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

Group B streptococcal (GBS) sepsis produces arterial hypoxemia in newborns. In piglets we previously found that hypoxemia develops because of increased ventilation perfusion heterogeneity, and reduced mixed venous pO2 occurring in association with decreased pulmonary blood flow. We hypothesize that increased thromboxane A2 (TxA2) synthesis mediates the immediate alterations in gas exchange found in GBS sepsis. We studied 18 anesthetized, ventilated piglets before, during, and after a 30-min infusion of 2 X 10(9) colony forming units/kg of GBS. Nine piglets were pretreated with 8 mg/kg of dazmegrel (DAZ), a TxA2 synthetase inhibitor, and nine animals received GBS without DAZ pretreatment. Pulmonary and systemic arterial pressures, pulmonary vascular resistance, pulmonary blood flow, respiratory gas tensions, intrapulmonary shunt, and SD of pulmonary blood flow, an index of ventilation perfusion mismatching, were measured. Systemic and pulmonary arterial levels of thromboxane B2 and 6-keto-PGF1 alpha were also measured. The sham-treated animals showed the expected rise in pulmonary arterial pressure from 12 +/- 3 to 29 +/- 7 torr, (p less than 0.02). By comparison, the animals pretreated with DAZ did not demonstrate pulmonary arterial hypertension and had a delay in the fall in pulmonary blood flow until 2 h postinfusion. Arterial PO2 did not decline significantly after the GBS infusion in the DAZ-pretreated animals; the untreated animals showed a significant fall in pO2 from baseline. There was no significant change in intrapulmonary shunt or SD of pulmonary blood flow compared to baseline in the DAZ-pretreated animals. The elevation in thromboxane B2 occurring with GBS sepsis did not occur in the DAZ-pretreated animals.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of the thromboxane synthetase inhibitor, dazmegrel (UK 38,485), on pulmonary gas exchange and hemodynamics in neonatal sepsis. 352 Apr 68

Captopril, an angiotensin converting enzyme inhibitor used in the treatment of hypertension, has been associated with hematologic as well as dermatologic side effects. Two patients with captopril-induced angioneurotic edema, one of whom had fatal granulocytopenia and overwhelming polymicrobial sepsis, are presented.
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PMID:Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy. 352 89

Eleven of 30 patients with MCTD, followed for a mean of 10 years, developed immune complex nephropathy (five membranous, two mesangial, one mixed, and one sclerosing) with NS in nine of 11. Another patient had membranous nephropathy at autopsy. Patients with renal disease tended to have more systemic manifestations than those without. NS was at times of abrupt onset, recurrent, and/or persistent. Anti-RNP and serum complement were not helpful in predicting nephritis. Seventy-two percent of nephropathy and 62% of NS episodes resolved or improved after corticosteroid therapy. Five patients became hypertensive, two developed chronic renal failure and required chronic dialysis, and one needed acute dialysis twice. One patient progressed to focal proliferative crescentic nephritis with necrotizing arteritis. Three patients with nephropathy died, two of pulmonary hypertension with acute cor pulmonale and one of overwhelming sepsis. Nephropathy is relatively common in MCTD, is associated with substantial morbidity, and with the risk of hypertension and chronic renal failure.
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PMID:Renal involvement in mixed connective tissue disease: a longitudinal clinicopathologic study. 356 25

During approximately a 9-year period, 37 severe preeclamptic-eclamptic patients had pulmonary edema for an incidence of 2.9%. The incidence was significantly higher in older patients (p less than 0.0001) and in multigravid patients (p less than 0.05). Eleven (30%) had antepartum edema with 10 (90%) of the 11 having preexisting chronic hypertension. Twenty-six (70%) had postpartum edema with an average onset of 71 hours post partum. The majority of these patients had excessive colloid and crystalloid infusions for various medical, surgical, and obstetric complications. There were four maternal deaths and morbidity was significant. Eighteen patients had disseminated intravascular coagulopathy, 17 had sepsis, 12 had abruptio placentae, 10 had acute renal failure, six had hypertensive crisis, five had cardiopulmonary arrest, two had rupture of the liver, and two had ischemic cerebral damage. The overall perinatal mortality was 530/1000 and neonatal morbidity was significant. Pulmonary edema is infrequent in severe preeclampsia-eclampsia without associated medical, surgical and obstetric complications. The occurrence of pulmonary edema in such patients is associated with high maternal and perinatal mortality and morbidity.
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PMID:Pulmonary edema in severe preeclampsia-eclampsia: analysis of thirty-seven consecutive cases. 357 33

Eight ventilator-dependent infants with bronchopulmonary dysplasia (BPD) were treated with dexamethasone (0.5 mg/kg/day). Therapy was initiated at 19.3 +/- 3.9 days of age, continued at the initial dose for 7 days, then tapered over 2 weeks. The clinical course of these infants with BPD was compared to that of 8 similar ventilator-dependent infants with uncomplicated hyaline membrane disease (HMD). At study entry, the BPD patients had significantly higher ventilator rates, peak inspiratory pressures, mean airway pressures, alveolar-arterial oxygen gradients and fraction of inspired oxygen (FiO2) values. After 7 days of dexamethasone therapy, ventilator rates, peak inspiratory pressures, mean airway pressures, FiO2 values and alveolar-arterial oxygen gradients improved significantly. At this time, ventilator rates, peak inspiratory pressures and FiO2 values were similar to those of patients with uncomplicated HMD. BPD patients were extubated after 6.5 +/- 2.4 days of therapy. The incidences of septicemia, rickets and retinopathy of prematurity were similar in the BPD and uncomplicated HMD patients. Most dexamethasone-treated patients developed arterial hypertension during the first 48 h of therapy. Blood pressures returned to normal within 7 days of stopping therapy. All BPD patients had cosyntropin responses tested 5.5 +/- 2.6 weeks after stopping therapy. Six were normal. Two had inadequate responses. At 1 year adjusted age, the dexamethasone-treated BPD infants and HMD infants had similar radiographic bone ages, similar growth patterns and similar scores on the Bayley infant development scale. Dexamethasone was useful in the treatment of early BPD. Used as short-term therapy, the drug had minimal complications and no long-term sequelae.
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PMID:Short-term dexamethasone therapy for bronchopulmonary dysplasia: acute effects and 1-year follow-up. 358 71

Fifteen pediatric patients (ages 5-17 years) with renovascular hypertension (RVH) are reported. The diagnosis was made by arteriogram in all patients as the intravenous pyelogram was not helpful in this group. Five patients had a coarctation of the abdominal aorta. Four of these had associated renal artery stenosis. Renal artery stenosis alone was present in 14 patients, unilateral in 8, and bilateral in 6. Three of the former had a contralateral hypoplastic kidney. A nephrectomy was performed in 2 patients, both of whom continue to be hypertensive. Renal revascularization was performed in 13 patients; one of these died of sepsis. Eight are normotensive, 2 are improved (normotensive with diuretics), and 2 remain hypertensive. The follow-up is from 1 to 15 years.
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PMID:Renovascular hypertension in pediatric patients. 365 34

Tuberous sclerosis (TS) represents a relatively frequent inherited disorder of the skin and neurological tissues. Defects of other organs may also be present, but subjects differ significantly in their individual involvement. Usually, white leaf - shaped macules, even though most subtle, are the first precocious sign of the disease in young patients. Other signs tend to appear when the patient grows older. Visceral disorders include renal angiomyolipomata; clinical behavior of these solid tumors is almost always benign. Sometimes the renal lesions present themselves as polycystic kidneys, and may be the earliest sign and the only manifestation of TS, such as the case here described. This unusual form of renal involvement may be a severe potential complication of TS for the possible blood hypertension, recurrent urinary sepsis and chronic renal failure. It is of the utmost importance to search for the classical stigmata of TS in any patient who has cystic renal enlargement as only apparent abnormality. Careful inquiry into the family history cannot be overemphasized. The authors believe that, failing availability of adequate therapy for TS, the role in genetic counseling is to provide as much informations as possible to enable the involved family to make an intelligent decision about future children.
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PMID:[Clinical aspects (especially nephropathologic) and genetic counseling in tuberous sclerosis. Presentation of a case with polycystic kidney]. 367 Nov 35

Characteristic features of expert evaluation of temporary disability during pregnancy and after abortion and labor adopted in the USSR are outlined. At the earliest stages of pregnancy, women should be assigned to the work not associated with potential exposure to hazardous factors. Women with pregnancy complications should undergo comprehensive examination, preferably in a hospital setting: average length of stay is 20 days for threatened abortion, 21 days for premature labor (28-37-week pregnancy), 16 days for hypertension, 14 days for vomiting or nephropathy, 17 days for anemia, and 14 days for Rhesus-incompatibility. After abortion on demand or abortion for medical indications, a woman should be given a sick leave. The length of sick leave depends upon the pregnancy term (56 days for pregnancy longer than 28 weeks). Women with normal pregnancy and labor can receive a leave for 112 calendar days (56 days during the prelabor period and 56 days for the postpartum period). In the case of labor complications or multiple pregnancy, duration of the postpartum leave should be increased to 70 days. Indications for a 70-day postpartum leave include preeclampsia or eclampsia; cesarean section or vacuum-extraction; profuse hemorrhage during labor requiring blood transfusions; tears of the cervix uteri; postpartum endometritis, thrombophlebitis, septicemia, and suppurative mastitis; history of heart valve disease or congenital heart defects; and premature labor.
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PMID:[Expert evaluation of temporary disability with regard to pregnancy, abortion and labor]. 368 64

A case of anaerobic sepsis associated with Fusobacterium mortiferum is reported. Blood cultures from a 60-year-old man with type II diabetes mellitus, hypertension, severe atherosclerotic cardiovascular disease, and renal insufficiency revealed on a gramstained smear highly pleomorphic gram-negative bacilli with bizarre forms and round bodies. Growth of the organism on nonselective anaerobic media and analysis of its pattern produced results characteristic of Fusobacterium mortiferum.
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PMID:Anaerobic septicemia secondary to Fusobacterium mortiferum. 371 72

During 1978-1983, 57 maternal deaths (23 in blacks, 32 in coloureds and 2 in whites) occurred among 131,288 deliveries (36,564 in blacks, 89,335 in coloureds and 5389 in whites) in the Peninsula Maternal and Neonatal Service, Cape Town. Data for whites were not analysed further. Maternal mortality rates (MMRs) were higher in blacks than in coloureds. Age- and parity-specific MMRs showed that black teenagers and primiparas and coloureds aged 20-34 years and of parity 2-4 had the lowest rates. Advanced age and grand multiparity had a much greater adverse effect in coloureds than in blacks. Eighteen per cent of deaths in blacks and 9% of those in coloureds were in unbooked patients. The main causes of death (obstetric and non-obstetric) in blacks were sepsis, abruptio placentae, eclampsia and pneumonia. In coloureds they were eclampsia, other manifestations of proteinuric hypertension, cardiac disease, sepsis, haemorrhage (grouped) and diabetes. Of those who died, 43% of blacks and 38% of coloureds had had a caesarean section. The perinatal mortality rate was 417 for blacks and 469 for coloureds. A number of avoidable factors were identified. Most, if not all, deaths occurred because simple perinatal rules were broken.
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PMID:Maternal mortality in Cape Town, 1978-1983. 371 61


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