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

Multiple-cause mortality data is examined in the Valencian Region. In addition to coding the underlying cause of death (UCD), all causes of death which appeared mentioned on death certificates (MCD) were coded according to preliminary rules established by the Mortality Statistics Office. Specific diseases were selected to explore mortality patterns. The average number of conditions coded per death certificate was 2.7. Two or more conditions on the lowest used line appeared in 33.8% of all medical certificates. Septicaemia, high blood pressure and arteriosclerosis stand out among the conditions more often coded as MCD than coded as UCD. Exploring for mortality patterns a statistical association between coronary heart disease and diabetes emerged (p less than 0.0001). Multiple-cause mortality coding allow to discriminate mortality patterns and show a new magnitude to some specific causes of death.
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PMID:[Multiple codification of the causes of death: from dying "of" to dying "from"]. 162 30

The risks of acute pyelonephritis in infants concern microbial invasion and parenchymal damage. There is a high rate of septicemia and of urinary malformations in children under 1 yr of age; in addition, the kidney is a growing organ with a high risk of scarring. Such parenchymal injury may lead to arterial hypertension, and renal failure when bilateral. Vesicoureteric reflux must be evaluated by ultrasound and cystogram; long-term renal scarring needs to be assessed by scintigraphy or pyelography when children are 7 yr old. Short- and long-term risks could be limited by early intravenous biantibiotherapy.
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PMID:[Urinary tract infections in infants: medical management]. 166 85

One hundred and ninety-three nephrotic children with a total of 271 admissions during the past decade, from 1980 to 1989, were retrospectively reviewed for acute complications and unusual features of nephrotic syndrome. One hundred and forty-nine patients were male, 44 female. Hypertension was found in 41 children (21.2%). Nine patients (4.7%) had a total of 11 episodes of hypovolemic shock. These shock patients had a more severe hemoconcentration (mean hemoglobin concentration 19.6 +/- 1.5 g/dl) and hyponatremia (mean serum sodium 127.5 +/- 8.5 mmole/L). Bacterial infections occurred in 28 children (14.5%) with primary peritonitis in 13, sepsis in 6, cellulitis in 4, urinary tract infection in 4 and osteomyelitis in 1. Almost all infections were caused by gram-negative bacilli. Other complications or features included tetany in 4 (2.1%), thromboembolism in 2 (1.0%), pancreatitis in one (0.5%) and Fanconi syndrome in one (0.5%).
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PMID:Complications of nephrotic syndrome in children. 168 Oct 1

Neutropenia in the newborn is often associated with sepsis, maternal hypertension, or prematurity. We describe a 654-g infant born at 30 weeks' gestation by cesarean section due to severe maternal hypertension. His course was complicated by five episodes of sepsis, including three with group B streptococcus. The results of hematologic and immunologic studies were normal except that absolute neutrophil counts were low (less than 1 x 10(9)/L) with intermittent increases during sepsis. Human recombinant granulocyte colony-stimulating factor administered subcutaneously (10 micrograms/kg per day initially) resulted in an absolute neutrophil count of greater than 30 x 10(9)/L within 2 weeks. The dosage was lowered and the absolute neutrophil counts were maintained at 8 to 12 x 10(9)/L with no further septic episodes. The human recombinant granulocyte colony-stimulating factor therapy was discontinued after 7 months, and the patient remained healthy with an absolute neutrophil count of greater than 2 x 10(9)/L. Thus, treatment with human recombinant granulocyte colony-stimulating factor may be useful as a temporary measure for neonatal neutropenia associated with sepsis. A controlled, clinical trial is warranted.
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PMID:Neutropenia in an extremely premature infant treated with recombinant human granulocyte colony-stimulating factor. 171 73

As newer treatment modalities become available for patients with severe lupus nephritis, it becomes increasingly important to identify patients at risk for renal failure. In this study, the records of 90 children presenting with systemic lupus erythematosus over a 13-year period were reviewed. Nineteen were lost to follow-up prior to completion of the study. Of the 71 remaining children, 16 (22%) progressed to chronic renal failure. Persistent hypertension lasting greater than 4 months, anemia, abnormalities of the urinalysis, and elevated serum creatinine level were significantly associated with progression to renal failure. Sex, race, age, abnormalities of creatinine clearance, and 24-hour urine protein collection were not associated with progression to renal failure. Renal biopsies were obtained in 45 children. Biopsies were initially classified according to World Health Organization criteria. Diffuse proliferative glomerulonephritis was significantly associated with progression to renal failure. The 45 biopsies available were reviewed by one of the authors and categorized by activity and chronicity indices. Both the active lesions of fibrinoid necrosis, synechiae, tubular casts, and vasculitic lesions and the chronic lesion of glomerular sclerosis correlated with progression to renal failure. Of the 16 children who progressed to renal failure, 2 had cadaver kidney transplants and are well 5 years posttransplant; 4 had fulminant lupus and died within 1 month of commencing dialysis; 10 began chronic dialysis. Five of the 10 children on chronic dialysis died from sepsis. These data suggest that children with systemic lupus erythematosus who undergo dialysis do poorly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lupus nephritis: prognostic factors in children. 140 32

Sepsis-induced pulmonary artery hypertension (SIPAH) causes an increase in right ventricular (RV) afterload, dilatation of the RV, leftward shift of the interventricular septum (IVS), and therefore decreases left ventricular compliance (LVC). This study was designed to evaluate the role of pericardiotomy during SIPAH as an alternative to vasodilators (which cause a detrimental increase in shunt fraction) to improve LVC. Systemic and pulmonary hemodynamics, pulmonary function, RV, and LVC were acquired at baseline (BL), during SIPAH with closed pericardium (PAHCP) and after opening the pericardium (PAHOP). Systemic hemodynamics and pulmonary function did not change significantly during the experiment. The infusion of live bacteria induced a significant rise in mean pulmonary artery pressure from 16 +/- 5.3 at BL to 36.8 +/- 3.3 and 35.0 +/- 6.4 mm Hg during PAHCP and PAHOP, respectively, (P less than 0.05). Pulmonary vascular resistance index and right ventricular stroke work index (RVSWI) displayed a similar rise in response to SIPAH (P less than 0.05 vs BL). Pericardiotomy did not affect pulmonary hemodynamics or RVSWI. Right ventricular contractility did not increase following pulmonary hypertension while the pericardium was closed (440 +/- 78 vs 410 +/- 125, P less than 0.05); however, it rose, although not significantly, to 615 +/- 326 after pericardiotomy. RV time tension index displayed a rise during SIPAH with the pericardium intact and returned to baseline values after pericardiotomy; however, these changes were not significant. RVC did not change significantly throughout the experiment. In contrast, LVC decreased significantly after SIPAH and significantly improved after pericardiotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pericardiotomy improves left ventricular compliance during sepsis-induced pulmonary artery hypertension. 173 27

Factors associated with mortality were examined for 27,370 hip fracture patients aged 65 years or older in Maryland hospitals, using discharge data for 1979-1988. Variables of interest included sociodemography, principal medical and injury diagnoses, E-code, year, disposition, and hospital. For both white males and white females, the hip fracture rate doubled with each 5-year increment in age. The overall proportion who died during hospitalization was 4.9% (n = 1,339). After multivariate adjustment, there remained a substantially increased risk of death for males. The relative odds (RO) of dying for males versus females were 1.6. Other factors associated with high relative odds of dying during hospitalization included the diagnosis of septicemia (RO = 12.3), pneumonia/influenza (RO = 4.9), and digestive system disorder (RO = 3.6). The RO of dying doubled in the presence of cardiac, neoplastic, or cerebrovascular disease. Patients with diagnoses of nervous system or mental disorder, hypertension, anemia, musculoskeletal system disease, or urinary tract infection were at decreased risk of dying. Results of the study suggest that the prevention or early diagnosis and treatment of serious infections in the elderly patient with a hip fracture remain an important challenge to clinicians.
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PMID:Hip fractures among the elderly: factors associated with in-hospital mortality. 174 23

Emerging evidence suggests the endothelium produces several substances capable of locally regulating organ blood flow. Vasoactive prostaglandins, endothelium-derived relaxing factor, and endothelin are examples of these vasoactive substances. Abnormalities of endothelial function may contribute to the pathogenesis of disease in several circumstances, including hypertension, diabetes, and septicemia. Evidence for the endothelium as a regulator of regional perfusion and several of the endothelium-derived substances and their potential role in disease are reviewed.
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PMID:The endothelium--a key regulator of vascular tone. 175 Apr 52

Maternal mortality is examined from June 1980 to December 1986 at Mulago, Nsambyo, Old Kampala, Rubaga, and Mengo Hospitals in Kampala, Uganda. Clinical or immediate causes, direct and indirect, were recorded from case summary forms based on ICD9 definitions of obstetric complications. The nonabortion maternal mortality rate (NAMMR) was 2.65/1000 deliveries (580 deaths); the abortion-related maternal mortality rate (ARMMR) was 3.58/1000 abortions. The hospital maternal mortality rate was 2.0/1000 deliveries. 75% of maternal deaths of women of 28 weeks' gestation or more had delivered outside the hospital. NAMMR doubled between 1980-86, a statistically significant increase. ARMMR increases were almost significant. 75% were direct obstetric and 21% were indirect obstetric causes. 38% had clinical anemia, 29% had some sepsis, 18% had substantial bleeding, and 14% had obstructed labor. Other contributing conditions were pneumonia, ruptured uterus, laparotomy, evacuations and curettage, malaria, preeclampsia, sickle cell anemia, pulmonary embolism, malnutrition, tetanus, meningitis, prolonged labor, and hepatitis. At admission, 48% were in poor condition, 30% in good condition, and 22% in fair condition. 27% had sickle cell anemia, high blood pressure, multiple pregnancy, or malaria at admission. 64% were admitted within 24 hours after delivery, 67% 1-7 days after delivery, and 92% 7-42 days after delivery. Those in good condition were all admitted 7 days postdelivery. 41% of deaths were due to lack of drugs, 7% lack of fluids, 20% with theater problems, 14% with doctor-related factors, and 3% with midwife-related factors. Better information is needed on mortality before delivery, mortality in hospitals vs. outside, and mortality from abortion, and ectopic and hydatidiform molar pregnancies. An explanation given for the increase in maternal mortality is the decline in economic conditions. Abortion complications may be due to the concealment practiced. Causes are consistent with trends from the 1950s, 1960s, and 1970s in Uganda and developing countries in general. Availability and accessibility of gynecological and obstetric services needs great improvement. Training traditional birth attendants and obtaining rural ambulance services are also needed. Health workers lack creativity and imagination for developing country conditions; scarce resources are not the only problem.
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PMID:Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986. 176 15

Neutropenia is common in neonates with sepsis and in those born to women with pregnancy-induced hypertension. Neutropenia has not previously been described, however, as a result of the twin-twin transfusion syndrome. We observed neutropenia of 4 to 8 days' duration in each of five "donor" (anemic) twins affected with the twin-twin transfusion syndrome. No evidence of infection was observed. Like neutropenia of pregnancy-induced hypertension, no left shift was seen. Neutrophil kinetic studies were performed on one of the neutropenic patients. Assessment of the marginal, storage, proliferative, and progenitor cell pools indicated that neutropenia resulted from diminished neutrophil production.
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PMID:Neutropenia in donor (anemic) twins involved in the twin-twin transfusion syndrome. 177 Mar 93


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