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)

56 cases of pregnant women with a positive HIV serology were reported in 20 months at the Maternity of the Nice Hospital Center. In 10 cases, there were clinical signs of the disease (9 ARC-Syndrome, one case of AIDS). The predisposing factor was most of the time drug addiction, 53 cases (94.5%) and one case occurred after a blood transfusion. In the majority of the cases (52%) the pregnancy was pursued because of the late term or the patient's decision. A therapeutic abortion was performed in 12 instances (25%) and an interruption before 12 weeks of amenorrhea in 15 cases. 24 women delivered. The obstetrical complications were frequent with especially a fetal death in utero, five premature deliveries and fifteen hypotrophies. A severe infectious complication (septicemia, pneumopathy secondary to Pneumocystis carinii) was observed in 9 cases, a marked thrombopenia causing profuse post-partum haemorrhages in one case. Finally, one woman died 35 days after delivery. The study of the consequences on the child is incomplete because of insufficient follow-up: all children were sero-positive at birth and among thirteen children aged between 12 to 20 months, there were one death, one AIDS syndrome, 4 ARC-syndrome, 4 sero-positive and 3 sero-negative. The notion of HIV sero-positivity in a pregnant woman presents serious problems for the obstetrician. Decompensation of the disease during the pregnancy is uncertain but it is now confirmed that the child is affected, and this is a well established fact. These important consequences lead to propose, at this time a therapeutic interruption of pregnancy when possible, depending on the term, and when accepted by the patient.
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PMID:[Positive HIV (human immunodeficiency virus) serology in the pregnant woman: current data on its management. Apropos of a continuous series of 56 cases]. 347 87

Patients requiring prolonged (greater than 24 hours) mechanical ventilation have various conditions that result in respiratory failure. All patients requiring prolonged mechanical ventilation were subdivided into the following six groups: uncomplicated acute lung injury; respiratory failure complicated by multisystem failure; previous lung disease; trauma; other medical causes; and routine postoperative ventilation. During a one-year period, 327 patients required prolonged mechanical ventilation; acute lung injury and chronic obstructive pulmonary disease were the predominant conditions. Sepsis was both the major predisposing factor for and complication of acute lung injury. Mortality for patients with acute lung injury was 40 percent in the uncomplicated group and 81 percent in patients with acute lung injury complicated by multisystem failure. Acute respiratory failure in association with acute renal failure had a mortality of 89 percent. Number of organ systems involved also correlated with mortality. In patients with chronic obstructive pulmonary disease and pneumonitis or retained secretions, mortality was lower (30 percent), but a significant percentage of these patients (43 percent) became ventilator-dependent. Ventilator dependence did not significantly increase mortality during the course of respiratory failure.
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PMID:Clinical outcome of respiratory failure in patients requiring prolonged (greater than 24 hours) mechanical ventilation. 374 48

The effectiveness of fiberoptic bronchoscopy with the addition of bronchoalveolar lavage (BAL) was evaluated in 72 patients with the acquired immune deficiency syndrome (AIDS) and parenchymal pulmonary disease. The diagnostic yield varied for different pathogens and was 94% (45/48 cases) for Pneumocystis carinii, 67% (14/21 cases) for cytomegalovirus, and 62% (8/13 cases) for Mycobacterium avium intracellulare. Of the 11 cases of documented Kaposi's sarcoma in the lung parenchyma, none were diagnosed from bronchoscopy, although characteristic endobronchial lesions were seen in 6 cases. Overall, the yield of bronchoscopy for all pathogens was 65%. Both transbronchial biopsy and BAL had high independent yields (88 and 85%, respectively) for diagnosing P. carinii pneumonia but combining the procedures gave the best yield. Cytomegalovirus was most often diagnosed from examination and culture of the BAL. Recovery of Mycobacterium avium intracellulare was highest with culture of both washings and lavage. Neither granuloma nor organisms were seen on examination of histologic specimens. Bronchoscopy with BAL was well tolerated with few complications even in 5 patients with thrombocytopenia and 10 patients requiring mechanical ventilation. Sixteen patients (22%) had an increase in temperature after the procedure without hypotension or sepsis and 1 patient (1.5%) had a moderate pulmonary hemorrhage after transbronchial biopsy. Fiberoptic bronchoscopy with BAL is a safe procedure with a high diagnostic yield in AIDS patient with lung disease.
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PMID:Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage. 609 9

Abnormal serum angiotensin converting enzyme (ACE) activity has been reported in various human lung disorders and in laboratory animals with acute lung injuries. To test the value of serum ACE activity as an indicator of lung damage and its assistance in diagnosis or prognosis, 328 serum samples were obtained from 108 hospitalized patients with lung disease and 26 normal subjects. When patients were clinically grouped by disease entity, only the sarcoidosis group showed elevated mean serum ACE. Significantly increased serum ACE was found in 17 patients with various lung diseases (15% of hospitalized patients) 12 of whom also had concomitant liver disease. It is hypothesized that the liver may play a role in the normal metabolism of ACE being released by lung endothelial injury. Significantly low levels were seen in many acute and chronic lung injuries; specifically the groups with chronic obstructive lung disease, lung cancer, acute pneumonia, aspiration pneumonitis, gram-negative sepsis, acute myocardial infarction, and congestive heart failure. Serial measures of ACE in 71 patients with lung injuries showed that significantly decreasing levels over successive days were associated with a very high mortality. A single ACE measurement did not predict the presence or extent of lung injury, or aid in diagnosis or prognosis, but serial levels are of value prognostically.
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PMID:The value of serial serum angiotensin converting enzyme determinations in hospitalized patients with lung disease. 609 28

Plasma angiotensin II concentration gradients across the pulmonary vascular bed, plasma renin concentration and serum converting enzyme activity were measured in 19 patients. The majority of the patients were critically ill. Nine patients had septicemia with acute respiratory failure, six patients had severe chronic lung disease and four patients had other serious disorders requiring haemodynamic monitoring. Pulmonary angiotensin II generation rates were calculated as the products of the pulmonary plasma flow and the angiotensin II concentration gradient across the lung. Several patients had a highly activated renin-angiotensin system. There was a strictly linear correlation between the plasma angiotensin II concentrations in mixed venous blood and in systemic arterial blood across a wide range, the concentration in arterial blood being 1.4-1.5 times that in mixed venous blood in each of the three groups of patients. Serum converting enzyme activity was not different from the level observed in a group of control patients above 50 years of age, but lower than in younger normal individuals. The maximal angiotensin II production rates in the pulmonary vascular bed of patients with life-endangering pulmonary disease were similar to the rates previously measured in hypertensive patients with renovascular or renal parenchymal disease. In conclusion, the process of angiotensin I conversion in the lung operates without impediment in spite of severe pulmonary injury.
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PMID:Pulmonary angiotensin II production in respiratory failure. 633 56

This paper compares the management of two groups of patients with flail chest. The 25 patients in group 1 had a flail chest without other significant injuries or shock, whereas the 57 in group 2 had a flail chest with multiple injuries, shock or both. The group 1 patients were treated with repeated multiple intercostal nerve blocks or high segmental epidural analgesia, oxygen, intensive chest physiotherapy, fluid restriction, furosemide diuretics, methylprednisolone sodium succinate and colloid infusion in an intensive care unit. In addition to these measures, the group 2 patients underwent endotracheal intubation and assisted mechanical ventilation with a volume respirator that provided continuous positive airway pressure and positive end-expiratory pressure. Of the 57 group 2 patients 36 required prolonged ventilation, eventually through a tracheostomy, because of severe head injury, pneumonia, severe facial injury, quadriplegia, pre-existing lung disease or severe sepsis. However, tracheostomy was avoided in the other 21 patients in group 2. There were no deaths in group 1, but 8 (14%) of the patients in group 2 died. These results show that avoidance of tracheostomy and ventilation in selected patients with flail chest is consistent with a low morbidity and mortality.
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PMID:Management of flail chest. 662 70

The factor VIII coagulant activity (FVIII:C), factor VIII related antigen (FVIII:RAG), and factor VIII ristocetin cofactor activity (FVIII:RCF) was determined in the cord blood samples of 30 healthy term newborns. Sodium citrate anticoagulant, cold, and a proteolytic inhibitor were used in sample processing. All three factor VIII activities were elevated in infants compared to adults; additionally, FVIII:RAG was significantly higher in vaginally compared with caesarean section delivered infants. Crossed immunoelectrophoresis of the term infant plasma showed a consistently normal factor VIII mobility. An additional group of 22 sick premature and term infants had determinations of factor VIII antigen and crossed immunoelectrophoresis. The FVIII:RAG of sick infants was approximately twice that of the well term infants. Infants with severe lung disease, asphyxia, thrombosis and sepsis had normal electrophoretic mobility despite marked elevations in FVIII:RAG. Abnormal, symmetrical, more anodal migrations were seen only in a group of severely ill newborns with dissiminated intravascular coagulation (DIC) or signs of activated fibrinolysis. These results suggest that the elevated FVIII activities seen in well infants and most sick newborns are the result of increased release of a normal form of the FVIII molecule. Those elevations seen in sick newborns with DIC result from increased release and the production of an altered, faster moving FVIII molecule.
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PMID:Newborn factor VIII complex: elevated activities in term infants and alterations in electrophoretic mobility related to illness and activated coagulation. 678 64

Perinatal changes in fetal heart rate (FHR) were monitored in infants in whom necrotizing enterocolitis (NEC) developed. Eleven of 16 monitoring strips indicated severe FHR changes consistent with perinatal hypoxia, two indicated mild changes, two indicated tachycardia alone, and only one was normal. Severe variable FHR decelerations indicating umbilical cord compression occurred in four cases, persistent late FHR decelerations occurred in two cases, persistent late and severe variable FHR decelerations occurred in two cases, prolonged bradycardia occurred in two cases, and bradycardia with persistent late FHR decelerations occurred in one case. These findings confirm that NEC does occur in infants with perinatal hypoxia and indicate that intestinal ischemia may occur before delivery and after delivery from hypoxia and acidosis from lung disease, exchange transfusion, or sepsis. Perinatal monitoring may become an important determinant in identifying the infant in whom NEC will develop.
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PMID:Fetal heart rate patterns in infants in whom necrotizing enterocolitis develops: a preliminary report. 719 Dec 46

A 66-year-old man had pneumonia, lung abscesses, and mediastinal adenopathy develop due to Yersinia enterocolitica. There was no evidence of septicemia or acute gastrointestinal disease. Diagnosis was confirmed by cultures of a transtracheal aspirate and sputum. Treatment with cefamandole nafate, which had not been used previously in Y enterocolitica lung disease, resulted in cure.
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PMID:Yersinia enterocolitica lung infection. 728 67

C reactive protein (CRP) levels are sequencially settled in 58 children, divided in three groups in dependence of their illness: acute bacterial pneumopathy, acute pyelonephritis or neonatal sepsis, all of them receiving antibiotic treatment. CRP values are compared with clinical, radiologic and bacteriologic findings, showing in patients of the first two groups a normalization between fourth and ninth day of treatment, together with clinical and radiologic improvement. In contrast, it was shown that normalization of CRP in neonatal sepsis group was quite slow related to the torpid evolution. The sequentially measure of CRP was prove useful as antibiotic treatment control in children affected with different infectious pictures.
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PMID:[C reactive protein as a standard of efficience in antiinfectious therapy (author's transl)]. 741 41


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