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)

Pharmacokinetics of ceftizoxime (CZX), a new cephalosporin antibiotic, was investigated in 9 children with normal renal and hepatic function. In addition, the clinical effect of CZX was evaluated in 26 pediatric patients with various infections. In 4 of the 9 children with normal renal and hepatic function, intravenous bolus injection of CZX in a dose of 20 mg/kg yielded a mean peak serum level of 36.5 micrograms/ml at 1/2 hour after infusion, and mean serum levels of 12.5 micrograms/ml at 2 hours and 6.0 micrograms/ml at 4 hours after infusion. The biological half-lives of CZX were estimated to be 1.25--2.55 hours. In another child, serum levels of CZX at 1/2, 2 and 4 hours after intravenous bolus injection in a dose of 10 mg/kg were 19.60, 5.96 and 2.06 micrograms/ml, respectively. The clear difference in dose response between 20 mg/kg and 10 mg/kg reflected the doubled dose levels. In the remaining 4 children, drip infusion of CZX in a dose of 20 mg/kg (1 child 17 mg/kg) over 0.5--1.5 hours yielded peak serum levels at the end of infusion. The biological half-lives of CZX were estimated to be 0.95--1.50 hours. About 80% of CZX was excreted in the urine within 6 hours after infusion in the 4 children tested. Twenty-six pediatric patients with various infections were treated with CZX intravenous doses of 20 mg/kg to 118 mg/kg b.i.d.--q.i.d. for 3--14 days. Of the 12 patients with acute bronchitis and pneumonia, 5 showed excellent response, 6 good and 1 fair response. Of the 5 patients with urinary tract infection, 4 showed excellent response and 1 good response. One patient each with colitis, tonsillitis and facial cellulitis, pharyngitis showed excellent response and 1 patient each with purulent thyroiditis and gluteal abscess showed good response. The single patients with sepsis showed excellent response. One patient each with pyothorax, purulent arthritis and cerebral abscess showed poor response. Overall effectiveness rate was 84.6%. although 22 of all 26 patients treated had serious underlying diseases such as APL, AML. A mild increase in GOT and GPT was observed in 1 patient during treatment with CZX, and the values returned to normal after discontinuation of the drug. These results suggest that ceftizoxime is 1 of the most important antibiotics for treating a wide range of infections in children as well as in adults.
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PMID:[Pharmacokinetics and clinical evaluation of ceftizoxime (author's transl)]. 627 8

Experience with 28 patients with acute diffuse complicated colitis operated on in emergency or semi emergency by the same surgical team is reviewed. The forms with colonic dilatation are the most numerous but do not resume the serious complications which may occur in the course of non specific inflammatory diseases of the colon. The operative mortality in this series was 10,7% (3/28). Peritoneal sepsis was the most significant factor contributing to mortality. It appears that the keystone to successful management is to prevent colonic perforation. Protracted medical management may be at last partly responsible for this complication. Failure of intensive medical therapy to induce rapid improvement constitutes an indication for definitive surgical treatment.
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PMID:[Surgical treatment of acute complicated colitis. Report on twenty-eight cases (author's transl)]. 628 5

Six patients with polyposis coli and five with chronic ulcerative colitis underwent total colectomy and mucosal proctectomy with preservation of the anal sphincter and levator ani muscle. An ileal reservoir, constructed from the terminal ileum, is brought out through the anal sphincter for anastomosis to to the anus at the dentate line. Two patients in the series had a three-limb reservoir with anastomosis of a short efferent ileal limb to the anus (Parks technique). Nine patients had a two-limb J-shaped reservoir with the apex of the reservoir anastomosed to the anus (Utsunomiya technique). All patients had a temporary defunctioning ileostomy. There were no deaths. Two patients suffered from severe infection within the rectal muscle cuff. One resolved completely with spontaneous drainage into the reservoir; the other had continuing sepsis and eventually required excision of the anus and conversion to a continent ileostomy. All patients remain in good general condition with no disturbance of urinary or sexual function. Continence is satisfactory in all patients but two wear a pad at night. All evacuate their reservoirs spontaneously: none requires the use of a catheter. For most patients stool frequency varies from four to eight times daily but two patients have more frequent bowel motions. Colitis patients have more frequent bowel activity than those with polyposis. Three patients take Imodium tablets to lessen bowel frequency. The operation should be reserved for specialized centres and is still under trial; however, it appears likely to become the operation of choice for all patients with polyposis coli and for many patients with chronic ulcerative colitis.
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PMID:Proctocolectomy without ileostomy: ileo-anal anastomosis with an ileal reservoir. 658 43

The clinical course of 75 patients with diarrhea and positive C. difficile toxin stool assays has been examined. The mean age of the patients was 68 years. Five of 25 surgical nursing units accounted for two thirds of the cases. Many patients were immuno-suppressed with cancer, sepsis, or diabetes mellitus. The median onset of diarrhea was 2.7 days after initial administration of antibiotics. Fever and leukocytosis were frequently seen. Diarrhea ceased in 30 percent of the patients after withdrawal of the offending antibiotics. The remainder required specific therapy with vancomycin, bacitracin, or metronidazole. Two deaths were directly attributable to C. difficile colitis. The hospital stay was prolonged in many patients. C. difficile colitis should be suspected in any patient in whom diarrhea develops during or after a course of antibiotics. Enteric precautions may prevent clustering in these cases and colonization in other susceptible patients.
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PMID:Clostridium difficile colitis in surgical patients. 671 51

Retrospective pathology data from necropsies of 162 marmosets, Saguinus oedipus, were studied to determine the nature of chronic wasting syndrome, a poorly defined entity associated with a high mortality rate in many marmoset colonies. Paraffin sections of the gastroenteric organs of 116 of these marmosets were re-examined in detail; lesions were identified, quantitated, and analyzed with a method of multiple chi-square testing for possible associations between findings. Five distinct disease entities were identified: prosthenorchosis, amebiasis, paramyxovirus disease, sepsis, and chronic colitis. Lesions of several of these often occurred in the same monkey, and all but the first were associated with cachexia. Lesions of chronic colitis were crypt abscesses, mononuclear and polymorphonuclear infiltration of the lamina propria, epithelial cell atypia, karyorrhexis, and lymphoid hyperplasia. The cause of chronic colitis was not identified, nor was any explanation found for weight loss and increased susceptibility to disease.
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PMID:An analysis of the association of gastroenteric lesions with chronic wasting syndrome of marmosets. 681 72

Our patient, who was known to have multiple myeloma, presented with weight loss, rectal bleeding, and a barium enema study suggestive of a colitis with a mass lesion. Colonoscopy with biopsy revealed the mass to be large mucosal folds infiltrated with amyloidosis. Amyloidosis has been reported to mimick malignancy, mainly by tumorous deposits in the stomach and less commonly in the small and large bowels. Gastrointestinal surgery in patients with amyloidosis potentially may have undesirable consequences due to failure of anastomotic suture lines and subsequent sepsis (6, 11, 17, 18). The knowledge that amyloidosis may be associated with multiple myeloma and an appreciation of the wide range of gastrointestinal roentgenographic findings in patients with amyloidosis should prompt the clinician to obtain endoscopic and biopsy evaluation of these patients.
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PMID:Amyloidosis masquerading as inflammatory bowel disease with a mass lesion simulating a malignancy. 708 Nov 72

Operations for intraabdominal abscess were performed in 46 (20 percent) of 230 patients with Crohn's colitis and ileocolitis treated at the Mount Sinai Hospital during the decade 1964 to 1974. Internal and external fistulas, intestinal obstruction, and abdominal mass occurred significantly more often in patients with intraabdominal abscess, while only overt bleeding was significantly less common. Abscesses were equally divided between 23 patients who had undergone previous surgery and 23 cases of spontaneous onset. IN ileocolitis, the most frequent site of origin was the terminal ileum with right lower quadrant abscess, as opposed to a sigmoid origin in colitis with presentation in the left lower quadrant. There was no mortality among 24 patients treated with simple drainage, usually for superficial abscess, but enterocutaneous fistulas persisted in 5 of these patients (21 percent). Four of 11 patients (35 percent) died after undergoing bypass or ileostomy diversion. Among the 31 patients surviving either of these procedures, 18 (60 percent) required subsequent resection of the diseased bowel. By contrast, among 11 patients treated with primary en bloc resection plus drainage, there was only 1 death (9 percent) and no abscess recurrence or chronic enterocutaneous fistula formation during a follow-up period of 1 to 4 years. The high mortality rate after bypass may be explained by the more serious nature of the disease and the preexisting deep intraabdominal abscess and postoperative sepsis. Simple extraperitoneal drainage is a safe procedure associated with an extremely low mortality; however, when feasible, resection of the diseased bowel seems to be the treatment of choice for abscess in patients with Crohn's colitis and ileocolitis.
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PMID:Intraabdominal abscess in Crohn's (ileo) colitis. 709 6

Examination of this series of 19 patients with antibiotic-associated pseudomembranous colitis revealed that most of the patients were given the antibiotics for trivial reasons. Many different antibiotics were identified as being related to the development of colitis. There were three deaths in this series; two of the 15 patients treated medically and one of the four treated surgically. The efficacy of all diagnostic procedures and medical therapies are discussed, and the role of surgery in treating patients with toxic state, sepsis, or perforation is presented.
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PMID:Antibiotic-associated colitis: a persistent clinical problem. 736 34

A 64-year-old woman was diagnosed as having myelodysplastic syndrome (MDS) at 45 months after receiving radiotherapy for advanced carcinoma of the uterine cervix. We chose low dose therapy of SPAC and ACR because of the diagnosis as therapy-related MDS and the existence of radiation colitis. She obtained minor response, but two months later she transformed to AML (M2). The interval between low dose therapies was getting shorter and shorter, so we tried intensive chemotherapy consisting of BHAC, ACR and 6MP. Blast numbers were reduced, but she died of sepsis and intestinal bleeding. The patients of MDS with t(8;21) and the patients of therapy-related AML (tAML) with t(8;21) are very rare. According to the literature, only karyotype is a prognostic factor in AML/MDS with t(8;21). And diagnosis by the criteria of FAB classification is of little value regarding clinical progress. That is to say, if the patient has only t(8;21) or karyotypic abnormalities which are of little value in prognosis, such as the loss of a sex chromosome, it must be treated as de novo AML, but if patient has karyotypic abnormalities such as -5, 5q-, -7, 7q-, and/or multiple (complicated) abnormalities, we must accept that the prognosis is poor and must treat it as ordinary MDS/tAML.
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PMID:[Therapy-related leukemia with t(8;21) initially diagnosed as MDS (RAEB in T)]. 756 9

Over a 30-year period (1963-1993), 12 patients out of 2091 renal allograft recipients (0.5%) were identified for an acute colonic complication. They were 7 males and 5 females with a mean age of 43 years. The mean elapsed time from transplantation to symptoms was 55 months. Peritonitis was diagnosed in all cases, requiring an emergency laparotomy in 6 patients (50%); delayed surgery was possible in 4 patients (33%) after failure of conservative treatment. One patient (9%) was operated electively later on while the last patient died before any surgery from sepsis after diffuse bowel ischaemia. Aetiology included complicated diverticulitis in 9 instances (75%), one colon perforation caused by faecal impaction, one cytomegalovirus colitis and one bowel ischaemia. Another patient died postoperatively after colon resection for perforated diverticulitis. The use of cyclosporine since 1985 did not reduce the incidence of colonic complication. In conclusion aggressive medical support and early surgical exploration are mandatory for renal recipients presenting with an acute colonic complication.
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PMID:Acute colonic complications after kidney transplantation. 761 Jul 50


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