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

In 182 critically ill patients, after admission delayed hyersensitivity skin testing have been systematically performed with 3 antigens (tuberculin, candidin, varidase). Mortality in anergic patients was 55% while it dropped to 19% when at least one response was positive. A highly significant relationship was found between anergy and mortality (p less than 10(-5)) whether death was related to sepsis (p less than 10(-4)) or not (p less than 0.02). In patients with major sepsis, anergy was more frequent (38%) than in non septic patients (21%) (p less than 0.01). In 69 patients skin testing with phytohemagglutinin was performed. Seven out of 8 unresponsive patients were anergic and 5 died. The results suggest that in critically ill patients cellular immunity skin testing may early select high risk patients exposed to septic complication. In these patients several important measures should be promptly taken including superinfections prevention, adapted nutritional intake and septic focus eradication.
Nouv Presse Med 1978 Sep 09
PMID:[Cellular immunity skin testing and sepis in intensive care patients : relationship between results and mortality (author's transl)]. 70 13

In 40 out of 45 children dead from sepsis in 1974--1976 the development of the syndrome of disseminated intravascular coagulation was proved on the grounds of the pathologic picture. In 27 cases histological changes were combined with characteristic clinico-laboratory manifestations of the syndrome. The latter was not found in 10 children who died of a severe local purulent process.
Vestn Khir Im I I Grek 1978 Sep
PMID:[Disseminated intravascular coagulation syndrome in sepsis in infants]. 70 15

Since January, 1970, the Center for Disease Control (CDC) has corridnated surveillance of nosocomial infections in a group of voluntarily cooperating hispitals in the United States. In 1970, this surveillance system failed to realize one of its major goals: detection of a nationwide epidemic of septicemia caused by contaminated intravenous products. However, retrospective review of infections reported to CDC revealed that the data received were sufficient for the outbreak to have been recognized. Beginning in July, 1970, one month after the contaminated products were first distributed and five months before the outbreak was actually detected. CDC data showed a persistent increase in the incidence of Enterobacter and Erwinia (presently designated Enterobacter agglomerans) bacteremia. Furthermore, monthly rates of cases of bacteremia caused by these organisms were higher in hospitals using the contaminated intravenous products than for hospitals not using them. Failure to detect this outbreak at the time of its occurrence was due to delays in data processing and insufficiently sophisticated data analysis. Based on this experience, CDC has modified the surveillance system to aid recognition of future outbreaks.
Am J Epidemiol 1978 Sep
PMID:The role of nationwide nosocomial infection surveillance in detecting epidemic bacteremia due to contaminated intravenous fluids. 70 89

A laminar airflow isolation burn ward was designed which would maintain a sterile environment and also allow unrestricted burn care and rehabilitation to be performed. A very low rate of sepsis and sepsis-related complications have been found in the 115 patients treated in the unit. Patient cross contamination has been completely controlled under laminar airflow conditions. The incidence of burn colonization and infection by virulent gram-negative organisms, namely pseudomonas, serratia, klebsiella, and proteus, in these patients has been extremely low, particularly in comparison with burn patients managed in a non-laminar flow intensive care environment.
Am J Surg 1978 Sep
PMID:The use of a laminar airflow isolation system for the treatment of major burns. 70 9

The effectiveness of antibiotics in the management of penetrating abdominal injuries was studied retrospectively in two non-controlled, non-randomized groups of patients. The uncontrolled group (107 patients) received a variety of antibiotic(s) mainly intra- and postoperatively. The protocol group (121 patients) received a combination of clindamycin and gentamicin preoperatively in the Emergency Room. The protocol group had a statistically significant reduction in the incidence of intraabdominal sepsis, 1.7% as compared to 8.3% in the uncontrolled group. Although the improved results cannot be attributed solely to the antibiotic regimen, the trend seems apparent. Therefore, to minimize septic complications in penetrating abdominal injuries, we advocate: 1. prompt resuscitation, 2. early and appropriate surgical intervention and 3. preoperative antibiotics that are effective against both the aerobic and anerobic resident flora of the gastrointestinal tract.
Am Surg 1978 Sep
PMID:Role of antibiotics in penetrating abdominal trauma. 71 7

Resort to laparotomy for the staging of Hodgkin's disease has been controversial because of its questionable advantage over nonsurgical staging methods. The recent concern over splenectomy and subsequent overwhelming infection has added to this debate. The author reviews experience with Hodgkin's disease in 34 patients whose ages ranged from 6 to 18 years. Seventeen patients underwent staging laparotomy after their disease had been staged by standard nonoperative methods; the duration of follow-up was from 2 to 7 years. In 7 of these 17 patients the stage of their disease was changed as a result of the laparotomy findings. Complications have been late septicemia resulting in death in one patient and subacute bowel obstruction not requiring reoperation in two patients. In the author's opinion staging laparotomy in children with Hodgkin's disease is a valuable means of deciding on their subsequent therapy.
Can J Surg 1978 Sep
PMID:Staging laparotomy for Hodgkin's disease in children. 71 63

The difficulties in maintaining vascular access in patients on long-term hemodialysis are well recognized. The author's experience with bovine grafts in such cases had been that late failure from sepsis or thrombosis was common, as reported in the literature by others. In May 1976 the expanded polytetrafluoroethylene (PTFE) prosthesis became the substitute of choice as a vascular graft. In the last 18 months these grafts have been placed as subcutaneous arteriovenous fistulas in 22 patients. Three early failures occurred as a result of graft thrombosis but one graft was salvaged by thrombectomy using a Fogarty catheter. Two late failures occurred, one after 3 and another after 6 months. All other grafts are functioning satisfactorily. Expanded OTFE grafts provide satisfactory vascular access for maintenance hemodialysis in selected patients and their use may prove to be the procedure of choice for hemodialysis in small children.
Can J Surg 1978 Sep
PMID:Expanded polytetrafluoroethylene prosthetic grafts for blood access in patients on dialysis. 71 65

Over the past 5 years, 107 patients have been evaluated for acute traumatic hemothorax at the University of Kentucky Medical Center. Immediate tube thoracostomy was performed on 90 patients for evacuation of blood and air. Only 2 patients died. Thoracotomy was performed as part of the initial therapy in 9 patients. Thoracotomy for continued hemorrhage from a pulmonary parenchymal injury was required in 3 patients from the entire group. Thoracentesis or observation was the initial therapy for limited hemothorax in 8 stable patients. Three of these patients subsequently required tube thoracostomy 2 to 23 days following injury due to expanding effusions, and 1 patient required multiple thoracotomies for sepsis, fibrothorax, and empyema. These observations indicate that early evacuation of blood by means of a tube thoracostomy is essential to minimize morbidity in acute traumatic hemothorax. If continuing hemorrhage after tube thoracostomy occurs, there is a higher association of injury to additional vital structures.
Ann Thorac Surg 1978 Sep
PMID:Acute traumatic hemothorax. 75 90

Group B streptococci are an important cause of infant septicemia and meningitis. A prospective study of group B streptococcal colonization in a 300-bed community hospital disclosed rates of 29% of 297 third-trimester women, 37% of 242 newborn infants, and 45% of 22 hospital personnel. Colonized parturients were more frequently black and anemic on admission for delivery. Infant colonization was statistically associated with a positive maternal genital culture, low birthweight, and prematurity. Nosocomial transmission of group B streptococci was strongly suggested by observations that 41% of colonized infants were born to culture-negative women and such infants became colonized later in their hospital stay than did colonized infants born to colonized women. Furthermore, hospital personnel working in the labor-delivery and nursery areas had a significantly higher prevalence of the organism than did personnel from other areas. Clearly, more information is needed about the epidemiology of group B streptococcal disease before appropriate and rational control measures can be recommended.
Pediatrics 1976 Sep
PMID:Nosocomial transmission of group B streptococci. 78 56

An unexpectedly high morbidity (28 per cent) followed colostomy closure in 100 patients. One patient died postoperatively because of sepsis resulting from disruption of the colon anastomosis. Wound infection (10 per cent), intraperitoneal abscess (1 per cent), bowel obstruction (7 per cent), and fecal fistula (4 per cent) were other significant complications. Wound sepsis was greater after primary than after delayed wound closure. Obstruction did not correlate with the use of either an open or closed technic of anastomosis. Three patients required reoperation for complications. Temporary colostomy was constructed for colon injury in 85 per cent of patients. In view of the considerable morbidity of colostomy closure, alternate technics of managing colon trauma should be considered. Such technics include primary closure and exteriorization of repaired colon. When temporary colostomy is unavoidable, closure is best done by open, two layer anastomosis with delayed wound closure. Colostomy should be recognized as an important procedure associated with significant morbidity.
Am J Surg 1976 Sep
PMID:Morbidity of colostomy closure. 78 53


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