the underlying disease.
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PMID:Percutaneous transhepatic biliary drainage for acute cholangitis. 367 29

Oriental cholangitis is a progressive hepatic disease characterized by episodic biliary obstruction and sepsis. This is the report of a case of Oriental cholangitis in a nine-year-old girl. Oriental cholangitis should be considered in the differential diagnosis of upper abdominal pain in the susceptible population.
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PMID:Oriental cholangitis. 373 37

To identify associations between abnormal measurements and development of life-threatening surgical sepsis, host-defence parameters were assessed in 2202 patients upon admission to hospital for operation. Measurements included the response to delayed type hypersensitivity (DTH) skin-test antigens, circulating blood-cell counts and hemoglobin levels, neutrophil adherence, chemotaxis, phagocytic and bactericidal function, and circulating serum albumin, serum globulin, serum immunoglobulin and complement levels. Sepsis was considered to be present when there was bacteremia, proven cholangitis or intracavitary abscess proven by operation or autopsy. The admission DTH response stratified patients into a reactive group (responding to two or more antigens out of five, 1373 patients), a relatively anergic group (with a response to one antigen, 306 patients) and an anergic group (with no antigen response, 523 patients). Sex, age and type of disease were similar in the three groups. There were abnormalities in neutrophil adherence, neutrophil chemotaxis, serum albumin and blood hemoglobin levels in all groups, compared with out-of-hospital controls. The reactive group had an 8% sepsis rate and a mortality of 4%, compared with 21% and 15% in the relatively anergic and 33% and 31% in the anergic groups respectively (chi 2 = 186, p less than 0.0001). The same observation was made in 1184 patients who were studied preoperatively: sepsis rates were 8%, 16% and 31% in the reactive, relatively anergic and anergic groups respectively (chi 2 = 76, p less than 0.0001) and mortality was 4%, 12% and 27% respectively (chi 2 = 99.7, p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Host-defence mechanisms in surgical patients: a correlative study of the delayed hypersensitivity skin-test response, granulocyte function and sepsis. 397 Dec 21


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