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

The clinical course of acute postabortion renal failure was studied in 97 18-45 year old women. The condition was the result not only of disorders of stability of the internal media of the body but also the result of major hermorrhage, intravascular hemolysis, allergic reactions, and sepsis. Active complex treatment is recommended.
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PMID:[Characteristics of clinical course of acute post-abortion renal insufficiency]. 116 59

The onset of infective phenomena following abdominal surgical operations requires a full assessment based on the danger of septic intraperitoneal focus, which can only be cured by surgery. The indications for re-operation depend on the presence, or absence, of two types of symptom: Firstly, the existence of local signs, such as peritonitis, intestinal obstruction, whether clinically or on XRay. Furthermore, the onset of general signs, such as septicemia, septic shock, acute organic renal failure, or interstitial pneumonia, may lead to re-operation, even in the absence of local abdominal signs, provided one has eliminated any obvious extra-peritoneal septic focus.
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PMID:[Indications for re-operation for infectious complication of abdominal surgery]. 119 86

After a criminal abortion, a 21-year-old woman developed clostridial sepsis, massive hemolysis, shock, and protracted renal failure. Anuria was present for 3 weeks and hemodialysis was required for 35 days. Because of the prolonged anuria, the patient was thought to have irreversible renal cortical necrosis. A renal biopsy demonstrated tubular necrosis only. Shortly after the biopsy procedure, urinary volumes began to increase, and renal function gradually returned to normal levels. This case demonstrates that a protracted course of renal failure following clostridial infection is not necessarily due to cortical necrosis but may result from tubular necrosis, and renal function may return to normal.
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PMID:Recovery after prolonged anuria following septic abortion. 124 89

Furosemide frequently is advocated as a prophylaxis against renal failure in septic and injured patients; this effect is thought to be secondary to an increase in renal blood flow. This postulate was tested within 72 hours of admission in 22 previously healthy patients with acute pancreatitis (two), massive trauma (ten), or severe sepsis (ten). Renal clearances of inulin (GFR), para-amino hippurate (ERPF), sodium (CNA), osmoles (COsm), and free water (CH2O) were measured in milliliters per minute before and after the intravenous infusion of furosemide (0.5 mg. per kilogram of body weight). Renal vein PAH levels (EPAH) in eight patients were used to calculate true renal plasma flow (TRPF), true renal blood flow (TRBF), and renal vascular resistance (RVR). Furosemide caused a significant increase in urine volume, CNa, and COsm; there were no significant changes in GFR, ERPF, RVR, TRBF, and EPAH. These findings also were observed when the patients were subgrouped according to elevated, normal, or low renal plasma flow and elevated renal vascular resistance. No significant changes were seen in EPAH, thus making a redistribution of renal blood flow unlikely. These studies indicate that furosemide has only a diuretic effect and no hemodynamic effect in the kidney; it has the potential of seriously reducing the circulatory volume and causing renal failure in critical patients.
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PMID:Renal hemodynamic response to furosemide in septic and injured patients. 126 63

Candida sepsis is a very serious complication in severely burned patients. This mainly affects patients whose immune system is weakened by illness and/or by drugs. Often diagnosis is difficult because candida sepsis occurs after an initial infection, but therapy is always difficult. Good fungicidal drugs are available, but their side effects limit their effectivity. Two severely burned patients who were suffering from a gram-negative sepsis confirmed by clinical and laboratory data developed candida sepsis. Conventional therapy failed, and both patients suffered from renal failure with constantly high candida-latex-antigen titre. By means of the liposomal encapsulated amphotericin B, which has the same fungicidal effect as amphotericin B, but without its limiting side effects, both, patients could be saved. The kidneys functioned as normal again, the laboratory findings were normal when the patients were discharged.
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PMID:[Candida infection in the severely burned patient--a successful treatment concept with liposomal amphotericin B]. 128 49

A case of a severe Candida sepsis is reported, which was treated successfully by a combination therapy of flucytosine with fluconazole. After an extensive abdominal operation, a 70-year-old man developed a syndrome of fulminant sepsis due to Candida albicans with the beginnings of renal failure. The latter fact forced us to search for a therapeutic alternative to the classical amphotericin B plus flucytosine combination therapy.
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PMID:Successful treatment of a Candida albicans sepsis with a combination of flucytosine and fluconazole. 130 6

A child with systemic lupus erythematosus who has been treated with prednisone for three years, developed crusted scabies. Scrapings from lesions revealed Sarcoptes scabiei adult mites mad eggs. The patient died with septicemia and renal failure soon after starting topical 20% sulfur. A marked improvement was observed in the cutaneous lesions.
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PMID:Crusted scabies in a child with systemic lupus erythematosus. 130 69

Continuous hemodialysis is advantageous for the treatment of renal failure in critically ill patients. This study reports our experience in the treatment of emergencies during chronic renal failure with continuous hemodialysis using a Cuprofane membrane. Eighteen patients with acute decompensations of chronic renal failure were treated with continuous hemodialysis (14 arteriovenous and 4 veno-venous). Procedures lasted a mean of 44.2 h, blood urea nitrogen decreased from 150.3 +/- 49.8 to 60.6 +/- 30.7 mg/dl, metabolic acidosis was corrected raising serum bicarbonate from 10.1 +/- 44 to 17.8 +/- 3.3 mEq/L and hyperkalemia was corrected. Mean ultrafiltration was 239.6 +/- 124.6 ml/h which allowed to withdraw a mean 10.590 ml of ultrafiltrate. Two patients were complicated with femoral artery pseudoaneurysms and one patient with a catheter related sepsis. Global mortality was 16.7%, which compared favorably with the 32.1% predicted mortality according to the Simplified Acute Physiology Score. It is concluded that continuous hemodialysis, a readily available procedure, is suitable for the treatment of emergencies during chronic renal failure.
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PMID:[Continuous hemodialysis in the treatment of chronic renal insufficiency in emergencies]. 134 79

In the patient with metastatic carcinoma, urinary diversion is usually achieved with indwelling ureteral stents or placement of a percutaneous nephrostomy tube. Most forms of surgical diversion carry an unacceptable morbidity rate, especially in the debilitated patient. Over a fifteen-year period (1974-1989), 29 adult patients with pelvic malignancy (32 ureters) underwent palliative cutaneous ureterostomy. This previously reported technique involves transverse nephropexy and construction of a stoma using a small skin flap. Indications included ureteral obstruction or severe urinary tract symptoms. Hydroureter, often considered a precondition for this procedure, was not present in several patients and was not a prerequisite to success. Complications related to the procedure included one postoperative death due to stroke, one death due to uremia and sepsis, and one instance of severe renal arterial stenosis resulting in renal failure. Preservation of renal function was possible in the 10 patients known to have survived from one to thirteen years postoperatively; only 3 patients eventually required stomal revision. By adherence to the surgical techniques described, the usually high incidence of stomal stenosis was avoided. Our experience reveals that although the indications for cutaneous ureterostomy are limited, this procedure can provide an alternative to permanent nephrostomy drainage or to a higher risk intestinal urinary diversion in carefully selected patients with a reasonable life expectancy.
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PMID:Cutaneous ureterostomy in adults. 137 44

Extracorporeal membrane oxygenation (ECMO) is effective for newborns with pulmonary failure unresponsive to conventional therapy. However, ECMO for the older child and adult has been controversial and not widely utilized. Over 4 years, 24 patients (aged 4 months to 16 years; 11 boys, 13 girls) underwent venoarterial ECMO (duration, 7 to 19 days) for respiratory failure. The diagnoses were: viral pneumonia (7), hydrocarbon aspiration (6), sepsis with adult respiratory distress syndrome (ARDS) (2), bacterial pneumonitis (2), tracheal stenosis (1), bilateral pulmonary contusion (1), diaphragmatic hernia with ARDS (1), ketoacidosis with ARDS (1), pulmonary artery injection of hydrocarbon (1), drowning (1), and epiglottis with barotrauma (1). Pre-ECMO blood gas ranges (and means) were PO2 18 to 65 (46), and PCO2 47 to 112 (65). Nineteen patients received dopamine, dobutamine, or other inotrope for associated cardiac and/or renal failure. Cannulation for ECMO was through neck or groin vessels in 17, and sternotomy in 7. ECMO flow rates were 150 to 250 mL/kg/min, to maintain PO2 greater than 100 and PCO2 less than 40. Nine patients (41%) survived ECMO, with eight long-term survivors, (4 hydrocarbon aspiration or injection, 1 pulmonary contusion, 1 viral pneumonia, 1 ARDS, 1 barotrauma), three of whom have mild neurological deficit. All patients with sternotomy, and 8 of 15 with neck and/or groin cannulation, required 1 to 5 explorations for hemorrhage while on ECMO. All survivors had primarily pulmonary failure; patients with combinations of pulmonary, cardiac, and renal failure did not survive. ECMO can be life-saving in the child with isolated pulmonary failure, but its efficacy in patients with multiorgan failure is uncertain.
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PMID:Prolonged extracorporeal support for nonneonatal respiratory failure. 140 44


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