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)

Twenty-seven cases of ascaris cholecystitis and cholangitis were managed in a surgical unit of a general hospital in Yangon, Myanmar, from January 1989 to March 1990. Nineteen women and eight men with a mean age of 42 years were studied. Main clinical manifestations were right hypochondrial pain, fever, chills, rigors, nausea, vomiting and jaundice. Diagnosis was established by abdominal ultrasonograms in all cases. Laparotomy was performed in all cases because of failure to respond to initial conservative treatment. Live and dead ascarids were found in the gall bladder and biliary ductal system. Cholecystectomy, bile duct exploration, worm extraction and T-tube drainage were done in all cases. There were no deaths. Two patients developed minor wound sepsis. During the follow-up period ranging from 3 to 12 months, there was no recurrence of symptoms in all patients. All patients were given antihelminthics before discharge and three weeks later.
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PMID:Ascaris cholecystitis and cholangitis: an experience in Myanmar. 780 58

In Pennsylvania, a 29-year-old woman was admitted to Temple University Health Sciences Center in Philadelphia with hypotension (100/80 mmHg), fever (105.3 degrees Fahrenheit), and a diffuse, nondesquamating erythroderma. Five weeks earlier, she had delivered her last child vaginally. Three days before admission, she had undergone endotracheal intubation so surgeons could perform a laparoscopic tubal ligation with Falope Rings. Two days before the tubal ligation, she had had a sore throat. She experienced no surgical complications and was discharged the same day as the operation. The day before her latest admission, she experienced nausea, vomiting, diarrhea, fever, chills, and diffuse abdominal pain. Upon admission, her surgical incisions were clean and dry and had no erythema. Her pulse rate was 140 beats/minute. Her respiration rate was 20/minute. The white blood cell count was 15,200 cells/cu. m (71% neutrophils, 23% band forms, 2% lymphocytes, and 4% monocytes). Her potassium level was 3.2 mmol/l. The anion gap was 22. All blood and urine cultures were negative. She experienced mild uterine tenderness. Upon admission, physicians administered ticarcillin-clavulanate and vancomycin for suspected postoperative pelvic infection. After learning that cervical and pharyngeal cultures were positive for Streptococcus pyogenes, physicians changed to ampicillin, 1 g intravenously every 6 hours. On the 6th day, she was discharged and prescribed 500 mg oral amoxicillin every 8 hours for 2 weeks. Within 2 weeks, she felt fine, had a normal physical examination, no fever, and no rash. The major signs and symptoms indicated a toxin-mediated illness. Both mucosal surfaces colonized by S. pyogenes were manipulated during laparoscopy and manipulation may have caused minor tissue injury and hyperemia with subsequent dissemination of streptococcal toxin. In conclusion, the patient had a S. pyogenes toxin-induced toxic shock-like syndrome that mimicked a pelvic wound infection with gram-negative septicemia.
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PMID:Streptococcal toxic shock-like syndrome as an unusual complication of laparoscopic tubal ligation. A case report. 799 32

Mycophenolate mofetil (RS-61443), a derivative of mycophenolic acid, is a new immunosuppressive agent that inhibits de novo purine synthesis in activated lymphocytes. In a clinical trial of mycophenolate mofetil in the treatment of recurrent or persistent heart rejection, 17 patients 0.6 to 104 months (median 5.4 months) after transplantation received a daily oral dose of mycophenolate mofetil of 3000 mg, with seven patients increasing to 3500 mg daily. Azathioprine was routinely discontinued at the start of mycophenolate mofetil treatment. One patient in shock from acute rejection required retransplantation before starting mycophenolate mofetil and died 68 days later of cytomegalovirus sepsis. Another patient died 72 days after mycophenolate mofetil of protracted multisystem failure (present before mycophenolate mofetil). One patient required early cessation of mycophenolate mofetil, and the other 14 patients were alive and well 5 to 10 months after initiating mycophenolate mofetil treatment. Three patients required transient dose reduction and one patient required discontinuation of mycophenolate mofetil because of nausea, diarrhea, or abdominal cramps. No other clinical side effects were noted. Frequency of rejection decreased from 0.67 rejection episodes per patient per month before mycophenolate mofetil to 0.27 rejection episodes per patient per month after mycophenolate mofetil (p < 0.0001). Frequency of infection was unchanged after mycophenolate mofetil (p = 0.9). Renal function was not affected by mycophenolate mofetil (creatinine clearance 1.8 mg/dl before mycophenolate mofetil vs 1.7 mg/dl after mycophenolate mofetil; p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of recurrent heart rejection with mycophenolate mofetil (RS-61443): initial clinical experience. 806 Oct 21

A 58-year-old man with diabetes had fever and chills 5 days after ingestion of raw seafood. Nausea, vomiting, watery diarrhea, bilateral calf pain, and neck stiffness subsequently developed. Generalized edema and ecchymotic patches with a vesiculobullous eruption appeared on the extremities. Four blood cultures were positive for Vibrio cholerae non-01. The patient was successfully treated with antibiotics. This is the first documented case of V. cholerae non-01 septicemia with cutaneous lesions and meningitis in Taiwan.
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PMID:Cutaneous manifestations of non-01 Vibrio cholerae septicemia with gastroenteritis and meningitis. 815 89

Thirty patients with previously untreated, inoperable non-small cell lung cancer (NSCLC) were treated with cisplatin, etoposide and vincristine. Among twenty-nine evaluable patients, eight patients achieved partial response and the overall response rate was 28%. No patient achieved a complete response. The median survival time was 51 weeks. Myelosuppression was the dose-limiting toxicity. Four patients had a leukocyte nadir of less than 1000/mm3, and one died from severe myelosuppression and sepsis. The other toxicities were nausea/vomiting, peripheral neuropathy, and alopecia. We conclude that cisplatin, etoposide, and vincristine combination chemotherapy offers moderate activity for inoperable non-small cell lung cancer.
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PMID:Cisplatin, etoposide, and vincristine combination chemotherapy in the treatment of non-small cell lung cancer. 824 5

Imipenem/cilastatin sodium (IPM/CS) which is a broad-spectrum agent against both Gram-positive and -negative bacteria was used in combination with fosfomycin (FOM) as a second-line chemotherapy for severe infections associated with hematologic disorders. FOM was partnered with IPM because FOM may enhance the bacteriocidal effects of IPM when given as pretreatment to IPM/CS therapy. Fifty two patients were treated with IPM/CS plus FOM. Of them, 41 were evaluated for effectiveness. Eleven patients were not evaluated: 4 were treated with a combination of other regimens such as cefixime, gamma-globulin, G-CSF and a large dose of methyl prednisolone; 2 were given IPM/CS plus FOM as a first choice; 3 were observed to have gastrointestinal side effects such as nausea which led to the discontinuation of the combination therapy; and 2 were thought to be suffering from not infectious but tumor fever. An excellent response was observed in 15 (36.6%) patients and a good response in 10 (24.4%), for a overall efficacy rate of 61.0%. Efficacies was 71.4% (5/7) in patients with sepsis, and 60.0% (9/15) in patients whose peripheral granulocyte count was below 100/microliters before chemotherapy. The elimination rates of Gram-positive and -negative bacteria were 57.1% (4/7) and 75.0% (6/8), respectively. In particular, 75.0% (3/4) of Pseudomonas aeruginosa identified were eliminated. Two patients who suffered from tumor fever, 2 who did not receive chemotherapy before the combination chemotherapy and 3 who did not receive a full course of the combination chemotherapy because of side effects, were included in the final evaluation of safety. Side effects were observed in 18 of 48 patients (37.5%). In 1 patient, skin eruption occurred 3 days after the initiation of the combination chemotherapy. In 17 patients, gastrointestinal symptoms such as nausea and vomiting were identified after a few days of IPM/CS plus FOM administration. Degree's of the symptoms were mild, however. Therefore, the treatment was not withdrawn. No abnormal laboratory results such as eosinophilia, liver disfunction or renal disfunction were observed. These results show that IPM/CS plus FOM is effective as a second-line combination chemotherapy for the treatment of severe infections in patients with hematologic disorders.
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PMID:[Clinical evaluation of imipenem/cilastatin sodium and fosfomycin as second-line combination chemotherapy in severe infections associated with hematologic disorders]. 833 78

Oneself presents the result of the prospective study from evaluate the morbility of the partial exchange-transfusion (exchange-dilution) to effect in two forms in newborn with polycythemia. The A group was newborn in the which extraction of blood volume was on peripheric vein is oneself administration crystalloid solution for another periphery vein; the B group was utilized umbilical vein to remove blood volume for another periphery vein is administration the crystalloid. To have 20 newborn in each group; to predisponent prenatal factors global were toxemic (12%); the plethora was the more frequent sing (55%) and nausea in (37%). Were not encountered difference in both groups for: gestational age, weight, birth rate, trophism, polycythemia type (asymptomatic vs symptomatic); neither to have difference in the seric electrolytes, protein and vital signs before and after procedure. Were encountered more infections process in the B group (P < 0.05). Were concluded what the exchange-dilution for polycythemia in newborn of term must be for periphery vein exclusive with security of not production metabolic and hemodynamic changes and without risk for sepsis and/or enterocolitis for manipulation of umbilical vessels.
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PMID:[Comparison of 2 methods of partial exchange transfusion in newborns with polycythemia: peripheral-peripheral and central-peripheral]. 837 43

Carcinomas of the exocrine pancreas respond poorly to most chemotherapy regimens. Recently continuous infusional 5-fluorouracil (200 mg m-(2)day-1) with 3 weekly cisplatin (60 mg m-2) and epirubicin (50 mg m-2) (the ECF regimen) has proven to be an active regimen in gastric and breast cancer and consequently worthy of further study in pancreatic cancer. Thirty-five patients were treated with the ECF regimen as above, of whom 29 were evaluable for response and 32 were evaluable for toxicity. The mean age was 59 years (range 37-75). Sixteen patients had locally advanced disease at presentation and 19 had metastases. Objective tumour responses were documented in five (17.3%) patients who achieved a partial response; in 18 (62%) patients there were no change and six (20.7%) patients progressed on therapy. Patients with either stable disease or partial response had a significantly improved overall survival (median = 253 days) compared with patients who progressed (median = 170 days; P = 0.01). Grade 3/4 (WHO) toxicity (all cycles) included alopecia in 18 (56%) patients, nausea/vomiting in eight (25%) stomatitis in three (9%) and diarrhoea in seven (22%) patients, with rhinorrhoea and excessive lacrimation in one patient each. Neutropenic sepsis occurred in 13 cycles in ten patients, and there was one toxic death due to sepsis. There were eight other episodes of non-neutropenic sepsis requiring hospital admission. Fourteen patients (40%) experienced complications with their Hickman lines, including thrombotic episodes (six patients) or their line falling out (five patients). ECF can prolong survival in patients with locally advanced or metastatic pancreatic cancer who demonstrate a response or stabilisation of their disease. However, this is associated with considerable toxicity.
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PMID:A phase II study of continuous-infusion 5-fluorouracil with cisplatin and epirubicin in inoperable pancreatic cancer. 863 Feb 89

The introduction of the haematopoietic growth factors (HGFs), together with the evolution of techniques to harvest haematopoietic stem cells from the peripheral blood, have greatly facilitated the use of high-dose chemotherapy (HDC). While haematological toxicity of HDC is no longer dose-limiting, damage to other tissues has become more pronounced. In fact, nonhaematological toxicity (NHTOX) is now often dose-limiting in HDC regimens. NHTOX associated with HDC regimens depends on the type and dose of the drugs used, the physical condition and the characteristics of the patients treated and the given comedication. We describe the most important toxic effects of commonly used HDC programmes, such as nausea, vomiting, and mucositis, neutropaenic fever and sepsis, various major organ toxicities, catheter-associated problems and long-term complications. In addition, we discuss the possibilities of preventing these side-effects and what action to take if they occur.
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PMID:Incidence and prevention of nonhaematological toxicity of high-dose chemotherapy. 873 47

Cisplatin (P) and 5-fluorouracil (5FU) have demonstrated activity for the treatment of squamous cell carcinoma of the esophagus. Previous studies have shown that leucovorin (L) may potentiate the antitumoral activity of 5FU, so we tested the combination P-5FU-L in 31 patients with inoperable squamous cell esophageal carcinoma. Chemotherapy consisted of P 20 mg/m2 in 4 h, followed by L 200 mg/m2 in 2 h and 5FU 600 mg/m2 in 18 h. This schedule was repeated for 5 days every 4 weeks. The treatment plan included three courses of chemotherapy followed by radiotherapy. The overall response rate was 58% (95% CI = 39-76%), with one complete remission (3%), and 61% of patients reported an improvement in dysphagia. Gastrointestinal toxicity was the main side effect: grade 3-4 mucositis appeared in 19% of patients, grade 3-4 nausea/vomiting in 13%, and grade 3-4 diarrhea in 6.5%. There was one toxic death caused by neutropenia and sepsis. Nineteen patients received local radiotherapy after chemotherapy, which increased the overall response rate to 63% (5% complete responses). Dysphagia improved in 75% of them. The median survival for all patients was 11 months. This study shows that sequential therapy with P-5FU-L and radiotherapy achieves a high response rate as well as adequate symptomatic relief in patients with inoperable esophageal cancer. The results justify further evaluation of P-5FU-L in patients with earlier-stage disease.
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PMID:Phase II study of cisplatin, 5-fluorouracil, and leucovorin in inoperable squamous cell carcinoma of the esophagus. ONCOPAZ Cooperative Group, Spain. 893 75


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