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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Analysis of the factors influencing the prognosis of acute renal failure was carried out in cases experienced during the past 10 years. The factors presumed directly affecting the renal function (acute insults) and coexistent predisposing factors (risk factors) were analysed. The followings were considered to be acute insults: surgery/trauma/burn, drug intoxication, sepsis, hypotension, dehydration, rhabdomyolysis, hepatorenal syndrome, and hypercalcemia/hyperuricemia. Suspected risk factors included age, urine volume, underlying disorders/complications. Risk factors rather than acute insults were related to the outcome of acute renal failure. The mortality rate increased as the associated risk factors increase in number. In non-oliguric cases, maximum serum creatinine level was lower than the anuric cases, however there was no difference in the duration of the impaired renal function between 2 groups. In survival cases, the factors affecting the time for the recovery of renal function were also studied, but no definite factors could be determined.
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PMID:[Clinical analysis of the factors affecting the prognosis of acute renal failure]. 850 61

From May 1984 to April 1995, a total of 16 patients (12 females, 4 males) with cerebral venous thrombosis, diagnosed by computed tomography (CT), conventional cerebral angiography, magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA), were reviewed retrospectively. The age ranged from 1 month to 16 years of age (average: 2.5 years) with 8 below 1 year of age. The presenting symptoms for infants were mental change (75%) and seizure (100%), mainly generalized (63%) in character. Associated illness was mainly closed head injury, diarrhea or dehydration. All infants had mild to severe motor handicap in a 1 to 10 year follow-up. In contrast, older children frequently presented with headache (37%) or consciousness change (50%), and were more frequently associated with sepsis or local infections. Four (50%) of them recovered completely, but two died and two were finally in a vegetative state. For the four patients with poor prognosis, all had severe initial insults and widespread sinus thrombosis. MRI and MRA are better than CT for the diagnosis of cerebral venous thrombosis. It was concluded that prognosis for venous thrombosis cases in infants is worse than in older children, but this also depends on the severity of initial insults. For infants who present with intractable seizures, cerebral venous thrombosis should be taken into account when the seizures are difficult to control.
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PMID:Cerebral venous thrombosis in children. 859 29

Records of all the diarrheal patients up to the age of 5 years who were admitted to and died in Dr. B.C. Roy Memorial Hospital for Children, Calcutta, between January and December 1990 were analyzed. The records were reviewed to assess the relative importance of three clinical types of diarrhea (acute watery diarrhea, acute dysentery and persistent diarrhea) as the causes of mortality. Annual hospital death rates of children suffering from acute watery diarrhea, dysentery and persistent diarrhea were 13.6%, 18.2% and 25.9%, respectively. Overall death rates in dysentery (p = 0.03) and persistent diarrhea groups (p < .00001) were significantly higher than watery diarrhea group. Maximum deaths occurred among children aged between 7 and 36 months in all categories of diarrhea. Shigella infected children had higher case fatality rate. In acute watery diarrhea, 30.9% cases were assigned to associated causes of death whereas the same could be assigned to 92.6% and 93.2% cases in dysentery and persistent diarrhea group, respectively. Deaths occurred in most of the cases who had bronchopneumonia as underlying cause, septicemia as immediate cause and protein calorie malnutrition as associated cause and these were most frequently associated in patients suffering from dysentery and persistent diarrhea. Only 2.0% children suffering from acute watery diarrhea had dehydration at the time of death. Significantly, a high percentage of deaths occurred among malnourished children who suffered from dysentery (54.4%) and persistent diarrhea. These data suggest that Diarrheal Disease Control Programme should also give emphasis on management of non watery, non-dehydrating type of diarrhea with complications.
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PMID:Assessing the cause of in-patients pediatric diarrheal deaths: an analysis of hospital records. 861 86

Equine neonatal septicaemia was confirmed in 24 foals hospitalised at the Rural Veterinary Centre between 1989 and 1992 with suspected septicaemia. Septicaemia was confirmed by culture of bacteria from blood of live foals and tissues obtained at necropsy of foals that died or were euthanased. Pathogenic bacteria isolated were predominantly Enterobacteriaceae (including Escherichia coli and Salmonella serovars) and Actinobacillus equuli. Clinical manifestations of septicaemia included signs of depression, dehydration, abnormalities in body temperature and manifestations of localised infection including diarrhoea, pneumonia, and septic arthritis. Most common haematological abnormalities were neutropenia and increase of circulating band neutrophils. Survival rate of foals with confirmed septicaemia was 70.8%. Survival was found to be less likely in the presence of pneumonia, severe signs of depression, marked haematological changes or septic arthritis at the time of admission. Seven foals were confirmed to have septic arthritis without concurrent septicaemia. Of these, 4 had multiple joint involvement. Bacteria isolated from infected joints were predominantly Salmonella serovars. Four foals with septic arthritis failed to survive, due to multiple joint infection, which was unresponsive to treatment. The clinical and haematological abnormalities present in foals with confirmed septicaemia and septic arthritis were consistent with those observed in other studies. The bacterial isolates from foals with confirmed septicaemia were similar to those isolated in other studies. In contrast, the bacteria isolated from foals with septic arthritis without concurrent septicaemia were different from other studies.
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PMID:Equine neonatal septicaemia: 24 cases. 866 Feb 28

To assess the long-term outcome of kidney/pancreas transplantation, patients were identified who had good graft function at one year posttransplant and a minimum of 3 years' follow-up. Fifty recipients from 1987-92 met these criteria. Records were reviewed for graft survival, graft function, readmissions, and medical complications. Psychosocial adjustment and quality of life were assessed using the SCL-90-R and SIP surveys, respectively. Patient, kidney, and pancreas survivals were 94%, 86%, and 85% at five years (Kaplan-Meier), with a mean follow-up of 4.3 years. The 3 deaths were due to 2 sudden arrests at home (presumed to be cardiac events) and 1 episode of sepsis. Other graft losses were due to rejection, except for one case of sepsis. The remaining patients are normoglycemic (glucose 92 +/- 23 mg/dl) and have a creatinine of 1.8 +/- 0.6 mg/dl. Mortality after the first year was 0.9%/year. Estimated kidney and pancreas half-lives were 15 +/- 2 and 23 +/- 7 years, respectively. Hospitalization, acute rejection, graft pancreatitis, dehydration, and severe infections all decreased dramatically after the first year. While CMV was the most common infection in the first year, foot infections predominated thereafter. Retinal hemorrhage was infrequent. Sudden death (presumably cardiac) was the chief cause of mortality, while peripheral vascular disease resulted in several amputations. Fractures were common, suggesting the need for increased attention to bone demineralization. Psychosocial and quality of life evaluations were within normal limits. In conclusion, most complications specifically related to transplantation occur in the first year, but underlying disease renders these patients susceptible to a variety of cardiovascular, bone, and other disorders.
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PMID:Long-term outcome of kidney-pancreas transplant recipients with good graft function at one year. 878 9

A male infant was born with generalized erythroderma and scaling; the newborn demonstrated poor neonatal development and developed several complications such as hypernatremic dehydration, septicemia, gastroenteritis and seizures. In the neonatal period, the erythema faded, but exfoliation persisted. The parents are healthy but related. One older brother, who died at the age of 3 months, had shown the same clinical picture in the neonatal period and was diagnosed with congenital psoriasis. All clinical investigations, including serum immunoglobulins, complement levels and lymphocyte counts, were normal. Only raised total IgE and multiple positive specific IgE reactions were noted. Skin biopsy revealed an image of ichthyosis. Polarization microscopy of scalp hair showed trichorrhexis nodosa and discrete focal twisting of the hair shaft. This clinical picture and all histological findings are compatible with the indications of Netherton's syndrome. The purpose of this report is to call attention to this severe presentation of congenital ichthyosis in the neonatal period and to the difficulty of a correct diagnosis when confronted with congenital erythroderma.
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PMID:Netherton's syndrome: a severe neonatal disease. A case report. 886 92

Critical illness polyneuropathy (CIP) is a recently identified entity for which reliable data is unavailable and of which the prevalence is unknown. Although the percentage of patients suffering CIP is low, more cases, including subclinical ones, are likely to be detected through the use of electroneurography. Any aged patient may be affected by CIP. It usually occurs a long stay in the intensive care unit (ICU) and is generally associated with sepsis, severe trauma and so-called multiple organ failure. The main clinical sign is distal weakness in the lower extremeties, although finding one or more of the following signs is not uncommon: quadriparesis, quadriplegia, difficult weaning, loss of osteo-tendon reflexes and muscle atrophy. The pathophysiology of CIP is unknown, although such mechanisms as cell dehydration, increased proteolysis and the activation of certain cytokins have been suggested. Before diagnosing CIP, other neuromuscle diseases and several recently described toxic myopathies must be ruled out. Electroneuromyographic study of axonal lesions may be of great utility, whereas analyses have low specificity. Histologic examination, when possible, allows axonal lesions (but never demyelinization) to be observed along with the non specific changes of myopathy. Although no specific treatment is available, the long-term prognosis is good if the underlying disease that gave rise to ICU admission is controlled, and if rehabilitation therapy is started early.
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PMID:[Critical illness polyneuropathy]. 899 88

Simultaneous pancreas/kidney transplantation (SPK) has evolved to become a therapeutic option for patients with renal failure resulting from type 1 diabetes mellitus. However, the appropriate route for drainage of the exocrine secretions of the pancreas allograft remains unclear. While bladder drainage (BD) is the current state of the art, it is associated with a high frequency of urologic complications, including urinary tract infections, hematuria, metabolic acidosis, dehydration, and reflux pancreatitis. Although enteric drainage (ED) is the more physiologic route, it has been associated in the past with decreased graft survival and increased infectious complications. In addition, BD offered a technique for detection of rejection through measurement of urinary amylase. However, with the advent of improved immunosuppression and antibiotic therapy, percutaneous pancreas biopsy, improved radiologic imaging, and greater understanding of pancreas transplantation, we hypothesized that ED could be performed without increased morbidity or cost. A group of 23 consecutive SPK was performed with ED during the period from July 1995 to November 1995. Another 23 age- and sex-matched recipients of SPK with BD performed from November 1994 to June 1995 served as a historical control group. Because of the differing lengths of follow-up, data were analyzed with respect to the first six months posttransplant. ED and BD were associated with equivalent actuarial one-year patient and graft survival rates: 100% and 88% for ED, and 96% and 91% for BD, respectively. Hospital charges, length of stay, readmissions, rejection, sepsis-related procedures were also equivalent in ED and BD. However, ED was associated with significantly fewer urinary tract infections and urologic complications. In addition, no grafts were lost as the result of sepsis. In the setting of SPK, ED represents a viable alternative to BD for primary drainage of pancreas exocrine secretions. Further studies with extended lengths of follow-up are necessary to confirm our observations.
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PMID:Simultaneous pancreas/kidney transplantation--a comparison of enteric and bladder drainage of exocrine pancreatic secretions. 902 Mar 24

Over a five-month period eight breastfed infants required readmission to Wesley Long Community Hospital in Greensboro, North Carolina, within 48 hours of discharge from the newborn nursery. The primary diagnoses upon readmission included hyperbilirubinemia and suspected sepsis. At discharge from the intensive care nursery, mild dehydration secondary to inadequate breastfeeding was deemed a significant factor in precipitating the need for readmission. This increase in readmissions represented a significant change from the past year. An intensive review of each initial hospital stay was conducted to attempt to identify causative factors and to develop a profile of infants who might be at risk for readmission in the future.
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PMID:Breastfeeding, dehydration, and shorter maternity stays. 903 42

This study was carried out to compare the efficacy of a cereal based ORS (prepared with 50 G of sagodana (cereal), 3.5 G/L sodium chloride, 1.5 G/L potassium chloride, 2.9 G/L trisodium citrate) with rice based oral rehydration solution (using same amounts of rice and electrolytes) for treatment of diarrhoea. One hundred and twelve children aged 3 months to 2 years with watery diarrhoea of less than 5 days duration with mild to moderate dehydration and no sepsis, were included in the study. The amount of ORS intake, stool volume and frequency were similar in both groups. Clinical success was seen in 79% of rice ORS group and 81% in sagodana group. Both can be used as a cereal based ORS in the management of acute diarrhoea in communities where it is culturally accepted and used as a weaning diet.
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PMID:Sagodana based verses rice based oral rehydration solution in the management of acute diarrhoea in Pakistani children. 905 31


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