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)

A 2-year-old amerasian male with anhidrotic ectodermal dysplasia (Christ-Siemens-Touraine Syndrome) was admitted for status epilepticus and Mycobacteria avium-intracellulare infection. A computed tomography scan of the head revealed a mass thought to be a subdural hematoma. The patient died following overwhelming Mycobacteria avium-intracellular and Pseudomonas aeruginosa sepsis. Autopsy revealed extensive extramedullary hematopoiesis of the dura forming a tumor-like thickening with focal subdural hemorrhage. To our knowledge, this is the first report of extramedullary hematopoiesis of the cranial dura associated with anhidrotic ectodermal dysplasia.
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PMID:Extramedullary hematopoiesis of the cranial dura and anhidrotic ectodermal dysplasia. 160 84

Because of a nationally apparent increased interest in emergency medical services for children and the need for a greater understanding of the relationship between office pediatric and emergency department care of children, a questionnaire was mailed to practitioners to (1) describe office physician involvement with emergent conditions, and (2) evaluate physician office preparedness for pediatric emergencies. Responses were received from 280 pediatricians and family practitioners, including information regarding the availability of equipment and medication, physician training, and practice characteristics. Of the responding physicians, 62% reported that they assessed in their offices more than one child each week who required hospitalization or urgent treatment. A preparedness score was developed and multiple regression analysis was used to investigate the relationship between this score and physician and practice characteristics. The mean overall preparedness score was 53.7 of a possible 156 (range 5 to 136, SD = 31.3). Characteristics related to this score were type of practice and advanced cardiac life support certification. Large multispecialty practices and practices with physicians trained in advanced cardiac life support tended to have better preparedness scores. Family practitioners tended to have more complete stock of medications than pediatricians. The data presented suggested that critically ill children who enter the medical system via the office setting may have a better than even chance of finding the office unprepared to treat the emergency: in fewer than one third of the offices in which it was reported that at least one patient was seen weekly with asthma, anaphylaxis, sickle cell vasoocclusive crisis, status epilepticus, and sepsis were they fully equipped to treat emergencies related to these conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pediatric emergencies in office practices: prevalence and office preparedness. 272 48

I have described an adult patient who had dissecting retropharyngeal abscess complicated by pneumonia, mediastinitis, pericarditis, sepsis, and status epilepticus.
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PMID:Dissecting retropharyngeal abscess due to Fusobacterium necrophorum in an adult. 398 69

Hyperosmolality complicating the management of burned patients has multiple etiologies. Sepsis, hyperglycemia, renal failure, electrolyte disturbances, shock, and substances absorbed from the burn wound may be contributing factors. Chemicals, such as propylene glycol, within bacteriostatic topicals may also lead to hyperosmolality. This report describes a patient who developed severe hyperosmolality after 5% Betadine-glycerin therapy for a 60% partial-thickness burn. Status epilepticus developed 36 hours later, and triglycerides were 9,700 mg/dl. After Betadine-glycerin was stopped the central nervous system status slowly improved but pre-seizure function was never regained.
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PMID:Hyperosmolality caused by percutaneously absorbed glycerin in a burned patient. 706 13

The patient first noticed general muscle stiffness at the age of 36. Two years later, she suffered from a tonic-clonic seizure which brought her to a hospital for the first time. Choreoathetoid movement, ataxia and cognitive deficit were apparent. At the age of 44, tonic-clonic seizures became more frequent and she was admitted to our hospital as being status epilepticus. After the cessation of clinical seizures, she became appllic. Gradual increase of atrophic changes in cerebrum, cerebellum and brain stem were observed by MRI and CT. Hematological study showed that she had abnormal hemoglobin, Hb Takamatsu. Four of her five children were clinically examined; all of them showed abnormal EEG findings; three being mentally retarded and had clinical generalized convulsive seizures; two had hemoglobinopathy (Hb Takamatsu). The patient died from sepsis at the age of 50 and the autopsy was carried out. The brain weighed 930 gram. Histological findings confirmed the diagnosis of dentato-rubro-pallido-luysian atrophy; neuronal loss accompanied by gliosis in dentate nuclei, red nuclei, lateral part of globus pallidus, and subthalamic nuclei. The coincidence of the hereditary traits of two independent diseases, DRPLA and familial hemoglobinopathy (Hb Takamatsu) suggests closeness of their genetic loci.
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PMID:[A familial case of DRPLA diagnosed by an autopsy associated with hemoglobinopathy (Hb Takamatsu)]. 825 33

Serum free carnitine levels in five children (aged between 2.5 months and 4 years) with the findings of septic shock without disseminated intravascular coagulopathy and seven children (aged between 1.5 and 6.5 years) with the first attack of idiopathic status epilepticus were compared with those of eight healthy children (aged between 2.5 months and 5 years). Serum free carnitine levels showed a statistically significant decrease in the sepsis (mean 51.5 +/- 19 mg/L) and status epilepticus groups (mean 4.1 +/- 12.4 mg/L) (P = 0.006 and P = 0.001, respectively) when compared with the controls (mean 90.8 +/- 17.2 mg/L).
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PMID:Could L-carnitine be an acute energy inducer in catabolic conditions? 911 66

Cefepime is a fourth-generation cephalosporin widely used for gram-negative sepsis. The authors report two patients in whom nonconvulsive status epilepticus developed while they were on treatment with cefepime for Pseudomonas aeruginosa infection. The status epilepticus resolved completely once the drug was withdrawn. Cefepime therapy can result in status epilepticus, especially if given in higher doses than required.
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PMID:Status epilepticus associated with cefepime. 1085 81

Most of the information on predisposing factors and mortality in status epilepticus (SE) arises from data obtained from patients presenting to the casualty department. However, another population which is frequently seen by consultative neurologists are medically ill patients who develop SE while in hospital. These patients are often notoriously difficult to treat once SE arises. We sought to characterize patients at risk for SE arising when they are hospitalized for other reasons. By doing this, risk factors for developing SE and prognostic indicators might be determined. We retrospectively reviewed records from three urban hospitals in the United States to identify hospitalized patients developing SE over a 1 year period. SE was defined as a clinical seizure lasting 30 minutes or longer, or repeated seizures without recovery. Patients who were admitted in SE or for an epilepsy-related problem, or who were less than 1 year old were excluded from the study. Forty-one patients with in-hospital SE were identified. There were 28 males and 13 females with an age range from 1 to 91 years (mean: 60 years, median: 65 years). The mean interval from hospital admission to the onset of status epilepticus was 26 days. Nineteen (46%) patients had a prior history of either epilepsy or symptomatic seizures, and of these, 10 were inadequately treated as judged by serum anticonvulsant levels at the time SE developed. Focal brain abnormality was present in 26 (63%) patients, the most common of which was stroke (17 patients ). Major metabolic derangements including hypoxia, electrolyte imbalance, hepatic encephalopathy, and sepsis were present in 23 (56%) patients. Eleven (27%) patients were being treated with theophylline preparations at the time SE developed. Mortality in this group of patients with in-hospital SE was 61% (25 deaths), with about one-third dying while in status, and two-thirds dying subsequently in hospital. In this retrospective study, there was no clear relationship between mortality and the duration of SE in this group of patients. In-hospital development of SE is usually related to underlying focal brain abnormality, especially stroke, in combination with systemic metabolic derangement. Prognosis is poor, and appears to be more related to underlying conditions rather than to status duration. More accurate prospective studies are warranted.
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PMID:Status epilepticus arising de novo in hospitalized patients: an analysis of 41 patients. 1140 54

Nonconvulsive status epilepticus in intensive care units (ICUs) is common and increases the risk of death. Nonconvulsive status epilepticus treatment delays are associated with poor patient outcomes. Continuous EEG or EEG-video monitoring is used in ICU settings to diagnose subtle seizures and nonconvulsive status epilepticus among at-risk populations including patients with closed head injuries and altered consciousness, stroke, subarachnoid hemorrhage, neonates at-risk for sepsis or hypoxic-ischemic encephalopathy, and children who have undergone surgery for congenital heart disease. However expert EEG interpretation, currently required for accurate diagnosis, often lags behind the real-time recordings by hours or even longer. At most hospitals the numbers of at-risk patients in intensive care units far exceeds the capacity of the available EEG equipment and personnel to perform and interpret EEGs. Seizure-detection software, compressed EEG spectral arrays, and near real-time remote EEG interpretation have brought us closer to the goal of real-time analysis of EEG for intensive care decisions, but even at major tertiary referral centers the vast majority of at-risk ICU patients do not undergo EEG monitoring. Additional technological advances, innovative use of EEG technologists and ICU personnel, and clinical trials of new EEG monitoring technology and associated clinical outcomes are needed to achieve the goal of optimal use of EEG data for intensive care decisions.
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PMID:Ellen R. Grass Lecture: Rapid EEG analysis for intensive care decisions in status epilepticus. 1660 69

Left cardiac myxoma and consecutive embolization into the brain is well documented, whereas the association of myxoma with multiple fusiform cerebral aneurysms is rare. A 48-year old female with chronic renal failure had complained of syncope after receiving hemodialysis. An echocardiogram showed a 3 x 4 cm sized myxoma and brain MRI displayed multiple fusiform aneurysms. The myxoma was successfully removed. Postoperatively, she developed status epilepticus. Unfortunately, the patient did not recover and expired due to sepsis.
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PMID:Multiple cerebral aneurysms associated with cardiac myxoma in a patient with chronic renal failure: how can we resolve multiple cerebral aneurysms? 1916 97


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