Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The possibility of bilateral femoral neuropathy after microsurgical tuboplasty for the reversal of sterilization is possible. There seems to be little awareness of this condition by gynecologists and fertility surgeons. This type of femoral neuropathy has an excellent prognosis and only physiotherapy is necessary to aid muscular function. Some cases have been reported where recovery has been extremely slow, normal functions had taken months, and some disability lasted years. The femoral nerve is not included in the pelvis, therefore injury through operative procedures are unlikely. The self-retaining retractors were used in all reported cases and verified through clinical experience. There are 2 types of injury to the femoral nerve: Direct pressure on the nerve itself by retractor blades, and impingement of the psoas muscle and the nerve against the lateral pelvic muscle. Factors that increase the possibility of this condition include diabetes mellitus, rheumatism, gout, alcoholism, malnutrition, syphilis, tuberculosis, typhoid fever, tetanus, liver abscesses, sepsis of distal parts of the body, polyarteritis nodosa, anticoagulants, and bleeding diseases. Femoral neuropathy has been observed after using self-retaining retractors such as O'Connor, O'Sullivan, Mann, Collin and Balfour. The preventive measures suggested are to use a retractor with appropriate blade depth.
 ...
PMID:Bilateral femoral neuropathy after microsurgical reversal of tubal sterilization: case report and analysis of contributing factors. 362 33

Twenty patients (15 male, 5 female) with nonresectable gastric adenocarcinoma were treated with FAP (5-fluorouracil 300 mg/m2 IV on days 1-5, adriamycin 50 mg/m2 IV on day 1, cisplatin 20 mg/m2 IV on days 1-5). Each course was repeated every 21 days. Eighteen patients were evaluable for response. The median age was 51 years, the range extending from 34 to 68. None had undergone chemotherapy. The median Karnofsky performance score was 80%. Nine (50%) partial responses (PR) and eight (44%) cases of stable disease (SD) were observed. One patient showed progression of the disease and died after 6 months. The median duration of response was 6+ months for PR and 6 months for SD. The median survival was 12 months. FAP toxicity was moderate, with the median WBC nadir 3.2 X 10(9)/l (range 0.7-4.2). One patient in PR died of septicemia. Nausea and vomiting were not dose-limiting. Neuropathy was mild in four and moderate in two patients. This FAP combination appears to be as effective with respect to response rate and duration as reported for 5-fluorouracil, adriamycin and mitomycin C (FAM).
 ...
PMID:Phase II trial of 5-fluorouracil, adriamycin and cisplatin (FAP) in advanced gastric cancer. 403 85

From 1969 to 31 March 1982, 1,769 organ transplants were performed by the University of Minnesota Transplant Service. Fifty-one patients had severe osteonecrosis develop requiring 83 total joint arthroplasties. Patients with diabetes were underrepresented in the arthroplasty population; this may be due to neuropathy masking some disease. All of the patients received dramatic relief from pain and experienced improved function. Only one surgical mortality occurred--a patient with sepsis. To minimize complications, prophylactic antibiotics were used, and most patients did not undergo prophylactic anticoagulation. The most common complication was dislocation of the hip, at five to eight times the rate of those in the nontransplant arthroplasty population. These can be minimized by avoiding the posterior lateral surgical approach and by meticulous capsular repair. Despite the youth and activity of these patients, component wear was not a problem. However, because of the multicentric nature of this disease, components and surgical approach should be chosen carefully. Incidence of severe osteonecrosis was highest among cadaver kidney recipients. No HLA identical kidney recipient had severe osteonecrosis develop. Consequently, we concur with previous authors that osteonecrosis may be caused by the higher dosages of immunosuppressive agents required to prevent rejection of HLA nonidentical organs.
 ...
PMID:Osteonecrosis in the transplant recipient. 648 89

A new inherited neuromuscular disease was identified in 4 patients (1 male, 3 females), offspring of consanguineous marriages, belonging to the same kindred. The proband was a 24-year-old female with history of ptosis and ophthalmoplegia since childhood and progressive intestinal pseudo-obstruction for the last 4 years of her life. A sural nerve biopsy showed axonal and demyelinating neuropathy. Muscle biopsies of pectoral and gastrocnemius revealed myopathic alterations with marked variation in muscle fiber size, atrophy of both fiber types and normal mitochondria. An upper gastrointestinal study showed barium in the stomach after 8 h and jejunal diverticula. Tests for absorption of fat, protein, carbohydrate, folic acid and vitamin B12 were normal. Serum levels of vitamin A and lipoproteins were also normal. The patient underwent partial gastrectomy and gastrojejunostomy. Postoperatively, she developed severe pancreatitis, sepsis, peritonitis and expired. Tissue samples from the proband and from her brother, revealed normal mucosa, but degeneration of smooth muscle of the stomach and small intestine. The myenteric plexus and vagus nerves were normal. The biochemical studies of contractile proteins (myosin, actin, tropomyosin) in the fresh and cultured smooth muscle cells of the proband obtained at the time of gastrectomy showed a 50-75% decrease in the synthesis of different contractile proteins. Turnover of contractile proteins and synthesis and turnover of collagen showed normal values. The reduction in synthesis of contractile proteins may account for the weak peristalsis and be a factor in the pathogenesis of the intestinal pseudo-obstruction.
 ...
PMID:Inherited ophthalmoplegia with intestinal pseudo-obstruction. 668 98

Between 1977 and 1983, 105 patients had a postanal repair for the treatment of faecal incontinence. All except 8 patients were women. The principal reasons for operation were: persistent incontinence after rectopexy (n = 25), obstetric trauma (n = 18), anal dilatation (n = 12) and pelvic floor neuropathy (n = 41). One patient died after operation. Of 89 patients followed up for at least six months after operation, 56 (63%) have complete control of faeces and flatus, but 19 have control of solid faeces only and 14 are no better. The poor results were associated with wound sepsis and previous operations particularly in men.
 ...
PMID:Postanal repair for faecal incontinence. 671 79

The diabetic neurogenic paralytic bladder is characterized by marked residual urine, secondary infection, pyelonephritis, sepsis, and azotemia. Initial manifestations were studied in diabetic patients with and without neuropathy and in nondiabetic controls, all without symptoms referable to the urinary tract. The nondiabetic controls and the diabetics without neuropathy were urologically normal. Eighty-three percent of the diabetic patients with neuropathy had objective evidence of neurogenic bladder involvement; however, there was no residual urine, infection, pyelonephritis, sepsis or azotemia. The disparity between early and late bladder involvement is determined by the factor of residual urine, which is the measure of advancing bladder neuropathy leading to decompensation. Progressive decompensation of the asymptomatic diabetic bladder may be a cause of the increased frequency of renal infection in diabetic patients.
 ...
PMID:Development of urinary bladder dysfunction in diabetes mellitus. 735 22

Trauma and non-traumatic insults can cause muscle damage to such an extent that serious sequelae to other organs may result. Myoglobinuria and subsequent acute renal failure (ARF) is a well known and widely studied fact of such sequelae. Twelve cases of ARF (between 1990-1993) who have developed renal dysfunction after prolonged muscular exercise e.g., squat jumping, sit-ups and blunt trauma from sticks or leather belts mainly given by law enforcing personnel for certain issues were studied. None of them had previous history of myopathy, neuropathy or renal disease. All were critically ill on presentation and required renal support in the form of dialysis. Although morbidity was high in all, eleven of them recovered and one expired due to sepsis.
 ...
PMID:Acute renal failure due to traumatic rhabdomyolysis. 759 12

Critical illness neuropathy is a distinct form of polyneuropathy that develops as part of a syndrome often observed in critical care units consisting of septicemia with encephalopathy, respiratory failure with difficulty in weaning and an axonal degenerative polyneuropathy. Critical illness neuropathy (CIN) has been discussed in the recent neurological and critical care literature, but has not been discussed, to the best of our knowledge, in the rehabilitation literature. This article acquaints rehabilitation personnel with the methods used to diagnose CIN and differentiate it from other neuropathies and the impact that multidisciplinary rehabilitation may have on the outcome of this disorder. We found that with an appropriate history, and compatible physical findings, electrodiagnostic testing helped diagnose CIN and that intensive rehabilitation was advantageous in improving our patients conditions.
 ...
PMID:Critical illness neuropathy: diagnosis and management. 760 92

Our experience and that of others indicate that the number of very distal bypass operations is growing. From the early 1970s, when we performed a few operations per year, our numbers have increased to 60 to 65 operations annually, about 20% of all infrainguinal open revascularizations. Amputation of one leg leaves a patient, should he survive for a few years, with a second limb that is at substantial risk of infection or gangrene. From over 20 years of experience with thousands of diabetic leg problems and approximately 600 paramalleolar bypasses, the following facts have emerged from our clinical practice. Primary pedal arterial arches are virtually never complete. This alone should not deter the surgeon from attempting paramalleolar bypass grafting. Clinical details such as neuropathy, sepsis, and general medical status and even family support should not be overlooked as "risk factors." The order of frequency for pedal distal anastomotic sites will be anterior tibial/dorsalis pedis, posterior tibial/common plantar artery, lateral plantar artery/medial plantar artery, and lateral tarsal artery. In each case the graft should be placed as proximal as possible on the vessel; tibial outflow should be considered. Use short grafts with distal inflow whenever possible. In the rare instance wherein no pedal target site is available, consider the isolated tibial segment. Failure of a very distal bypass procedure seldom results in an amputation that is more proximal than otherwise would have been required if no bypass were attempted. As a corollary, after sepsis is controlled and all lesions and amputations are healed, failure of the graft may spare the limb from further risk of amputation. In diabetics, the presence of a palpable popliteal pulse and absence of foot pulse are tantamount to identifying the paramalleolar bypass graft candidate. Even the presence of palpable pedal pulses does not exclude patients who could achieve limb salvage with pedal bypass. That determination depends upon an angiogram. Pulsation and flow are not equivalent. Just as the obligations of the surgeon who performs an amputation are not discharged until healing and rehabilitation are complete, likewise, the vascular surgeon's duties after paramalleolar bypass must include a return to the ambulatory status. Careful follow-up, ongoing explicit patient and family education about foot care, and orthotics and shoes will enhance the life and life expectancy of the bipedal patient.
 ...
PMID:Bypass grafts to the ankle and foot. A personal perspective. 763 16

The initial diagnoses of associated injuries in patients with traumatic brain injury (TBI) are often overlooked because of the priority given to life-sustaining measures. Pelvic and abdominal injuries comprise less than 5% each of the concurrent injuries associated with TBI and multiple trauma. This report describes a 32-year-old man who sustained a moderate TBI with facial, pelvic, and extremity fractures secondary to a fall. His hospital course was complicated by sepsis, acute renal failure, and retroperitoneal hemorrhage. Admitted to the rehabilitation service 6 weeks after the fall, the patient was found to have a previously undiagnosed profound quadriceps muscle weakness. A diagnosis of femoral neuropathy was confirmed by electrodiagnostic studies and was attributed to compression by pelvic hematomas. Rehabilitation management included use of a solid ankle cushion heel (SACH) wedge, a functional knee brace, a progressive ambulation program, neuromuscular stimulation, and patient and family education with an emphasis on safety. The patient progressed rapidly with his rehabilitation program, improving from moderate assistance in all skills to independence in 3 weeks. This case illustrates the importance of the physiatrist's role in the early detection of associated injuries in patients with multiple trauma and TBI; it also illustrates some of the rehabilitation techniques that may be employed to aid a patient with a femoral neuropathy to regain junctional ability.
 ...
PMID:The rehabilitative management of the traumatic brain injury patient with associated femoral neuropathy. 774 23


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>