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

The periodicity of morbidity rate in heifers and dairy cows kept on pasture (278 animals) and in stables (187 animals) was studied in relation to macroclimatic conditions under the assumption of two peaks per annum. The following conditions were used as the parameters of morbidity: purulent inflammations of uterus, sterility, lesions of the female tract and sepsis, dystocia, retention of placenta, mastitis, foot diseases and lying down after parturition. No significant differences were found between the studied groups of animals. A statistically significant up to highly significant dependence was found between the health of the heifers and cows and macroclimatic conditions both in stables and on pasture; an increase in morbidity rate was recorded in spring and autumn.
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PMID:[Health status of cattle in relation to the time of year]. 641 43

Infections in patients with gynecologic malignancies occur frequently and are the cause of death in 50 to 60% of the cases. The patient with cancer is a compromised host with an increased susceptibility to infection due to the malignancy itself on the one hand and due to therapeutic-modalities, like extensive surgical procedures, radiation- and cytotoxic chemotherapy on the other hand. Aetiologically these infections are mostly due to a disruption of anatomic structures which normally prevent the invasion of exogenous or endogenous microorganisms, or to obstructive processes or to tumour necrosis. Septicaemia can result from propagation of such a localized infection beyond the site of the tumour. The causative pathogens infecting the compromised host are mostly members of the indigenous microbial flora of the genital tract, which is influenced by surgery, irradiation and chemotherapy. Postoperatively in the vaginal vault the number of most potentially pathogenic aerobic and anaerobic bacterial species is higher, polymicrobial mixed infections are frequent. Neither the intracavitary radiation-therapy with Radium or Iridium-192 (afterloading) nor the external high-voltage therapy decrease the number of pathogenic bacterial species in the uterus and in the vagina of patients with cervical or endometrial cancer. The symptoms of infection in cancer patients can be "masked". Fever in patients with genital malignancies is mostly due to local infections and influences the prognosis negatively. The 5-year survival rate of irradiated patients with fever is significantly lower. Infections following radical hysterectomy, irradiation and/or cytotoxic chemotherapy like pelvic abscesses, peritonitis, pneumonia and septicaemia can be fatal. Urinary-tract-, wound- and vaginal vault-infections occur frequently, but are rarely severe. Therapeutically in severe infections a combination antibiotic therapy, which is effective against most pathogenic members of the genital flora, is required. Short courses of perioperative prophylactic antibiotics are useful both in radical hysterectomy and with intracavitary irradiation.
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PMID:[Infections in patients with gynecologic malignancies]. 641 69

Hydrocolpos is the result of vaginal obstruction and can become an emergency in the newborn period. The treatment of imperforate hymen is well defined, but the treatment of vaginal atresia is more complex. We encountered two cases of hydrocolpos secondary to distal vaginal atresia, that were operated on in the first days of life. One baby had distal atresia without persistance of urogenital sinus. Surgery combining abdominal perineal approaches and a posterior vaginoplasty was carried out. The second baby had hydrocolpos with persistance of urogenital sinus. Drainage through the sinus was unsuccessful because the baby developed sepsis by trapping urine in the uterus. Finally an abdominoperineal vaginal pull-through was successfully done. The embryology and literature are reviewed. The classification, indications and surgical technique are discussed.
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PMID:Hydrometrocolpos in neonate due to distal vaginal atresia. 650 18

Information from 2 recent books on the most common abortion techniques is presented. Menstrual aspiration can be performed up to 14 days after a missed period. A flexible plastic cannula 4-5 mm in diameter is passed through the cervix to the uterus, and the contents are evacuated using a syringe. Little dilatation is required and the procedure is done under local anesthesia. Aspiration through the 12th week is usually done under general anesthesia using a cannula and mechanical aspiration. A curette is used to assure that the abortion is complete. Local anesthesia is used in some places. From 12-16 weeks a combination of scraping and aspiration is used with general anesthesia and sometimes forceps. The uterine cervix requires greater dilatation. After 16 weeks the amniotic fluid is removed and a solution of salt and water is injected into the woman under local anesthesia. Contractions begin about 24 hours later. Labor may also be induced by oxytocin or prostaglandins which result in 8-15 hours of labor. This method of abortion probably causes the greatest amount of anxiety in the patient. Uterine scraping is described in the 2nd book as a procedure in which the cervix is progressively dilated with metal instruments of different sizes until it is sufficiently dilated to permit passage of the curette. Laminaria tents were previously placed in the cervix 24 hours prior to the abortion to achieve slow and progressive dilatation. General anesthesia is required because cervical dilatation is painful. In uterine aspiration the contents of the uterus are removed using tubes called Karmen cannulas. It is sometimes possible to avoid cervical dilatation by using thin cannulas, in which case general anesthesia may be avoided. After the aspiration the uterus may be scraped to assure the complete removal of the uterine contents. Prostaglandins may be used to initiate uterine contractions leading to expulsion of the uterine contents during the 2nd trimester of pregnancy. The procedure may cause significant side effects. Other procedures consist of injecting various substances into the uterine cavity during the 2nd trimester of pregnancy. Hysterotomy involves surgical opening of the abdomen and is analogous to cesarean section. Possible complications of an induced abortion include uterine perforation, bleeding, infection, and in extreme cases maternal death through sepsis. Medical attention should be sought in cases of hemorrhage, abdominal pain, fever, or general malaise after an induced abortion.
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PMID:[Literary but technical abortion]. 655 11

This paper presents data on perinatal and maternal deaths occurring in the Black Lion Hospital, Addis Ababa, in 1980. The data were collected by a research midwife. A total of 3936 infants were delivered to 3868 women during this period. The stillbirth rate was 52.6/1000; the perinatal mortality rate was 8.6/1000; and the maternal mortality rate was 7.8/1000. Of the 207 stillbirths 92 (44.5%) were unexplained, 66 (31.9%) were due to mechanical causes (e.g., ruptured uterus, cord prolapse, obstructed labor), 34 (26.4%) resulted from pregnancy complications (e.g., hemorrhage,hypertensive disease, congenital abnormalities), and 15 (7.3%) were due to intrapartum death. There was no obvious pathology in 38 of the 84 neonatal deaths. The remaining cases were due to conditions such as intrapartum asphyxia, antepartum hemorrhage, septicemia, and congenital abnormalities. 10 of these death involved preventable factors. Of the 30 maternal deaths, 13 were due to sepsis, 9 to hemorrhage, 4 to surgical conditions, 3 to medical conditions, and 1 to eclampsia. Inadequate monitoring of shocked patients and the nonavailability of blood tranfusions contributed to some of these deaths. Although socioeconomic and cultural factors play a role in perinatal and maternal mortality, coordinated maternity services could produce short-term improvements. Such maternity services should embrace both primary care, with an emphasis on the training of traditional birth attendants and health assistants, and high-risk hospital care. Good prenatal care and monitoring can identify women at high risk and ensure that they receive adequate medical supervision.
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PMID:Maternal and perinatal deaths in an Addis Ababa Hospital, 1980. 674 50

A 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7

Infections are still the most frequent peripartal complications. Very often they are nosocomial (hospital acquired) infections. Diagnosis and therapy of severe conditions may pose considerable problems. The most significant clinical factors in patient survival are the attentive surveillance and early recognition of the patient's disorder. The choice of antibiotics has to be done in consideration of the bacteriology of the vagina (endogenous infection). Removal of the infection site (uterus with or without adnexae) is the therapeutic procedure with the highest success rate in cases with sepsis or bacterial shock. Prophylaxis of infectious morbidity following caesarean section seems to be possible and advisable in patients with certain risk factors (labour, rupture of membranes, repeated vaginal examinations).
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PMID:[Peripartal infections]. 692 31

Previous reports have implicated the Dalkon shield intrauterine device (IUD) in septic second trimester abortion and maternal death from sepsis. In the case reported here, Fusobacterium necrophorum, a rarely pathogenic vaginal anaerobe, gained access to the uterus in a woman wearing a Dalkon shield and caused acute parametritis, overwhelming peritonitis, systemic sepsis, and death. It is well known that IUDs can contribute to the development of serious pelvic infections, and in this case it is possible that the Dalkon shield was the cause of the ascending infection into the uterus.
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PMID:Fatal peritonitis following IUD-associated salpingitis. 726 60

Ordinarily the IUD does not give rise to any unpleasant effects on the woman's organism. But the literature does contain references to peritonitis, sepsis, and even perforation of the uterus. The present case describes an IUD which passed through the uterine tube into the abdominal cavity. The patient, a 28-year old woman, had been fitted with an IUD and a month later came to the clinic with a serious case of nonspecific pneumonia. Soon after she died of cardio-pulmonary insufficiency. At autopsy, in the left uterine tube (in the ampulla) we discovered the IUD threads, while the IUD itself was hanging in the abdominal cavity. We could not find any macro- or micro-pathological changes in the uterus. The reasons might have been connected with the fact that the IUD was inserted 1 month after the woman had a stillbirth. The basic mechanism would be that the IUD was wedged into the isthmus of the uterine tube at the time of insertion and then compressed, thus facilitating its subsequent movement toward the abdominal cavity.
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PMID:[Rare complication of intrauterine contraception]. 728 93

In 2 case reports the radiologic diagnosis of pelvic abscess caused by a Dalkon Shield type IUD was demonstrated. In the 1st case the pelvic abscess was visualized as an impression on the anterior rectal wall and the displacement of the distal 1/3 of the sigmoid. This was confirmed at laparotomy when a Douglas abscess and an inflamed uterus was found. In the 2nd case a segmental narrowing of the rectum and distal 1/3 displacement of the sigmoid were radiographically demonstrated. The spontaneously draining sacrouterine abscess healed with conservative treatment. The Dalkon Shields were removed in both cases. Although the newer IUD's carry less risk of infection this risk is still considerable as reported in the literature. A 1978 review of 6 epidemiologic studies points to a 3 to 5-fold higher risk of pelvic infection with IUD use. This risk may be higher for women without previous pregnancy and may drop to a low of 1.7 in women with previous pregnancy. Some authors point to a higher risk of adnexitis with the Dalkon Shield compared to other types of IUDs. The Dalkon Shield has been removed from the market in the US and other countries after a US publication of 35 fatalities caused by sepsis in IUD users.
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PMID:[Radiologic demonstration of pelvic abscess associated with I.U.D. (Dalkon Shield) in two patients (author's transl)]. 732 15


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