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

Between January 1, 1974, and December 31, 1978, patients over 50 years of age underwent colon resections in three West Virginia Hospitals. The patients were studied by decades of age to compare the operative risks in younger and elderly patients. Preoperative assessments of cardiovascular, pulmonary, renal, hepatic, metabolic and nutritional states were compared with the postoperative morbidity and mortality rates. Complications occurred in 33% of all the patients who had resections, with 17 (4.8%) deaths. Mortality rates compared by decades of age correlated with the number of pre-existing conditions, and not with age as an isolated factor. There were no deaths in patients with no pre-existing conditions. The rate of infectious complications increased because the number of emergency procedures increased. This was also true for the mortality rate. Preoperative pulmonary and nutritional problems were significant contributing factors in the patients who died from sepsis. Careful preoperative assessment, correction of pre-existing pulmonary and nutritional deficiencies, and avoidance of emergency procedures may improve the morbidity and mortality rates associated with colon resections in elderly patients.
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PMID:Operative risk factors of colon resection in the elderly. 744 28

Severe anemia has remained a major cause of morbidity and mortality in children of Southern Ghana since the early 1960s. Cases of anemia and anemia-associated mortality in the Korle Bu Teaching Hospital (KBTH), Accra, that occurred from January to December 1991 were reviewed. Data on hemoglobin levels, hypochromia, and malaria parasitemia of children referred from January to December 1991 were collected and analyzed to determine the prevalence of moderate/severe malaria parasitemia, anemia, and severe anemia. 10,989 (71.1%) of 15,450 children attending KBTH referred to the laboratory for hematological studies had hemoglobin (Hb) levels below 11.0 g/dl; while 3049 children (27.7%) of anemic patients had Hb levels below 7.0 g/dl. Of these 3049 children with severe anemia, 2185 (71.7%) had Hb levels below 5.0 g/dl, thus requiring urgent blood transfusion. Though the Department of Child Health alone utilized 32.2% of total blood processed by the National Blood Transfusion Service at KBTH, as many as 259 (58.1%) of the 554 deaths (306 male and 248 female) in the emergency room in children beyond the neonatal period were related to severe anemia. The main causes were nutritional anemia (n = 135), anemia associated with severe malaria (n = 56), anemia associated with sickle cell disease (n = 28), anemia associated with protein-energy malnutrition (n = 22), and 18 cases of anemia complicating gastroenteritis, pneumonia, meningitis, and convulsions. 108 (19.5%) deaths occurred because of neonatal sepsis, severe neonatal hyperbilirubinemia, meningitis and bronchopneumonia, severe anemia secondary to hemorrhage of the newborn, and faulty cord ligation. A significant decline occurred in the prevalence of childhood anemia in the developed world following improved counseling in nutrition, fortification of foods with iron, and iron supplementation to infants and schoolchildren with the attendant improvement in growth velocity and intellectual performance. A planned national anemia survey and early consideration of iron supplementation to older infants and preschool children at risk are recommended.
West Afr J Med
PMID:Childhood deaths from anaemia in Accra, Ghana. 749 16

Of the 587 neonates born in ABUTH, Zaria, Nigeria and successfully followed up, 99 were clinically jaundiced (16.9%). Of these, only 38 (38%) had significant hyperbilirubinaemia (serum bilirubin above 170 umol/L). During the same period, 279 neonates were admitted through Emergency Paediatric Unit (EPU) of whom 70 (25%) were jaundiced and 64 (95%) of them had serum bilirubin above 170 umol/L. Jaundice was more severe and the incidence of kernicterus higher in babies born outside the hospital than in those born in hospital and periodically followed up. The incidence of kernicterus was 20.3% and 2.6% respectively. The pattern of aetiological factors was similar in the two groups of jaundiced neonates. Septicaemia (50%) and G6PD deficiency (40%) were the major aetiological factors. Exposure to traditional herbal medications, oxytocin induced/augmented labour, cephalhaematoma and tribal incidences did not play statistically significant roles. Jaundice due to Rh-incompatibility was not encountered. Results of this double prospective study were compared with the previous findings in this and other centres in Nigeria.
West Afr J Med
PMID:Neonatal jaundice in Zaria, Nigeria--a second prospective study. 762 27

The characteristics of brain abscess in the Central Province of Saudi Arabia are outlined in this report which is a review of 22 consecutive cases that were treated at King Khalid University Hospital between 1985-1991. The incidence of brain abscess in Saudi Arabia is calculated to be 3.6 cases/500,000 population/year which is twice as high as the incidence reported from the West. There were 17 males and 5 females with an age range of 8 months-80 years (mean 29.9 years). The parietal lobe was involved in 27%, while the abscess was in the posterior fossa in 14% and multiple in another 14% of cases. The primary source of sepsis was unknown in 50%, post-traumatic in 18% and from a dental and mastoid origin in 14% of cases only. Duration of symptoms ranged between 4-30 days (mean 12 days). Fever was present in 55% of cases and epilepsy in 23%. Sixteen (73%) cases had burr hole aspiration, while 3 (14%) had craniotomy and excision, and 3 (14%) cases were managed with antimicrobial treatment only. Staphylococci were the pathogens in 27%, while streptococci were cultured in 23% cases and the culture was negative in 23%. Three (14%) cases all of which died had fungal abscesses caused by Fonsecaea pedrosoi. The mortality was 18%, good recovery in 68% and fair recovery in 14%. Follow-up was from 3 months to 5.5 years (mean 1.8 years).
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PMID:Experience with brain abscess in the central province of Saudi Arabia. 794 Oct 5

Liver specimens obtained immediately after death from eight severely malnourished children were examined by electron microscopy, and compared with seven liver biopsy specimens from children who had recovered from malnutrition. The liver cells from the fatal cases showed mitochondrial swelling, with coarse densities in the matrix, cholestasis, depletion of the endoplasmic reticulum and Golgi apparatus, diminished glycogen stores, prominent lipid deposits and focal cytoplasmic degradation. The nucleoli were enlarged. There was marked reduction in peroxisomes. In contrast, the biopsies from recovering children showed good cellular organisation, and a normal frequency of peroxisomes. Multiple factors, including sepsis, may lead to depletion of peroxisomes. Loss of peroxisomes may interrupt beta-oxidation of long-chain fatty acids and accentuate the accumulation of lipid. Moreover, a reduction in the concentration of catalase may remove one avenue for the detoxification of free radicals. As the concentration of other anti-oxidants, notably glutathione, is also reduced, free radical damage may occur, leading to lipid peroxidation of membranes, mitochondrial damage, pump failure and influx of water and electrolytes into the cell.
West Indian Med J 1994 Mar
PMID:Peroxisomes and the hepatic pathology of childhood malnutrition. 803 10

A comprehensive management plan is presented for patients with severe acute pancreatitis. These patients may have pancreatic or peripancreatic necrosis or pancreatic fluid collections. Multiple organ failure often develops in patients with severe pancreatitis. We therefore recommend that all patients with acute pancreatitis be evaluated for pancreatic anatomy and function. If a patient is seriously ill, a computed tomographic (CT) scan with vascular enhancement should be done. Meanwhile, vigorous fluid replacement is necessary using Swan-Ganz monitoring. Patients with necrosis do not need surgical intervention unless the clinical course or CT scan-guided aspiration shows infection. The objective of an operation should be to remove all infected tissue and fluid. A preoperative CT scan with vascular enhancement should be used as a guide during the operation to ensure that all foci of infected necrosis or fluid are eliminated. We have found that open packing and irrigation with sodium oxychlorosene are helpful in patients with extensive necrosis or those who become infected early after the onset of symptoms. In all, 40% to 50% of patients treated by closed drainage will require reoperation because of incomplete debridement. Persistent sepsis is an indication for reoperation.
West J Med 1993 Dec
PMID:Management of necrotizing pancreatitis. 812 95

Haemophilus influenzae strains of serotype a very rarely cause life-threatening infections. Examination of strains from the Gambia, West Africa, that caused septicemia, meningitis, or both revealed that a clone has emerged that carries a DNA deletion previously identified only in type b strains that is hypothesized to contribute to the special virulence of that serotype. This clone appears to have arisen by transfer of DNA between type a and type b strains, a transformation event that has happened more than once, as shown by the discovery Kenya, East Africa, of a clonally distinct type a strain bearing the identical deletion. The implications for the emergence of clinically important non-type b strains of H. influenzae are obvious.
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PMID:Natural genetic transfer of a putative virulence-enhancing mutation to Haemophilus influenzae type a. 815 50

Retrograde urethrography is a valuable diagnostic aid of lesions in the urethra. It, however, has inherent hazards in the form of urethrocavernous and urethrovascular reflux of contrast medium, particularly in the presence of inflammatory urethral stricture. A case of massive urethrocavernous and urethrovascular reflux is reported. The dangers of such systemic reflux of urethral contents, including pathogens and contrast material are highlighted. Observation of reflux during retrograde urethrography exposes the patient to bacteremia and sepsis, and this fact must not be overlooked by the radiologist and the clinician. Prompt admission of the patient with adequate prophylactic antibiotic cover is the rule in such situation.
West Afr J Med
PMID:Urethrocavernous and urethrovascular reflux of contrast medium and excretory urogram during retrograde urethrography. 819 69

The case histories of two patients with sickle cell disease and gram negative sepsis complicated by encephalopathy and hypertension is presented. The first patient had 2 episodes of "hypertensive encephalopathy" before control of her blood pressure was achieved while the second patient had only one. The occurrence, though apparently rare, can have serious implications. Possible mechanisms are discussed and the need to monitor the blood pressure of children with sickle cell disease is stressed.
West Afr J Med
PMID:Acute encephalopathy, hypertension and gram negative sepsis in sickle cell disease. 831 20

New monoclonal antibodies directed against the lipid A moiety of the endotoxin present in gram-negative bacteria have been developed to improve the clinical outcome in patients with sepsis. Two studies of monoclonal antibodies HA-1A and E5 retrospectively identified specific patient subgroups showing benefit with therapy. I analyze and summarize the new sepsis nomenclature, the structure of endotoxin, the data implicating endotoxin as a causative agent in septic patients' morbidity and mortality, and specific data from the 2 clinical studies of monoclonal antibody therapy.
West J Med 1993 Apr
PMID:Monoclonal antibodies to endotoxin in the management of sepsis. 831 38


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