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)

We report on a 52-year-old female patient with a bulky, recurrent cervical carcinoma involving the vagina and bladder, who developed entero-recto-vesicovaginal fistulas and sepsis with pelvic cellulitis after external radiation of 40 Gy and 2 courses of concurrent chemotherapy. Chemoradiation was interrupted and an ileostomy was performed. After recovery, no residual tumor was detectable. Thirteen months after ceasation of chemoradiation, repair of vesicovaginal and rectovaginal fistulas via posterior sagittal approach was performed. Revision of double bowel ileostomy and ileo-T-colostomy was performed 17 months later. The patient enjoyed the restoration of enteral and urinary function only temporarily. She developed rectovesical fistula and underwent an ileostomy again 6 months later. She had another episode of peritonitis and upper gastrointestinal bleeding and expired at 4 years from initiation of salvage therapy. She had no evidence of cancer recurrence during a series of laparotomies and biopsies. The dramatic regression of the tumor may be attributed to its extraordinary radiosensitivity or chemosensitivity. The acute pelvic inflammatory complications may also contribute to the tumor cell killing. The prognosis of recurrent cervical carcinoma is invariably poor except in small tumors confined to vagina. This case gives support to the efficacy of chemoradiation and the potential role of biologic therapy in treatment of this dismal disease.
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PMID:Sustained complete remission after incomplete chemoradiation complicated with pelvic cellulitis in a patient with recurrent cervical carcinoma. 939 13

Yeast colonization of the vagina is found in about 30% of all pregnant women. Premature infants are severely endangered by generalized fungal infections due to their immature immune system. The objective of this study was to elucidate the relationship between vaginal yeast colonization of the mothers and Candida septicemia in their premature babies. In a prospective study, running from 12/1994 to 8/1996, 176 mothers, facing probable premature birth, were investigated, when hospitalized, for vaginal yeast colonization. 150 premature infants (birth weights ranging from 550 to 2390 g) of these mothers were culturally examined for yeasts in specimens from the mouth, ear, stool and urine immediately after birth as well as once weekly in the following weeks. The patients were divided into two groups. In group A, oral prophylaxis with nystatin was practiced only in infants with at least one positive yeast culture. In group B, all patients received nystatin prophylaxis. Candida septicemia developed one or two weeks after birth mainly in infants with birth weights below 1000 g. Primary oral prophylaxis with nystatin lowers considerably the risk of developing Candida infection.
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PMID:[Is Candida septicemia in premature infants a nosocomial infection?]. 1008 84

Transvaginal ultrasonography (US) is a noninvasive, readily available imaging technique that has greatly enhanced diagnostic sensitivity and accuracy for both gynecologic and nongynecologic disease. High-frequency US probes placed in the vagina allow high-resolution assessment of all the pelvic viscera, including portions of the gut and urinary tract. In addition, they allow visualization of the peritoneum of the pelvic pouch and the pelvic side walls without interference from bowel gas or adipose tissue. Evaluation of these areas requires a modified US technique that includes the use of the highest-frequency probes with angulation of the transducer to allow assessment of the region of interest. In women of childbearing age, the similarity of symptoms in gynecologic and gastrointestinal tract disease in particular underscores the potential utility of transvaginal US, which may, for example, help differentiate appendicitis in a pelvic appendix from pelvic inflammatory disease. Transvaginal US may also help determine the correct course of therapy, thereby improving patient management. Other indications for transvaginal US include assessment for pelvic appendicitis and diverticulitis, rectal and perianal complications of Crohn disease, and ureteric and bladder calculi and tumors as well as evaluation of the anal sphincters in women with fecal incontinence. Transvaginal US is also superior to routine US in the detection and characterization of ascites and peritoneal disease. Transvaginal US examination should include the entire pelvic cavity and contents, especially in women at risk for pelvic sepsis or peritoneal disease.
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PMID:Nongynecologic applications of transvaginal US. 1051 54

Pelvic inflammatory disease (PID) is a generic term relating to a broad range of conditions. The term is used to describe infections of the fallopian tubes, uterus, ovaries, or peritoneum. PID is a potentially life-threatening condition in any woman, but HIV-positive women are at serious risk of severe complications or death. PID is caused when infection-producing organisms spread upwards from the vagina through the cervix to the upper reproductive organs. Untreated sexually transmitted diseases are a leading cause of PID. Consequences include chronic pelvic pain, abdominal abscesses, inflammation of the covering of the liver, sepsis, and death. Sterility may also result from PID. PID is generally treated with a combination of antibiotics, and it is crucial to treat other concurrent infections as well. Early treatment of PID in HIV-positive women is essential.
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PMID:Pelvic inflammatory disease. 1136 14

The Dalkon shield tail theoretically can provide a mechanism whereby pathogenic bacteria can move from the vagina to the uterine cavity and cause sepsis. However, an in vitro experiment was run for 3 months and Escherichia coli did not move up the tail. Therefore, if a patient is satisfied with the Dalkon shield, it is not necessary to remove it. However, pregnancy can cause the IUD tail to enter the uterine cavity bringing bacterial contaimination with it. Therefore, Dalkon shield wearers should be adivsed to report to their physician as soon as a period is missed.
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PMID:Escherichia coli transport by Dalkon shield string. (Letter to the editor). 1225

An analysis of causes of maternal deaths in the Southern Highlands Zone of Tanzania, concentrating on avoidable factors contributing to these deaths, was conducted in 1983. Deaths were ascertained by forms sent to doctors in hospitals and assistants in health centers, by visiting hospital and centers regularly, and from reports to Regional Medical Officers. The majority of deaths occurred in hospitals, producing a maternal mortality rate of 2.5/1000 in hospitals, compared to 0.8/1000 for the Zone overall. Total numbers and notable cases were discussed in each of the following etiologies: ectopic pregnancy (1), sepsis after abortion (20), placenta previa (3), eclampsia (4), postpartum hemorrhage (21), anemia (3), obstructed labor (6), puerperal infection (10), sepsis after surgery (7), puerperal pulmonary embolism (2), aspiration after anesthesia (1), herbal medicines (2). The greatest number of deaths were in gravida 3 women. The main avoidable factors were lack of blood for transfusion, no partogram being kept in labor, and risk factors noted but not acted upon. Blood was not available for several reasons: blood not kept in maternity ward, equipment not available to transfuse and relatives refused to give blood. Some other avoidable risk factors were: lack of or slow transport to facility, interference abortion, no antenatal care, lack of gas gangrene serum, packing vagina with cloths to stop bleeding, staff errors. It was felt that isolation of rural doctors contributed to errors, which may possibly be avoided by holding periodic seminars and reviews.
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PMID:Preliminary report on maternal deaths in the Southern Highlands of Tanzania in 1983. 1228 47

Because abortion is illegal in Senegal, it is not easy to determine its frequency. Women suffering complications of illegal abortions are often unwilling to aid in their own treatment by divulging the means used to induce the abortion. Clandestine abortions are associated with poor hygienic conditions exposing the woman to risk of infection. Abortion operators are often ignorant of elementary notions of genital anatomy and unskilled in gynecological surgery. Death may result in a few minutes from shock or embolism. The operator is unable to take any action because of the illegal status of the abortion. Secondary complications may appear because of local trauma, infection, or from caustic or toxic agents. Hemorrhage may be external and abundant, originating in the cervix, vagina, or uterine cavity. It may occur within the abdominal cavity if an organ is perforated. In both cases surgical treatment may be required to save the woman's life. An infection or a state of toxicity may result from the abortion, or both may occur simultaneously. Infections of varying degrees of seriousness may be localized in the genital organs (pelviperitonitis), spread throughout the abdomen (general peritonitis), or spread throughout the organism. Pelviperitonitis results from performing abortions under septic conditions and from uterine retention of part of the embryo. Symptoms include abdominal pain, fever, vomiting, and arrest of intestinal transit. Symptoms are often masked by uninformed use of antibiotics, which allows the infection to spread to the other abdominal organs. Generalized peritonitis results from grave lesions of the genital or intestinal tracts produced by traumatizing instruments. In the absence of medical and surgical treatment, the patient's condition rapidly deteriorates and death ensues. Generalized infection may be due to septicemia, tetanus, or hepatonephritis. Hospitalization in a specialized service is required. Thromboembolic complications may also follow clandestine abortions. Late complications and sequelae may include chronic abdominal pain, menstrual disturbances, secondary sterility, or inability to have sexual relations because of vaginal lesions caused by caustic agents. Later pregnancies may be ectopic, or may spontaneously abort because of cervical lesions caused by trauma. Psychic sequelae may include depression or confusion. Information and contraceptive services should be made available to young girls to prevent illegal abortions. Social legislation should be modified to assist future mothers.
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PMID:[Illegal abortion in Senegal]. 1231 24

Group B streptococci (GBS) are an important cause of neonatal sepsis, pneumonia and meningitis. In some newborns, GBS sepsis may have a severe course, including septic shock with high mortality rate, whereas other newborns are colonized with GBS on their surfaces without any clinical signs of bacterial infections. Interferon (IFN)-gamma is produced in neonatal GBS sepsis, and transforming growth factor (TGF)-beta is also found in the uterus. The involvement of IFN-gamma and TGF-beta in the earliest phase of infection might be a determinant of susceptibility and/or progression of infection in vivo. The aim of this study was to assess the effect of IFN-gamma and TGF-beta on adherence and intracellular viability in ECV304 cells of GBS serotype III isolated from cerebrospinal fluid (CSF) and vagina (strains 90356 and 80340, respectively). Interaction of GBS-ECV304 cells showed that the CSF isolate exhibited a more efficient adherence mechanism than the vagina isolate (P<0.001). Intracellular viability was observed for the CSF 90356 isolate within 2 h incubation. Results suggest the expression of additional bacterial virulence factors that favor some GBS type III strains to cause invasive disease. Detection of genotypic virulence marker (162-kb) in the CSF 90356 isolate by PFGE emphasizes the high risk of invasive infection by some GBS-III strains. Treatment of ECV304 cells with IFN-gamma and/or TGF-beta increased adherence of both GBS strains (P<0.001). Intracellular survival of the CSF 90356 isolate was observed after 24 h incubation following treatment of ECV304 cells with IFN-gamma and TGF-beta. Our data suggest that both IFN-gamma and TGF-beta may favor virulence of GBS strains. Variation of IFN-gamma and TGF-beta producing capacity of host cells of different individuals may influence development of invasive disease by GBS-III.
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PMID:The effects of interferon-gamma and transforming growth factor-beta on adherence and survival of group B Streptococcus type III strains in ECV304 cells. 1257 48

Streptococcus agalactiae or group B streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis in neonates. One of the major questions is whether the GBS strains able to cause neonatal invasive disease have peculiar genetic features. A collection of S. agalactiae strains, isolated from cervix, vagina and rectum of 10 mothers and from throat, ear and umbilicus of their newborns was genetically characterized by pulsed-field gel electrophoresis (PFGE). This study demonstrated that the strains isolated from each mother and her child were all genetically identical but that the strains from the 10 mother/child pairs mutually were genetically heterogeneous and 10 different PFGE patterns were found. Although it has been suggested that PFGE would be able to identify virulence traits to direct decisions in antibiotic management, the heterogeneous feature of GBS strains does not support broad application.
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PMID:Genetic analysis of Streptococcus agalactiae strains isolated from neonates and their mothers. 1272 74

Only partially understood host defense mechanisms operate against infections affecting maternal and fetal morbidity. Subclinical ascending infections through the lower female genital tract are predominant worldwide. Important micronutrient deficiencies may prevail in low-income countries where these infections are much more common than in high-income countries. Important morbidities related to poor perinatal outcome both for the mother and for the fetus and newborn comprise preterm birth, prelabor rupture of membranes, placental abruption (predelivery detachment of the placenta), postpartum sepsis and maternal anemia. In the fetus, sepsis and intrauterine growth retardation are suspected to be consequences of ascending maternal infections. In the newborn, septicemia and respiratory disorders as well as some neurological disorders seem to be consequences of such ascending genital infections in the pregnant woman. It is concluded that much more attention should be given to efforts to elucidate the host defense mechanisms and antimicrobial barriers from the vagina through the cervix, fetal membranes and amniotic fluid including the early fetal immunocompetence in the second and the third trimester of pregnancy.
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PMID:Infection-related morbidities in the mother, fetus and neonate. 1273 Apr 81


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