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)

Skin tests (ST) in 1332 patients are associated with increased morbidity from sepsis. Patients with normal skin tests had a 7% major sepsis rate and 2% mortality rate. Thirty-six per cent of anergic (A) patients and 21% of relatively anergic (RA) patients died; 52% of A patients and 34% of RA patients had sepsis. These data include all patients studied and represent their worst skin test. Two studies were done. The first was a retrospective evaluation of effect of surgery upon 49 anergic patients with biliary tract disease, colon cancer, bowel obstruction, hypovolemia and visceral abscesses. The patients did not receive total parenteral nutrition (TPN). The data show that surgery without TPN can reverse the anergic state and did so in 84% of patients reported. The second study was a prospective, double-blind, randomized trial of the effect of levamisole on skin tests, neutrophil chemotaxis (CTX), sepsis and mortality iin 39 preoperative anergic patients. Major sepsis was significantly increased in placebo group (p less than 0.05). Mortality, minor sepsis, restoration of skin tests and chemotaxis were somewhat better in levamisole patients but not statistically so. These studies show that in addition to TPN, surgery and immunorestorative drugs are viable approaches to the management of selected anergic patients.
 ...
PMID:Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. 11 27

Over a 7 year period, 85 cancer patients were managed by the nutrition service of St. Joseph's Hospital, Toronto. All these patients were nutritionally depleted, had obstruction to the gastrointestinal tract, or had postoperative complications such as enterocutaneous fistulas, evisceration or intraabdominal sepsis, which left total parenteral nutrition (TPN) as the only means of achieving positive nitrogen balance. A prospective study started in 1970 has found that when cancer was resectable and TPN was started preoperatively and continued postoperatively (24 patients-group 1) until the patient could take a normal diet, no deaths or significant complications occurred. When TPN was first started after life-threatening complications had occurred (53 depleted patients-group 2), the mortality was 17.0%. This mortality was only 4.5% after complications following operations for colon cancer, but was much higher with esophageal, pancreatic and bladder cancer, and especially after complications following surgery where radiotherapy had previously been given to abdomen or pelvis. When TPN was used in inoperable, cachectic patients (8 patients-group 3) to permit them to tolerate radiotherapy or chemotherapy, the mortality was 37.5%. This latter group is small, but TPN is worthwhile in selected patients where significant palliation and improvement in the quality of life can occur.
 ...
PMID:Specialized nutritional support in the cancer patient: is it worthwhile? 41 70

We prospectively studied patients with Streptococcus bovis septicemia for the presence of gastrointestinal lesions. This study was prompted by our reported findings of the association of fecal carriage of S. bovis with carcinoma of the colon. We studied 29 patients with 30 episodes of S. bovis septicemia. Fifteen completed gastrointestinal evaluations that included colonscopy, surgery, or autopsy. Eight of these had carcinoma of the colon, three had adenomatous polyps of the colon without carcinoma, and two had carcinoma of the esophagus. The 14 patients who did not have complete evaluations included one each with carcinoma of the stomach, gastric lymphoma, and adenomatous polyp of the colon and three with colonic masses not further delineated. Nineteen patients had no gastrointestinal signs or symptoms or stools positive for occult blood at admission. The results of our study suggest that all patients with S. bovis septicemia need aggressive evaluation of the gastrointestinal tract, especially the colon.
 ...
PMID:Streptococcus bovis septicemia and carcinoma of the colon. 48 53

The efficacy of the neomycin-erythromycin combination as prophylaxis before operation for carcinoma of the colon (3 gm. of each of the day preoperatively, plus mechanical cleansing) was evaluated in a study of 74 patients for whom primary operations for colon carcinoma were performed from January 1973 through June 1974. Twenty three other patients received other preparations. Of the 74 who received neomycin and erythromycin, 4 had postoperative infectious complications (5 per cent). Of the 23 patients who received other preparations, 8 had significant complications (35 per cent). Although operability, age, concurrent medical problems and surgical technique probably influence postoperative sepsis, the use of oral neomycin-erythromycin combination as preoperative prophylaxis appears satisfactory for prevention of infection after operations for colon carcinoma.
 ...
PMID:Preoperative preparation of the patients with carcinoma of the colon. 110 33

The records of 56 patients at an urban hospital who had positive blood cultures for clostridia were reviewed. Each patient was classified as immunologically normal or immunosuppressed. Data were collected on clinical history, type of clostridial bacteremia, physical and laboratory determinants of infection, therapeutic intervention, clinical course and outcome. Of the 56 patients, 22 were determined to be immunosuppressed. Among all 56 patients, 28 had a malignancy, usually gastrointestinal or hematologic in origin. Fever, leukocytosis and abdominal pain were common in both groups. Clostridial bacteremia almost always heralded clostridial septicemia. A gastrointestinal source of infection, particularly carcinoma of the colon or rectum or enterocolitis, was evident or presumed in 43 of the 56 patients. Clostridium perfringens was the most frequently isolated microorganism, but C. septicum was associated with more complications and a higher mortality rate. Septic complications and mortality were higher among the patients with immunosuppression.
 ...
PMID:Clostridial septicemia in an urban hospital. 155 7

Ten previously untreated patients with gastric cancer were treated with etoposide, 120 mg/m2 intravenously (i.v.) on days 4, 5, and 6, Adriamycin, 20 mg/m2 i.v. on days 1 and 7, and cisplatin, 40 mg/m2 i.v. on days 2 and 8 (EAP). Etoposide, 240 mg/m2 on days 4, 5, and 6, was administered orally instead of intravenously in alternating cycles, and pharmacokinetic studies were performed in those who had previously undergone gastrectomy or who had tumor infiltrating the stomach to determine oral bioavailability. Nine patients had advanced measurable gastric cancer, and one patient had an elevated carcinoembryonic antigen after surgery for synchronous gastric and colon cancer. The median age was 54 years (range 38-69), and the median Eastern Cooperative Oncology Group (ECOG) performance status was 2 (range 0-3). Nine of 10 patients had poorly differentiated adenocarcinoma. Twenty-four cycles were administered to 10 patients, and hematologic data were available for 23 courses. ECOG grade 4 neutropenia and thrombocytopenia developed in 19 (83%) and 8 (53%) courses, respectively. Thirteen courses (54%) were complicated by fever requiring parenteral antibiotics. Two patients (20%) died due to neutropenic sepsis. The profound myelotoxicity observed in our study prompted us to terminate the investigation prior to completing accrual. The oral bioavailability of etoposide was 21% and 36% in the two patients who had had prior gastrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Phase II trial of etoposide, doxorubicin (Adriamycin), and cisplatin (EAP regimen) in advanced gastric cancer. 222 Jun 57

Recombinant interferon alfa-2a (rIFN alpha-2a) synergistically augments the cytotoxic effects of the antimetabolite fluorouracil (5-FU) against two human colon cancer cell lines. A pilot clinical trial was initiated to determine whether this same combination of agents would show clinical utility greater than that expected with 5-FU alone in patients with advanced colorectal carcinoma. 5-FU was administered at 750 mg/m2/d for 5 days as a continuous intravenous infusion followed by weekly bolus therapy. rIFN alpha-2a was administered at 9 million units subcutaneously three times per week starting on day 1. Doses of 5-FU were modified for mucosal toxicities and myelo-suppression, and doses of rIFN alpha-2a were modified for fatigue and neurologic toxicities. Thirty-two previously untreated patients with advanced colorectal carcinoma were entered into a clinical trial. With the exception of one patient with a destructive lesion of the sacrum, all patients had metastases to visceral organs, abdominal wall, or pelvis. Twenty patients (63%) achieved a partial response, seven remained stable, and five had progressive disease. Mucosal toxicities limited delivery of full projected dose. Two patients died following episodes of watery diarrhea progressing to sepsis. A third died suddenly, secondary to an interstitial pneumonitis. The remainder of the toxicities were managed with dose reductions. At the median follow-up of 8 months, 23 of 32 patients remain alive. Nine are alive at 16 to 30+ months. The early results of this single-institution study are promising, but will require confirmation in a multi-institutional setting currently being conducted by the Eastern Cooperative Oncology Group.
 ...
PMID:Clinical update on the role of fluorouracil and recombinant interferon alfa-2a in the treatment of colorectal carcinoma. 240 91

The Mayo Clinic and the North Central Cancer Treatment Group (NCCTG) conducted a randomized clinical trial comparing five different combination chemotherapeutic regimens to single-agent 5-fluorouracil (5-FU), given by intravenous bolus technique (500 mg/m2 for 5 days) as a control, in the treatment of advanced colorectal cancer. This report summarizes the results of treatment in 208 patients who were randomized to 5-FU alone or 5-FU with leucovorin in either a high-dose (200 mg/m2) or a low-dose regimen (20 mg/m2) intravenously for 5 days. Both of the 5-FU with leucovorin regimens were associated with improved survival compared with single-agent 5-FU (P less than 0.03). The interval to tumor progression, measurable tumor response rates, and measures of quality of life (performance status, weight gain, and symptomatic relief) were also improved significantly with the addition of leucovorin. There was no therapeutic advantage associated with the use of high-dose compared with low-dose leucovorin. The dose-limiting toxicity of 5-FU/leucovorin was stomatitis. There was one treatment-related fatality (due to sepsis) among the 138 patient receiving 5-FU/leucovorin (0.7%). The most favorable regimen in this trial was 5-FU with low-dose leucovorin, based upon considerations of therapeutic effectiveness, toxicity, and cost. A national intergroup trial is being coordinated by the National Cancer Institute that will test the efficacy of low-dose leucovorin with 5-FU as one approach to adjuvant therapy after a curative surgical resection in selected patients with Dukes' Stage B2 or C colon cancer.
 ...
PMID:A phase III trial of 5-fluorouracil and leucovorin in the treatment of advanced colorectal cancer. A Mayo Clinic/North Central Cancer Treatment Group study. 246 76

Based on in vitro studies that have demonstrated synergy between recombinant alfa-2a-interferon (rIFN alpha-2a) and the fluoropyrimidine, fluorouracil (5FU), against two human colon cancer cell lines, a pilot clinical trial was initiated to determine the effects of the combination of 5FU and rIFN alpha-2a in patients with advanced, unresectable colorectal carcinoma. A total of 30 patients were enrolled; all were evaluable. 5FU was administered as a loading course, 750 mg/m2 daily for 5 days by continuous infusion followed by weekly bolus therapy, rIFN alpha-2a, 9 MU, was administered subcutaneously three times per week. Of 17 previously untreated patients evaluable for response, 13 achieved a response. Three patients had disease progression. No previously treated patients had a major response. There was one death clearly related to therapy, an event preceded by watery diarrhea and neutropenic sepsis. Other toxicities were reversible and responded to dose reduction. With a median follow-up of 16+ months, median survival has not been reached among the previously untreated patient cohort. We conclude that the combination of 5FU and rIFN alpha-2a is an active regimen against disseminated colorectal cancer in previously untreated patients.
 ...
PMID:Fluorouracil and recombinant alfa-2a-interferon: an active regimen against advanced colorectal carcinoma. 258 16

Symptoms, cause and survival in 11 patients with right heart endocarditis hospitalized from 1973 to April 1989 were analyzed. The main symptoms were high fever, chest pain and dyspnea due to septic pulmonary emboli. The age of the 6 men and 5 women ranged from 19 to 66 years. 9 intravenous drug abusers and a patient with a pacemaker and carcinoma of the colon had tricuspid valve endocarditis. In another patient without known risk factors the aortic valve was affected as well. Staphylococcus aureus was isolated in 9 cases, in two as a double infection with Candida albicans and streptococcus group G respectively; beta-hemolytic streptococci group A and enterococci were found in the two remaining patients. Based on the well known high sensitivity of 2D-echocardiography, only cases with detectable tricuspid valve vegetations have been included in this retrospective study since this method became available. 10 patients were treated by antibiotics. In a single patient the tricuspid valve was removed after antibiotic pretreatment and an artificial valve was implanted 7 months later. Two patients died, one a few days after admission due to overwhelming sepsis, and one from intracerebral hemorrhage caused by an embolized aortic valve vegetation. The other patients have survived for a mean 44 months (range 2 to 183 months). Endocarditis of the right heart differs from left heart endocarditis through its typical clinical presentation, a different spectrum of microorganisms and a favourable outcome under antibiotic treatment.
 ...
PMID:[Right heart endocarditis]. 268 8


1 2 3 4 5 6 7 Next >>