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

In a 13-year review of maternal deaths at the University of Benin Teaching Hospital, Benin City, abortion was one of the 3 major causes of death, accounting for 37 (22.4%) out of the 165 deaths. Induced abortion was responsible for 34 (91.9%) of these deaths. The usual victim is the teenage, inexperienced school girl who has no ready access to contraceptive practice. Death was mainly due to sepsis (including tetanus), hemorrhage and trauma to vital organs, complications directly attributable to faulty techniques by unskilled abortion providers, a by-product of the present restrictive abortion laws. Total overhaul of maternal child health services and the family health education system, are suggested. Contraceptive practice should be made available to all categories of women at risk, and the cost subsidized by governmental and institutional bodies. Where unwanted pregnancies occur, the authors advocate termination in appropriate health institutions where lethal and sometimes fatal complications are unlikely to occur. In effect, from the results of this study and a review of studies on abortion deaths in Nigeria and other developing countries, it is obvious that a revision of abortion laws as they operate, notably in the African continent, is overdue.
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PMID:Abortion-related morbidity and mortality in Benin City, Nigeria: 1973-1985. 290 Jan 75

A Pseudomonas aeruginosa polysaccharide-tetanus toxoid (Ttxd) conjugate vaccine was produced. Polysaccharide was derived from lipopolysaccharide (LPS) and covalently linked to Ttxd by using carbodiimide with adipic acid dihydrazide as a spacer molecule. The conjugate possessed a relative molecular weight of greater than 350,000 and was nontoxic and nonpyrogenic. The vaccine bound serospecific monoclonal antibodies with an avidity similar to LPS and reacted with murine and human opsonic antibody. The vaccine was immunogenic in rabbits and mice and elicited IgG antibody to both LPS and Ttxd. The vaccine was safe when parenterally administered to humans and evoked only mild, transient reactions. Mean titers of IgG antibody to LPS rose 19-fold after immunization, with 82% of the volunteers responding with a fourfold or greater rise in titer. IgG antibody to LPS evoked after immunization was opsonic and highly effective at preventing fatal experimental burn wound sepsis due to P. aeruginosa.
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PMID:Pseudomonas aeruginosa polysaccharide-tetanus toxoid conjugate vaccine: safety and immunogenicity in humans. 309 8

The single breath test for carbon dioxide (SBT-CO2) is the plot of expired FCO2 or CO2% against expired volume. It can be monitored during anaesthesia and in the intensive care unit with modest additions to generally available equipment. This paper describes some aspects of a computer program for presenting SBT-CO2 during controlled ventilation, in particular, the corrections to the primary data necessary for scientific accuracy. Examples are given of how the use of SBT-CO2 has increased our understanding of factors which influence the arterial-end-tidal PCO2 difference (PaCO2-PE,CO2). PaCO2-PE, CO2 is, in a given individual, usually dependent on tidal volume and frequency. Changes in lung volume and manoeuvres such as opening the pleura also affect gas exchange. Monitoring CO2 elimination gives a measure of metabolic rate if ventilation and pulmonary perfusion are maintained. This facilitates ventilatory therapy in situations where CO2 production is greatly increased, e.g. sepsis and tetanus. On the other hand, if metabolism and ventilation are unchanged, a reduction in CO2 elimination implies reduced pulmonary perfusion. This can be seen during increased right-left shunting, such as in surgery in patients with congenital heart disease.
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PMID:On-line expiratory CO2 monitoring. 309 79

Orbital dog bites, though statistically uncommon, occur most frequently in children and are associated with severe ocular adnexal injury. Of 16 victims, two-thirds were under 10 and over half under 5 years of age. The wounds consisted of numerous periorbital punctures, and in most cases, full-thickness lid lacerations involving the tear system. There were no serious injuries to the globe. Reversible amblyopia occurred in two children under 3 years of age with damage to the levator muscle. One child suffered a naso-orbital fracture. Because of the obvious nature of the injury, most patients present early and can be managed well with meticulous wound care and primary surgical repair. The use of prophylactic antibiotics, though controversial, appears prudent in such cases. Ophthalmologists treating these injuries must be aware of serious potential complications including occult facial fracture or intracranial penetration in young children, septicemia caused by bacillus DF-2 in patients with prior splenectomy, tetanus, and rabies.
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PMID:Ocular adnexal injury and complications in orbital dog bites. 315

Using 1984 perinatal mortality rates as indicators of the level of maternal and newborn health care service quality and efficiency, Libya's high perinatal loss is compared to perinatal losses of 9 other developing countries. Timely antenatal care is identified as the essential component needed to reduce perinatal loss. Libyan perinatal, still birth, and early neonatal death rates were 26.3, 11.4, and 14.9/100, respectively. Perinatal death rates of other countries in the study ranged from 18.8 to 100/thousand. The major causes of still births in Libya included antepartum hemorrhage, cord accidents, maternal diabetes mellitus, and fetal malformations. The effect of timely obstetric care in reducing still birth rates (SBR) is evidenced by comparing SBRs of 16.8 to 63.8 in pregnant women receiving or not receiving minimal antenatal care at a peripheral health center, respectively. The clinical causes of early neonatal death were major congenital malformation (24.9%), hyaline membrane disease and aspiration syndrome (26.1%), birth asphyxia and injury (17.9%), very low birth weight (17.2%), and sepsis/meningitis (13.1%). High general fertility rates of developing countries leads to increased proportions of women under 20 and over 35 years of age bearing children. These women are prone to bearing offspring comparatively more vulnerable to early neonatal death. Consanguineous marriages leading to congenital malformation, and lack of maternal immunization with tetanus toxoid are also cited as factors contributing to high perinatal mortality. In closing, the authors call for future community-based studies, and recognize socioeconomic level as a main determinant in obtaining obstetric care.
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PMID:Perinatal outcome at Benghazi and implications for perinatal care in developing countries. 316 32

This retrospective study of the main causes of child mortality was conducted within the Department of Child Health, Dr. Pirngadi General Hospital, between January-December 1986. The main causes were: bronchopneumonia, encephalitis, purulent meningitis, serous meningitis, sepsis, tetanus, and several malnutrition. Case fatality rates were: 29%, 44%, 41%, 31%, 47%, 12%, and 18%, respectively.
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PMID:Seven diseases as main causes of death in Department of Child Health, Dr. Pirngadi General Hospital. 324 52

The outcome of neonatal care was studied in 3 subdistricted rural areas in Yogyakarta Province with a total population of 112,075 people. All pregnancies and deliveries between May 1983-April 1984 were registered and seen twice during pregnancy, on delivery, and 5 days and 1 month postpartum by trained health personnel. There were 1819 singleton liveborn infants with a neonatal mortality rate of 25.3% in which 82.6% of the deaths occurred in the early neonatal period. 91.5% of the women delivered in their own homes and 83.9% were assisted by a traditional birth attendant (TBA) who was either trained or untrained. There were still 27.1% of the pregnancies which did not receive any antenatal care. 75.2% received tetanus immunizations and there was a 1.1% incidence of tetanus. The incidence of lowbirth infants was 8.1% among these, 19.7% died prior to 1 month of age and represented 63% of neonatal mortality. The causes of neonatal mortality were: birth asphyxia and hypoxia--56.5%; prematurity/low birthweight--13%; infection/sepsis--13% diarrhea--8.7%, tetanus neonatorum--4.4%, and other unknown causes--4.4%. In rural areas, TBAs play a key role in labor and in caring for mothers and their newborns up to 1 month of age. Clearly there is much needed improvement in health service delivery at all levels of the healthcare system, especially in the areas of resuscitation of newborns and in problems of low birthweight.
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PMID:Neonatal mortality in Yogyakarta rural areas. 327 Aug

A total of 150 patients were treated for tetanus in the tetanus ward of the J. J. Hospital, Bombay, between October 1983 and January 1986. The complications of tetanus and the mode of management in the presence of restricted resources are outlined. Intensive care, proper nutrition, early tracheostomy and ventilator support in severe tetanus were chiefly responsible for an overall reduction in mortality from 30 to 12%. The mortality in severe tetanus was reduced from 70 to 23%. Sudden death due to unexpected cardiac arrest was an important complication in severe tetanus. We observed that an abrupt marked rise in rectal temperature (greater than 107 degrees F, 41.7 degrees C), if undetected, could lead to sudden circulatory collapse and death. Well-marked hypoxaemia was observed in all patients with severe tetanus, and was related to ventilation perfusion inequalities and to an increase in the true venous admixture (increased Qs/Qt) in the lungs. Bronchopulmonary infections and the adult respiratory distress syndrome added significantly to morbidity and mortality. Autonomic cardiovascular disturbances included bradycardia alternating with tachycardia, and hypertension which was either labile, paroxysmal or sustained. Persistent hypotension was of ominous significance. Amongst numerous complications involving other systems, sepsis and septic shock were associated with a high mortality.
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PMID:Tetanus and its complications: intensive care and management experience in 150 Indian patients. 342 73

An analysis of the causes of death in the neonatal nursery of the Port Moresby General Hospital in Papua New Guinea from 1982-1985 is presented, and conclusions were enumerated. The nursery has beds for 24 babies, subdivided into intensive care, infection and growing areas. Dormitory space for 12 mothers is available, and breast feeding is encouraged, whether by sucking, cup or tube: no bottle feeding is done. Up to 9 sisters staff the unit. A total of 2948 infants were admitted, including 831 cesarean births. 343 deaths occurred. 80 deaths were previable babies less than 1000 g. The neonatal mortality was 10/1000. The most common causes of death were septicemia or meningitis (24%), perinatal asphyxia (20%), respiratory distress syndrome (15%), congenital abnormalities (12%), meconium aspiration 7%, apnea of prematurity (7%). Other causes included pneumonia, hypothermia, intrauterine infection syndrome, cerebral hemorrhage and kernicterus. Note that hypothermia can occur in tiny babies, even in the tropics. Both respiratory distress and jaundice appear to be rare in melanesians compared to caucasians. Infections were due to tetanus, E. coli, S. aureus a Strep. faecalis, rather than the Group B hemolytic Strep. more often seen in the West. It was concluded that several inexpensive measures can be put in place to markedly enhance survival: train birth attendants to prevent perinatal asphyxia; maintain body temperature by available means; feed adequately, using expressed breast milk if necessary; maintain oxygenation properly using simple equipment such as a nasal catheter or perspex head box; prevent infection by scrupulous hand washing, cord care and overall cleanliness; manage neonatal jaundice.
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PMID:Neonatal care in perspective: results of neonatal care at Port Moresby. 347 16

Although periorbital and orbital dog bites are rare, they most frequently occur in young children and commonly involve significant associated adnexal injuries. In most cases, the dog is either the family pet or is otherwise known to the victim. The exact precipitating event is usually unknown. Most victims are treated by a physician soon after injury, and can be reconstructed primarily following meticulous local wound care, including adequate irrigation. Infection is rare, but because of its potentially disastrous consequences, prophylactic treatment with penicillinase-resistant penicillin or cephalosporin seems indicated. Serious, potentially fatal consequences due to underlying intracranial injury in children under aged 2 years, fatal septicemia in splenectomized individuals, tetanus, and rabies must be considered by ophthalmologists who treat such patients.
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PMID:Orbital and periorbital dog bites. 350 36


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