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)

Nineteen patients (11 women and eight men) aged 20-68 received long-term parenteral nutrition, mostly at home, for six to 63 months (mean 19 months). Indications for LTPN were extensive, active Crohn's disease in three patients, intestinocutaneous fistulas in three, and short-bowel syndrome in the remaining 13 patients. Subclavian or intra-atrial (Broviac) catheters were most commonly used, for which the average life was four and seven months respectively. Complications of long-term parenteral nutrition included pneumothorax in four out of 48 subclavian vein punctures. Catheter-induced thrombosis of central veins was shown by phlebography 17 times in nine patients, and eight episodes of total occlusion occurred. Two of these patients had pulmonary infarction. Nineteen episodes of catheter sepsis occurred in 11 patients, but only one was fatal. Complications related to intestinal disease included intra-abdominal abscesses and intestinal fistulas, and disturbances of liver function. Five patients died, though in only two was death related to long-term parenteral nutrition. One of these patients died from catheter sepsis, the other had subdural haematoma possibly caused by anticoagulant treatment. Eight of the 14 surviving patients still needed parenteral nutrition. All received a disability pension, but six had an acceptable quality of life with almost normal social activities.Despite problems such as difficulties in maintaining standardised infusion programmes, it was concluded that long-term parenteral nutrition at home is practicable and consistent with an acceptable quality of life.
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PMID:Long-term parenteral nutrition. 9 99

The presence of acute pulmonary infarction is not uncommon in severely ill patients and is considered by some to be a contraindication to heart transplantation. It has been our policy to accept these patients for operation. The purpose of this investigation is to examine the results of this policy in patients receiving immunosuppression with cyclosporine A and azathioprine. Between September 1982 and April 1985, eight patients undergoing heart transplantation demonstrated clinical and radiographic evidence of acute preoperative pulmonary infarction. These patients represented 5.5% of our heart transplantation population during this period (total = 145). The age range in these eight patients was from 22 to 55 years. Congestive cardiomyopathy was present in four patients, and four patients had ischemic cardiomyopathy. All patients were New York Heart Association functional status class IV. Five of the eight patients were on inotropic support, and one patient had associated renal failure. Pulmonary infarcts were located in the right, middle, or lower lung field in seven patients and in the left lower lung field in one patient. All patients were treated perioperatively by intensive physiotherapy and specific antibiotics. In four patients the lesions resolved on medical treatment alone. Three patients developed extensive empyema and required chest drainage with or without decortication. Two of these patients survived with complete resolution of the lung lesions, and one patient died from prolonged renal failure and sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The influence of acute preoperative pulmonary infarction on the results of heart transplantation. 330 55

To determine the relative importance of multiple interrelated factors that have been considered to contribute to pulmonary infarction, the authors performed a discriminant analysis on consecutively autopsied patients with pulmonary embolism. From the clinic records of 45 individuals, the authors tabulated the underlying illness, history of valvular or ischemic heart disease, right and left ventricular failure, sepsis, shock, malignancy, premortem functional status, and the clinician's suspicion of pulmonary embolism. At postmortem examination, the authors measured and recorded the extent of emphysema, pneumonia, neoplasia, pulmonary vascular atherosclerosis; thickness and dilatation of both cardiac ventricles; the presence of valvular heart disease; the number, diameter, and amount of occlusion of the pulmonary arteries that contained thromboemboli; the extension of the clot, the size of the infarct; the Reid-Index; and the thickness of pulmonary and bronchial arterial wall. The major determinants of infarction were as follows: poor premortem functional status, the number of lobes having emboli, left ventricular failure, and the presence of lung cancer. The authors then tested the equation generated from these patients on 21 additional patients. The discriminant function correctly classified 81% of first group and predicted the occurrence of infarction in new patients with 70% accuracy. The size of the infarct was most correlated with the use of vasodilators and the embolic burden.
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PMID:Factors associated with pulmonary infarction. A discriminant analysis study. 401 73

Knowledge of common complications of central venous catheters is completed by a case of bacterial tricuspid endocarditis with recurrent pulmonary infarction. This rare, life threatening complication should be considered in differential diagnosis, when in case of central venous catheter sepsis, changing pulmonary infiltrations with pleural effusion as well as different auscultatory findings above the tricuspid valve do occur. The diagnosis can be supported by echocardiographic demonstration of tricuspid vegetations.
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PMID:[Tricuspid valve endocarditis with pulmonary infarction caused by central venous catheter (author's transl)]. 720 4

A new method of sealing fabric vascular prostheses with autologous adipose tissue was clinically applied as an alternative to preclotting with fresh blood. Thirty-six patients with peripheral arterial occlusive disease were implanted with highly porous fabric prostheses. The prostheses were prepared by sealing the fabric pores with autologous adipose tissue that had been chopped up into small pieces and enmeshed in the fabric by forceful injection of the tissue suspension through a syringe. There was no complication related to the sealed graft such as graft bleeding after implantation. In-hospital mortality occurred in 4 patients: 1 case each of pneumonia, pulmonary infarction, sepsis, and acute myocardial infarction. During the period of 274 +/- 190 days, 3 prostheses were found to be occluded. All the other grafts were patent. The overall patency rate was 91.4%. Postoperative angiography revealed neither intimal thickening at the anastomotic sites nor irregularity of the prosthetic surface. The method proved safe and useful for implantation of smaller caliber artificial grafts.
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PMID:Sealing of a fabric vascular prosthesis with autologous adipose tissue: a preliminary report of its clinical application. 774 39

The acute chest syndrome is a clinical entity appearing in patients suffering from sickle cell anaemia. It presents with pleuritic pain, fever, leucocytosis and pulmonary infiltrates in the thoracic radiology. The etiological diagnosis is difficult, and it is necessary to distinguish between pneumonia and pulmonary infarction. This syndrome is quite frequent among the patients at risk, and can be lethal according to the severity and the etiology of the event. A case of acute chest syndrome due to a S. pneumoniae sepsis is presented. The interest of the case lies in the rareness of this disease in our population and the peculiar evolutive clinical features of this case, with the development of intracranial hypertension and death.
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PMID:[Acute thoracic syndrome]. 798 60

Clostridial necrotising pneumonia is a rare complication of aspiration, bronchial tumour or foreign body, pulmonary infarction, trauma and debilitating medical conditions. Although spontaneous clostridial pneumonia has been reported previously, close scrutiny of those case reports suggests that most of the patients had a recognised predisposing cause. We report a case of true spontaneous Clostridium perfringens pneumonia complicated by septic shock, pneumothorax and pulmonary necrosis. The patient responded poorly to conventional treatment with benzylpenicillin, and although the addition of metronidazole produced dramatic resolution of the sepsis, lobectomy was required to effect cure.
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PMID:Spontaneous Clostridium perfringens lung abscess unresponsive to penicillin. 844 82

A retrospective study of 155 patients with submucosal gastric carcinoma compared the clinicopathologic features with mucosal and muscularis proprial gastric carcinoma. Fifty-seven percent of the patients presented with gastrointestinal symptoms, whereas 36.1% had been detected by mass screening. The incidence of curative resection, lymph node metastasis, and complications were 96.1, 20.6, and 14.8%, respectively. Two patients died of sepsis and pulmonary infarction 30 days post-operatively. Five patients died of recurrent gastric cancer 1-5 years postresection. The overall 5-year survival rate was 90.2%. Recurrence patterns, histologic type, lymph node metastasis, lymphatic and venous infiltration, and growth pattern were similar to those of muscularis proprial carcinoma rather than mucosal carcinoma. Therefore, curative gastrectomy with extended lymphadenectomy (D2) may be feasible for submucosal carcinoma of the stomach.
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PMID:Clinicopathologic features of submucosal carcinoma of the stomach. 917 33

Factors that predispose pulmonary thromboembolism to infarction have not been completely understood. The present autopsy study was carried out to evaluate these factors both clinically and pathologically. Between 36 subjects with pulmonary infarction and 33 individuals who had multiple pulmonary thromboembolism but no infarction, clinical and pathological features including congestive heart failure (CHF), shock, sepsis, neoplasm, emphysema, pneumonia, the amount of pleural effusion, diameter of occluded arteries, and segmental and dimensional location of thromboemboli were compared. Multiple regression analysis revealed that clinically CHF was significantly associated with the development of infarction. In pathological factors, thromboemboli located in the distal artery and in the lower lobe were significantly associated with infarction. The size of the infarcts was small and all the complete infarcts were in contact with the pleura. In addition to CHF, occlusion of small arteries in the lower lobe and near the pleura seems to be associated with the occurrence of infarction.
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PMID:Correlation between clinical and pathological features of pulmonary thromboemboli and the development of infarcts. 976 21

Mortality of meningococcal septicemia remains high in spite of the improvement of antibiotics treatment and critical care medicine. A 23-year-old male, who had been well until a day earlier, was admitted to the hospital because of a high-grade fever and headache. On the second hospital day, he was still febrile, and it was confirmed that he had disseminated intravascular coagulation. There was no purpuric skin lesion, and a lumbar puncture revealed no abnormality. The condition was complicated by a splenic infarction on the second hospital day, and he suffered a pulmonary infarction on the 8th hospital day. The blood culture was positive for Neisseria meningitidis, making the diagnosis meningococcal septicemia. He was successfully treated with antibiotics and intensive care. Although meningococcocemia in adults is relatively rare in Japan, the disease mortality is still high even in the modern era. Then, once the diagnosis is suspected, it is essential to keep in mind that meningococcal infection requires early recognition of the disease process, prompt initiation of adequate antiinfectious therapy and intensive treatment of multiorgan failure.
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PMID:[Meningococcocemia complicated by disseminated intravascular coagulation, splenic infarction and pulmonary thromboembolism in a young adult: case report]. 1135 26


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