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

The application of parenteral nutrition in patients in intensive care units can be limited by shock, septicemia and metabolic disorders. Stress- or trauma-induced glucose intolerance sometimes makes it difficult to maintain the caloric requirements with glucose. Sugar substitutes seem to be of advantage in these cases. Meticulous care is essential to avoid severe complications arising from the use of the central venous feeding catheters.
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PMID:[Problems with hyperalimentation in intensive care units (author's transl)]. 82 90

Neonatal mortality rate is perhaps the most reliable indicator of perinatal outcome. An assessment of perinatal outcome can be made through knowledge of causes of death. This study was undertaken to evaluate the neonatal deaths in the Neonatal Division, Lady Hardinge Medical College. Livebirths (n=7309) and deaths (n=328) during a 6-month period were retrospectively analyzed. These were grouped into nonpreventable and potentially preventable causes of death. The single most important factor contributing to mortality was respiratory distress (29.3%), followed by sepsis (24.4%), and birth asphyxia (16.2%). The nonpreventable causes of mortality (e.g., lethal congenital malformations, extremely low birthweight) accounted for 10.4% of the total mortality. The idealized neonatal mortality rate was 4.6/1000 livebirths, while the salvageable death rate was 40.2/1000 livebirths. Mortality increased significantly if the birthweight fell below 2 kg. The salvageable deaths could perhaps be prevented through better antenatal and intranatal care, ventilatory support, and sepsis prevention.
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PMID:Neonatal mortality patterns in an urban hospital. 180 Mar 43

Cultures of postoperative wounds after head and neck surgery reveal a variety of oropharyngeal anaerobic and aerobic flora, aerobic gram negative rods and fungi. Control clinical trials have shown that preoperative antibacterial prophylaxis reduces the incidence of postoperative wound infections. When an antibiotic is used prophylactically, it must be active against the micro-organisms known to cause the infection which the patient is supposed to be protected from. Antibacterial prophylaxis should begin just before the operation beginning, earlier is unnecessary and beginning later is less effective. It is indicated for a variety of surgical procedures that high risk of wound sepsis, superinfection and the emergence of resistance has not been shown to occur if antibacterial agents are used only "perioperatively".
Hell Period Stomat Gnathopathoprosopike Cheir 1990 Jun
PMID:[The use of prophylactic antibiotics in oral and maxillofacial surgery]. 213 57

Previous work demonstrated that glucose-6-phosphate (G6P) and fructose-6-phosphate (F6P) levels declined early in endotoxemic and septic livers. Since glucocorticoids are known to support hepatic gluconeogenesis in endotoxemia, these agents were tested in a peritonitis model produced by cecal incision in fasted adult male rats. Dexamethasone sodium phosphate (DMS) and methylprednisolone sodium succinate (MPS) were given in doses of 1 mg and 3 mg, respectively, per 100 gm rat weight at time of incision. Freeze-clamp biopsy samples obtained at 5 hr were enzymatically assayed. G6P and F6P in sepsis (N = 12) decreased 50% and 36%, respectively, below sham-operated control values (N = 15) of 236 and 61 nmole/gm wet tissue. The decrease with DMS was 20% and 16% and with MPS was 22% and 23%, showing partial restoration to normal levels. Phosphoenolpyruvate (PEP) did not decline in the moderate, non-terminal stage of peritonitis when compared to the control value (N = 19) of 209 nmole/gm. Treatment with glucocorticoids raised PEP to supernormal levels: DMS (N = 19) a 63% elevation, MPS (N = 12) a 51% elevation above controls in peritonitis rats. The glucocorticoid effect was similar in both rapid endotoxic and the slow peritonitis shock models. It is concluded that hexose monophosphate (HMP) increase is secondary to the support of PEP synthesis with glucocorticoid treatment. Changes in sham-operated control rat livers treated with glucocorticoids did not reach statistical significance.
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PMID:Glucocorticoid action on rat hepatic glycolytic intermediates during experimental peritonitis. 730 24

A 64-year-old woman was diagnosed as having myelodysplastic syndrome (MDS) at 45 months after receiving radiotherapy for advanced carcinoma of the uterine cervix. We chose low dose therapy of SPAC and ACR because of the diagnosis as therapy-related MDS and the existence of radiation colitis. She obtained minor response, but two months later she transformed to AML (M2). The interval between low dose therapies was getting shorter and shorter, so we tried intensive chemotherapy consisting of BHAC, ACR and 6MP. Blast numbers were reduced, but she died of sepsis and intestinal bleeding. The patients of MDS with t(8;21) and the patients of therapy-related AML (tAML) with t(8;21) are very rare. According to the literature, only karyotype is a prognostic factor in AML/MDS with t(8;21). And diagnosis by the criteria of FAB classification is of little value regarding clinical progress. That is to say, if the patient has only t(8;21) or karyotypic abnormalities which are of little value in prognosis, such as the loss of a sex chromosome, it must be treated as de novo AML, but if patient has karyotypic abnormalities such as -5, 5q-, -7, 7q-, and/or multiple (complicated) abnormalities, we must accept that the prognosis is poor and must treat it as ordinary MDS/tAML.
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PMID:[Therapy-related leukemia with t(8;21) initially diagnosed as MDS (RAEB in T)]. 756 9

During 1992, 53 women were admitted to Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital in New Delhi, India, for septic induced abortion and 1855 were admitted for medical termination of pregnancy (MTP). Most septic induced abortion cases lived in semi-urban/urban slums (64.15%), were Hindus (98.11%) and married (94.34%), and had a parity of less than 2 (56.6%). The leading reason for abortion was unwanted pregnancy among septic abortion cases (81%) and contraceptive failure among MTP cases (98.3%). No septic abortion case had used contraception. Among septic abortion cases, termination methods included instrumentation by untrained midwives (62%), foreign body insertion (7.5%), and dilatation and curettage or suction by unqualified personnel (7.5%). About 33% of septic abortion cases presented with generalized peritonitis, septicemia, septic shock, acute renal failure, or disseminated intravascular coagulation (DIC). All septic abortion cases had pelvic inflammatory disease compared to 3.55% among MTP cases. 94.35% had anemia. About 34% needed a blood transfusion compared to 0.16% among MTP cases. MTP cases were significantly less likely to suffer uterine perforation than septic abortion cases. None of the MTP cases had septicemia. The need for laparotomy was more common among septic abortion cases than MTP cases (26.4% vs. 0.43%). A hospital stay of more than one week was also more common (72% vs. 0.43%). On discharge, MTP cases were more likely to be in satisfactory condition than septic abortion cases (100% vs. 75.7%). No one in the MTP group died, while 13.2% died in the septic abortion group. The causes of death were septic shock (7 cases), hepato-renal failure (2 cases), and DIC (1 case). The abortion ratio was 312/1000 births. The abortion mortality ratio was 1.7/1000 abortions. Illegally induced abortions were responsible for 20% of all maternal deaths at this institution in 1992. These findings suggest that family planning education, contraceptive use, and safe pregnancy termination facilities would prevent abortion-related morbidity and mortality.
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PMID:Maternal mortality and morbidity associated with clandestine abortions. 765 45

Vibrio vulnificus is a pathogenic gram-negative bacterium, endemic to brackish waters, which is often isolated from sediments, from the water column or from shellfish. It is associated with wound infections and septicemia in humans and the virulence of V. vulnificus has been strongly associated with encapsulation. The capsular polysaccharide purified from a virulent strain of V. vulnificus 6353 did not show cross reactivity with antibodies to the capsular polysaccharide of a related pathogenic strain of V. vulnificus (MO6-24) the structure of which was recently reported. NMR spectroscopic analysis of the purified polysaccharide from strain 6353 showed that the polymer is composed of four sugar residues per repeating subunit including 2,6-dideoxy-2-N-acetylamino-alpha-D-glucose (QuiNAc), 2-deoxy-2-N-acetylamino-alpha-D-galactose (alpha-D-GalNAc), 2-deoxy-2-N-acetylamino-alpha-D-galcturonic acid (alpha-D-GalNAcA) and 2-N-acetylamino-alpha-D-glucuronamide (alpha-D-GlcNAcANH2). The 1H- and 13C-NMR spectra were completely assigned by homonuclear and heteronuclear NMR spectroscopy. Sugar types and anomeric configurations were determined from proton homonuclear coupling constants and glycosidic linkages were determined from 1H-13C heteronuclear multiple bond correlation spectra. Sugar identities were confirmed by high performance anion-exchange chromatography and absolute configurations were determined by gas chromatography in combination with molecular modeling and NMR spectroscopy. The structure of the polysaccharide repeating unit is: [-->4)-alpha-D-GalpNAc-(1-->3)-alpha-D-GalpNAcA-(1-->3)-alpha-D-++ +QuipNAc-(1-->]n alpha-D-GlcpNAcANH2 (1-->4)- -->. While there are some common features shared among the structures of the capsular polysaccharides of pathogenic strains of V. vulnificus, there are distinct differences in the detailed structures.
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PMID:Structure determination of the capsular polysaccharide from Vibrio vulnificus strain 6353. 969 29

AIM:To examine whether age alone or co-morbidity is a risk factor for death in older adults who developed Clostridium difficile (Cd) colitis during hospitalization.METHODS:A retrospective, observational study design was performed in our Lady of Mercy Medical Center,a 650-bed, urban, community-based, university-affiliated teaching hospital. 121 patients with a positive diagnosis of Cd colitis (aged 23-97 years) were studied, and data pertinent to demographic variables, medical history, co-morbidity, physical examination,and laboratory results were collected.Age was examined as a continuous variable and stratified into Age1 (< 80 vs 80+); Age2 (< 60, 60-69, 70-79 and 80+); or Age3 (< 60, 60-69, 70-79, 80-89,90+).RESULTS:Cd colitis occurs more frequently with advancing age (55% of cases > 80 years). However, age,per se,had no effect on mortality. A history of cardiac disease (P = 0.036), recurrent or refractory infection > 4 weeks (P=0.007),low serum total protein (P= 0.034), low serum albumin (P = 0.001), antibiotic use > 4 weeks (P<0.010), use of over 4 antibiotics (P=0.026), and use of certain classes of antibiotics (P=0.035-0.004) were predictive of death. Death was strongly predicted by the use of penicillin-like-antibiotics plus clindamy-cin, in the presence of hypoalbuminemia,refractory sepsis, and cardiac disease (P=0.00005).CONCLUSION:Cdcolitis is common in the very old.However, unlike co-morbidity,age alone does not affect the clinical outcome (survival vs death).
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PMID:Co-morbidity, not age predicts adverse outcome in clostridium difficile colitis. 1181 56

The Lady Dufferin Fund, founded in 1885 in India, had by 1940 established 400 hospitals to alleviate diseases and mortality related to childbirth. After independence 2328 community health centers and 21254 primary health centers were created in the country. During 1974-94 more than 131,000 subcenters were set up and about 620,000 auxiliary nurse midwives (ANMs) had been trained. The Ministry of Health introduced four health prevention schemes in 1969: 1) immunization of children against diphtheria, pertussis, and tetanus; 2) immunization of pregnant women against tetanus; 3) prophylaxis of mothers and children against nutritional anemia; and 4) prophylaxis of children against blindness caused by vitamin A deficiency. As a result, infant mortality declined from 146/1000 live births to 74/1000 in 1993; but maternal mortality still stayed around 4-5/1000. In 1993 an estimated 117,356 maternal deaths occurred out of a total of 26,057,000 births, equalling 4.5 deaths per 1000 live births. The main causes of maternal deaths are hemorrhage, anemia, abortion, toxemia, and puerperal sepsis. Only about 411 first referral units in community health centers are functioning properly. Prenatal care of mothers includes the administration of tetanus toxoid and iron-folic acid tablets. However, the prenatal coverage reached only about 50% of mothers; and the coverage was only 21.4% in Bihar, 23.8% in Nagaland, 29.3% in Rajasthan, and 29.6% in Uttar Pradesh. In these areas administrative inefficiency is widespread with nonavailability of essential drugs for malaria, infections, sepsis, dysentery, and colds. During 1992-93 the rate of hospital deliveries ranged from 6.1% in Nagaland to 88.4% in Kerala, with a national average of only 25.6%. 71% of deliveries in rural areas and 30% in urban areas were conducted by untrained assistants. Although there are 450 ANM training schools in the country, the level of training has deteriorated. The major causes of infant deaths are respiratory infections and diarrhea, responsible for 13.5% and 6.9% of mortality, respectively. Severe malnutrition and inadequate vaccination are other major causes of child deaths and morbidity.
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PMID:Maternal and child health in India: a critical review. 1229 Sep 61

From 1959-1964 the incidence of puerperal sterilization was 3.5% at the Lady Hardinge Hospital in New Delhi, an increase over the incidence of 2.15% from 1952-1957. The group analyzed in this study consists of 301 women sterilized during the 1959-64 period. Sterilizations were postpartum (191), during caesarean section or hysterotomy (74), and miscellaneous (36, including post-abortion). Average age was 32.5; average parity was 6.0. The majority had at least 2 male children. Indications for sterilization were socioeconomic (90%), obstetric (7%), and medical (3.3%). Immediate postoperative sequelae, studied in the postpartum cases only, included pyrexia and sepsis at rates of 25% and 24% of postpartum women. The most common late sequelae among all the women were chronic fatigue (44%), menstrual disturbances (28.9%), headache (28%), backache (26.5%), and lower abdominal pain (27.5%). The high incidence of chronic pelvic inflammation, 15%, was probably associated with the use of silk sutures. 2 patients became subsequently pregnant; the pregnancy rate was thus an unsurprising 0.7%.
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PMID:A review of 301 cases of sterilisation. 1233 82


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