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)

The first reported case, in an adult, of cholestyramine induced hyperchloremic metabolic acidosis is a 70 year old female with a two year history of primary biliary cirrhosis confirmed by histologic and immunologic criteria. After taking cholestyramine II sachets twice daily for two months she presented with lethargy, confusion and drowsiness. Examination revealed confusion, jaundice, signs of chronic liver disease, portal hypertension and hepatic encephalopathy. Laboratory investigations confirmed a metabolic acidosis (pH 7.15) and hyperchloremia. Multiple cultures failed to reveal sepsis and a urinary pH of 4.85 together with tests of renal acidification, excluded renal tubular acidosis. She received 600 mEq of sodium bicarbonate intravenously over 36 hours by which time her mentation, electrolytes and pH were normal. It is presumed that her hyperchloremic metabolic acidosis was secondary to cholestyramine because of the similarity to pediatric reports; the rapid and lasting response to intravenous sodium bicarbonate; the absence of another etiology; normal serum potassium, chloride and bicarbonate despite continued spironolactone therapy after recovery.
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PMID:Cholestyramine induced hyperchloremic metabolic acidosis. 659 13

In an attempt to develop a rational basis for performing lumbar puncture in sepsis workups, the hypothesis was tested that, for each of eight variables with a known association with bacteremia, the frequencies for patients having bacterial meningitis would be significantly greater than those in patients having bacteremia alone. In a one-year period, 168 lumbar punctures were performed in children having a mean age of 7.3 months. Patients were assigned to four groups: bacterial meningitis, bacteremia only, aseptic meningitis, and normal. Mean age, frequencies of symptoms, clinical appearances, ethnic groups, and sex ratio were determined for all groups. Frequencies of eight variables were determined and compared between Groups I and II.Results indicated that frequencies were not significantly different for groups I and II and that lethargy and petechiae, although distinguishing between groups I and IV, did not distinguish among the three groups having serious disease. It was concluded that since one cannot distinguish among groups having serious disease, all such patients suspected of sepsis should undergo lumbar puncture.
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PMID:Should lumbar puncture be routinely performed in patients with suspected bacteremia? 665 17

A progress report is presented on two on-going clinical trials in women with advanced breast cancer. In Trial I to date, 56 patients have been randomized to tamoxifen (TAM) alone or TAM plus aminoglutethimide (AG) (plus hydrocortisone). Patients failing TAM can then receive AG. The two groups are reasonably well balanced with respect to prior hormonal therapy exposure (TAM, 19%; TAM plus AG, 17%), age, disease-free interval, performance score, and estrogen receptor status. The TAM plus AG group has a higher incidence of visceral dominant disease (41 versus 26%) and prior chemotherapy exposure (41 versus 33%). Responses have been observed in 7 of 27 (26%) patients on TAM and 11 of 28 (39%) on TAM plus AG. Median times to treatment failure (defined as disease progression, unacceptable toxicity, or patient refusal) are 211 and 123 days, respectively (log-rank on time to treatment failure, p = 0.87). Toxicity is greater for TAM plus AG with a higher incidence of skin rash, lethargy, and dizziness. Thrombotic events were seen in one patient on TAM and two patients on TAM plus AG. One patient on TAM plus AG developed leukopenia and sepsis. The data are too preliminary for one to draw firm conclusions regarding relative efficacy. In TRial II to date, 35 patients with prior tamoxifen exposure have received AG. The mean number of prior systemic therapies is 3.2 (range, 1 to 7). The response rate is 20% and similar with (21%) or without (19%) prior chemotherapy exposure. The median time to treatment failure is 92 days. One patient developed leukopenia and sepsis. Additional patient accrual is necessary to allow characterization of potential efficacy within prognostically important subsets.
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PMID:Progress report on two clinical trials in women with advanced breast cancer. Trial I: tamoxifen versus tamoxifen plus aminoglutethimide. Trial II: aminoglutethimide in patients with prior tamoxifen exposure. 704 29

Six infants with disseminated HSV had no mucocutaneous lesions at any time during the course of the illness. These infants presented with lethargy, poor feeding, apnea, acidosis, and hepatomegaly. The diagnosis of HSV was made by culturing the infant's oropharynx and blood, and the maternal cervix. Eight infants with HSV encephalitis had no skin, eye, or mucous membrane lesions. These infants presented with lethargy and low-grade fever, followed within 24 hours by the onset of focal partial motor seizures. The seizures were refractory to anticonvulsant therapy. The mean CSF white cell count was 131 cells/mm3;the glucose and protein concentrations were in the normal range. Brain biopsy was required for the early diagnosis of HSV encephalitis. These 14 cases presented 70% (14/20) of all infants with neonatal HSV diagnosed during the study period. HSV infection should be considered in infants with no mucocutaneous lesions who have signs usually associated with bacterial sepsis or who develop focal seizures during the first three weeks of life.
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PMID:Neonatal herpes simplex infection in the absence of mucocutaneous lesions. 706 32

To determine whether inexperienced health workers can recognize severe infection in infants less than 3 months of age, a study was conducted of 200 infants with cough, fever or 'not feeling well'. The presence or absence of five symptoms: cough, difficulty in breathing, feeding problem, fever or history of convulsions, and ten signs: appearing ill, respiratory rate > or = 60/min, chest indrawing, grunting, cyanosis, wheeze, lethargy, 'too hot', 'too cold' or abdominal distension, were recorded by a health worker, who made a diagnosis of 'ill' or 'mildly ill'. Each infant was then reviewed by an experienced paediatrician who made a diagnosis of 'ill' (pneumonia, sepsis, meningitis or other severe illness) or 'mildly ill'. Using these diagnoses as the 'gold standard', the sensitivity, specificity, and positive predictive values of each parameter were calculated. In 89% of the 200 infants, the health worker made the correct diagnosis. Forty infants were admitted. In 36 instances (90%) the health worker made the correct decision. The most discriminating symptoms and signs were 'not feeding well', 'appears ill', chest indrawing and grunting. A respiratory rate > or = 60/min was 78% sensitive and 69% specific. Our study suggests that inexperienced health workers can recognize severe illness in infants under 3 months of age.
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PMID:Recognition of illness in very young infants by inexperienced health workers. 750 92

The present study examines the effect of acute liver failure induced by a single intraperitoneal (i.p.) injection of D-galactosamine-HCl (3 g/kg) on somatostatin (SS) binding and levels in the rat frontoparietal cortex and hippocampus. Neurobehavioural changes were evaluated by the method of Zieve et al. [(1984) J. Lab. Clin. Med., 104:655-664]. The rats were decapitated as soon as they reached neurobehavioural stage I or II. In stage I, rats had lethargy and in stage II they showed mild ataxia, mainly in the hind limbs. The administration of D-galactosamine elevated serum transaminase levels (mean peak level 2,242 IU/1) but hypoglycemia, gross cerebral edema, or signs of sepsis were not detected in any of the animals studied. In addition, D-galactosamine did not affect somatostatin-like immunoreactivity (SSLI) levels in either brain area in any of the experimental groups as compared to the control groups. The rats sacrificed in stage I showed no change in the number or affinity of specific 125I-Tyr11-somatostatin (125I-Tyr11-SS) receptors in synaptosomes from the frontoparietal cortex and hippocampus. The rats sacrificed in stage II showed a decrease in the number of specific 125I-Tyr11-SS receptors in synaptosomes from both brain areas, with no change in receptor affinity. Binding studies were also conducted on synaptosomes from the frontoparietal cortex and hippocampus of rats that received D-galactosamine but did not develop acute liver failure and consequently did not develop neurobehavioural changes. The SS receptors in these synaptosomes did not change in comparison with controls, indicating that the D-galactosamine was not directly responsible for the changes in the cerebral SS receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Brain somatostatin receptors in a rat model of acute liver failure. 757 Mar 44

Listeria monocytogenes is rarely reported as a cause of septicemia in foals. In this case, the foal had diarrhea 2 weeks prior to the onset of signs of lethargy, high rectal temperature, and leukopenia with a left shift. Listeria monocytogenes was isolated from the blood culture. The most commonly isolated organism causing septicemia in foals is Escherichia coli. Without the blood cultures, a definitive diagnosis would not have been possible.
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PMID:Listeria monocytogenes septicemia in a foal. 759 28

Forty-four dogs with histologically confirmed malignant tumors were used in a prospective study to determine the toxicity of the chemotherapeutic agent mitoxantrone, when administered at dosages higher than what has been previously reported for use in dogs. After each dose was administered, dogs were evaluated for signs of toxicosis for 3 weeks or until the dog developed progressive disease, died, or was euthanatized. Forty dogs had been refractory to 1 or more treatment modalities (surgery, n = 26; chemotherapy other than mitoxantrone, n = 17; radiation, n = 2) prior to entering this study. Ten dogs were given mitoxantrone at a dosage of 5.5 mg/m2 of body surface, IV, every 3 weeks (39 total doses); 11 were given mitoxantrone at a dosage of 6.0 mg/m2, IV, every 3 weeks (26 total doses); and 23 were given mitoxantrone at a dosage of 6.5 mg/m2, IV, every 3 weeks (70 total doses). The most common signs of toxicosis were vomiting, anorexia, diarrhea, lethargy, and sepsis secondary to myelosuppression. Two dogs, both of which received the highest dosage, died of complications attributable to mitoxantrone administration. The prevalence of toxicoses was not associated with age, breed, sex, tumor type, number of doses, or dosage. Dogs did develop myelosuppression 7 days after they were given mitoxantrone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Toxicoses associated with the administration of mitoxantrone to dogs with malignant tumors: a dose escalation study. 796 Oct 92

A 21-day-old boy presented to our emergency department hypotonic, lethargic, and intermittently unresponsive to pain. A workup for ketoacidosis, sepsis, and central nervous system hemorrhage was negative. A urine drug screen collected eight hours after hospitalization showed 39 mg/dl of isopropyl alcohol and 76 mg/dl of acetone. The first serum drug analysis was not performed until 18 hours after admission, at a time when there had been clinical improvement. The isopropyl alcohol concentration was 8 mg/dl, and the acetone concentration was 203 mg/dl. Management was supportive, and the patient stabilized. He was discharged from the hospital in good health in three days. A further review of the history showed no evidence for an oral exposure to isopropyl alcohol. However, since leaving the maternity hospital the mother had been applying gauze pads or cotton balls soaked with isopropyl alcohol to the umbilicus with every diaper change. We conclude that the child suffered from an isopropyl alcohol intoxication that occurred by absorption through the umbilical area.
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PMID:Isopropyl alcohol intoxication in a neonate through chronic dermal exposure: a complication of a culturally-based umbilical care practice. 802 19

Sixteen dogs with a histologic diagnosis of hemangiosarcoma were treated with surgery and doxorubicin/cyclophosphamide. The patients' characteristics, ie, age, size, and breed, were similar to those of previous studies. Historic controls for surgery alone were used to evaluate efficacy of the chemotherapy. The results show a trend of improved survival in dogs with localized disease (Stage I) receiving combination therapy. The median survival was 250 days, with a mean of 403 days. The survival times for dogs with stage I, II, and III disease was also improved with combination therapy, when compared to historical controls treated with surgery alone. The overall median survival was 202 days with a mean of 285 days. Toxicities included mild to moderate neutropenia (9 of 16) and clinical signs, such as lethargy, anorexia, vomiting, diarrhea, and fever (13 of 16). Three dogs had severe neutropenia requiring hospitalization and supportive care. One dog died from sepsis and related complications. Chemotherapy with doxorubicin and cyclophosphamide appears to improve survival with acceptable morbidity in patients with early stage disease.
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PMID:Chemotherapy of canine hemangiosarcoma with doxorubicin and cyclophosphamide. 811 34


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