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)

Four hundred sixty-one consecutive admissions to the Pediatric Intensive Care Unit (PICU) were evaluated using the Therapeutic Intervention Scoring System (TISS). Patients requiring an increased level of care, defined as TISS points greater than or equal to 10, accounted for 75% of patient days in the ICU. Within this group, the primary reason for admission to the ICU was congenital heart disease, trauma, malignancy, respiratory failure, and sepsis. Survival was inversely related to TISS points, through TISS itself could not differentiate between survivors and nonsurvivors. The mortality rates for children who had a congenital malformation, a cardiac arrest before admission, or who developed acute failure secondary to other disease processes were significantly increased. Comparison of critically ill children and adults using TISS showed mortality rates that were similar. Assuming that the cost of intensive care is related to both seriousness of illness (assessed by TISS) and length of hospitalization, in this pediatric population the cost of hospitalization was not disproportionately high for nonsurvivors compared to survivors. Reduction in mortality rates in a PICU population will be dependent on factors largely uncontrollable buy ICU practitioners. This will come about by reduction in the numbers of congenital malformations and the prevention of childhood trauma.
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PMID:Pediatric intensive care: factors that influence outcome. 679 47

For women who are prescreened to be at low risk, the birthing room located in a hospital can provide a home-like environment as well as proximity to the regular obstetrical unit in case of an unforeseen complication. Charts of 356 pairs of infants and mothers who were admitted to birthing rooms at three different hospitals were reviewed. The average age of the mother was 25.9 years. Approximately 20 percent of the women had complications requiring their transfer from the birthing room. Fifteen required a cesarean section. The mean Apgar scores of infants born to all women admitted to the birthing room (including those who were subsequently transferred) were 7.7 at one minute and 8.8 at five minutes. Neonatal complications included meconium aspiration (1), sepsis (1), a question of sepsis (1), congenital heart disease (1), and transient tachypnea of the newborn (1). Four infants and one mother required readmission. Although mothers were prescreened to be at low risk, complications did arise for both mother and infant that made proximity to the regular obstetrical and neonatal units advantageous.
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PMID:Outcomes of three birthing rooms. 684 49

We assessed cardiac function by acute pressure loading with phenylephrine in 7 patients who had hyperdynamic sepsis and in 8 patients who had heart disease. All patients with sepsis had a positive Limulus lysate teat, a septic focus, and a cardiac output (CO) greater than 6.0 L/min. Phenylephrine was given iv to elevate systolic arterial pressure by 30 mm Hg. Cardiac index (CI) and stroke index (SI) increased significantly in patients with hyperdynamic sepsis, whereas systemic vascular resistance index (SVRI) showed no change. In patients with heart disease, CI and SI decreased significantly, whereas SVRI increased significantly. The marked differences in response to phenylephrine by the two groups suggest lack of cardiac dysfunction in patients with hyperdynamic sepsis.
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PMID:Circulatory responses to afterloading with phenylephrine in hyperdynamic sepsis. 708 67

Eight children with congenital asplenia syndrome have been studied for their cardiac and immunologic status. All patients were greater than 2 years of age and had severe complex cyanotic heart disease. All eight patients had abnormalities of cardiac and/or visceral situs. All patients had evidence of pulmonary stenosis or atresia and a common atrium or large atrial septal defect. Five patients required palliative cardiac surgery. All patients were given prophylactic antibiotics; there were no documented episodes of sepsis. One patient had an isolated deficiency of IgM; two patients had an isolated deficiency of IgE. Seven of eight patients were immunized with a dodecavalent pneumococcal vaccine. Four of the seven patients failed to have a twofold or greater antibody response. Our findings suggest that prophylactic antibiotics may reduce the incidence of sepsis in the asplenia syndrome. Because the prognosis for these patients must be optimistic, we recommend early documentation of splenic function in children suspected of having the asplenia syndrome, prophylactic antibiotics, and parent education. Children immunized with bacterial vaccines should have their antibody responses monitored.
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PMID:Congenital asplenia: immunologic assessment and a clinical review of eight surviving patients. 725 76

A retrospective review of the deaths in 2877 consecutive operations for biliary calculus disorders was directed at defining the high-risk factors in operations for stone disease. A correctable factor in biliary operative mortality relates to errors in differential diagnosis and iatrogenic technical errors that result in hemorrhage, anastomotic leaks, duodenal injuries, and the tardy recognition and treatment of postoperative intraabdominal sepsis. A less manageable problem is the patient over 70 with advanced heart disease and/or diabetes, who presents with acute biliary sepsis. The combination of circumstances puts the individual at great risk, albeit there is no present alternative to surgery.
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PMID:Fatal complications in surgery for biliary calculi. 730 34

Septicaemia caused by Cardiobacterium hominis in a woman aged 67 is reported. She had been treated for metastatic adenocarcinoma for nine months with cytostatic drugs prior to the development of a fatal septicaemia. She had no known pre-existing heart disease. Isolation and identification of the strain are discussed.
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PMID:Septicaemia caused by Cardiobacterium hominis. A case report. 731 48

Patients with cardiovascular disease commonly present with problems requiring surgical treatment. They are more vulnerable than patients without cardiovascular disease to the cardiovascular stresses associated with general anesthesia and surgery--hypotension, hypoxemia, sepsis, and thromboembolism. Their risk of morbidity and mortality is higher. Certain clinical factors have a profound impact on the patient's likelihood of serious cardiac complications or death: Overt heart failure, recent myocardial infarction, and cardiac arrhythmias are the most worrisome. A careful clinical evaluation and formal assessment of the patient's risk dictate better perioperative monitoring and treatment. Early hospital admission provides time for control of other health problems. Prophylaxis with heparin and antimicrobial agents minimizes problems of thromboembolism and sepsis, respectively. Overaggressive treatment of hypertension is avoided, and withdrawal of propranolol or clonidine is carefully supervised. The use of digoxin is restricted to patients with atrial tachyarrhythmias or heart failure. Hemodynamic monitoring via a Swan-Ganz catheter or temporary transvenous pacing may be necessary for selected high-risk patients. Such careful evaluation, monitoring, and treatment are the clinician's methods for improving the chance for patients with heart disease to benefit from surgery.
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PMID:Perioperative care of patients with cardiac disease. 735 25

In a retrospective review of 100 consecutive patients requiring above-knee amputation for arterial occlusive disease, the operative mortality was 15%. An additional 26% mortality occurred during a two-year follow-up period. Principal causes of death were sepsis in 54%, heart disease in 16%, and stroke in 11%. The poor prognosis of patients requiring amputation was related to progression of systemic diseases and to generalized debility among these patients.
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PMID:Morbid implications of above-knee amputations. Report of a series and review of the literature. 735 31

Two families have been presented. In one, asplenia occurred with and without gastrointestinal malformations. In the other, cardiovascular malformations occurred in one member and Ivemark syndrome in the other. All three children with asplenia died in infancy, two with evidence of sepsis. Sudden death in infancy may be due to sepsis in a child with isolated asplenia syndrome and impaired resistance to infection. Both isolated asplenia and some cases of congenital heart disease without asplenia may be related to Ivemark syndrome. New infants born in families with a history of congenital cardiovascular malformations, visceral heterotaxy, or other malformations associated with Ivemark syndrome should be tested for asplenia, primarily by searching for Howell-Jolly bodies. Infans with asplenia should be protected with prophylactic antibiotics. Pneumococcal polysaccharide vaccine is indicated at the age of 2 years. It would appear worthwhile for pediatric surgical or pediatric cardiologic services to perform a screening program for Howell-Jolly bodies.
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PMID:Familial asplenia, other malformations, and sudden death. 736 May 56

6 cases of endocarditis and 1 of septicemia caused by Haemophilus parainfluenzae have been observed in our hospital from 1970 to 1977, as against no case from 1957 to 1969. The mean age of the patients was 46 years. The clinical picture did not differ from that seen in cases of septicemia and endocarditis from other cases. In 4 cases no underlying heart disease was known. In 2 of them, endocarditis developed in the mitral and in 1 in the aortic valve. Of 3 patients with preexisting heart disease, 2 had involvement of the aortic valve and 1 of the mitral valve. Six patients were cured, 2 or possible 3 by treatment with ampicillin, 2 with cephalothin, and 1 with co-trimoxazole. In 2 patients intractable heart failure necessitated the insertion of prosthetic valves, and 1 patient died. Thus, cases of septicemia and endocarditis due to H. parainfluenzae have been observed only in recent years and they appear to be serious infections.
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PMID:Haemophilus parainfluenza--an uncommon cause of septicemia and endocarditis. 737 29


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