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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case studies of four patients with post-transplantation calcinosis are presented. Three of the four patients died of inanition and sepsis secondary to infection of extensive soft tissue ulcers and diffuse cutaneous vascular calcification with gangrene. The fourth patient survived following removal of all four parathyroid glands and autografting of approximately one-half of one gland. Common to the patients was secondary hyperparathyroidism, elevated mean serum calcium levels after transplantation, and radiographic evidence of small and medium vessel calcification. No other differences could be found between these patients and other patients with post-transplantation hyperparathyroidism without calcinosis. In the face of apparently minor complaints of lower extremity discomfort, elevated parathyroid hormone levels (PTH) and positive xerography may indicate subtotal parathyroidectomy regardless of the serum calcium level.
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PMID:Lethal post-transplantation calcinosis. 37 90

Three hundred fifty-seven groin hernia repairs were performed under local anesthesia using a long-lasting local anesthetic agent. An ilioinguinal, iliohypogastric, and twelfth intercostal nerve block was carried out initially, followed by regional infiltration of the agent, using a technic first described by Ponka [8] with several modifications. This technic can be employed suffessfully in the majority of groin hernia repairs. It requires careful attention to detail in the administration of preoperative sedation and analgesia and the use of sharp dissection only and greater gentleness in the handling of tissue. We have observed a significant reduction in postoperative discomfort and the virtual elimination of urinary retention, urinary sepsis, atelectasis, and phlebitis in these cases. All patients are fully ambulatory, without assistance immediately after surgery and the majority are discharged the same day or the following morning. This results in a marked reduction in the total cost of repairing a groin hernia.
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PMID:Change in the management of adult groin hernia. 41 25

Three cases are presented and analyzed in which a Lippman Transfixion Hip Prosthesis had to be replaced because of the discomfort of the patient. In each case, there was evidence of wear between the head of the prosthesis and the flange. The different wear patterns indicated problems which exist in the alignment of component parts of the prosthesis. In each case there was low grade sepsis to which the debris may have contributed. Because of phagocytosis, amount of debris accumulation was difficult to evaluate. The factors which appear to have contributed to the amount of debris accumulation were: the length of time the prosthesis had been used; the degree of alignment and amount of debris which may be formed and is phagocytized; the degree of manufacturing control. The design of this prosthesis incorporated mechanical problems which are generally undesirable because of: the eventual deformation of the end of the pivot rod or hole in the head of the prosthesis: progressive loosening of the movement due to this and inherent malalignment; the difficulty in fabrication, assembly and installation of the prosthesis because of the multiplicity of parts; the difficulty in maintaining adequate control of surface finishes.
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PMID:Biomechanical considerations of multiple-component hip prostheses. Analysis of three failures of the Lippman transfixation hip prosthesis. 112 66

Renal and ureteral calculi are treated primarily using extracorporeal lithotripsy, with percutaneous nephrostolithotomy retaining an important role for the treatment of large stones and complex situations. Aspects of pretherapy evaluation are reviewed. The vast majority of calculi 5 mm or less in diameter in the mid and lower ureter will pass spontaneously; in patients with acute ureteral obstruction, lower-osmolar nonionic contrast for urography caused as much discomfort as conventional high-osmolar contrast. Treatment planning for extracorporeal lithotripsy has changed in that internal stenting is no longer routinely recommended. Milk-of-calcium and calyceal diverticular stones respond poorly to extracorporeal lithotripsy. The access route used for percutaneous stone removal varies among investigators. Some advocate an intercostal approach for up to one third of patients; substantial complications occur with placement of a track above the 11th rib. Sepsis develops after percutaneous nephrostomy in up to 21% of patients, but the risk of sepsis can be decreased significantly by the administration of antibiotics during and after the procedure. Complications of extracorporeal lithotripsy include renal hematoma (especially if the patient is hypertensive or is taking aspirin), regional organ injury, and bacteremia. Although originally feared to occur frequently, hypertension occurring after or caused by extracorporeal lithotripsy was not confirmed to be a major problem. The incidence in a 2-year postlithotripsy follow-up was no greater than that for control subjects.
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PMID:Radiology and treatment of urinary tract stone disease. 155 85

A 3-day-old Quarter Horse colt was examined because of signs of severe depression, discomfort, and abdominal straining. The foal seemed disoriented, and the abdomen was tense and distended ventrally. The differential diagnoses included ruptured urinary bladder, retained meconium, septicemia/bacteremia, and neonatal maladjustment syndrome. Serum biochemical analysis revealed marked hyponatremia, hypochloremia, and moderate hyperkalemia, as well as mildly high urea, creatinine, and phosphorus concentrations. The primary differential diagnosis at this time was ruptured urinary bladder. Abdominocentesis was performed to confirm this diagnosis. Microscopic examination of abdominal fluid revealed calcium carbonate crystals, which originated from the urine of the foal. Biochemical analysis also confirmed the diagnosis of ruptured urinary bladder, because the ratio of peritoneal fluid creatinine to serum creatinine was 2.8:1. The foal died before surgical correction could be attempted.
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PMID:Diagnosis of ruptured urinary bladder in a foal by the identification of calcium carbonate crystals in the peritoneal fluid. 161 90

Sarcomas which develop after radiotherapy mainly involve the soft tissue and the bone. Postirradiation angiosarcomas involving the internal organs are exceedingly rare and so far only three cases have been reported. Here, a case of angiosarcoma of the terminal ileum in a 48-year-old female is reported. The tumor developed 39 months after radiotherapy for recurrent squamous cell carcinoma of the uterine cervix. Angiosarcoma recurred locally and metastasized to the liver eight months after initial resection of the primary lesion of the terminal ileum. The patient died from sepsis 23 days after the resection of the recurrent ileal and metastatic hepatic neoplasms. Hence, any patients complaining of new discomfort that occurs in an irradiated field two years or more after radiotherapy should be promptly searched for the presence of the postirradiation neoplasms.
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PMID:Postirradiation angiosarcoma of the terminal ileum. 165 87

The Wallstent biliary endoprosthesis is a mesh of stainless steel that is delivered percutaneously over a 7-French catheter but expands to achieve a 1-cm lumen when released across a bile-duct stricture. The small transhepatic track required makes insertion easier, less painful, and probably safer when compared with plastic stents, and the large internal lumen reduces the rate of occlusion by encrusted bile. Wallstent endoprostheses were inserted under local anesthesia in 41 consecutive patients with malignant obstructive jaundice. Biliary drainage was considered the treatment of choice in all of these patients. The diagnosis was based on biopsy results in 32 patients and on radiologic appearances in nine. The patients were followed up in outpatient clinics for 16 months and had repeated radiologic examinations only if they had symptoms suggesting stent occlusion. No cases of hemobilia due to damaged hepatic vessels occurred. Two patients had septicemia treated with antibiotics. Three patients had recurrent jaundice due to growth of tumor below or above the stents. Endoprosthesis migration was not seen. No cases of stent occlusion due to encrustation of bile occurred. The median survival of patients was 105 days (range, 10-545 days). Our experience shows that Wallstent endoprostheses can be inserted with little discomfort for the patient and with relatively few complications. They provide good palliation in patients with malignant obstructive jaundice.
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PMID:Self-expandable stainless steel endoprostheses for treatment of malignant bile duct obstruction. 170 74

Oral complications of cancer therapy often have systemic consequences. Pain and discomfort are common and can lower intake of fluid and nutrients, which in severe cases can lead to dehydration and malnutrition, requiring hospitalization. Oral infections are frequent accompaniments of cancer treatment. Herpes simplex virus is the most common symptomatic oral viral infection, and, in latently infected patients the virus is frequently reactivated after cytoreductive therapy. Viral (infectious) oral mucositis is often indistinguishable from noninfectious mucositis. Bacterial infections are less commonly observed today, perhaps because of the routine use of empiric broad-spectrum antibiotics; however, many episodes of septicemia in neutropenic patients apparently originate from oral microorganisms. Fungal infections are frequent and are usually due to Candida species. Spread to the esophagus or systemic dissemination can occur. Noninfectious oral mucositis can be used as a marker of toxic effects in other organs, especially hepatic veno-occlusive disease. In bone marrow transplant patients with mucositis, hepatic veno-occlusive disease is six times more frequent than in such patients without mucositis.
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PMID:Oral complications of cancer therapies. Infectious and noninfectious systemic consequences. 218 56

Use of a single percutaneous silastic IV catheter for cystic fibrosis hospitalizations was evaluated among 23 patients during 45 hospitalizations. Patients ages ranged from 4 to 20 years and weights from 18 to 60 kg. Percutaneous silastic catheters were used for infusion of all IV antibiotics and IV fluids. Catheters remained in place for a total of 549 patient days (mean 12.2, range 2-34). No patient demonstrated clinical signs of local infection or sepsis. Thirty six catheters served as the single IV access for a patient's entire hospitalization. Nine catheters were removed because of discomfort, obstruction, or mechanical dysfunction before the conclusion of the hospitalization. A single, percutaneously placed silastic catheter appears to be a safe and effective way of maintaining IV access throughout the duration of hospitalization for cystic fibrosis exacerbations.
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PMID:Use of a single silastic i.v. catheter for cystic fibrosis pulmonary exacerbations. 283 85

Cefbuperazone (CBPZ) was administered to patients with severe infections complicating hematologic diseases to assess its efficacy and safety under such clinical conditions. Primary diseases in this series of 78 cases included; acute leukemia in 41 cases, chronic leukemia in 6 cases, other leukemia in 9 cases, malignant lymphoma in 13 cases, multiple myeloma in 3 cases, aplastic anemia in 5 cases and 1 other case. Types of infection included sepsis; proven or suspected, in 59 cases, pulmonary infection in 8 cases, upper respiratory infection in 5 cases, and other cases. CBPZ was infused by an intravenous drip method at a dosage of 4-8 g daily. Patients' ages ranged from 14 to 85 years. Clinical response to the CBPZ regimen was excellent in 24 cases, good in 22 cases, fair in 2 cases, and poor in 30 cases. Thus the overall efficacy rate (percentage of cases showing an excellent or good response) was 59.0%. Efficacy rates for individual types of infection were: documented sepsis 16.7%, suspected sepsis 58.5%, lower respiratory infection 62.5%, and upper respiratory infection 100%. CBPZ also proved to be effective in 61.0% of cases with a neutrophil count of less than 500/mm3 prior to therapy. Side effects encountered were diarrhea in 1 case, gastric discomfort in 1 case and hepatic dysfunction in 5 cases. These side effects, however, were not dose-related, and none were serious. These results indicate that CBPZ has a high therapeutic efficacy even in patient with compromised immunodefenses.
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PMID:[Efficacy and safety of cefbuperazone in severe infections complicating hematologic diseases Hanshin Infection Study Group]. 304 32


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