Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MRSA (methicillin-resistant Staphylococcus aureus) infection was admitted to 4 cases out of 171 cases that carried out the home medical treatment and exist to, period until to March, in 1998 with this hospital in April, in 1986. As for age, a sex distinction was a mal whichere from 63 years old to 78 years old. A cause disease that reached to home medical treatment was brain blood vessel obstract 2 cases, spine damage 1 case, pulmonary emphysema 1 case. MRSA disappeared with many times wound treatments and a calorie by intra venous hyper alimentary increase that a bed sore cases. An intestinal case was seen a sepsis and candida, MRSA dermatitis with MRSA dermatitis. Bthing servis of it passes, start vancomycin hydrochloride administration peculiar to transnasal tube with improved. The respiratory case pass under tracheostomy tube control with balloon and the detection of MRSA is not admitting with diabetes control with mouth ingestion. It exists and as for MRSA infection the risk of severe infection concurrence is few with only settlement unlike an in hospital a home medical treatment cases with. If an enfeebled persons inside a home are paid attention rigid control is unnecessary. Most important thing are control of local area and improvement of whole body, and whole body.
 ...
PMID:[MRSA infection concured and exsited and the examination of a home cases]. 988 47

Bronchial rupture is a rare but severe complication of intubation with a double-lumen tube. Cardinal symptoms are mediastinal and subcutaneous emphysema as well as pneumothorax. Larger injuries result in an air leak and the endtidal carbon dioxide decreases. The gas exchange may worsen drastically when mucosal prolapse or bronchial haemorrhagia lead to bronchial occlusion. Mediastinitis or sepsis can be the sequel of the opened mediastinum. If bronchial injury is suspected probably fibreoptic bronchoscopy is indicated. We report on a case of bronchial rupture due to overinflation of the endobronchial cuff or movement of the inflated cuff when repositioning the patient. The conservative therapy was successful in spite of the fact that surgical intervention is recommended in the literature following bronchial rupture. To avoid tracheobronchial injuries an adequate tubus size must be selected. The more flexible polyvinylchloride (PVC) tubes without a carinal hook should be preferred to the Carlens tube. An atraumatic intubation is promoted by leaving the stylet inside after the tip of the tube has passed the vocal cords. To identify the minimum occlusive pressure of the endobronchial cuff for lung isolation different methods are described and should be used. The cuff has to be deflated when the patient is repositioned and when one-lung-ventilation is not required. Tumours of the tracheobronchial tree and weakness of the bronchial wall caused by steroid hormone therapy or COPD may increase the risk of tracheobronchial laceration.
 ...
PMID:[Diagnosis, procedures and conservative therapy of a bronchial rupture after intubation with double-lumen tube]. 1007 58

We report the case of a 42 years old, non-immunocompromised native Austrian living in Vienna. He presented at home with severe dyspnea and had to be intubated immediately. Shortly after hospital admission, he developed severe adult respiratory distress syndrome (ARDS) and septic shock with massive, bilobar patchy to confluent infiltrations and a need for norepinephrine. A CT-scan revealed severe loss of functional lung tissue with areas of consolidation and multiple communicating cystic spaces. Air leaking into the mediastinum through fistulas produced pneumomediastinum, pneumoperitoneum, and a massive soft tissue emphysema. Bronchoalveolar lavage performed within the first 24 hours of admission revealed + of acid-fast bacilli. Even though appropriate tuberculostatic medication was started immediately, the patient succumbed the next day to ARDS due to massive tuberculous pneumonia and miliary disease (Sepsis tuberculosis gravissima).
 ...
PMID:Fulminant lethal tuberculous pneumonia (Sepsis tuberculosis gravissima) with ARDS in a non-immunocompromised western European middle-aged man. 1019 49

The proteinase-proteinase inhibitor balance plays an important role in mediating inflammation-associated tissue destruction. alpha 2-Macroglobulin (alpha 2M) is a high-affinity, broad-spectrum proteinase inhibitor found abundantly in plasma and interstitial fluids. Increased levels of alpha 2M and proteinase-alpha 2M complexes can be demonstrated in patients with sepsis, emphysema, peridontitis, rheumatoid arthritis, and other inflammatory diseases. Despite these increased levels, proteolysis remains a significant problem. We hypothesized that a mechanism for inactivating alpha 2M-mediated proteinase inhibition must exist and recently demonstrated that alpha 2M isolated from human rheumatoid arthritis synovial fluid is oxidized and has decreased functional activity. The oxidant responsible for alpha 2M inactivation and the mechanism of such destruction were not studied. We now report that while hypochlorite and hydroxyl radical both modify amino acid residues on alpha 2M, only hypochlorite can abolish the ability of alpha 2M to inhibit proteinases. Hydrogen peroxide, on the other hand, has no effect on alpha 2M structure or function. Protein unfolding with increased susceptibility to proteolytic cleavage appears to be involved in alpha 2M inactivation by oxidation. The in vivo relevance of this mechanism is supported by the presence of multiple cleavage fragments of alpha 2M in synovial fluid from patients with rheumatoid arthritis, where significant tissue destruction occurs, but not in patients with osteoarthritis. These results provide strong evidence that hypochlorite oxidation contributes to enhanced tissue destruction during inflammation by inactivating alpha 2M.
 ...
PMID:Mechanism of hypochlorite-mediated inactivation of proteinase inhibition by alpha 2-macroglobulin. 1052 45

Our objectives were to evaluate the frequency of air leaks (AL) from the respiratory tract (pneumothorax, pneumomediastinum, pneumoperitoneum, subcutaneous emphysema) in critically ill children on mechanical ventilation (MV) for severe respiratory diseases, and to examine whether AL could be correlated with specific clinical events or ventilator settings. The study constitutes a retrospective cohort of 80 consecutive critically ill children receiving MV for severe respiratory diseases between 1986 and 1993. Patients (mean age 2.9 +/- 0.6 years, 49 males and 31 females), were admitted to the Pediatric Intensive Care Unit (PICU) with acute respiratory syndrome (ARDS) (27%), asthma (15%), bronchiolitis (10%), pneumonia (21%), pulmonary congenital diseases (9%), or foreign body aspiration (18%). Patients were divided into two groups; those with AL (n=22) and those without air-leaks (non-AL) (n = 58). Air leaks developed in 22 of 80 patients or in 27.5%. Survival was significantly lower in the AL group, compared to the non-AL group (41% vs. 76%, P < 0.01). The odds ratio that a patient with multiple organ system failure (MOSF) or infection would develop AL was 2.96 and 2.19, respectively. Candida and Pseudomonas species were recovered with significantly higher frequency in the AL group compared with the non-AL group (P < 0.025). There was a strong positive correlation between the incidence of AL and high ventilatory pressures (PIP 36 vs. 29.7 cm H(2)O, P < 0.001), or large tidal volumes (V(T) 12 vs. 9 mL/kg, P < 0.05), suggesting that large volumes might elicit injury to the pulmonary epithelium. Multiple logistic regression analysis showed that only V(T) was independently associated with the development of AL in children with primary severe respiratory disease (r(2) = -0.38, P = 0.01). In conclusion, MV will produce AL, particularly when high peak airway pressures (barotrauma) or large tidal volumes (volotrauma) are delivered by the ventilator. Sepsis, MOSF, and lung superinfection with Pseudomonas or Candida species may be also important factors in the development of AL in critically ill children.
 ...
PMID:Air leaks from the respiratory tract in mechanically ventilated children with severe respiratory disease. 1063 3

Persistent pulmonary hypertension of the newborn (PPHN) remains one of the most challenging situations in the neonatal intensive care unit, and it is associated with high mortality and morbidity. The optimal treatment for PPHN is controversial. We report our 9-year experience in the management of PPHN through a retrospective review of 29 neonates with persistent pulmonary hypertension. The diagnosis of PPHN is made by echocardiography and/or preductal and postductal oxygen tension difference. The treatment modalities include supportive medical care, vasodilator therapy, mechanical ventilation and correction of underlying conditions. The wide diversity of etiologies of PPHN, the complications of vasodilator therapy, the management of assisted ventilation, the mortality and the morbidity are evaluated. There are 29 patients enrolled in this study, including 18 male and 11 female babies. Twenty-two patients (72%) are referred from other hospitals. The mean birth body weight is 2707 +/- 693 grams (range: 1450-4100 grams) and the mean gestational age is 37.1 +/- 3.1 weeks (range: 31-41 weeks). The underlying clinical conditions include meconium aspiration syndrome (n = 8), perinatal asphyxia (n = 7), respiratory distress syndrome (n = 5), sepsis and/or pneumonia (n = 4), congenital diaphragmatic hernia (n = 3) and idiopathic persistent fetal circulation (n = 2). In addition to supportive medical care and correction of underlying clinical conditions, most of the patients receive vasodilator therapy (Tolazoline) and nonhyperventilation respirator management. The overall mortality rate is 27.6% (8/29). The duration on ventilator therapy in the survival group (9.3 +/- 8.6 days) is not significantly different from in the mortality group (6.0 +/- 7.1 days) (p = 0.13). There is also no statistically significant difference between these two groups both in the maximal alveolar-arterial oxygen tension difference (594 +/- 53 mmHg and 613 +/- 37 mmHg, p = 0.145) and in the maximal oxygenation index (49.7 +/- 29.6 and 61.1 +/- 36.9, p = 0.172) before vasodilator therapy. However, twenty-four hours after treatment, these two parameters change significantly with the former changes to 426 +/- 198 mmHg and 643 +/- 7 mmHg, respectively (p < 0.001), and the latter changes to 21.6 +/- 15.8 and 82.3 +/- 54.8, respectively (p < 0.001). Skin rash, gastrointestinal hemorrhage, hypotension and hyponatremia are the most common complications of Tolazoline therapy. Eight patients have pulmonary complications including pneumothorax (n = 5) and pulmonary interstitial emphysema (n = 3). Two patients develop chronic lung disease. Three patients have neurodevelopmental handicap. In conclusion, we achieve a survival rate of nearly 75% in PPHN mainly with the administration of Tolazoline therapy and the nonhyperventilation respirator approach. Further well-controlled and multicenter studies with newer treatment modalities are crucial for the improvement of survival of PPHN in Taiwan.
 ...
PMID:Persistent pulmonary hypertension of the newborn: experience in a single institution. 1135 72

A triad of signs constitutes Boerhaave syndrome: forceful vomiting, chest pain and subcutaneous emphysema. The syndrome results from spontaneous rupture of the oesophageal wall leading to an oeso-pleural or oeso-mediastinal fistula. Positive diagnosis is established with a water-soluble swallow, sometimes coupled with computed tomography of the thorax. Boerhaave syndrome is a surgical emergency. We report three cases of spontaneous rupture of the oesophagus and analyze the importance of emergency surgery as well as emergency treatment of the sepsis, an important prognosis factor.
 ...
PMID:[Spontaneous rupture of the esophagus or Boerhaave syndrome. Report of 3 cases and review of the literature]. 1188 72

Sterilization is most often indicated when the desired family size is reached and no more children are desired. Because of technical advances and societal changes surgical sterilization is increasingly becoming the most utilized method of contraception. Since female sterilization is more common, several methods have been devised to make it safe and reliable. The traditional large abdominal incision (laparotomy) is now replaced by minilaparotomy, which is a small abdominal incision. Other techniques, such as transvaginal and trancervical approaches require no incision at all. These method permit occlusion of any part of the fallopian tube. Minilapatomy is the recommended method of female sterilization for 3rd world countries. Laparoscopic sterilization appears to be more psychologically acceptable to 3rd world women who have an inherent dread of surgery. A higher incidence of hematoma formation has been reported in puerperal laparoscopic sterilizations and the failure rate is also higher than in other methods. Other complications associated with laparoscopic sterilization include wound sepsis, surgical emphysema of the parieties and uterine perforation. Laparoscopic sterilizations can be performed under local, general, spinal or epidural anesthesia. Local and general anesthesia is the commonest. Both tubal ligations and vasectomies have been available in Malaysia since the 1960s. Laparoscopy was 1st introduced in Malaysia in the early 1970s. Several laparoscopy centers have been established in Malaysia to provide specialized family planning services. Outpatient laparoscopic sterilization is a feature of the Kuala Lumpur Specialist Center. Traditonally doctors and specialists in Malaysia received their practical training in sterilization techniques during their internship or residency. Since 1980, however, a formal training program was initiated. Because laparoscopy provides interval sterilization without major abdominal surgery, this procedure has played a major role in promoting acceptance of female sterilization. The use of mass media to promote sterilization has not been fully utilized because of religious and political sensitivities.
 ...
PMID:Some aspects of the sterilization program in Malaysia. 1226 15

Measles is caused by a virus which exclusively affects humans. Erroneously it has been considered benign, although it causes high morbidity and mortality because of the complications it precipitates. The Expanded Program of Immunization estimated that 1.5 million children in the world die every year because of measles. The objective was to analyze the incidence of measles and complicated measles in children who had been admitted to Dr. Robert Reid Cabral Pediatric Clinic, Santo Domingo, Dominican Republic, during the period of January 1991 to January 1992. A total of 311 patients were enrolled with the diagnosis of measles during the 13 months of the study, with an average of 24 cases per month. October and December were the months when most patients presented with measles: respectively, 56 (18%) and 60 (19.4%) patients of the total caseload. Pneumonia was the most frequent complication with 277 cases (87.1%), followed by acute diarrheal disease with 25 cases (8.0%). The most affected was the 1-3 year age group with 143 patients (46.0%). In 135 cases (43.4%) the children with measles had not been vaccinated; only 72 patients (23.3%) had received vaccination. Furthermore, 104 patients (33.3%) did not know their vaccination history. 170 patients (54.7%) were malnourished. During the study period 37 children (11.9%) died in the hospital and 24 of these children (64.9%) died as a result of the complication of pneumonia. Other causes of death were: laryngotracheitis (4), encephalitis (3), subcutaneous emphysema (4), and septicemia (2). This investigation showed that pneumonia is a very grave complication in malnourished children and in children under one year of age.
 ...
PMID:[Incidence of measles with complications]. 1234 61

Between January 1997 and June 2002, we retrospectively reviewed the records of all premature infants (birth weight less than 2000 g) admitted to the newborn intensive care unit (NICU) at Chi Mei Medical Center. Among the 399 premature infants (birth weight less than 2000 g) surviving more than one week, 111 infants were diagnosed with patent ductus arteriosus (PDA). Seventeen premature infants underwent surgical closure of PDA after failure of indomethacin treatment. The indication for surgical closure of PDA was ventilator dependence and/or congestive heart failure in infants with echocardiographic evidence of a ductus arteriosus. The mean gestational age and birth weight were 26.9 +/- 2.4 weeks (range 23-32 weeks) and 978.8 +/- 360.1 g (range 494-1920 g), respectively. The mean age and weight at the time of operation were 28.1 +/- 12.4 days (range 13-61 days) and 950.8 +/- 390.4 g (range 402-2120 g), respectively. All the operation procedures were performed in our NICU, using operating room personnel, thus eliminating the risks of patient transport. There was no intraoperative death. Three infants died in hospital due to other problems. One died of sepsis and the other two died due to bronchopulmonary dysplasia (BPD) and suspected sepsis. There were only two infants who had complications after surgical closure of PDA. One infant had left pneumothorax with subcutaneous emphysema and the other one had right upper lung collapse. We conclude that surgical closure of the PDA for the premature infant can be a safe and effective procedure performed in the NICU, when indomethacin closure is ineffective or contraindicated.
 ...
PMID:Surgical closure of patent ductus arteriosus in preterm infants at neonatal intensive care unit. 1496 85


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>