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

Seventy-three dermotomy-fasciotomies (DFs) were performed in 68 patients from 1986 to 1991. A database record was compiled on each patient. Variables included age, mode of injury, method of initial wound closure, and associated injuries. A multivariate stepwise logistic regression analysis was performed to determine which variables were associated with wound complications. Thirty-eight percent of patients who underwent DF developed wound complications. One hundred percent of those patients with postoperative arterial or graft thrombosis developed wound complications (p less than 0.01) as did 78% of those with thromboembolic disease (p less than 0.05). Conversely, only 5% of those who underwent closure of their DF wounds utilizing skin grafts developed wound complications (p less than 0.01) as compared with 51% of those who underwent secondary or primary closure only. Subsequent analysis of the remaining patients, excluding those with severe soft tissue injury, showed an association between location of DF (upper versus lower extremity) and the development of wound complications that approached statistical significance (p less than 0.06). DF is frequently necessary in the treatment of patients with compartment syndrome but is associated with significant morbidity. This study suggests that closure of DF wounds utilizing skin graft allows for continued osteofascial decompression while concomitantly minimizing invasive sepsis.
 ...
PMID:Clinical results of decompressive dermotomy-fasciotomy. 141 31

We report a case of cellulitis, compartment syndrome, and septicemia associated with fish handling. The etiologic pathogen isolated from the wound and blood cultures was Plesiomonas shigelloides. The pathogen can cause serious illness in people handling fish.
 ...
PMID:Cellulitis and compartment syndrome due to Plesiomonas shigelloides: a case report. 190 Jan 18

The first and principal aim of the preclinical care of polytraumatized patients is preserving life through the restoration of respiration and circulation. Following this, the external hemorrhages should be treated. Early reduction of closed and open fractures relieves the pressure on the skin and surrounding soft tissues and prevents secondary transport-damage. Immobilization of the fractures, together with the proximal and the distal joints in a pneumatic splint, is carried out before transport. During the clinical phase, the operative stabilization of the fractures follows reanimation and life-saving operations. Primary treatment is performed as far as possible, because it reduces late death due to sepsis and multiorgan failure. In case of several fractures, an order of treatment is set up: fractures with an arterial lesion, second or third-degree open fractures and fractures with an impending compartment syndrome are the most urgent. The principles of fracture treatment in elective surgery are also valid for emergency osteosynthesis, but the choice of the fixation-device can be different. The external fixation is the first-choice treatment for fractures of the lower leg, while plate osteosynthesis is preferred for femur and humerus.
 ...
PMID:Preclinical and clinical care of extremity lesions in polytraumatized patients. 233 27

Aggressive control of intragastric pH in the burn patient has essentially eliminated upper gastrointestinal bleeding. The recent spectrum of complications in the thermally injured patient has shifted. Vascular occlusion and missed associated injury were the most frequent early complications in this review. Those complications occurring late in the course were attributed to sepsis originating in the burn wound. The common diagnostic error was to blame the burn injury for the patient's signs and symptoms. A high index of suspicion of an occult process must be exercised when caring for the burn patient who has burn shock with a decreasing hematocrit value or a compartment syndrome that does not respond to escharotomy or fasciotomy or the septic patient with a clean burn wound.
 ...
PMID:Surgical complications of thermal injury. 320 73

The primary function of the circulatory system is to transport oxygen, nutrients, and waste products. Hemodynamics of the vessels are governed by a variety of physical properties and laws that explain blood flow through the vascular system. Blood flow is affected by pressure differences, radius of the vessel, length, and viscosity (Poiseuille's Law). Flow is directly proportional to the difference in pressure and inversely proportional to resistance. Any disturbance in blood flow in the arterial and venous system disrupts the delivery of oxygen and nutrients and the elimination of waste products. Disturbances of blood flow can be due to compression of the blood vessel (edema, hematoma, compartment syndrome), structural changes within the vessel (atherosclerosis), vasospasm (Raynaud's syndrome), vasodilatation (sepsis, distributive problems), or blood clot (thrombus or embolus). Decrease in perfusion will promote compensatory mechanisms such as vasodilatation, development of collateral vessels, and anaerobic metabolism. If compensatory mechanisms are unable to meet the oxygen demand by the tissues, ischemia develops, and eventually, tissue death occurs.
 ...
PMID:Peripheral vascular anatomy, physiology, and pathophysiology. 749 55

A single-centre experience of military vascular injuries in the recent conflict in Yugoslavia is reviewed. From 1 April to 13 December 1991, 1020 casualties were admitted to the Surgical Clinic at the Teaching Faculty of the University in Zagreb, Croatia. A total of 120 injured blood vessels in 76 patients were treated in the department of vascular surgery. Casualties were transported to the hospital after treatment by forward surgical facilities. The transportation time ranged from 3 to 18 (mean 7) h. The most common injuries were to the popliteal artery (12.5%) and brachial veins (10.0%). After segmental resection, arterial and venous revascularization with saphenous vein graft interposition was the preferred option. Twenty-six fasciotomies were performed because of compartment syndrome. Indications for six amputations included sepsis, deep vein thrombosis and extensive myonecrosis. Concomitant bone fractures were stabilized by an external fixator in 90.4% of cases. Vascular injuries were repaired before orthopaedic stabilization. Completion arteriography was used to delineate concomitant distal lesions.
 ...
PMID:Military vascular injuries in Croatia. 807 91

Experience and late results in patients with a compartment syndrome which was either missed or diagnosed too late are reported. In the case of 14 patients we were consulted after a delay of 24 h, in another three patients 48 h after the causative event. At that time the diseased extremity was severely swollen, blistered and extremely painful. Ten patients presented with loss of sensitivity; in eight the peripheral pulses were not palpable. CPK was elevated in nine patients (up to 30,000); in six patients CPK was not determined. Causative factors included vascular occlusion (n = 6), paravenous infusions or injections (n = 4), compression in heroin or alcohol abusers (n = 4) and infections secondary to i.m. injections, sepsis or snake bites (n = 4). One patient developed a compartment syndrome after the closure of a muscular hernia. The late results were sobering: eight limbs had to be amputated, another 13 showed muscle necrosis necessitating necrosectomy, and both transitory and persistent median, ulnar, radial and peroneal nerve damage was observed. Our experience shows that dermatofasciotomy should be done on a more generous scale, because it obviously prevents sequelae and because the late complications following inadequately treated compartment syndromes are grave.
 ...
PMID:[Compartment syndrome. Frequently missed, with severe sequelae]. 855 98

Vascular nursing presents constant challenges. The natural history of vascular disease coupled with the complexity of the patient population provides an environment for constant learning. Providing care to these unique individuals demands a thorough knowledge of vascular anatomy and physiology, diagnostic interventions, treatment modalities, multidisciplinary resources, and nursing interventions. This case study explores the multifaceted realm of vascular nursing by examining the hospital course and multidisciplinary plan of care of a 22-year-old man whose hospital course began with a lower extremity deep venous thrombosis and progressed to pulmonary embolus, phlegmasia cerulea dolens, compartment syndrome, sepsis, arterial thrombosis, severe coagulopathy, priapism, laryngeal bleeding/laryngospasm, and subsequent notification of having received a unit of blood from a donor whose human immunodeficiency virus status was later determined to be positive. The intent of this article is not to define a specific means of practice but to share with colleagues the wealth of knowledge that was gained from this experience.
 ...
PMID:Undiagnosed hypercoagulable state: a case study. 870 92

The gluteal compartment syndrome is a rare, often unrecognized condition which, left untreated, can lead to renal failure, sepsis, and death. The etiology, physiology, and manifestations are similar to those seen in the more common and readily recognized compartment syndromes of the lower leg and forearm. The large gluteal muscle mass confined by the fascia lata of the thigh and tensor fascia lata can, under the right conditions, produce muscle necrosis, acidosis, elevations of creatinine phosphokinase, and ultimately renal failure. A gluteal compartment syndrome most commonly occurs in individuals with an altered mental status due to drugs or alcohol who remain in one position for an extended period of time. This prolonged compression leads to muscle damage, edema, and a full-blown compartment syndrome. Due to its anatomic location and rarity, diagnosis is missed or delayed, resulting in significant morbidity and possible mortality. The mainstay of treatment consists of fasciotomy and debridement.
 ...
PMID:The gluteal compartment syndrome. 929 May 30

Multiple studies have demonstrated that muscle poorly tolerates ischemia. When the ischemic state is unduly prolonged, the successfully replanted or revascularized limb undergoes deleterious biochemical reactions that cascade to vessel intimal damage, increased vessel permeability, and lowering of pH. The resultant tissue edema leads to increasing compartment pressures, which not only impede the recovery of function, but also can lead to irreversible muscle necrosis, increased risk of infection, and sepsis if not reversed in a timely fashion. The development of compartment syndrome jeopardizes not only the injured limb, but life itself secondary to the biochemical toxins produced by the ischemic extremity. A thorough understanding of the biochemistry of ischemia and reperfusion provides insight into the role of fasciotomy in the replanted or revascularized extremity. The scientific basis for fasciotomy in the revascularized or replanted limb is discussed as well as the potential "protective" role of pharmacologic agents in ischemic and reperfusion injury.
 ...
PMID:The role of prophylactic fasciotomy and medical treatment in limb ischemia and revascularization. 974 24


1 2 3 4 5 6 7 8 9 10 Next >>