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

In 144 pull-through-operations performed for anorectal-atresia, following complications were observed: pneumonia 11%, sepsis 8.3%, peritonitis 5%, bowel obstruction 5%, osteomyelitis 1%, retraction of the pulled-through colon 4%, anal stenosis 16%, secondary megacolon 9%, fistula relapse 8%, mucosal prolapse 4%. Recto-urethral, recto-vesical- and recto-vaginal fistula relapses are managed by interposition of the gracile muscle. Anal stenoses and secondary megacolon are prevented by a sufficiently long postoperative bougienage.
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PMID:[Therapy of postoperative complications following abdominoperineal or abdominosacroperineal pull-through surgery in anal atresia]. 343 Dec 99

Between January 1982 and December 1985, 355 fiberoptic pouchoscopies were performed in 123 patients with a continent ileostomy. These examinations have been reviewed to determine the effectiveness of the technique as a diagnostic and therapeutic tool. The Olympus GIF-XP pediatric endoscope was used after pouch lavage, and the afferent loop of ileum, the pouch, and (by retroflexion) the nipple valve were examined on each occasion. There were 63 males and 60 females, with a median age of 35 years (range, 16 to 71 years). The median length of follow-up after pouch construction was 36 months (range, 6 to 120 months), and an average of three examinations were performed per patient (range, 1 to 12). Of 127 examinations performed in asymptomatic patients, the pouch was normal in 117 cases, and there was mesh erosion into the pouch in 10 cases. The remaining 228 examinations were for symptoms that included pouchitis (56), difficulty in intubation (47), incontinence (35), follow-up of treated pouchitis (18), parastomal sepsis (22), blood in the stool (13), anemia (8), excess mucus discharge (6), valve prolapse (4), and purulent discharge from the stoma (1). Eighty-four examinations were normal; 144 revealed a likely cause for the symptoms and led to appropriate treatment, which in 45 patients was surgical. Fiberoptic endoscopy was therapeutic in 6 patients in whom it was used on 10 occasions to intubate a pouch with a slipped valve. Radiographic studies were seldom used, with pouchograms being carried out in 16 patients and fistulograms in 5. Only the fistulograms contributed to the assessment of each patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of fiberoptic endoscopy in the management of the continent ileostomy. 359 85

Sixteen selected patients with rectal procidentia, anal incontinence, or both were treated by the insertion of a Dacron impregnated Silastic sling at the Lahey Clinic between 1981 and 1984. The indications for operation were incontinence in 14 patients, procidentia with incontinence in one patient, and procidentia alone in one patient. No operative deaths occurred. Immediate complications included urinary retention in the three patients and hematoma in one patient. Late complications included infection, requiring removal of the Silastic sling in four patients; however, two of these patients underwent subsequent successful reinsertion of the sling after control of local sepsis. Among patients for whom follow-up data were available, satisfaction with the results of this procedure were excellent in two patients, good in six, fair in two, and poor in one. Sphincter repair with a Silastic sling is a safe, reliable alternative in the treatment of selected patients with anal incontinence or rectal procidentia.
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PMID:Sphincter repair with a Silastic sling for anal incontinence and rectal procidentia. 405 2

Within 7 years 4 cases of prolapse of the small bowel through the vaginal vault stump were observed. These occurred between 5 and 10 years following two cases of radical abdominal hysterectomy for cancer and two cases of vaginal hysterectomy and colporrhaphy. The small bowel was replaced three to six hours following the prolapse by median laparotomy. One patient died following late sepsis after the laparotomy.
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PMID:[Prolapse of the small bowel through the vaginal vault, following hysterectomy]. 655 21

A new inherited neuromuscular disease was identified in 4 patients (1 male, 3 females), offspring of consanguineous marriages, belonging to the same kindred. The proband was a 24-year-old female with history of ptosis and ophthalmoplegia since childhood and progressive intestinal pseudo-obstruction for the last 4 years of her life. A sural nerve biopsy showed axonal and demyelinating neuropathy. Muscle biopsies of pectoral and gastrocnemius revealed myopathic alterations with marked variation in muscle fiber size, atrophy of both fiber types and normal mitochondria. An upper gastrointestinal study showed barium in the stomach after 8 h and jejunal diverticula. Tests for absorption of fat, protein, carbohydrate, folic acid and vitamin B12 were normal. Serum levels of vitamin A and lipoproteins were also normal. The patient underwent partial gastrectomy and gastrojejunostomy. Postoperatively, she developed severe pancreatitis, sepsis, peritonitis and expired. Tissue samples from the proband and from her brother, revealed normal mucosa, but degeneration of smooth muscle of the stomach and small intestine. The myenteric plexus and vagus nerves were normal. The biochemical studies of contractile proteins (myosin, actin, tropomyosin) in the fresh and cultured smooth muscle cells of the proband obtained at the time of gastrectomy showed a 50-75% decrease in the synthesis of different contractile proteins. Turnover of contractile proteins and synthesis and turnover of collagen showed normal values. The reduction in synthesis of contractile proteins may account for the weak peristalsis and be a factor in the pathogenesis of the intestinal pseudo-obstruction.
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PMID:Inherited ophthalmoplegia with intestinal pseudo-obstruction. 668 98

This paper presents data on perinatal and maternal deaths occurring in the Black Lion Hospital, Addis Ababa, in 1980. The data were collected by a research midwife. A total of 3936 infants were delivered to 3868 women during this period. The stillbirth rate was 52.6/1000; the perinatal mortality rate was 8.6/1000; and the maternal mortality rate was 7.8/1000. Of the 207 stillbirths 92 (44.5%) were unexplained, 66 (31.9%) were due to mechanical causes (e.g., ruptured uterus, cord prolapse, obstructed labor), 34 (26.4%) resulted from pregnancy complications (e.g., hemorrhage,hypertensive disease, congenital abnormalities), and 15 (7.3%) were due to intrapartum death. There was no obvious pathology in 38 of the 84 neonatal deaths. The remaining cases were due to conditions such as intrapartum asphyxia, antepartum hemorrhage, septicemia, and congenital abnormalities. 10 of these death involved preventable factors. Of the 30 maternal deaths, 13 were due to sepsis, 9 to hemorrhage, 4 to surgical conditions, 3 to medical conditions, and 1 to eclampsia. Inadequate monitoring of shocked patients and the nonavailability of blood tranfusions contributed to some of these deaths. Although socioeconomic and cultural factors play a role in perinatal and maternal mortality, coordinated maternity services could produce short-term improvements. Such maternity services should embrace both primary care, with an emphasis on the training of traditional birth attendants and health assistants, and high-risk hospital care. Good prenatal care and monitoring can identify women at high risk and ensure that they receive adequate medical supervision.
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PMID:Maternal and perinatal deaths in an Addis Ababa Hospital, 1980. 674 50

A double-blind placebo controlled trial was embarked upon to study the prophylactic effect of intravenous metronidazole in the prevention of septic complications following gynaecological surgery. Comparison was made between the effect of a single dose only, given during the operation and that of a single dose given during the operation with an additional dose given 12 h later. 270 patients took part in the trial. These patients were admitted for elective hysterectomy, abdominal or vaginal, or for repair of uterovaginal prolapse. They were randomly allocated to one of three treatment groups. In group I, each patient received 500 mg/100 ml of metronidazole i.v. given over a 20 min period at the beginning of the operation followed by a second dose of 500 mg/100 ml of metronidazole i.v. 12 h later. In group II, the procedures were the same but the second dose was 100 ml of normal saline (placebo). In group III, both doses were 100 ml of normal saline. Out of 90 patients in group I, 2 patients (2.2%) developed postoperative sepsis. 8 patients (9.0%) out of 89 in group II developed sepsis. In the placebo group (group III) 19 patients (20.9%) developed sepsis. The results clearly indicate that a two-dose i.v. metronidazole regimen is highly effective in the prevention of post-operative sepsis in gynaecological surgery.
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PMID:A comparative study of the prophylactic effect of one dose and two dose intravenous metronidazole therapy in gynaecological surgery. 694 47

Twenty-two female patients (mean age 75 years) with complete rectal prolapse have been treated by operative fixation of the rectum to the sacrum using a perineal approach. There has been no operative mortality, sepsis or serious morbidity. Recurrence of complete prolapse has been seen once only within a month of operation and was due to inadequate operative fixation. The other 21 patients have been followed for up to 4 years. This type of operation may be the treatment of choice in the elderly patient considered unfit for major abdominal surgery but further experience is required before it can be advocated in other groups of patients.
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PMID:Perineal rectopexy for rectal prolapse. 702 58

94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of intrapartum mortality without maceration, 114 were caused by retroplacental hematomas, 61 by placenta previa, 74 by uterine rupture, 119 by prolapse of the cord, 51 by fetal malformation, 45 by dystochia, 53 by twin pregnancies, 104 by fetal distress, 44 by obstetrical trauma, 55 by prematurity, and 75 by undetermined causes. In 361 cases of early neonatal mortality, 88 were caused by renovascular syndromes, 24 by diabetes, 13 by Rh incompatibility, 34 by placenta previa, 94 by prematurity, 28 by fetal malformation, 35 by fetal infections, 31 by fetal distress, and 14 by obstetrical trauma. The rates of maternal and perinatal mortality are very high compared to those of European countries.
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PMID:[Maternal mortality and perinatal mortality]. 720 85

There have been many techniques applied to the repair of mitral valve prolapse, and the method used in a particular case is usually selected according to the position and extent of the lesion. To simplify and standardize the technique of mitral valve repair, we have adopted the resection, sliding plasty and ring annuloplasty methods since December 1992. Of 10 consecutive surgical cases, 2 involved prolapse of the anterior leaflet, 1 the posteromedial commissural, and 7 the posterior leaflet. One patient with posterior leaflet prolapse required valve replacement due to dehiscence of the plastied site on the 3rd postoperative day, and one died because of sepsis. However, the remaining patients were doing well without mitral regurgitation at a mean of 20 months (range: 8-32) after the operation. The advantages of these techniques include easy adjustment of the height of the leaflet and a good chance of long-term durability, since the affected lesion is resected.
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PMID:[Repair of mitral valve prolapse by resection and sliding plasty]. 764 1


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