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)

Acute and chronic starvation is often associated with childhood cancer. Total parenteral nutrition (TPN) with 20% glucose and 3.0% amino acids, and minerals and vitamins was instituted to treat or prevent malnutrition in 41 children with cancer, ages three months to 18 years. TPN was required for anorexia, vomiting and diarrhea associated with anti-cancer therapy in 33 patients for intestinal complications or surgery in nine, and for preoperative correction of malnutrition in two. During TPN, general nutrition and appearance improved in all patients. Weight gain was noted in most. Despite gastrointestinal complications which usually require the interruption of chemotherapy and irradiation, in 21 children treatment could be continued at full dose with nutritional support by TPN. TPN was discontinued in six patients when blood cultures became positive. Sepsis was treated successfully by removal of the central venous catheter in all six and administration of antibiotics in three. No metabolic complications were noted. TPN appears to be a safe and effective means of combating the malnutrition which may occur with cancer and its therapy.
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PMID:Parenteral nutritional support in children with cancer. 40 34

A number of medical and surgical conditions in gastro-enterology are important indications for modern parenteral nutrition. In such conditions only parenteral nutrition can provide adequate nourishment and prevent malnutrition. It is important in these cases to provide complete intravenous nutrition, comprising amino acids, carbohydrates, fat, electrolytes and vitamins. Furthermore, a special infusion technique must be used in order to reduce such complications as catheter sepsis to a minimum.
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PMID:Parenteral nutrition in surgical and medical gastroenterology. Clinical review. 41

In the USA, erythrocytic glutathione reductase (GSSG-R) deficiency is significantly more common, and can be considerably more pronounced in hospitalized patients (118/3198) than in outpatients (37/1639) or in apparently healthy persons (12/849). Retrospective analysis of illnesses found in 118 inpatients with erythrocytic GSSG-R deficiency revealed a striking and previously unsuspected association of the enzyme deficiency with a variety of chemotherapeutically treated hematological or nonhematological malignancies (51/118 patients, 43.2%, or 51/170 diagnoses, 30.0%). The prevalence of erythrocytic GSSG-R deficiency also increased in malnutrition, liver disease, and sepsis. Drugs of the nitrosourea class, particularly BCNU [1, 3-bis(2-chloroethyl)-1-nitrosourea] are causally implicated in the association of GSSG-R deficiency with malignancies. Severe of complete GSSG-R deficiency may handicap host response to infections.
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PMID:Erythrocytic glutathione reductase deficiency in a hospital population in the United States. 60 23

A 6 month-old mulatto boy was admitted on account of acute gastroenteritis, malnutrition and dehydration. In the hospital, the child developed septicemia, and temperature reached up to 38.6 degrees C. Despite intensive antibiotic treatment the patient died 12 days after admission. Necropsy disclosed bilateral bronchopneumonia, bilateral fronto-parietal subarachnoid hemorrhage, and extensive necrosis of the inferior half of both cerebellar hemispheres. On histopathological examination of the necrotic cerebellar cortex, numerous sickled erythrocytes were observed in petechial hemorrhages, and, in lesser quantities, inside capillaries. Lesions of the central nervous system in sickle cell anemia most often involve the cerebral cortex, and a single extensive cerebellar infarction as present in this case seems extremely rare. The pathogenetic mechanism of the necrosis is unclear, since thrombosis was not observed either in large blood vessels or in capillaries. Possible contributory factors were the infectious condition (septicemia), fever, and anoxia caused by the extensive bronchopneumonia.
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PMID:[Extensive cerebellar necrosis in sickle cell anemia. Report of a case]. 75 14

Among fourteen patients with disruption of the thoracic esophagus, the overall mortality rate was 36%. The mortality was greatly reduced in a group of five of these patients who were treated by closed-chest tube drainage and intravenous hyperalimentation. The cause of death in most cases was sepsis and malnutrition. Although the ideal treatment in early cases of eosphageal disruption is thoracotomy and direct suture, it is believed that in patients presenting late, in old and debilitated patients, and in cases of a leaking thoracic anastomosis, the mortality will be greatly improved by the use, primarily, of conservative measures,, with the addition of intravenous hyperlimentation.
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PMID:Management of late cases of esophageal disruption with intravenous hyperalimentation. 80 43

The study in 14 patients with severe and protracted infectious gastroenteritis is reported. In all cases, intolerance to monosaccharides was present and in 13 cases, third degree malnutrition was evident. The period of evolution of the diarrhea was, as an average, 67.6 days at the moment when parenteral feeding was initiated. Eight of the cases had shown sepsis, intestinal pneumatosis and hypoglycemia in six and gastrointestinal hemorrhage was found in another six patients. They were managed with parenteral feeding for an average period of 21.5 days, during which, they gained an average of 14.6 g/day. Six episodes of sepsis were seen during the procedure, but in no case did it follow infection through the central catheter. Four of the patients died, but in no case was there any direct relationship to the procedure. In this type of severely ill patients with protracted diarrhea, parenteral feeding is a resource that allows the defunctionalization of the intestine and recovery of these patients.
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PMID:[Parenteral feeding of infants with prolonged diarrhea and intolerance to monosaccharides]. 81 49

Nutritional therapy is influence both by disease and nutritional status. In addition, the degree of protein depletion in large part dictates the urgency of aggressive nutritional therapy. The presenceof hypermetabolism where the hormonal substrate response is distinctly antagonistic to replacement therapy precludes effective repair of nutritional depletion. Sepsis further antagonizes efforts at nutritional support. For these reasons no elective or semielective procedure that carries a risk of prolonged stress, hypermetabolism, and sepsis should be performed until adequate nutritional status has been obtained. Enteral feeding programs are to be preferred due to their risk-benefit and cost-benefit ratios. However, impaired digestive function related to disease often limits their use and reliance on parenteral nutrition becomes necessary. While each patient has unique needs and responses, a systematic approach based on objective measurements will most often result in effective nutritional therapy. The accomplished therapist will apply the "modular" approach using the wide variety of products and techniques now available. Ignoring the support of protein synthesis and the preservation of lean body mass can no longer be considered good patient care even in the management of the semistarved state. There is no longer any justification for allowing nosocomial malnutrition to alter the morbidity and mortality of disease. With proper skills in the techniques of protein-calorie therapy and the availability of adequate techniques for nutritional assessment, the science of nutritional therapy now affords the opportunity to provide optimal care for the injured hospitalized patient.
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PMID:Nutritional care of the injured and/or septic patient. 82 48

One hundred and nineteen patients with gastrointestinal fistulas were treated in the Massachusetts General Hospital, Boston, in the period from January 1960 to January 1970. None of these patients was hyperalimented. The mortality in this seris amounted to 15%; 78.2% of the patients had their fistulas closed. These results are correlated with primary disease, etiology, fistula output, fistula location, type of treatment, malnutrition, electrolyte disturbances and sepsis. In the discussion it is concluded that treatment based on sound surgical principles acquired in the past decades, with the support of modern techniques of intensive patient care, should considerably diminish mortality and improve closure rate.
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PMID:One hundred and nineteen patients with gastrointestinal fistulas. 84 64

Delayed hypersensitivity skin testing was performed on 520 surgical patients. Significantly higher incidences of sepsis and mortality (p less than 0.001) were found in the abnormal patients as compared to normal responders in the preoperative (322 patients), postoperative and post-trauma (115 patients), and nonoperative (83 patients) groups. Sequential testing in individual patients was of even greater prognostic value. Of the 177 patients who either remained normal or whose responses became normal, the sepsis rate was 10.1%, and the mortality rate was 8.4%. However, a sepsis rate of 57.6% and a 78% mortality rate were found in those patients who developed abnormal responses or whose responses did not improve. Cancer and increased age (older than 80 years) did not account for the incidence of anergy and relative anergy. The mortality rate was higher in the cancer group. Anergy and relative anergy were found to be associated with malnutrition, sepsis, shock, and trauma. In the clinical setting, effective treatment of these associated conditions, especially the maintenance of body cell mass by the use of total parenteral nutrition, was associated with reversal of the anergic state and an improved prognosis.
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PMID:The delayed hypersensitivity response: application in clinical surgery. 88 2

The study included 28 infants with infectious gastroenteritis who evolved with disturbances of coagulation and in whom laboratory tests were practiced by micromethods through capillary puncture. The most frequently seen abnormality was a combination of vitamin K dependent factors deficiency with thrombocytopenia. Another observation in our study is that hypofibrinogenemia in infants with infectious gastroenteritis is not always secondary to disseminated intravascular coagulation. A decrease in fibrinogen in these cases is explained by a lack in synthesis of this factor in infants with malnutrition since out of 16 malnourished infants, 75% evolved with hypofibrinogenemia, while eutrophic infants evolved with normal fibrinogen. The disseminated intravascular coagulation syndrome was seen more frequently in patients with infectious gastroenteritis complicated with septicemia and shock, 57% of the patients did not show manifestations of bleeding nor of thrombosis which justifies in these cases a systematic investigation of the coagulation mechanism.
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PMID:[Blood coagulation disorders in infants with infectious gastroenteritis]. 91 59


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