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)

The present study aimed to observe the clinical features of hypoglycaemia, and identify predictors of hypoglycaemia in under-five diarrhoeal children requiring hospitalization for close observation and support. Such information could be useful to the clinicians and policy makers in developing appropriate management protocols both for identification of such children and optimizing their management. We performed a prospective study in 782 under-five children who presented with diarrhoeal illnesses. Blood glucose was determined when hypoglycaemia was suspected in 598 (62%), and 65 (11%) of them were hypoglycaemic (study group). From the other 533 non-hypoglycaemic children, 195 were randomly selected as comparison group. Bacteraemia was significantly (P = 0.026) often detected in 17 out of 260 (7%) children as opposed to 3 out of 184 (2%) children who did not have a rapid glucose test performed. Among hypoglycaemic children, 7 (11%) were bacteraemic and among non-hypoglycaemic children 10 (5%) had bacteraemia. In univariate analysis, history of shorter (<72 h) pre-admission duration of diarrhoea (75 vs. 58%, P = 0.01), documented convulsion (28 vs. 11%, P < 0.001), shorter (<72 h) hospitalization (52 vs. 33%, P = 0.01), higher case fatality rate (28 vs. 14%, P = 0.02) were associated with hypoglycaemia. In logistic regression, bacteraemic children (with clinical sepsis) were 4 times more likely to develop hypoglycaemia (OR = 4.2, 95% CI = 1.4-12.9, P = 0.012). Therefore, in a diarrhoeal disease health care service with limited resources, a rapid bedside glucose test may be considered as an inexpensive alternative in the management decisions of diagnosing bacteraemia and initiating empiric antibiotic treatment.
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PMID:Hypoglycaemia in under-five children with diarrhoea. 1738 3

Congenital adrenal hyperplasia is relatively an uncommon condition, and it is considered a rare event to be associated with hypertension on presentation. In this report we describe six patients with growth acceleration and hypertension occurring in early childhood; three patients had hypertensive encephalopathy. The eldest patient in this report is an 18-year old with a genetic female karyotype reared as male. The second and the third patients had skeletal abnormality (short fourth metatarsal), which is a rare combination. The 4th and 5th patients are siblings, a boy and a girl; both of whom had several months of muscle weakness and hypokalemia. The girl had concentric left ventricular hypertrophy and underwent vaginoplasty and clitoral rescission. The sixth patient is an infant with history of neonatal septicemia and convulsions. In all the cases, growth acceleration and features of pseudoprecocious puberty were overlooked. Two patients out of six were reared incorrectly as males.
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PMID:Hypertension in children with ambiguous genitalia: six cases. 1764 69

Fifty-two consecutive cemented total knee arthroplasties were performed using the Press-Fit Condylar (DePuy, Warsaw, Ind) knee system on patients aged 55 years or younger at Mayo Clinic Rochester from 1988 to 1994. Patients were followed for a minimum of 10 years, with an average follow-up of 12 years (range, 10-15 years). There were 8 total revisions (15%), including 2 revisions before 10 years, one for sepsis at 1 year, and one for instability at 8 years. Six revisions occurred between 10 and 15 years, all associated with polyethylene wear and osteolysis. Implant survival rate was estimated to be 96% at 10 years and 85% at 15 years of follow-up.
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PMID:Cemented total knee arthroplasty using a modern prosthesis in young patients with osteoarthritis. 1782 19

The goal of this study was to determine whether there was an association between perinatal risk factors of prematurity and vestibular evoked myogenic potentials (VEMPs). A prospective case-control trial was designed. Fifty preterm newborns (100 ears) with a gestational age <37 weeks were included. The control group consisted of 20 healthy term infants (40 ears). VEMP recordings were performed, and mean latencies of p13 were calculated in all study subjects. Multivariable logistic regression was used to investigate the influence of perinatal variables on abnormal VEMP responses. VEMPs were elicited in all term infants (40 ears). In preterm infants, the responses were normal in 71 ears, delayed in 24 and absent in 5. There was a significant difference between abnormal VEMP rates for preterm and term infants (p < 0.001). Asphyxia (OR = 13.985, p = 0.048) and time of VEMP test (OR = 0.865, p = 0.038) were related to abnormal VEMP responses. There was no association between delayed VEMPs and gestational age, birth weight, hemoglobin and bilirubin levels, phototherapy, intracranial hemorrhage, convulsions, sepsis, ototoxic drugs, transfusion, mechanical ventilation, retinopathy of prematurity, bronchopulmonary dysplasia and respiratory distress syndrome. These results suggest a delay in the maturation of VEMPs in premature infants. Asphyxia was the most important risk factor for abnormal VEMP responses in preterm infants.
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PMID:Vestibular evoked myogenic potentials in preterm infants. 1866 93

The French Indian Ocean island Mayotte was hit by an outbreak of chikungunya in January 2005. The purpose of this retrospective study is to report data recorded over a five-month period (February - June 2006) in the pediatric-neonatal department of the Hospital Center in Mayotte. The study cohort includes a total of 50 children in whom chikungunya was confirmed by molecular tools. Mean age was 9.3 years and the male-to-female sex ratio was 1:5. The main symptoms were intense pain (88%), high fever (82%), and skin rash (80%) that was less common in children under 2 years of age. Neurological complications were observed in 46% of patients including hypotonia (22%) that occurred mainly in newborns, meningitis syndrome (18%) and convulsions (16%) that occurred mainly in children over 2 years of age. Infectious complications included pneumonia (4%), pyelonephritis (2%), and possible nosocomial septicemia due to Pseudomonas (6%). The main hematological abnormalities were lymphopenia (27%) and thrombopenia (16%). Serum CRP values were moderately high (mean, 25 mg/l). Elevated AST (24%) and ALT (10%) values were observed. High CSF protein levels were noted in 30% of cases. A total of 25 children required hospitalization for more than 10 days. There were two deaths in newborns infected before the seventh day of life. The main risk factors for hospitalization longer than 10 days were premature birth and age at the time of chikungunya infection.
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PMID:[Confirmed chikungunya in children in Mayotte. Description of 50 patients hospitalized from February to June 2006]. 1906 81

The systemic consequences of status epilepticus occur in two stages: the first stage is a hyperadrenergic period (high blood pressure, tachycardia, arrhythmia, hyperventilation, hypermetabolism, hyperthermia), the second stage a collapsus period, sometimes with acute circulatory failure, and hypoxemia. Symptomatic resuscitation aimed at restoring vital functions should be undertaken. Resuscitation must be started immediately before hospital transfer, by a trained emergency team. Respiratory care includes at least oxygen intake, but it can also require oral intubation (crash induction) and mechanical ventilation. The arterial blood gas objectives are SaO(2)> or =95%, and 35mmHg< or =PaCO(2)< or =40mmHg. Fluid and electrolyte care includes intravenous infusion of normal saline, with control of sodium and calcium levels as well as blood pH within normal limits. Heart rate and blood pressure must be monitored. Mean blood pressure must be kept between 70 and 90mmHg, first by means of plasma volume expansion, and then norepinephrine if necessary. Hyperthermia must be corrected to prevent further neuronal damage. Cerebromeningeal sepsis should be ruled out. Capillary glucose (most often elevated) must be corrected using a pre-established insulin infusion algorithm. Rhabdomyolysis is rare, but can result in hyperkaliemia, acidosis, and acute renal failure. In case of associated intracranial hypertension (traumatic, vascular or infectious injury), status epilepticus is considered as a secondary insult for the brain, that can worsen neuronal damage. Numerous compounds have experimental neuroprotective properties, but none have proven significant efficacy in clinical conditions. Nevertheless, convulsion cessation is considered as a neuroprotective measure.
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PMID:[Non specific treatment of status epilepticus]. 1924 65

Sepsis is the most common cause of mortality in intensive care units. Although sepsis-associated encephalopathy (SAE) is reported to be a leading manifestation of sepsis, its pathogenesis remains unclear. In our previous studies, we showed that heat shock pretreatment can reduce mortality in polymicrobial septic rats and protect the cerebral cortical function during hypoxia or drug-induced convulsion. In the present study, we investigated to what extent heat shock pretreatment might affect the development of SAE in septic rats and the possible mechanism behind its effect was discussed. To do this, we used lipopolysaccharide (LPS) to induce septic response in a SAE animal model. Heat shock pretreatment was performed and rectal temperature maintained between 41 and 42 degrees C for 15 min using an electric heating pad. Electroencephalography (EEG) activity, a sensitive electrophysiological recording of electrical activity in the brain, was used as an indicator of cerebral cortical dysfunction in SAE. In LPS rats not pretreated with heat shock, the EEG background activity decreased 10 min after intraperitoneal administration of LPS. However, in rats pretreated with heat shock, this decrease was significantly attenuated. Untreated septic rats were also found to have earlier, more frequent epileptic spikes. In summary, we found that heat shock could attenuate the electro-cortical dysfunction in rats with LPS-induced septic response, suggesting that heat shock response might potentially be used to prevent SAE in sepsis.
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PMID:Heat shock pretreatment attenuates sepsis-associated encephalopathy in LPS-induced septic rats. 1957 6

The University Hospital Center is the only hospital in Brazzaville, Congo with a pediatric emergency room. The purpose of this prospective study carried out from January 1 to December 31, 2006 was to evaluate nighttime emergency room attendance by comparing children (excluding newborns) admitted between 7 p.m. and 7 a.m. (group 1) to those admitted between 8 a.m. and 2 p.m. (group 2). A total of 5796 emergency room admissions were recorded including 2648 children (45.7%) between 7 p.m. and 7 a.m. and 2209 (38.1%) between 8 a.m. and 2 p.m. The delay for admission was comparable for the two groups. The death rate at the time of admission was significantly higher in group 1 than group 2: 84.6 % vs. 15.4 % (p<0.01). The main reasons for seeking emergency room care in group 1 were fever (84.6%), digestive problems (44.2%), cough (35.7%), and convulsions (13.9%). The rate of hospitalization was the same in the two groups: 56.7% in group 1 versus 52.8% in group 2. The most common reasons for hospitalization were acute gastroenteritis (24.7%), bronchopulmonary infection (18.9%), malaria (17.3%), severe septicemia (9.3%) and ORL infection (8.1%). Risk factors for hospitalization included age under 2 years, arrival before midnight, and malnutrition. The death rate within 24 hours after hospitalization was 23% in group 1 and 11.5% in group 2 (p<10-4). The death rate was higher in children admitted before midnight. Nighttime attendance as well as hospitalization and death rates remain high at the pediatric emergency room of the University Hospital Center in Brazzaville. The most frequent reason for attendance was fever. Improving outcomes will require providing better information to parents (reducing admission delay) and upgrading hospital resources in terms of patient assessment and medical intervention (health care personnel and facilities).
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PMID:[Nighttime attendance at the Pediatric Emergency Room of the University Hospital Centre in Brazzaville, Congo]. 1970 53

Hereditary prothrombin deficiency is one of the rare congenital coagulation defects. We report a case of 4 months old child who initially presented at 11/2 month of age with high-grade fever, generalized convulsions and brownish aspirate through nasogastric tube, diagnosed and managed as meningitis and sepsis. He was readmitted at 4 months of age with bruises over legs. Coagulation profile was suggestive of common pathway defect. Further evaluation revealed absent prothrombin level while other factors were within normal limits.
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PMID:Hereditary prothrombin deficiency. 1975 Aug 64

Early diagnosis and intervention intensity were suggested to be crucial factor in cerebral palsy (CP) treatment. Herein we observed 347 children diagnosed for CP in Clinical Hospital Mostar, Bosnia and Herzegovina, and studied the relationship between (a) intervention start point and the final motor outcome, (b) intensity of treatment and final outcome, and (c) relationship between documented risk factors and early diagnosis of the CP. Our study suggests that it is possible to relatively accurately diagnose the CP in the first trimester. Previous miscarriages, sepsis and intracerebral haemorrhage were significantly related to early diagnosis, while delivery outcome, RDS, premature birth, intracerebral haemorrhage, sepsis, meningitis, hydrocephalus and convulsions were found as significantly related to final motor CP outcome. We have found no significant influence of the intervention intensity and final diagnosis. Our results support the idea that the intervention start point has to be considered as one of the most important factors for the effective intervention program. In future studies dealing with the CP interventions and risk factors, special attention should be paid to homogeneity and size of the sample, as well as necessity of including the non-treated controls in the investigation.
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PMID:Cerebral palsy: early diagnosis, intervention and risk factors. 2012 Apr 1


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