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)

Despite the increasing number of patients with the human immunodeficiency virus (HIV) infection, surgical experience with these patients remains limited. A retrospective review over a 9 year period (January 1985 to December 1993) was undertaken to determine the indications, operative management, pathologic findings and outcome of major abdominal surgery in these patients. A total of 51 procedures were performed in 45 patients; 30 patients had acquired immunodeficiency syndrome (AIDS) and 15 patients had asymptomatic HIV infection. Indications included gastrointestinal bleeding, complicated pancreatic pseudocysts, cholelithiasis, bowel obstruction, immune disorders, acute abdomens, elective laparotomy, colostomy formation, menorrhagia and Caesarean section. Pathologic findings directly related to the HIV infection were found in 81% of the AIDS patients and 35% of the asymptomatic HIV infected patients (P < 0.05). These included opportunistic infections, non-Hodgkin's lymphoma, Kaposi's sarcoma, immune disorders, lymphadenopathy and pancreatic pseudocysts. It was noted that AIDS patients had more complications than asymptomatic HIV infected patients with most complications related to chest problems and sepsis (61 vs 7%; P < 0.01). Emergency operations carried a higher complication rate than elective operations though this was not significant. The hospital mortality was 12%. On follow up, 13 of the 25 AIDS patients had died with the median survival of 7 months, while three of the 14 asymptomatic HIV infected patients had died with the median survival of 40 months. Of the remaining patients, the 12 AIDS patients had a median postoperative follow up of 7 months and the 11 asymptomatic HIV infected patients had a median postoperative follow up of 29.5 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Abdominal surgery in HIV/AIDS patients: indications, operative management, pathology and outcome. 774 74

Sepsis following caesarean section remains an important cause of morbidity in Uganda's Mulago Hospital. This study was designed to assess whether asymptomatic HIV infection could be contributing to this form of morbidity. A total of 500 patients who had undergone emergency CS had their blood tested for HIV-1 on the 1st postoperative day. They were followed-up for wound sepsis, genital tract infection and duration of stay in the hospital after the operation. There were 98 (20.5%) HIV-1 seropositives. The incidence of postoperative wound sepsis (p = 0.948, 95% CI 0.56-1.86), genital tract infection (p = 0.339, 95% CI = 0.74-2.39) and hospital stay > 8 days (p = 0.327, 0.78-2.09) were not statistically significantly different between the cases and controls. Significant predisposing factors to postoperative morbidity were poor general condition on admission, dehydration, preoperative clinical anaemia, and ruptured membranes prior to the operation. Postoperative morbidity following emergency caesarean section was not statistically associated with retrospective asymptomatic HIV-1 infection.
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PMID:Maternal morbidity following emergency caesarean section in asymptomatic HIV-1 infected patients in Mulago Hospital Kampala, Uganda. 1906 65

Patients positive for the human immunodeficiency virus (HIV) are more susceptible to sepsis and malaria, two conditions known to activate the coagulation system. As chronic HIV infection also influences haemostatic mechanisms, we determined the influence of HIV co-infection on coagulation, anticoagulation and the endothelium during sepsis or malaria. We performed a prospective observational study in 325 subjects with or without HIV infection (103 with sepsis, 127 with malaria and 95 asymptomatic controls) in an HIV endemic area in Central Africa. We measured plasma biomarkers indicative of activation of distinct haemostatic mechanisms. Sepsis and malaria had similar effects with elevated markers of coagulation, reduced anticoagulation markers and activation of endothelium. In particular, asymptomatic HIV infection reduced the plasma levels of the anticoagulant co-factor free protein S, and increased activation of the vascular endothelium, which were not normalized by combination antiretroviral therapy. HIV co-infection during sepsis and malaria caused more profound changes in free protein S and von Willebrand factor in sepsis and malaria, and ADAMTS13 in sepsis, while not influencing sepsis- or malaria-induced coagulation activation. These results show for the first time that HIV infection augments selective haemostatic changes during sepsis and malaria, which may contribute to the enhanced morbidity of these conditions in HIV patients.
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PMID:Impact of HIV infection on the haemostatic response during sepsis and malaria. 2697 Apr 8