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)

Thirty-three nosocomial outbreaks of infusion-related septicemia since 1965 have dramatically pointed up the microbiologic hazards of infusion therapy. At least 25,000 patients develop device-related septicemia in the United States each year, but the source of many of these bacteremias is never recognized. Most infusion-related septicemias, including those in hyperalimentation, originate from the device used for vascular access. Epidemics stem from infusate contaminated by Klebsielleae species or pseudomonads, either from a source in the hospital or in the manufacturing plant. Device-related infection in infusion therapy can be greatly prevented by scrupulous attention to local asepsis and by limiting the duration of cannulation of peripheral veins (less than or equal to 3 days) and arteries (less than or equal to 4 days).
 ...
PMID:The prevention and management of device-related infection in infusion therapy. 694 56

Nursing care of the burned child requires an understanding of the pathophysiology of burn injury, the response of children to burn trauma, the impact of injury on the child and his or her parents, and the child's developmental needs, among others. Immediately following injury, burn shock represents a life-threatening problem. Treatment involves administration of Ringer's lactated solution for the first 24 hours, followed by plasma. Measures to enhance oxygen delivery to tissues are important nursing interventions. Airway damage may also be present and requires prompt assessment and treatment. Sepsis is the major cause of death and morbidity among burn victims. Immaculate care of the burn wound, monitoring for sepsis, and strict infection control procedures are essential. Interrelated with sepsis prevention and wound healing is adequate nutritional management. Diet, enteral hyperalimentation, and parenteral nutritional therapy may be required to meet the child's extraordinary nutritional requirements.
 ...
PMID:Critical care of the child with burns. 703 99

Thirteen episodes of Staphylococcus epidermidis sepsis occurred over a 20-month period in 11 patients receiving general surgical and medical care. These episodes were characterized by fever, toxicity, multiple positive blood cultures, and uniformly colonized intravascular catheters. An additional 16 patients had possible sepsis. Four associated deaths occurred; all three patients autopsied had multiple pulmonary abscesses in which gram-positive cocci were profusely present. In individual patients, prolonged episodes of septicemia were confirmed by multiple blood culture isolates of S. epidermidis, identical in antibiotic resistance pattern, phage type, and biotype. A prominent feature of the S. epidermidis isolates was resistance to many commonly used antimicrobial agents. Case-control studies and review of laboratory records indicated a significant association between multiply resistant S. epidermidis blood isolates and prolonged hospitalization and parenteral hyperalimentation. Most of these patients were hospitalized in the intensive care unit; nose and hand cultures taken from the personnel showed frequent carriage of multiply resistant S. epidermidis Staphylococcus epidermidis associated with intravascular devices may produce life-threatening bloodstream infections.
 ...
PMID:Nosocomial septicemia due to multiply antibiotic-resistant Staphylococcus epidermidis. 705 81

A 6 1/2 month old male infant presented a week after his birth with secretory diarrhea of unknown etiology. He was sustained by central hyperalimentation for the rest of his life, and treated for presumed sepsis with a wide variety of antibiotics. The brain showed vacuolation in the diencephalic nuclei and white matter of the brain stem. There were also many clusters of enlarged Purkinje cell dendrites in the molecular layer. In Golgi preparations the primary and secondary dendrites showed segmental swellings and absent tertiary branchlets. The swellings were due to remarkable accumulations of mitochondria. The pathogenesis of the dendritic changes is discussed, and 'dying back' phenomenon is proposed to explain the changes.
 ...
PMID:'Dystrophic' Purkinje cell dendrites in an infant. 712 43

Twenty patients with pancreatic abscesses were studied to determine if recent diagnostic and therapeutic advances have improved the outlook for those with the disease. An abscess developed as a complication of alcoholic pancreatitis in 10 patients and was due to previous surgery in 9. Ultrasonography and computerized tomographic scanning of the abdomen were helpful in the diagnosis and localization of the abscesses. All 20 patients were treated surgically. Operative mortality was 30 percent and was due to multiple system failure from continuing sepsis. Only 2 of 15 patients who had sump drainage died compared with 3 of 4 patients who were drained with Penrose drains alone. There were two deaths among 10 patients who received nutritional support and four deaths in 10 patients who did not receive hyperalimentation. Pancreatic abscess remains a life-threatening condition. Ultrasonography and computerized tomographic scanning have helped in diagnoses and localization. The addition of sump drainage has reduced the mortality rate from 75 ot 13 percent. Nutritional support also appears to be helpful in reducing mortality.
 ...
PMID:Pancreatic abscess: an unresolved surgical problem. 713 63

Salmonellosis in older children and adults is usually a self-limited disease, but the risk of complications in infants is not well-defined. We performed a retrospective review of 52 patients. 90 days of age or less, seen at the St. Louis Children's Hospital between 1975 and 1981 with stool cultures positive for salmonella. Sixteen were 30 days old or less (neonates), 21 were 31- 60 days of age, and 15 were 61-90 days old. Among patients in whom blood cultures were done initially, bacteremia was most frequent in neonates: 5/11 (45%), compared to 2/18 (11%) in older infants. All seven infants presenting with bacteremia received 10 or more days of antibiotic therapy: yet complications (osteomyelitis, fatal meningitis or chronic diarrhea) developed in three of five neonates and one of two older infants. Complications also developed in seven of 22 patients who initially had negative blood cultures, including two infants in whom sepsis later developed and two infants who required intravenous hyperalimentation because of chronic diarrhea and malnutrition. The group of 23 patients who did not have blood cultures all did well. Salmonellosis is not necessarily a self-limited infection in young infants. Even in the absence of bacteremia, clinicans would appear to be justified in using antimicrobial therapy in infants 3 months of age or les with salmonella gastroenteritis, particularly neonates of older infants with symptoms of dysentery or failure to thrive.
 ...
PMID:Salmonella gastroenteritis in the first three months of life. A review of management and complications. 714 Jan 21

Candida albicans arthritis in the pediatric patient is rarely reported. In each instance, the patient has had one of the factors that predispose to fungal sepsis: broad spectrum antibiotic therapy, hyperalimentation, prematurity, abdominal surgery, corticosteroid or immunosuppressive therapy, malnutrition, maternal vaginal candidiasis, or lymphoproliferative disorders. To avoid the potentially fatal consequences of delayed treatment, early recognition of the disease is imperative. The patient usually refuses to use the affected joint and plain radiography shows a joint effusion with soft tissue swelling. Osteomyelitis develops in approximately half of the cases. Arthrocentesis with fungal cultures is the best method to make the diagnosis. Treatment is primarily chemotherapeutic and the drug of choice is the membrane inhibitor amphotericin B given intravenously. The antimetabolite 5-fluorocytosine is a second-line drug to be used if resistance develops. All cases before the present one involved the knee joint initially. The case presented involved the left hip and was successfully treated with intravenous amphotericin B.
 ...
PMID:Pediatric Candida albicans arthritis: case report of hip involvement with a review of the literature. 714 47

Spontaneous perforation of the esophagus still carries a high rate of morbidity and mortality because of frequent delay in diagnosis, extensive mediastinal contamination, and inadequate surgical repair. We used a nonoperative approach in two patients in whom the perforation was well contained, with evidence of drainage back into the esophagus and few symptoms or signs of sepsis. Nonoperative management included administration of intravenous antibiotics and hyperalimentation. Both patients had a satisfactory outcome.
 ...
PMID:Nonoperative management of contained esophageal perforation. 728 21

The perinatal histories and hospital courses of all neonates born at Grady Memorial Hospital who developed Pseudomonas aeruginosa sepsis or meningitis in the 5-year period 1989-1993 were reviewed. In addition a case-control study was performed to evaluate selected risk factors for this infection. Twenty-one patients had one or more blood cultures positive for P. aeruginosa. An additional patient had P. aeruginosa meningitis without bacteremia. All infections occurred after 5 days of age. The overall incidence of P. aeruginosa infection was 0.7/1000 live births. All cases occurred in infants < 1500 g at birth, for a birth weight-specific rate of 19.5/1000 livebirths in this weight class. Clinical manifestations of disease did not distinguish P. aeruginosa from other causes of fulminant neonatal sepsis. Fifty percent of cases died. Mortality was inversely related to postnatal age at diagnosis. The 22 cases were compared with 44 controls matched for birth weight, gestational age, sex, duration of hospital stay and admission date. Cases were more likely than controls to have a history of feeding intolerance, interrupted enteral intake and prolonged parenteral hyperalimentation. Case infants received intravenous antibiotics for a significantly longer period of time than did controls. There was an association between P. aeruginosa sepsis and necrotizing enterocolitis (36% cases vs. 7% of controls had prior or concurrent necrotizing enterocolitis, P < 0.01). In summary P. aeruginosa sepsis is primarily a late onset nosocomial infection in very low birth weight infants. The case fatality rate of 50% in this series emphasizes its continued importance.
 ...
PMID:Pseudomonas aeruginosa infection in very low birth weight infants: a case-control study. 763 11

Intestinal fistulae are an uncommon but serious complication of pelvic exenteration. To characterize factors leading to fistula formation and to define optimal management of this complication, we reviewed 533 cases of patients who underwent pelvic exenteration at the University of Texas M. D. Anderson Cancer Center between 1957 and 1990. Forty-two of those patients developed an intestinal fistula following total (n = 29), anterior (n = 12), or posterior (n = 1) exenteration which was not tumor related. Prior to routine pelvic floor reconstruction, the fistula rate was 16%. With the advent of omental pedicle grafts and gracilis flaps, the rate decreased to 4.5%. The fistulae described included those from the small bowel to the pelvic cavity (n = 15) or the neovagina (n = 8), and from the large bowel to the neovagina (n = 8). Complex fistulae were noted in 11 patients. Early fistulae, those that developed during initial hospitalization, occurred in 25 patients and were mainly related to infectious complications. Twenty-three patients underwent attempted surgical repair of fistulae. Eleven died during their hospitalization of sepsis, recurrent wound complications, or fistula. Late fistulae, those that developed after discharge, occurred in 17 patients and were mainly related to delayed healing. Early and late fistulae did not differ in location. Only two patients with late fistula formation died from complications of therapy. Significant long-term morbidity, however, included short bowel syndrome. Based on our review, we conclude the following: (1) Pelvic floor reconstruction, careful attention to surgical technique and aggressive treatment of infections reduces the risk of early fistula formation; (2) in cases associated with significant infection, treatment should be surgical; and (3) in stable patients, conservative management with hyperalimentation and bowel should be considered.
 ...
PMID:Intestinal fistulae formation following pelvic exenteration: a review of the University of Texas M. D. Anderson Cancer Center experience, 1957-1990. 789 87


<< Previous 1 2 3 4 5 6 7 8 9 10