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)

A frequent and previously uncharacterised association of anorectal inflammatory disease in seven of twenty-two patients undergoing therapy for nonhaematological malignancy is described. Sepsis and secondary pulmonary infection were distant complications of the anorectal lesions. The degree of granulocytopenia induced by chemotherapy appears to be the major predisposing factor. Management includes early surgical intervention, and preventive measures specific for this patient population.
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PMID:Anorectal disease in patients with non-haematological malignancy. 5 10

Our experience with 18 patients undergoing pelvic exenteration for advanced primary or recurrent pelvic malignancies is presented. Only one postoperative death was noted, and morbidity was minimal despite the advanced age and high incidence of radiotherapy failures seen in our patients. Although no improvement in cure of malignancy has been seen in this small series, appreciable periods of symptom-free life have been achieved in patients who were previously incapacitated by extensive pelvic pain, fistulas, sepsis, hemorrhage and urinary-fecal incontinence. Because of the symptomatic palliation obtained in our experience, with minimal morbidity and mortality, we have developed a liberal attitude toward the use of pelvic exenteration in the management of selected patients with extensive pelvic malignancy, even when cure is not anticipated.
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PMID:New look at pelvic exenteration. 5 61

It has been traditional to exclude patients with radiation-recurrent carcinoma of the uterine cervix or other pelvic neoplasms, incapacitating pelvic pain, postirradiation fistulas, hemorrhage, or malodorous draining tumor necrosis from pelvic exenteration if cure of the malignant disease is not achievable. This negative attitude is a direct result of the reported high morbidity, prohibitive mortality, and low salvage rate previously associated with pelvic exenteration, the only acceptable surgical approach to these diseases. A recent experience with eighteen patients who underwent pelvic exenteration for advanced primary or recurrent carcinoma of the cervix, urinary bladder, or rectum has led us to challenge several traditional concepts regarding this operative procedure. We have observed but one operative death and our morbidity has been minimal. This may reflect our belief that an aggressive pelvic lymphadenectomy in those patients with direct visceral involvement from radiation-recurrent carcinoma of the pelvic viscera is not advantageous since no significant survival has ever been documented for patients with pathologic visceral involvement and positive lymph nodes. In addition, significant morbidity has always been associated directly with pelvic lymphadenectomy in the irradiated pelvis, and elimination of this phase of the operation in selected patients with radiation-recurrent carcinoma is indicated. Moreover, the considerable decrease in morbidity and the minimal mortality observed have led us to adopt a very liberal attitude toward preoperative selection criteria, and we regularly now use pelvic exenteration not only for cure but as intentional palliation in selected patients. We strongly believe that elimination of pain, fistulas, pelvic sepsis, hemorrhage, and malodorous areas of tumor necrosis are important for improving the quality of life for both the patient and family.
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PMID:Pelvic exenteration as palliation of malignant disease. 5 24

According to cell cycle synchrony principles, bleomycin was infused for 48 hours, followed by a dose of either methotrexate or hydroxyurea after a 24-hour rest, in 36 adult patients with disseminated carcinoma. In this preliminary study, a 59% response rate was noted among patients with epidermoid carcinoma of the head and neck. Four of four patients with transitional cell carcinoma of bladder and one patient with hypernephroma also responded. No responses were noted among five patients with epidermoid carcinoma of the lung. The length of response ranged from 1 to 8 months (median, 2 months). Seventy-seven percent of the responders had extensive prior radiotherapy. The first patient treated had fatal sepsis with leukopenia, which prompted a widening of the treatment interval. Subsequently, toxicity was mainly mild or absent, the moderate or severe toxicity was primarily neutropenia, which was reversible. The use of low-dose bleomycin infusion is safe and may play a role in cancer therapy in combination with other agents specific for certain tumors. The length of infusion should be determined by the cell cycle of the tumor, if its potential synchronizing capabilities are to be exploited.
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PMID:Intravenous bleomycin infusion as a potential syncronizing agent in human disseminated malignancies: a preliminary report. 6 5

The factors important in host defense against group B streptococci are not well understood. The role of antibody and complement in the prevention of serious infection by these organisms is not known because, to date, a reliable measure of functional opsonic activity has not been developed. Recently, it has been shown that neutrophils produce a chemiluminescence after ingestion of particulate matter, and that this event can be detected and quantitated in a liquid scintillation system. We have adapted the chemiluminescence procedure to examine rabbit hyperimmune and human serum for the presence of group B streptococcal opsonins. Group B streptococci of types Ia, II, and III that were opsonized in homologous but not heterologous type serum produced a peak in chemiluminescence when added to normal human neutrophils. Such activity was correlated, in each instance, with ingestion of bacteria by neutrophils and deposition of immunoglobulin and C3 on the bacterial surface as detected by indirect immunofluorescence. With this assay, we have examined sera from colonized and diseased patients for the presence of opsonins to types Ia, II, and III group B streptococci. Maternal sera often contained type-specific opsonins which resided in the IgG fraction and which crossed the placenta to appear in paired cord specimens. 63% of patients colonized with group B streptococci had serum opsonins to their colonizing type of organism. In contrast, none of the 15 patients with sepsis or meningitis had opsonins directed against their infecting strain. These data suggest that the lack of type-specific opsonins to group B streptococci may be one of the important factors in determining host susceptibility to systemic infection with strains of this group.
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PMID:Assessment of group B streptococcal opsonins in human and rabbit serum by neutrophil chemiluminescence. 6 61

Indices of nutritional state were measured in 105 surgical patients. The indices were chosen to give information on protein-calorie malnutrition, anaemia, vitamin deficiency. Abnormal values for the various indices were common in the group as a whole and most frequent (50%) in patients who were still in hospital more than a week after major surgery. These patients had a high frequency of anaemia, vitamin deficiency, weight-loss, loss of arm-muscle bulk, and low plasma levels of transferrin and albumin. These abnormalities had gone almost entirely unrecognised, even in patients with sepsis after major surgery, who would benefit from improvement in nutritional state.
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PMID:Malnutrition in surgical patients. An unrecognised problem. 6 85

The value of selecting patients for antibiotic cover during biliary surgery by the use of immediate gram stains of bile was determined in a nonrandomized prospective study which compared two groups of patients. Group A consisted of 119 consecutive patients in whom antibiotics were administered during operation according to the results of immediate gram stains on bile. Group B included 101 patients, none of whom received antibiotics. In Group A gentamicin was given for gram-negative bacteria, ampicillin for gram-positive organisms, and no antibiotics were given if no bacteria were seen on the gram stain. In Group A the incidence of wound sepsis was 7 percent, compared with 22 percent in Group B (p less than 0.005). Septicemia occured in 2 percent of Group A, compared with 8 percent in Group B. It is concluded that immediate gram stains of bile will provide a means of selecting patients requiring antibiotic cover during biliary surgery; furthermore, this procedure is a practical way of reducing postoperative sepsis while avoiding unnecessary antibiotic administration.
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PMID:Selecting patients requiring antibiotics in biliary surgery by immediate gram stains of bile at operation. 6 64

Seventy-eight patients underwent palliative resections for adenocarcinoma of the colon or rectum. The operative mortality was 6.4 per cent. The high morbidity rate of 43.5 per cent, mostly attributable to errors in operative technic and sepsis, could not be related to the extent of tumor spread. In fifty-nine patients long-term follow-up revealed a mean survival time of 12.4 months and a median of 9.1 months. Thirty-eight patients (64.4 per cent) survived six months, twenty patients (33.8 per cent) one year, seven patients two years, and one patient five years. Patients with only local extension of disease had the most favorable duration of survival. Hepatic or peritoneal involvement alone did not preclude long-term survival, but with the two combined the outlook was less favorable. There is a small group of patients with extensive metastatic disease who will not benefit from resection. Otherwise, adenocarcinoma of the colon or rectum with local or distant metastases should be resected when feasible.
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PMID:Palliative resections in the treatment of primary colorectal cancer. 6 9

A phase II study utilizing 5-azacytidine in the treatment of patients with solid tumors was carried out by the Southwest Oncology Group (SWOG-7208). Of 214 patients entered in the study 191 were eligible and 167 were evaluable. While initially they received 225 mg/m2 iv on Days 1--5 every 3 weeks because of toxicity the dose was subsequently reduced to 175mg/m2 and later to 150 mg/m2. Five partial regressions, 2.6% of the eligible patients and 3% of the evaluable patients, lasting from 28 to 77 days were observed. Sixteen patients 8.4% of the eligible patients and 9.6% of the evaluable patients, had no significant change in their disease for 39--255 days. The major toxicities were myelosuppressive and gastrointestinal with 13 deaths attributable to drug toxicity: 11 due to sepsis and two due to cerebral hemorrhage. 5-Azacytidine induced few favorable responses; those that did occur usually were of poor quality and short duration and were associated with significant toxicity.
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PMID:Phase II study of 5-azacytidine in solid tumors. 6 93

In a group of 69 patients receiving levamisole the drug had to be discontinued in 15 (21-7%) because of intolerable but reversible side-effects including gastrointestinal upset, "flu-like" syndrome, central nervous system disturbances, and skin rash. Reversible agranulocytosis with life-threatening sepsis occurred in a patient receiving levamisole immunotherapy for colonic carcinoma. Neutrophils and platelets were both severely affected. Levamisole-dependent leucoagglutinins appeared with circulating immune complexes during the acute phase of the illness, suggesting an immune drug reaction.
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PMID:Complications of cancer immunotherapy with levamisole. 6 26


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