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)

An autopsy case of smoldering adult T-cell leukemia (ATL) is presented. 67 year-old woman was admitted to our hospital with complaints of fever, cough and increasing dyspnea on October 2, 1985. Laboratory findings revealed high LDH, azothermia and slightly leukocytosis with low percentage of flower cells. CRP was strongly positive. Gas disturbance was markedly. Anti-ATLA antibody using indirect immunofluorescence method was X40 positive. Subsets of peripheral lymphocytes showed OKT 4 dominant. (OKT 3; 67.5%, OKT4; 60.6%, OKT8; 8.8%). A chest X-ray film revealed cardiomegaly and fine granular shadows in bilateral lower pulmonary fields. Diagnosis of interstitial pneumonitis was defined in transbronchial lung biopsy (TBLB) specimen. O2 therapy, steroid therapy added antibiotics were ineffective, respiratory failure and renal failure were progressive, she died by septic shock in 39th hospital days. In autopsy, no characteristic histological changes of ATL were found in lymph node, bone marrow, spleen, liver, kidney and lung. Sepsis was the cause was of death. Finally this case diagnosed smoldering ATL and pulmonary fibrosis due to bronchial ectasia with repeated pulmonary bacterial infections. The pulmonary complications of patients with ATL were discussed.
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PMID:[Smoldering adult T-cell leukemia complicating severe respiratory failure--an autopsy case report]. 288 12

Central pontine myelinolysis, also known as osmotic demyelination syndrome, is an uncommon disorder associated with rapid correction of severe hyponatremia. We present the case of a healthy young pregnant woman with hyperemesis gravidarum who developed severe hyponatremia (serum sodium 103 mEq/L). After rapid correction of her serum sodium within 12-15 hours with a 0.9% saline solution, the patient became comatose and died of sepsis and respiratory failure. Examination of the brain showed extensive demyelination in both pontine and extrapontine areas.
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PMID:Central pontine myelinolysis and pregnancy. 291 74

Bacteremia with resultant damage to multiple organ systems remains a serious problem in intensive care of human patients. We have developed a clinically relevant swine model of sepsis-induced adult respiratory distress syndrome (ARDS). Twenty-three animals were given various doses of Pseudomonas aeruginosa intravenously. Low cardiac output septic shock was prevented with massive fluid infusion. It was found that a dose of 1.0 X 10(7) colony forming units per 20 kg/min for 2 hours reliably produced respiratory failure in a setting of hyperdynamic sepsis which meets the diagnostic criteria of human ARDS.
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PMID:Cardiopulmonary responses to Pseudomonas septicemia in swine: an improved model of the adult respiratory distress syndrome. 291 83

Victims of smoke inhalation with and without burns and burn patients with respiratory insufficiency for reasons other than smoke at a regional burn unit are profiled in terms of age, burn size, length of stay, and mortality. The diagnostic characteristics of patients with an inhalation injury (N = 108) are listed; 7% of all patients (N = 52) have known smoke exposure with equivocal evidence for injury to the airway or pulmonary parenchyma. The degree of respiratory (visceral) failure experienced by patients with inhalation injury is not uniformly severe. Many of the clues to this diagnosis are indirect and not always related to the severity of pulmonary injury. Timing and degree of visceral failure control the severity of the injury, which increases progressively from that in patients with a burn only (parietal injury) through those with a visceral injury only (smoke without burn), those with both smoke and burn, to those with a burn and uniformly severe respiratory failure on the basis of sepsis.
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PMID:Smoke inhalation and airway management at a regional burn unit: 1974-1983. Part I: Diagnosis and consequences of smoke inhalation. 292 Dec 59

Multiple organ system failure is a major cause of mortality in the adult respiratory distress syndrome (ARDS). We serially evaluated parameters of multiple organ function in 24 patients during the first week after the diagnosis of ARDS and related them to outcome. The adult respiratory distress syndrome was associated with sepsis (n = 16), postoperation (n = 7), and trauma (n = 1). Fourteen of the 24 patients (58 percent) died. Although there were no significant differences in the indices of pulmonary or renal dysfunction between survivors and nonsurvivors, evidence of hepatic dysfunction was different in the two groups. On the day we identified ARDS, serum bilirubin was 1.2 mg/dl +/- 0.9 mg/dl in patients who survived, and was 2.3 mg/dl +/- 2.8 mg/dl (chi +/- SD) in those who died. Initial serum glutamic oxalacetic transaminase (SGOT) and alkaline phosphatase levels were lower in survivors than in those who died (71 +/- 44 IU/L vs 399 +/- 807 IU/L, and 121 +/- 53 IU/L vs 269 +/- 243 IU/L, respectively). These abnormalities persisted during the first week of respiratory failure, with significant differences in serum bilirubin and alkaline phosphatase between survivors and nonsurvivors (p less than 0.01). The degree of pulmonary and renal dysfunction was similar in both groups. These data suggest that liver function may be a major determinant of survival in patients with the adult respiratory distress syndrome.
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PMID:Hepatic dysfunction in the adult respiratory distress syndrome. 292 17

The use of tracheostomies in burned patients with inhalation injuries is now reserved for specific indications rather than as prophylactic airway management. A 5-year burn center experience with tracheostomies used in this fashion is presented. Ninety-nine tracheostomies were performed in 3246 patients who had indications of prolonged respiratory failure or acute loss of airway. Although colonization of the sputum was universal, neither rates of pulmonary sepsis nor mortality were significantly increased in patients who underwent tracheostomies. Twenty-eight patients developed late upper airway sequelae, including tracheal stenosis (TS), tracheoesophageal fistula (TEF), and tracheoarterial fistula (TAF). Duration of intubation correlated only with development of TAF, whereas patients in whom TEF developed were significantly older and more likely to have evidence of tracheal necrosis at the time of tracheostomy. The pathogenesis of upper airway sequelae in these patients as divergent responses to the combined insults of inhalation injury, infection, and intubation is considered.
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PMID:Tracheostomies in burn patients. 293 Feb 91

The effect of two ranitidine intravenous infusion regimens on intragastric pH was studied in 134 critically ill patients admitted to 15 intensive care units. Intragastric pH was determined hourly for 30 hours. Those patients whose intragastric acidity fell below pH 4.0 for 3 or more of the first 6 hours were considered 'at risk' of developing stress-related gastric lesions and randomized to receive a 50 mg bolus of ranitidine together with a continuous intravenous infusion of either 0.125 or 0.25 mg kg-1 h-1 ranitidine for 24 hours. The maximal elevation in intragastric pH was achieved within 12 hours. The median intragastric pH for the last 20 hours of the infusion period was 5.9 for the higher dose group and 5.6 for the lower dose group. The increase in intragastric pH achieved by the two dosage regimens did not differ significantly throughout the 24 hour period. Patients having two or more of five major risk factors (head injury, major trauma, sepsis, respiratory failure/insufficiency and major surgery) had better overall control of intragastric pH on the higher dose of ranitidine than those receiving the lower dose. The majority of intensive care patients are likely to receive satisfactory treatment with the lower dosage regimen that was tested (0.125 mg kg-1 h-1). Those with multiple risk factors may, however, require treatment with higher doses of ranitidine (0.25 mg kg-1 h-1).
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PMID:A comparison of two ranitidine intravenous infusion regimens in critically ill patients. 297 34

Six patients accepted into a cardiac transplantation program have been supported with a Biomedicus LVAD. Five of the six patients deteriorated while awaiting a donor organ; the sixth was being supported with a device following mitral valve surgery and showed no recovery of ventricular function. In all cases the device was used only after all other therapeutic modalities had failed. The periods of support ranged from 2.5 to 31 days, mean of 10 days. Three patients underwent cardiac transplantation and all three have been discharged and are well. The three survivors were supported for 2.5, 3, and 31 days. Three deaths occurred in the patients supported for 5, 9, and 15 days, the causes being sepsis, massive cerebral embolism, and respiratory failure. Patients were for the most part maintained with some degree of heparinization, and hemolysis was a significant problem in only one patient and associated with a very small arterial return cannula. Flows were routinely maintained above 2.4 L/min/m2, and all showed recovery of other organ functions while being supported. The patient supported for 31 days was capable of limited mobilization by use of the removable drive system. The Biomedicus LVAD represents a relatively inexpensive support modality for patients awaiting cardiac transplantation.
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PMID:Nonpulsatile ventricular assist bridging to transplantation. 305 81

Malnutrition has a tremendous impact on respiratory functions. It affects respiratory muscle performance, lung structure, defense mechanisms, and control of ventilation and predisposes to respiratory failure and prolonged mechanical ventilation. Calling clinicians' attention to this common clinical problem is the first step toward developing a systematic approach to patient care in which correction of malnutrition is an integral part of the therapy. The increased morbidity and mortality in malnourished patients can be better understood when they are superimposed on other disease conditions, such as chronic lung disease, sepsis, trauma, and cardiovascular dysfunction. Most important is the fact that many of the consequences of malnutrition can be partially reversible with appropriate refeeding.
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PMID:Malnutrition and respiratory function. 308 50

The effect of preoperative total parenteral nutrition (TPN) on morbidity and mortality was studied in medical records of discharged surgical patients. Patients were classified into two groups on the basis of their ability to meet established criteria for malnutrition and the use of preoperative or postoperative TPN. The control group consisted of 44 patients who received TPN only after surgery or for less than 5 days preoperatively. The experimental group consisted of 26 patients who received treatment for at least 5 days before surgery and/or after surgery. Nutrition parameters measured included serum albumin, total lymphocyte count, hemoglobin, weight, and percent weight loss. Major septic complications (MSC) considered were intra-abdominal sepsis, wound dehiscence, septicemia, and pneumonia. Other complications included respiratory failure, congestive heart failure, fistulas, urinary tract infection, shock, and death. The experimental group showed improvements after surgery in the nutritional parameters listed and had a lower incidence of morbidity and mortality. Deficits in serum albumin, total lymphocyte count, and weight losses greater than or equal to 10% have been significantly (p less than .01) linked to the incidence of MSC. MSC also has been more frequently noted among patients who did not have TPN prior to surgery and who died following surgery. Therefore, preoperative TPN does appear to make a difference in the outcome of surgery.
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PMID:The effect of preoperative total parenteral nutrition on surgery outcomes. 311 53


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