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)

Four cases of midfacial necrotizing lesions are reported. All patients were males with ages ranging from 25 to 76 years. The relationship between subjective symptoms and laboratory data prior to therapy (leukopenia, elevated ESR, increment of IgA and IgG), as well as between fever crisis with sweats and chills and the progression of the lesions were pathognomonic clinical signs for us. In all cases, paranasal sinus and nasopharynx were involved. Middle ear, eye and kidney involvement was present in 2 cases, and joints lesions only in one. Three patients died (2 of sepsis and one from hemorrhage) despite therapy. A pleomorphic cellular infiltrate with atypical lymphocytes and a tendency to angiocentricity was found in these cases. Such features and PAP positivity to beta and kappa chains led us to consider these lesions as an extranodal B-lymphocyte lymphoma-like. In the fourth case the histological picture was that of a necrotizing granuloma with clustered giant cells. This patient, treated only with prednisone, had a total remission of his symptomatology up to 11 years after the onset of the disease.
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PMID:Midfacial granuloma syndrome. A clinic and pathological report on four patients. 361 71

Sixteen dogs with lymphoma underwent splenectomy to relieve signs of massive splenomegaly including splenic rupture. The most common preoperative hematologic abnormalities, anemia and thrombocytopenia, were reversed in all dogs surviving the initial postoperative period. Within 6 weeks after surgery, 5 dogs died because of disseminated intravascular coagulation and sepsis. The remaining 11 dogs underwent chemotherapy. These 11 dogs had a complete response rate of 66% at one month after surgery; the mean and median survival times were 9.3 and 5 months, respectively. In 7 dogs evaluated until death, the mean and median survival times were 13.4 months and 14 months, respectively.
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PMID:Use of splenectomy in the management of lymphoma in dogs: 16 cases (1976-1985). 367 80

We report the clinical features and outcome of 16 patients with cryoglobulinaemia. Two patients with Type I cryoglobulinaemia both had IgG kappa monoclonal paraproteins. Nine of 10 with Type II disease had monoclonal IgM kappa and polyclonal IgG; one had monoclonal IgG kappa and polyclonal IgG in the cryoglobulin. Underlying disorders identified in 3 of the 4 Type III patients were Sjogren's syndrome, infective endocarditis, and non-A non-B hepatitis and HTLV III infection. The commonest presenting features were rash in 94 p. 100 (ulceration 25 p. 100), arthralgia in 63 p. 100 (erosive arthritis 32 p. 100), renal disease in 63 p. 100, neurological involvement in 56 p. 100, hepatomegaly in 32 p. 100 and splenomegaly in 32 p. 100. Major associated conditions were progressive bronchiectasis in one case, and severe peripheral vascular disease in another; underlying malignancy was found in 2 cases (lymphoma and malignant melanoma). Treatment was with plasma exchange (PE) and immunosuppressive drugs (ID) in 10, PE alone in 3, ID alone in 2 and antibiotics [corrected] in 1. Fourteen of 16 patients showed an initial clinical response and fall in cryoglobulin levels. Four patients have died, one each from gastro-intestinal haemorrhage, sepsis, pulmonary embolism and lymphoma. Of the remaining 12 patients, all are symptomatically controlled and 10 have persisting cryoglobulinaemia (3 on PE and ID, 2 on PE, 2 on ID and 3 on no treatment). Of the two cases in whom cryoglobulinaemia resolved, one (Type II) had received PE and ID and the other (Type III) had been treated with antibiotics and surgery for infective endocarditis.
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PMID:Cryoglobulinaemia: clinical features and response to treatment. 376 96

The surgical treatment of gastric cancer in the elderly (over 65 years of age) was retrospectively studied in the department of surgery, at the Mount Sinai Medical Center, Miami Beach, Florida. The authors found 22 patients who were operated on for gastric cancer between 1979 and 1982. Ages ranged from 69 to 90 years of age. The male-to-female ratio was 1:1. Twenty of 22 patients were found to have carcinoma. Eleven of 20 had regional spread to the perigastric nodes, transverse colon, omentum, spleen, and liver. Stage of disease was: stage I--four patients, stage II--five patients, stage III--eight patients, and stage IV--three patients. Two of 22 patients had lymphoma. The mean hospital stay was 17.1 days, but decreased to 12.4 days if no complications occurred. Postoperative complications were minimal and included pneumonia, urinary tract infection, wound infection, and dumping syndrome. There were two postoperative deaths (9%) due to sepsis and myocardial infarction, respectively. Six of the remaining 18 patients died within 1 year. Seven of 18 were alive after 2 years, and six patients survived greater than 36 months (33%). Of the six long-term survivors, two had stage III and one had stage IV disease at the initial exploration. The average survival was 23.5 months. The authors conclude that gastric resection should not be withheld in the elderly. The elderly have the same morbidity and mortality from surgery for gastric cancer as patients under age 65.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastric cancer in the elderly. 382 9

Current therapy for children with cancer includes a variety of invasive procedures many of which require repeated venous access over a considerable period of time. Such procedures are poorly tolerated by children and by their veins. Recently it has become possible to undertake the majority of such procedures by means of permanent indwelling silastic catheters improving the quality of life of the children and their parents and increasing the scope of therapeutic intervention. In the period July '83 - August '84 we have used 46 of these catheters in 45 children with malignant disease, 12 with acute myeloid leukaemia, 12 with neuroblastoma, 7 with B cell leukaemia-lymphoma, 6 with rhabdomyosarcomas, 2 with Ewing's Sarcoma, 2 with Wilms' tumor and 1 case each of Hodgkin's disease, teratocarcinoma, osteosarcoma and juvenile chronic myeloid leukaemia. The children's ages ranged from 2 months to 14 years; 22 were male and 23 female. The catheters were inserted under general anaesthesia (duration 20-40 minutes) usually without difficulty, except for a single patient in whom no suitable vein could be found. No complications connected with the placement of the catheter were observed. Subsequent management of the catheter was initially complicated and time-consuming, but was subsequently simplified so that acceptance by parents, children and nursing staff was eventually excellent. The duration of use of 46 catheters ranges from 7 to 350+ days; 24 catheters are presently in use at 30-350+ days from insertion. Eight children died as a result of disease progression and two of sepsis with the catheter in place.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Advantages of a permanent venous access in children treated for cancer. Preliminary results]. 383 38

We describe 20 adult patients with malignant lymphoma with primary presentation in the spleen. The most common presenting symptoms were fever, malaise, and weight loss. Physical examination revealed prominent splenomegaly without palpable lymphadenopathy. Small lymphocytic lymphoma was the most frequent histologic type (11/20), followed by large cell lymphoma and mixed cell lymphoma (3/20 each). Bone marrow involvement was found in ten of 17 patients. At laparotomy, lymph node involvement, usually retroperitoneal, was found in six of 13 patients. There was liver involvement in seven of 15 patients. Follow-up has been relatively short, with an average of 24 months (range, one to 48 months). Four patients died as a result of progressive disease, one died of sepsis after splenectomy, and one died two years after diagnosis of a stroke. The prognosis in primary splenic lymphoma appears to be similar to that in nodal lymphoma.
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PMID:Malignant lymphoma with primary presentation in the spleen. A study of 20 patients. 384 Sep 80

To our knowledge this is the first case of hemorrhagic bullae caused by Morganella morganii septicemia. The presence of organisms in the bullae, demonstrated by Gram strain and culture, and the acral location of the bullae suggest that the skin lesions were due directly to blood-borne infection. Multiple factors predisposed this patient to gram-negative bacteremia, including lymphoma, chemotherapy, neutropenia, systemic steroids, multiple hospitalizations, and treatment with broad-spectrum antibiotics.
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PMID:Hemorrhagic bullae associated with Morganella morganii septicemia. 388 21

Micronomicin (MCR) at a daily dose of 120 to 360 mg was administered to patients with severe infections who had hematopoietic disorders as underlying diseases. Efficacy and safety of the drug were evaluated. The underlying diseases in the 56 patients included in the evaluation of efficacy were acute myelocytic leukemia (24 cases), acute lymphocytic leukemia (8), acute promyelocytic leukemia (6), acute monomyelocytic leukemia (4), acute monocytic leukemia (1), erythroleukemia (1), chronic myelocytic leukemia-blastic crisis (4), malignant lymphoma (3), aplastic anemia (2), and others (3). The infections were septicemia in 9 patients, suspected septicemia in 48, respiratory tract infection in 7, and perianal abscess in 2. The clinical efficacy of MCR was 'excellent' in 12 patients, 'good' in 17, 'fair' in 7, 'poor' in 30 for an efficacy rate of 43.9%. The efficacy rate classified according to infections was 22.2% in septicemia, 56.3% in suspected septicemia. The organisms isolated from the patients with septicemia were Escherichia coli in 2, Klebsiella pneumoniae in 2, Pseudomonas aeruginosa in 1, alpha-Streptococcus in 1, Serratia marcescens in 1, and Acinetobacter sp. in 1. The efficacy rate was 15.4% in the 13 patients whose causative organisms were identified. The efficacy rate for patients who had failed to respond to prior antibiotic therapy was 43.9%. The efficacy rate in patients (34 cases) with an initial neutrophil count less than 100/microliter was 44.1%. Side effect which might have been caused by MCR was skin eruption in only one episode among 83 episodes those were evaluated for safety.
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PMID:[Therapeutic effects of micronomicin against severe infections in patients with hematopoietic disorders. Hanshin Infection Study Group]. 390 33

Malakoplakia is a distinctive type of histiocytic inflammatory reaction that occurs most commonly in the urinary tract and is usually due to infection by coliform bacteria. A 68-year-old woman developed a pathologic fracture of the right femoral neck secondary to malakoplakia of bone. The patient had received multiagent chemotherapy for a malignant lymphoma prior to the development of malakoplakia. Chemotherapy-related leukopenia and hypogammaglobulinemia resulted in Escherichia coli cystitis and sepsis. Bacterial cultures of tissue from the femoral fracture site also grew E. coli. Presumably, hematogenous spread of the bacteria led to infection of the femoral neck. Prosthetic repair of the fracture and antibiotic therapy resulted in a good clinical response. This is the third case of malakoplakia involving bone that appears to have been reported in the literature. Malakoplakia should be considered in the differential diagnosis of lytic bone lesions that occur in immunosuppressed patients.
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PMID:Malakoplakia of bone. An unusual cause of pathologic fracture in an immunosuppressed patient. 406 94

One hundred and nine patients with infection accompanying hematologic disorders including leukemia and lymphoma were treated with aztreonam (AZT). Of the 90 patients in whom the efficacy could be evaluated, 17 (18.9%) responded markedly and 29 (32.2%) moderately, the effective rate being 51.1%. The efficacy rate classified according to infections was 25% in septicemia, 46.3% in suspected septicemia, 57.1% in pneumonia and 100% in urinary tract infection. The efficacy rate to the Gram-negative bacteria was 78.9% and to the Gram-positive bacteria was 20.0%. In 4 (66.7%) out of 6 patients in whom P. aeruginosa was the causative organism, AZT was effective. The efficacy rate was 52.2% in the 23 patients whose causative organisms were identified and 50.7% in 67 patients whose causative organisms were not identified. There was no significant difference in the efficacy rate between the patients who failed to respond to prior antibiotic therapy (53.6%) and those treated with AZT from the beginning. The initial neutrophil count did not affect the efficacy rate. Side effects which might have been caused by AZT were eruption and fever in 4 patients. Hepatic disorders and eosinophilia were observed in 7 patients. However, the relationship between AZT and these abnormal findings was not established. These results indicate that AZT is an effective and safe antibiotic for the treatment of infections accompanying hematologic disorders.
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PMID:[Therapeutic effectiveness of aztreonam on severe infections associated with hematologic disorders. Hanshin Infection Study Group]. 407 14


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