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)

A man received a cadaver renal allograft for end-stage renal failure. After 35 months of immunosuppressive therapy with azathioprine and prednisone, he developed septicemia and a high leukocyte count. In spite of successful treatment of the infection, the leukocyte count continued to rise and a diagnosis of Philadelphia chromosome positive chronic granulocytic leukemia was made. An increased incidence of malignant disease, especially lymphoreticular malignancy, is well described in immunosuppressed patients with allografts. However, the association of chronic granulocytic leukemia and immunosuppressive therapy previously has not been reported. An additional etiological factor in this patient may have been the extensive diagnostic radiological investigations undertaken in childhood. The recent addition of allopurinol to the immunosuppressive therapy has normalized the platelet and leukocyte counts, probably by potentiating mercaptopurine.
Arch Intern Med 1978 Sep
PMID:Chronic granulocytic leukemia in a patient with a renal allograft. 35 95

Nowadays, in severe infections during the neonatal period new bacteria--group B streptococci--have to be taken into account, since in some clinics they already predominate over gramnegative rods. Septicemia and meningitis may be caused by group B streptococci. The septicemia which especially threatents prematures starts with apnoeic spells in the very first hours after birth and may be easily misdiagnosed as an idiopathic respiratory distress syndrome. The mortality is very high (about 60%). Meningitis starts later, normally during the 3rd to 4th week. Seizures are typical at the onset. Group B streptococci may be identified in the CSF by counterimmunoelectrophoresis within one hour. The prognosis is more favourable in meningitis than in septicemia (mortality about 20%). Survivors have little neurological sequelae. Penicillin G or ampicillin combination with an aminoglycoside is recommended as chemotherapy. Exchange transfusion should be considered early. Group B streptococci causing the septic form may be transfered during labour since up to 25% of pregnant women are colonized. Nosocomial transmission of group B streptococci may be the reason for meningitis. Prophylactic penicillin does not seem to help in preventing the disease, but it is possible, that meningitis of the newborn may be prevented by immunizing the mother during pregnancy.
Monatsschr Kinderheilkd 1978 Sep
PMID:[Group B streptococcus infections during the neonatal period (author's transl)]. 35 54

A study of 120 patients undergoing elective colorectal operations has investigated the effect of adding oral neomycin and metronidazole to bowel preparation in a double-blind randomized controlled trial. Comparisons have also been made between a standard mechanical preparation and the use of an elemental diet. The addition of neomycin and metronidazole to bowel preparation significantly reduced the rate of wound sepsis (P less than 0.01), septicaemia (P less than 0.02) and anastomotic dehiscence (P less than 0.02); anaerobic infections were abolished and there was a significant reduction in the incidence of aerobic Gram-negative infections. Elemental diets were shown to have no advantage over mechanical preparation.
Br J Surg 1978 Sep
PMID:Randomized multicentre trial of oral bowel preparation and antimicrobials for elective colorectal operations. 35 83

Splenectomy is a surgical procedure of medium severity, the mean lethality rate is 1%, the complication rate 10 to 20%. The surgical risk is dependent upon age and general condition of the patient, the severity of the disease, and the experience of the surgeon. The risk of late complications due to surgery is determined mainly by infections as well as ileus, requiring relaparatomy. The risk of infections is higher in children than in adults: one has to be aware of miningitis and sepsis in about 10% of the patients; half of those cases end lethal. An analysis of advantages versus risks of splenectomy must be made for each patient individually. For optimal treatment it is necessary to know the stage of the disease. Concerning M. Hodgkin, explorative laparatomy combined with splenectomy should be performed in stage I to III A. If, however, the surgical risk is rather high primarily and if there are no therapeutical consequences to be expected, splenectomy should not be performed because of the known risks and disadvantages.
Fortschr Med 1978 Sep 28
PMID:[What are the dangers of splenectomy in Hodgkin's disease?]. 35 41

The effect of an 8-hour, 3-dose perioperative regimen of cefazolin or placebo was evaluated in 97 patients. Postoperative morbidity occurred in 13 patients (27.1%) in the cefazolin group and in 17 patients (34.7%) who received placebo. The clinical sites of infection were similar in both groups except that wound infections (2) and sepsis (2) were found only in patients receiving placebo. Aerobic organisms diminished and anaerobes increased in patients who received antibiotics. Aerobic isolates were essentially unchanged and fewer anaerobes were recovered from patients given placebo. Antibiotic levels observed at cesarean section were in the therapeutic range. The only risk factor which correlated with morbidity was the presence of ruptured membranes. This short course, single drug regimen did not significantly reduce morbidity although it was bacteriologically effective.
Obstet Gynecol 1978 Sep
PMID:Perioperative antibiotic prophylaxis is cesarean section. 36 Jan 20

A patient with congenital generalized lipodystrophy developed nephrotic syndrome with progressive renal glomerulosclerosis attributed to diabetic nephropathy. Renal transplantation was performed and the patient was discharged with normal renal function. Marked hyperlipidemia (17,500 mg/dl) persisted. One month later renal malfunction developed, and an open renal biopsy was performed when there was no response to antirejection therapy. Massive lipid deposition in renal tubular cells with tubular necrosis and hemorrhage was present but only minimal evidence of graft rejection. Rejection therapy was tapered and renal function stabilized. Death occurred 2 months later because of pulmonary sepsis. Patients with generalized lipodystrophy and severe hyperlipidemia may be at an unusually high risk for renal homograft destruction.
Transplantation 1978 Sep
PMID:Renal transplantation in a patient with lipoatrophic diabetes. A case report. 36 May 16

Different types of dermoplasty aimed at the closure of reactive wounds were applied in the treatment of 26 cases with protracted non-healing wounds (up to 30 years) following burns, frostbites, open fractures, outcomes of acute suppurative diseases with sepsis phenomena. The treatment failed only in one patient. The transplantation of free stamp-like skin grafts proved to be the most effective one. Biostimulating effect of the single grafts which fuse has been noted.
Vestn Khir Im I I Grek 1978 Sep
PMID:[Autodermoplasty in the treatment of wound emaciation]. 36 May 93

The incidence of serratia marcescens in an intensive care unit was investigated in course of several years. After a trial of Cephalosporin-Gentamycin prophylaxis, infection and death due to serratia rose dramatically. The significance of decreased resistance to infection, hygiene regimes as well as mode of administration of antibiotics is related to selection of this rare microorganism causing septicemia.
Anaesthesist 1978 Sep
PMID:[Increasing incidence of Serratia marcescens bacteraemia in intensive care patients (author's transl)]. 36 83

The case of a kidney allograft recipient, who suffered from several episodes of Salmonella dublin sepsis following massive immunosuppressive therapy to overcome a transplant rejection crisis, is presented. The focus of sepsis was the chronic inflamed gallbladder. The Salmonella dublin strain isolated from the blood during the last episode was found to exhibit multiple resistance to antimicrobiol drugs. Because the resistance phenotype was characteristic for the gramnegative flora of the university hospital, it was suggested that transfer of a resistance plasmid, frequently found in gramnegative enterobacterial isolates, to the Salmonella strain had occurred in the patient. The comparative examination of a Klebsiella pneumoniae strain, representing the hospital flora, and Salmonella dublin revealed that both strains produced the aminoglycoside 3'-phosphotransferase type 1, the 2''-nucleotidyltransferase and the 3''-adenylyltransferase, enzymes responsible for resistance to aminoglycoside antibiotics. Furthermore, in both strains a TEM type beta-lactamase was found to render the organism resistant to penicillins and cephalosporins. Transfer experiments showed that the host ranges of the R-plasmids of both strains were identical. Furthermore, both plasmids were found to be the fi+ type. These data support the view of in vivo transfer of an R-plasmid from the enterobacterial hospital flora to a potential pathogen in a patient.
Zentralbl Bakteriol Orig A 1978 Sep
PMID:Acquisition of multiple antibiotic resistance by Salmonella dublin from the gramnegative hospital flora, in a kidney allograft recipient. 36 85

Myocardial failure is uniformly fatal when associated with post-traumatic sepsis and multisystem failure. Controversy exists as to whether endotoxin has a direct effect on the myocardium. A nonanoxic isolated arterially perfused rabbit interventricular septum was used in this study to evaluate the effects of endotoxin, live E. coli, and endotoxin/septic shock plasma on myocardial function and ultrastructure. Purified E. coli endotoxin and live E. coli bacteria did not have a significant direct effect on rabbit cardiac muscle function or ultrastructure. Perfusion of the rabbit septum with plasma from rabbits exsanguinated following a 2-hour septic or endotoxin shock insult, however, caused significant (p less than 0.02) myocardial depression when compared with control septa perfused with normal rabbit plasma. Septa perfused with shock plasma demonstrated ultrastructural alterations of mitochondria that were not noted in control preparations.
J Trauma 1978 Sep
PMID:Myocardial depression in sepsis. 36 63


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