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)

Mycoplasma hominis was recovered from the blood of 7 patients with various underlying disorders. One patient had a legal abortion, another a Caesarian section, both followed by septicemia. Three patients had genital infections in pregnancy, followed by septicemia and spontaneous abortion. M. hominis was also recovered from cervix and urethra in 2 of these women. High serum antibody levels against M. hominis were demonstrated in 3 women. One female developed septicemia after cancer surgery, one male after heart surgery. In the first 6 patients described the septicemia was of short duration and self-limiting, in the 7th patient it was of long duration and appropriate antimicrobial treatment was required. From this patient M. hominis was also isolated from infected operation wounds.
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PMID:Septicemia due to Mycoplasma hominis. 684 81

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.
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PMID:Urethrocavernous and urethrovascular reflux of contrast medium and excretory urogram during retrograde urethrography. 819 69

Bladder reconstruction using bowel segments was advanced when intermittent catheterization proved so acceptable. Access to the reservoir by way of the urethra is often not possible in children, especially boys. Implantation of the isolated appendix into the bladder remnant or colon segment similar to a ureteral reimplant provides a continence mechanism with ready catheter access (the Mitrofanoff principle). Since 1982 we have applied this principle in 41 pediatric cases of bladder reconstruction (64% boys). Primary diagnoses included bladder exstrophy (46%) and myelomeningocele (34%). Extending the concept of a flap valve continence channel with a narrow tube into the reservoir, segments of tapered ileum and ureters were also used (appendix 61%, ileum 12%, ureter 27%). Results of continence (100%) and uncomplicated catheterization (93%) have been satisfactory. Unfortunately, the longer the experience (average 3.2 years of followup), the more stone formation we experienced (32%), which is due to mucus production and bacteriuria as the stone nidus. There were 2 deaths, including 1 from a renal stone obstructing the ureter with sepsis and 1 a likely suicide. Reoperation was required for 3 stomal revisions, 2 bowel obstructions and 7 stone removals in 3 of the 6 cases in which the bladder neck was closed. Unique aspects of these reconstructions are presented, such as our current preference to bury the stoma in the umbilicus (7 cases), placement of the ureteral segment into the perineum as a neourethra and an unusual conjoined twin reconstruction.
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PMID:Appendicovesicostomy (and variations) in bladder reconstruction. 843 67

Between 1982 and 1990, 4 males with extensive intraurethral warts presented with marked inflammation of the external genitalia. When sepsis had settled all patients underwent ventral urethrotomy, in which the urethra was divided median as far back as was necessary to expose all of the warts. Surgical and electro-excision were the preferred methods of removal. Of 3 patients who developed recurrences 2 were lost to follow-up. A third remained without treatment for 1 year and when next seen the warts had spontaneously resolved and his urethra was closed. A fourth patient was lost to follow-up for 4 years before returning with destruction of his external genitalia by a verrucous carcinoma. The human immunodeficiency virus (HIV) did not appear to be a factor in the natural history of intraurethral warts in 2 patients who were negative for serum antibodies 2 and 8 years after presentation.
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PMID:Extensive condylomata acuminata of male urethra: management by ventral urethrotomy. 840 46

We report the thirteenth case of a recto-urethral fistula in Crohn's disease. The patient, a 37-year-old white male, had a 20-year history of intestinal Crohn's disease and had undergone numerous bowel resections. His symptoms were fecaluria, urorrhea and passing of urine from an orifice just outside the base of the scrotum. He had urinary infection and severe ileocolitis. He underwent a diagnostic evaluation (cystourethroscopy, proctoscopy, retrograde pyelography, intravenous urography, voiding cystourethrography) that revealed a fistula comprising the membranous urethra, the rectum, the perineum and the scrotum. He was treated with Metronidazole (20 mg/kg/day/12 mo). At 1 year no signs of intestinal disease and urinary sepsis were noted. The external orifice and the perineal fistulous network were closed, and the drainage from the rectum and the urethra had improved. No side effects limited use of the drug. No relapse was observed in the 3 months, after the therapy was discontinued. We present a review of the literature on the management of rectourethral fistulas in Crohn's disease. Surgeons have used successfully several approaches in the repair of this lesion, but no single procedure has proved optimal or even universally applicable. We emphasize, as the literature suggests, that the management must be individualized. Medical therapy with metronidazole has an important role in a patient with rectourethral fistula and concomitant proctitis, ileocolitis, urinary sepsis and multiple previous surgical procedures.
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PMID:Management of rectourethral fistulas in Crohn's disease. 856

Corneal opacities and urinary tract sepsis were previously observed by the authors in rats given muscarinic agonists mixed in the diet or by gavage. To explain the differential toxicity generated by each means of administration, toxicokinetics of the muscarinic agonist CI-979 were investigated. In addition, the muscarinic antagonist scopolamine was co-administered with CI-979 to evaluate the relationship of these effects to pharmacological mechanism of action of CI-979. Female rats were given CI-979 daily by gavage at 0, 1, 10 and 30 mg/kg body weight or in the diet at 0, 1, 10 and 50 mg/kg body weight for up to 14 days. Dose-related clinical signs of muscarinic stimulation, such as sialorrhoea and dacryorrhoea, were observed predominantly in rats given 10 and 30 mg/kg body weight CI-979 by gavage, and corresponded with the high plasma drug concentrations. In contrast, hydronephrosis, pyelonephritis, and inflammation and necrosis of the kidney, urinary bladder, urethra and urinary papilla were linked to sustained, albeit lower plasma drug concentrations attained by dietary administration of CI-979 at 10 and 50 mg/kg body weight. Comparable incidences of corneal opacities were induced by both means of administration, but lesions appeared more rapidly and were generally of greater severity when CI-979 was given in the diet. The induction of corneal lesions, as well as urinary sepsis, may not relate simply to maximum plasma concentrations or to areas under the curve per se, but rather may arise when plasma drug concentrations are sustained. Corneal opacification and development of urinary tract pathology were inhibited by scopolamine, suggesting that these effects were related to the muscarinic mechanism of action of CI-979.
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PMID:Toxicological comparison of a muscarinic agonist given to rats by gavage or in the diet. 864 67

Four patients with upper urinary tract transitional cell carcinoma were treated with bacillus Calmette-Guerin (BCG) via a percutaneous nephrostomy tube or a retrograde ureteral catheter. A 68-year-old female and an 80-year-old male had carcinoma in situ (CIS) in the left upper urinary tract (cases 1 and 2). A man aged 47 had CIS in the left upper urinary tract, bladder, and prostatic urethra (case 3). CIS in the left upper urinary tract was identified in a woman aged 63 with chronic renal insufficiency (case 4). Two patients (cases 1 and 2) responded to this therapy. In the other two patients nephrectomy was performed due to residual tumor. There were extensive tuberculous granulomas in the kidneys. In one resected kidney (case 4) carcinoma had invaded the renal parenchyma. The reviewed literature showed that BCG perfusion therapy was effective in 71% (27 of 38 renal units) for the upper urinary tract tumors and that there were 5 cases of severe complication, including sepsis in 2, high fever in 2, and ureteral stricture in 1. Based on the fact that the kidney receives a profuse blood supply and that the renal pelvis and ureter have a thin wall, careful management is mandatory to prevent severe adverse effects and insidious tumor progression.
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PMID:[Intracavitary bacillus Calmette-Guerin therapy for upper tract transitional cell carcinoma]. 869 56

The authors report on two patients who had fusiform megalourethra with unusual features. The first patient had left hydronephrosis with duplication of the ureter, oblique sagittal septum in the urinary bladder, and Y duplication of urethra with megalourethra of both channels. The second had features of the abdominal muscle deficiency syndrome, with anterior ectopic anus, rectourethral fistula, and fusiform megalourethra. Both patients were treated by preliminary urinary diversion. The first patient subsequently had staged reconstruction. The other patient died of urinary sepsis. The authors believe that preliminary urinary diversion followed by planned staged reconstruction offers hope for the reconstruction and rehabilitation of these cases.
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PMID:Congenital megalourethra. 870 23

Perineo-genital wounds involving the anterior perineum or the urogenital perineum are uncommon; 1-4% of all war wounds. We report 18 cases observed in war situations. Isolated uretrogenital wounds are rarely life-threatening, but the functional prognosis is always compromised in these men whose mean age is under 30 years. Debridements should be limited and all isolated lesions should be repaired early with tight suture of the cavernous body albuginea, preservation of viable testicular and adnexal tissue (but the rate of orchidectomy is greater than 50%), and immediate suture of any wound to the urethra rather than simple alignment. In war situations, these wounds are usually caused by perforating or blast trauma. The wounds are complex, with damage to the soft tissues, sometimes involving lesions to the anal sphincter, the gluteal masses or the abdomino-pelvic structures. Laparostomy for hemostasis is justified. The risk of sepsis is high, requiring triple antibiotics, cystostomy, careful debridement, discharge drainage or possibly colostomy. Treatment of urogenital lesions is a secondary operation in these cases but must not be neglected if the mictional and sexual functions are to be preserved.
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PMID:[Perineal-genital wounds in war medicine. Apropos of 18 cases]. 929 6

One hundred and forty three patients who had urethroplasty for urethral stricture between 1980 and 1989 were reviewed. Their age ranged from nine to 75 years with a mean of 39 +/- 10.2 SD years. Infection caused stricture in 51% and trauma in 46.9%. Urethral trauma resulted mostly from road traffic accidents. The inflammatory strictures were located in the anterior urethra, whilst traumatic ones were in the bulbomembranous region. Urethroplasty was indicated as the initial treatment in 80.4% because the strictures were impassable or complicated by perineal sepsis or fistulae. In 16% urethroplasty was employed as an alternative to frequent or complicated urethral dilatation. Sixty (42%) patients had anastamotic urethroplasty while 54.5% had island patch urethroplasty using scrotal, penile or preputial island skin flap. The commonest late complication was restricture which occurred in 20.9% of the patients. Overall, 72% were satisfied with their treatment. Urethroplasty is advocated upon less strict indications as it cures the stricture and prevent the complications of repeated instrumentation.
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PMID:Urethroplasty at Ahmadu Bello University Hospital, Zaria. 929 30


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