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

In addition to a layer of mucus, the gastric mucosa barrier is mainly formed of a tight junction consisting of the surface membranes of epithelial cells. It is this that mainly impedes the flowback of H+ ions. Buffers conveyed by the blood neutralise the small numbers of ions that do flow back, even under physiological conditions. Damage to the barrier results in a considerable backflow of ions that enhance acid secretion and release of histamine and other vasoactive substances, so that further mucosal lesions occur. Such damage may be of exogenous or endogenous origin. Alcohol and acetylsalicylic acid are two examples. The latter is undissociated and hence liposoluble in the highly milieu of the stomach and can easily enter the cells and damage them. Severe hypovolaemia, stress and sepsis are instances of endogenous sources of damage. In the final analysis, the damage caused by sepsis is linked to cell anoxia.
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PMID:[The gastric mucosa barrier and gastropathy]. 7 72

The results of operative treatment of thirty-six patients with acute gastric mucosal hemorrhage are presented. Alcohol and surgery/trauma were the most frequent causes, and renal failure, sepsis, or multisystem disease caused most deaths; overall mortality was 44 per cent. Vagotomy-pyloroplasty and vagotomy-resection are compared, and no statistically significant difference in rebleeding, reoperation for bleeding, or mortality is identified.
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PMID:Choice of operation for acute gastric mucosal hemorrhage. Report of 36 cases and review of literature. 33 75

Sepsis induces primary myocardial dysfunction. Yet, both hyper- and hypodynamic cardiac states characterize the sepsis syndrome, suggesting a modulatory role of septic mediators. Platelet activating factor (PAF), implicated in the pathogenesis of sepsis, is an endogenous phospholipid with diverse intracellular and extracellular effects. The purpose of this study was to investigate the influence of PAF (1) upon basal mechanical function of the heart, (2) upon receptor-coupled function of the heart, and (3) on basal and stimulated myocardial function at differing concentrations. In order to focus on the relationship between PAF and cardiac mechanical function, rat hearts were isolated and crystalloid perfused using a modified Langendorf preparation. Separate hearts received intracoronary vehicle (5% ethanol, 2.5% BSA) or PAF (20 or 40 microM) as a bolus, followed 10 min later by 0.25 microM isoproterenol (beta-receptor agonist) infusion over 3 min. Both 20 and 40 microM PAF produced a rapid decrease in rate pressure product (RPP = HR X LVDPmax) relative to control (P < 0.05). The depressive effect of PAF upon basal myocardial function did not persist and by 10 min RPP was not different (P > 0.05) among the groups. Isoproterenol infusion increased (P < 0.05) RPP in all groups. However, hearts pretreated with 20 microM PAF demonstrated a greater (P < 0.05) response to beta-adrenergic stimulation relative to vehicle-pretreated controls. This amplified response to isoproterenol was not observed with pretreatment at a higher concentration of PAF (40 microM, P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Platelet activating factor alters receptor-coupled function in the isolated perfused rat heart. 132 66

The aim of the present study was to determine whether hearts that demonstrate depressed myocardial reserves as a result of sustained hypermetabolic sepsis would show a potentiation of the dysfunction after an infusion of high doses of alcohol. We have previously shown that myocardial depression is present in hearts removed from hypermetabolic septic rats. Acute alcohol administration has also been shown to have a negative inotropic effect on the heart. In this study, myocardial function was assessed under in vitro conditions in which preload could be varied and aortic outflow resistance controlled and thus heart function could be determined under both low and high workloads. The alcohol-infused group increased cardiac performance as a function of increasing preload similarly to the controls. Heart rate, however, was significantly elevated compared with control. Isolated hearts from septic, saline-infused animals showed depressed cardiac performance both in terms of stroke volume and myocardial work over a range of preloads. The septic, alcohol-infused animals did not show this depression. Thus, a loss of myocardial reserve was demonstrable in hearts isolated from septic, saline-infused rats but not in septic, alcohol-infused rats. Alcohol, at least acutely, seemed to reverse or ameliorate the loss of myocardial reserve induced by sepsis possibly by increasing the ability of the heart to fill during diastole and thus perform volume work.
Alcohol Clin Exp Res 1991 Dec
PMID:Function of isolated hearts from septic, saline-infused, and septic, alcohol-infused rats. 178 83

We report a patient who developed multiple liver abscesses and sepsis caused by lactobacilli after the percutaneous intratumoral injection of ethanol for hepatocellular carcinoma. We diagnosed the liver abscess at an early stage because of a the finding of gas on ultrasound and computed tomography. Blood cultures grew Gram-positive rods, which were of the Lactobacillus species. The patient responded to the administration of antibiotics, and his hepatic tumors have not recurred in the 7 months since treatment. This is the first report of liver abscess following percutaneous ethanol injection therapy.
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PMID:Liver abscess complicating intratumoral ethanol injection therapy for HCC. 217 43

The increased glucose turnover seen during the hypermetabolic, hyperdynamic phase of sepsis is part of the body's defense mechanisms. In contrast, the metabolism of ethanol (ETOH) is known to compromise hepatic gluconeogenesis under certain conditions. This study tested the hypothesis that acute infusion of ETOH inhibits the elevated glucose production that is manifested during infection and thereby alters the normal responses to sepsis. In catheterized conscious rats, ETOH or saline infusion was started 24 hours before the induction of sepsis, and continued throughout the experiment. In vivo glucose kinetics were assessed by the infusion of [6-3H, U-14C]-glucose 24 hours after the induction of sepsis. The characteristic sepsis-induced hyperthermia was prevented in ETOH-infused animals. Sepsis increased the plasma lactate concentration (100%), as well as the rates of glucose appearance ([Ra] 77%), recycling (213%), and metabolic clearance ([MCR] 82%) in saline-infused control animals. In contrast, ETOH infusion prevented the sepsis-induced increase in glucose Ra and markedly attenuated the increase in plasma lactate (49%) and glucose recycling (97%). The infusion of ETOH increased the lactate/pyruvate and beta-hydroxybutyrate (BHBA)/acetoacetate (AcAc) ratio in both septic and nonseptic rats. These results indicate that ETOH administration attenuates the increased glucose production, utilization, and elevated arterial lactate, and prevents the hyperthermic response seen during the hypermetabolic phase of sepsis. Thus, ethanol intoxication alters the normal metabolic responses to sepsis, thereby contributing to the compromised host defenses against the challenging bacteria.
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PMID:The effect of ethanol infusion on the altered glucose turnover during bacterial infection. 219 Nov 87

Since the introduction of the LeVeen modification of the peritoneovenous shunt (PVS) in 1974, these devices have been placed in a relatively large number of patients. The most common indication has been for medically intractable ascites in the setting of chronic liver disease. A review of a series of studies shows that we can expect approximately an 18% perioperative overall mortality rate, a 46% survival rate at 21 months, and loss of ascites in 59% of the survivors at 18 months. The PVS has not been shown by prospective trials to prolong survival significantly in patients with either intractable ascites or the hepatorenal syndrome (HRS), although it may shorten hospitalizations, compared with medical controls. A few well-documented cases of reversal of the HRS have been documented. The best results of PVS therapy have been evident in those patients with milder liver disease. The loss of ascites need not correlate with a functioning shunt. Alcohol abstinance is associated with hepatic functional recovery and may relate to the disappearance of renal sodium retention, resulting in shunt occlusion due to low flow. A number of serious complications with the PVS have been described. Nutritional repletion follows successful shunting, but might, in part, relate to simultaneous alcohol abstention. The more common complications of coagulopathy and fluid overload are preventable by total ascitic drainage at the time of surgery. Shunt patency remains a clinical problem. Only 18.6% of the total shunts placed functioned in the survivors at 2 yr. Perioperative infections with staphylococcal and Gram-negative organisms occur. Postoperative bacterial peritonitis or septicemia requires shunt removal for cure.
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PMID:The peritoneovenous shunt: expectations and reality. 219 58

Edwardsiella tarda (E. tarda) is gram negative enterobacteriaceae which has been found generally in animal hosts and occasionally in human feces. We have reported a case of sepsis caused by E. tarda, complicated panophthalmitis and pyogenic spondylitis. A 39-year old patient suffered from fever, polyarthralgia and lumbago. We performed blood culture, from which E. tarda was isolated. Spinal CT scan showed destruction and osteogenesis of the fourth and fifth lumbar vertebral body and cranial CT scan showed destruction of the right lens. So we diagnosed sepsis with pyogenic spondylitis and panophthalmitis. We suspected that chronic ethanol administration reduced the resistance to infection of E. tarda which caused sepsis.
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PMID:[A case of sepsis caused by Edwardsiella tarda complicated panophthalmitis and pyogenic spondylitis]. 221 56

Fluoxetine (PROZAC) is a recently marketed straight chain antidepressant unrelated to the cyclic anti-depressants. There is only limited information on fluoxetine and a single case report on overdose (benign outcome) in the literature. In response to this we performed a 1y retrospective chart review at 2 AAPCC certified poison centers. Forty-four exposures to fluoxetine were reviewed from 1988; 31 cases were treated in a HCF, 2 cases were followed at home by phone and 11 cases were lost to follow up. Thirteen cases with follow up (FU) reported no coingestants; 3 cases reported increased anxiety without cardiovascular (CV) changes, 2 cases presented confused with out CV changes, and 8 cases were asymptomatic. Eight cases with FU had ETOH and/or benzodiazepines as a coingestant and experienced only a decreased level of consciousness that could be explained by the coingestant. Five cases remained asymptomatic with reported coingestants of APAP #3, lorazepam, haloperidol, molindone, alprazolam, propranolol, phenobarbital (level 18.2). Four cases were excluded from the evaluation due to the coingestants involved. No seizures were recorded in this series. Three possible drug reactions occurred; 2 cases had reactions with tranylcypromine (PARNATE), and 1 case with a diagnosis of septicemia had a severe hyperthermic reaction with therapeutic coingestants of mephytoin, verapamil, digoxin and indocin. We believe overdose with fluoxetine present minimal risk of serious cardiovascular or neurological complications.
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PMID:Fluoxetine ingestion: a one year retrospective study. 232 65

Intestinal aerobic gram-negative bacilli (IAGB) are considered to be important in the pathogenesis of wound infection following major head and neck surgery. These micro-organisms have been shown to originate endogenously from the stomach, in spite of broad spectrum chemoprophylaxis. We have attempted to interrupt this gastro-oral pathway by instilling an antiseptic (40% ethanol) into the stomach after surgery. We studied 16 patients who were randomly allocated to an 'alcohol' or control group. Alcohol was administered to 8 patients regularly via the nasogastric tube until the 5th postoperative day. The mouth, tracheostomy site and gastric aspirates were sampled on the 1st, 5th, and 10th days after surgery. No patients had IAGB grown from the mouth before surgery, but after surgery coliforms were prolific in all sites in both patient groups, and the administration of alcohol did not have any noticeable affect. However, even though coliforms were ubiquitous during the recovery period, wound complications were few, and their importance in the pathogenesis of wound sepsis is reconsidered.
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PMID:The clinical significance of the gastro-oral pathway of intestinal bacteria after head and neck cancer surgery. 344 46


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