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)

Forty primary uncemented total hip arthroplasties (THAs) were performed in 34 patients with an average age of 41.2 years (range, 21-78 years). Four hips had one component placed with cement: three femoral, one acetabular. Diagnoses included rheumatoid arthritis (30 hips), juvenile rheumatoid arthritis (seven hips), and systemic lupus erythematosus (three hips). The follow-up period averaged 3.7 years (range, two to six years). Thirty-five percent of the patients were using corticosteroids before hip replacement and throughout the follow-up period, whereas 44% of the patients had been using steroids in the past. Additionally, 79% of the patients were taking some form of antiinflammatory medications at follow-up examination. Clinical evaluation based on a ten-point rating scale indicated significant improvements from preoperative to the most recent follow-up examination for pain (from 3.1 to 9.0), walking (4.0-7.3), function (3.5-6.0), and activity (3.0-4.9). None of the hips required revision surgery, and none are pending. There was no evidence of roentgenographic failure; however, 43% of femoral and 12.8% of acetabular components showed some minor radiolucencies with sclerotic lines. None of these involved 100% of the bone-prosthesis interface. Femoral component subsidence occurred in two hips, and acetabular component migration occurred in one hip. Complications included three (8.1%) intraoperative femoral fractures, of which two required internal fixation. One patient had postoperative, culture negative, wound drainage. No deep sepsis occurred. These findings suggest that uncemented THA may be successful in the rheumatoid patient. Pain relief, walking, function, and activity levels are similar to those seen in cemented replacements with this length of follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Uncemented total hip arthroplasty in rheumatoid arthritis diseases. A two- to six-year follow-up study. 155 38

Although systemic lupus erythematosus (SLE) no longer has the very poor prognosis that it had 50 years ago, there remains a significant mortality. We were able to determine the causes of death in 27 of the 29 patients with SLE who died over the period 1985 to 1989. This represents one and five year mortality of six and 24% respectively. In common with other studies, sepsis was a major factor, being implicated in the deaths of 37% of our patients. However, sepsis (i) occurred almost exclusively in patients with active SLE; (ii) often occurred after prolonged hospitalisation; and (iii) was a terminal event in otherwise fatal SLE in several patients. Overall, active disease was determined to be a cause of death in 67% of the patients. An unexpected observation was the finding that active cardiopulmonary disease accounted for 37% of deaths. Although late mortality from degenerative vascular disease is being increasingly reported with the modern prolonged SLE survivorship, it was identified in only one patient. We conclude that active disease remains the most important factor in mortality in SLE.
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PMID:Mortality in systemic lupus erythematosus: active disease is the most important factor. 158 Aug 64

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

In the present study 19 Greek Caucasian children with systemic lupus erythematosus (SLE), onset before the age of 16, were followed up for 1-12 years (mean 5.6 yrs.). Diagnosis was determined early in 14 patients and delayed by 2 to 6 years in 5. The clinical manifestations and laboratory findings did not differ significantly from those reported in adults with lupus. The major organ system involvement at onset and early course were skin and joints (80%) followed by kidneys (42%). During the course of the disease 26% of the children developed central nervous system (CNS) involvement. All the patients were treated with steroids and/or cytotoxic drugs in severe uncontrolled progressive disease. At the mean 5.6 years follow-up most patients were in remission on small doses of steroids; one patient still presents signs of active lupus nephritis and one patient died from sepsis. All the patients with CNS involvement recovered without permanent CNS residue.
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PMID:Clinical and serological spectrum of systemic lupus erythematosus in Greek children. 179 Jun 34

Because of the potential importance of interleukin 1 (IL-1) in modulating inflammation and the observations that human blood neutrophils (PMN) express IL-1 receptors (IL-1R) and synthesize IL-1 alpha and IL-1 beta, we studied the IL-1R on blood PMN from a group of patients with the sepsis syndrome. We report a marked enhancement in the sites per cell of IL-1R expressed on sepsis-PMN of 25 consecutively studied patients compared to 20 controls (patient mean = 9,329 +/- 2,212 SE; control mean = 716 +/- 42 SE, respectively). There was no demonstrable difference in the Kd of IL-1R on sepsis-PMN (approximately 1 nM) as determined by saturation curves of 125I-IL-1 alpha binding and the IL-1R on sepsis-PMN had an apparent Mr approximately 68,000, a value like that of normal PMN. Cytofluorographic analysis indicated that the sepsis-PMN phenotype is a single homogeneous population with respect to IL-1R expression. In contrast, expression of the membrane complement receptor CR3 is not increased on sepsis-PMN. Similar increases in expression of IL-1R were not observed in various other inflammatory processes, including acute disseminated inflammation and organ failure not caused by infection, acute infection without organ failure, and immunopathologies such as active systemic lupus erythematosus and rheumatoid arthritis. Enhanced expression of IL-1R was not related simply to the state of myeloid stimulation. Increased expression of IL-1R on normal PMN was induced in vitro by incubating cells with recombinant human granulocyte-macrophage/colony-stimulating factor for 18 h and this response was inhibited by cycloheximide, suggesting the possibility that de novo synthesis of IL-1R might occur in PMN during the sepsis syndrome.
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PMID:Increased expression of the interleukin 1 receptor on blood neutrophils of humans with the sepsis syndrome. 183 97

In this review of 159 pts with systemic lupus erythematosus (SLE) followed for 18 years, 78 pts had major infections (20/100 pt-years). Patients with infection had a higher incidence of proteinuria, central nervous system involvement, the use of methylprednisolone boluses and mortality rate. Infection was independent of the amount of steroids and immunosuppressor drugs used. Microorganisms were isolated in 77% of the cases, gram negative enterobacteria were the most common isolates. 30% of the pts had pulmonary infection; and 84% of the infections happened during steroid therapy. Immunosuppression was associated to repeated infections. The 19 pts with fatal infections had a higher frequency of pneumonia and septicemia, and received high doses of steroids (> or = 40 mg). No relation to immunosuppression was found in this group. In 26% opportunistic microorganisms were isolated in association to the use of high doses of steroids. Even if survival of SLE has improved in the last 40 years, infections are still an important cause of mortality, most of them related to aggressive steroid therapy.
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PMID:[Infections in systemic lupus erythematosus]. 184 4

Lupus erythematosus first diagnosed in pregnancy or puerperium is a problem both for the obstetrician and for the internist. We report on a case of lupus manifestation with signs and symptoms similar to sepsis diagnosed in the puerperium.
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PMID:[Acute initial manifestation of systemic lupus erythematosus in the puerperium]. 186 Jun 63

Infection is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). A review of all SLE admissions to our hospital during a 5-year period was conducted to determine the rate and nature of infection, and its association with overall disease activity, measured by the SLE Disease Activity Index (SLEDAI). Eighty-one patients (79 women, 2 men) were admitted for a total of 2,738 days (176 admissions). There were 53 proven infections, giving an infection rate of 1.94/100 hospital days. Twenty-three (43.4%) of these were major infections (requiring IV antibiotics). Two of 3 deaths were due to septicemia. By logistic regression analysis, infection was significantly associated with disease activity (p = 0.005), but not with disease duration or prednisone dosage. Our data confirm that infection is common in hospitalized patients with SLE, is associated with overall disease activity independent of prednisone dose, and causes significant mortality. These facts should be borne in mind when hospitalization is considered for patients with SLE.
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PMID:Infection and disease activity in systemic lupus erythematosus: a review of hospitalized patients. 194 20

We report on the rare association of Hodgkin's disease with systemic lupus erythematosus. Two years after the diagnosis of systemic lupus erythematosus, the patient developed upper abdominal pain, jaundice, splenomegaly, and fever of unknown origin. He had a rapidly fatal clinical course, despite being treated for systemic lupus erythematosus, cholecystitis, and possible sepsis. Autopsy revealed Hodgkin's disease, lymphocyte-depletion type, involving lymph nodes, liver, spleen, and bone marrow. The awareness of the association of Hodgkin's disease with systemic lupus erythematosus and its modes of presentation will help in the early diagnosis and management of such patients.
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PMID:Hodgkin's disease associated with systemic lupus erythematosus. 205 Mar 74

The aim of the study was to evaluate survival rates and causes of death of a large group of male patients with systemic lupus erythematosus (SLE). The group consisted of 120 patients with evident SLE that were observed at the Institute of Reanimatology from 1976 to 1989; the mean age was 31.3 years; the mean age for the disease onset was 29.6 years; the mean follow-up duration was 9.1 years. The survival pattern was obtained with the method of the life table analysis. Maximum lethality was observed during the first years of the disease: in 1-4 years 11 patients died, in 5-6 years--6 patients, and in 8-12 years--7 patients; 27 patients died during the follow-up period, 17--died of lupus nephritis, 4--of neurological involvement, one patient--of heart insufficiency, one--of lung tuberculosis, one--of ischemic heart disease, one--of amyloidosis, one--of sepsis and one patient died of chronic lung insufficiency.
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PMID:[An analysis of the survival of 120 male patients with systemic lupus erythematosus]. 207 48


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