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)

A 26-year-old male who had been diagnosed as pulmonary tuberculosis three years ago with an antituberculous chemotherapy of only two months, complained of tiredness, exertional dyspnea and fever since a month ago. Bloody sputum, bloody stool and hematuria have developed three days before admission. Petechiae over the body trunk and lower extremities were observed on admission. Peripheral blood examination revealed lymphocytopenia (672/microliters), low hemoglobin content (6.2 g/dl), thrombocytopenia (3,000/microliters), elevated FDP (36.2 micrograms/ml) and D-dimer (25.0 micrograms/ml) values. Chest radiograph showed a massive pleural effusion in the right hemithorax, bilateral pulmonary infiltrates and a cavity on CT scan. Together with positive acid-fast bacilli in sputum, diagnoses of relapsed pulmonary tuberculosis, tuberculous pleurisy associated with DIC (disseminated intravascular coagulation) were made. Left hydronephrosis which was presumed to be a consequence of infundibulum stenosis due to renal tuberculosis, was detected by abdominal ultrasonography. Treatment with antituberculous drugs and protease inhibitors were started with thoracic tube drainage. DIC condition was improved by the 20th hospital day and sputum culture turned to be negative after the 4th week, however, fever up to 38 degrees C continued until the end of the 7th week and a D-dimer which is a representative marker for secondary fibrinolysis, continuously showed a high level up to the 10th week of hospitalization. The patient was uneventful during the three months follow up period after discharge. DIC is a well known complication of sepsis including miliary tuberculosis, whereas it is rarely associated with cavitary tuberculosis and no case of prolonged elevation of D-dimer have been reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of pulmonary, pleural, and renal tuberculosis associated with DIC and a prolonged increase in D-dimer]. 804 Oct 60

The use of ureteral stents to assure continuity and patency of the upper urinary tract has become common in endo-urology. We present an 82-year-old bedridden woman with hydronephrosis and pseudomonas sepsis. Because of ureteropelvic junction stenosis a stent was inserted. Shortly thereafter the stent fragmented spontaneously into 5 pieces. The importance of being familiar with endo-urological manipulations and their complications is emphasized.
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PMID:[Early spontaneous fragmentation of a ureteral stent]. 818 97

Between August 1982 and May 1988, 503 patients underwent construction of a continent ileal reservoir (Kock pouch) for cutaneous urinary diversion at our university. Stenosis of the afferent antireflux valve resulted in upper urinary tract obstruction in 11 patients (2%). In addition, 2 patients underwent Kock pouch diversion elsewhere and upon referral to our institution they had afferent valve stenosis. To date 13 patients have been identified with this problem. Hydronephrosis was present in 100% of the functional kidneys in these patients. Radiographs of the Kock pouch were uniformly normal without evidence of reflux or other pathological condition. The most common presenting symptom was flank pain in 7 patients (54%) and the most common presenting sign was creatinine elevation above baseline in 7 (54%). Infections recurred with or without sepsis in 5 patients (38%). Ureteroileal anastomotic strictures were not present in any patient. The interval from creation of the Kock pouch to the diagnosis of stenosis ranged from 2 to 75 months (mean 39). All patients underwent endoscopic evaluation of the Kock pouch confirming stenosis of the afferent antireflux valve, and subsequent mechanical dilation of the stenotic valve. Dilation procedures were repeated in 6 patients (46%), 4 of whom subsequently required open surgical revision of the afferent valve. Of these patients 3 are clinically stable and 1 died of the primary malignancy. The remaining 2 patients are clinically and radiographically stable after multiple dilations. Of the 7 patients (54%) requiring only a single dilation 6 are clinically stable and 1 died of the primary malignancy. Stenosis of the afferent antireflux valve of the Kock pouch, previously unreported to our knowledge, is a rare late complication leading to flank pain, hydronephrosis, recurrent infection and elevation of serum creatinine levels. Approximately 50% of the patients respond to a single dilation of the nipple valve. However, most patients who require repeat dilation will need open surgical revision.
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PMID:Stenosis of the afferent antireflux valve in the Kock pouch continent urinary diversion: diagnosis and management. 828 19

From November, 1987 to December, 1990, 399 cases of ureteral calculi were treated by rigid ureteroscopy (URS). Our success and complication rates are presented. Of these, 99 (25%) had a calculus in the pelvis (78/99), iliac (15/99) or lumbar (6/99) ureter, and 300 (75%) had Sandstrasse in the distal ureter. The cases with Sandstrasse were submitted to ureteroscopy within the first 48-72 hours to remove the ureteral obstruction, prevent hydronephrosis or sepsis and to expedite treatment. If symptomatic, obstructive and/or 7 mm or more in diameter, a nephrostomy tube was placed first whenever there was sepsis [23/300 (7%) of those with Sandstrasse and 3/99 (3%) of those with a ureteral calculus] or marked dilatation of the renal cavities [29/300 (9%) and 6/99 (6%), respectively]. The success rate was 93% for the cases with Sandstrasse versus 85% for those with a ureteral calculus, and the complication rates were 5.7% versus 9%, respectively. The foregoing results confirm the high success rate and scant morbidity of ureteroscopy in the treatment of ureteral calculus and Sandstrasse.
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PMID:[Ureteroscopy. Our results and complications]. 834 76

Corneal opacities and urinary tract sepsis were previously observed by the authors in rats given muscarinic agonists mixed in the diet or by gavage. To explain the differential toxicity generated by each means of administration, toxicokinetics of the muscarinic agonist CI-979 were investigated. In addition, the muscarinic antagonist scopolamine was co-administered with CI-979 to evaluate the relationship of these effects to pharmacological mechanism of action of CI-979. Female rats were given CI-979 daily by gavage at 0, 1, 10 and 30 mg/kg body weight or in the diet at 0, 1, 10 and 50 mg/kg body weight for up to 14 days. Dose-related clinical signs of muscarinic stimulation, such as sialorrhoea and dacryorrhoea, were observed predominantly in rats given 10 and 30 mg/kg body weight CI-979 by gavage, and corresponded with the high plasma drug concentrations. In contrast, hydronephrosis, pyelonephritis, and inflammation and necrosis of the kidney, urinary bladder, urethra and urinary papilla were linked to sustained, albeit lower plasma drug concentrations attained by dietary administration of CI-979 at 10 and 50 mg/kg body weight. Comparable incidences of corneal opacities were induced by both means of administration, but lesions appeared more rapidly and were generally of greater severity when CI-979 was given in the diet. The induction of corneal lesions, as well as urinary sepsis, may not relate simply to maximum plasma concentrations or to areas under the curve per se, but rather may arise when plasma drug concentrations are sustained. Corneal opacification and development of urinary tract pathology were inhibited by scopolamine, suggesting that these effects were related to the muscarinic mechanism of action of CI-979.
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PMID:Toxicological comparison of a muscarinic agonist given to rats by gavage or in the diet. 864 67

Renal candidiasis in the neonate is encountered infrequently. We report a newborn with ichthyosis, who during the hospital course had five episodes of culture-proven sepsis, probably due to skin lesions. For these infections various antibiotic combinations were used. During the therapy of the last sepsis attack, unilateral hydronephrosis developed secondary to renal candidiasis. Percutaneous nephrostomy with amphotericin B irrigation, coupled with five weeks of intravenous amphotericin B therapy was successful. We believe that with this approach the mortality and morbidity of renal candidiasis could be reduced.
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PMID:The management of renal candidiasis in the newborn. 870 92

The authors report on two patients who had fusiform megalourethra with unusual features. The first patient had left hydronephrosis with duplication of the ureter, oblique sagittal septum in the urinary bladder, and Y duplication of urethra with megalourethra of both channels. The second had features of the abdominal muscle deficiency syndrome, with anterior ectopic anus, rectourethral fistula, and fusiform megalourethra. Both patients were treated by preliminary urinary diversion. The first patient subsequently had staged reconstruction. The other patient died of urinary sepsis. The authors believe that preliminary urinary diversion followed by planned staged reconstruction offers hope for the reconstruction and rehabilitation of these cases.
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PMID:Congenital megalourethra. 870 23

Sixty-five abdominal computed tomography (CT) scans of 54 systemic lupus erythrematosus (SLE) patients were retrospectively evaluated together with their clinical records. This was to assess the spectrum of CT findings and to determine the value of abdominal CT in this group of patients. Over a 3.5-year period, abdominal CT scans had been requested for suspected renal vein or inferior vena cava thrombosis (n = 52, 80%), sepsis, mesenteric ischaemia, Conn's syndrome, evaluation of hepatosplenomegaly, portal hypertension and hydronephrosis. The most frequent indication for CT was suspected renal vein thrombosis (RVT). An SLE patient with previously stable renal function who rapidly develops nephrotic syndrome with deteriorating renal function has an increased risk of thromboembolic phenomenon. Also, renal vein thrombosis is difficult to diagnose clinically and prompt anticoagulation can help preserve remaining renal function. Of these with suspected RVT, two had RVT only and five had thrombosis in both renal veins and inferior vena cava. Two patients had CT features strongly suggestive of mesenteric ischaemia, one had bilateral hydronephrosis thought to be secondary to lupus cystitis and CT confirmed two abdominal abscesses. Other incidental CT findings were: subscapular renal haematoma, overall enlargement or diminution of renal size, serositis, bowel wall thickening, splenic, hepatic and pancreatic enlargement and mild para-aortic lymphadenopathy. Abdominal CT revealed many diverse findings and aided the management of these SLE patients.
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PMID:Abdominal computed tomography in systemic lupus erythematosus. 911 46

The endoscopic incision of ureterocele in children is still a controversial procedure. In two Departments of Pediatric Surgery, between January 1990 and December 1994, 47 patients (34 females, 13 males), for a total of 53 ureteroceles, underwent endoscopic incision of the ureterocele as the primary form of treatment; 41 ureteroceles were in duplex kidney. In 33 cases (70%) the prenatal ultrasound had observed hydronephrosis or duplex kidney or the presence of the ureterocele; these babies were free of urinary infection before treatment. 45 of the 47 babies were less than 6 months old at the time of the endoscopic incision. Vesico-ureteral reflux developed in none of the single systems, and in 32% of the duplex systems; however a preexisting reflux spontaneously disappeared in 41%. At 1 year follow-up the mean increase in renal parenchyma as evaluated at ultrasound was from 6.4 to 11.1 mm in single systems, and from 3.4 to 6.3 mm in duplex kidneys. Scintigraphy or urography showed a stable or improved renal function in all previously functioning units; 40% of the non-functioning units before section showed signs of function at 1 year follow-up. One to 3 years after section, 14 children underwent open surgery for persisting vesico-ureteral reflux, urinary infections or non-functioning unit: 9 ureteroneocystostomies and 5 heminephrectomies were performed. The endoscopic incision is proposed as the early first treatment of ureteroceles, mainly in cases of prenatal diagnosis, possibly performed in the neonatal age. In the Authors' experience it has been effective in preventing sepsis in all patients and in preserving the renal function of the involved unit; surgery has been avoided in over 60% of cases and when necessary it has been safely postponed after more than 1 year of age.
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PMID:[The prenatal diagnosis and early endoscopic section of ureterocele]. 917 6

The incidence of tuberculosis has risen in many parts of the world, and more attention is being focused on genitourinary tuberculosis (GT), the second most common extrathoracic form of tuberculosis. Although chemotherapy is the mainstay of treatment, ablative surgery as a first-line management may be unavoidable for sepsis or abscesses. In cases with hydronephrosis and progressive renal insufficiency caused by obstruction, renal drainage (by stenting or nephrostomy) must be performed immediately. In all other situations triple-drug chemotherapy should be undertaken for at least 6 months and stable conversion obtained before ablative or reconstructive surgery is planned. Nephrectomy or partial nephrectomy is indicated for nonfunctioning or poorly functioning kidneys, particularly if continuous flank pain or hypertension is present. Stenosis of the ureter usually can be managed by temporary stenting and adjuvant corticosteroid therapy. Today the indications for augmentation are rare, but bladder replacement may be combined with ureter replacement using segments of intestine.
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PMID:Indications for surgical management of genitourinary tuberculosis. 920 38


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