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)

The potential deleterious effects of aerosolized fibrin on contaminated procedures were investigated in a rat model of peritonitis. One hundred forty rats were divided into two groups. In the control group, gelatin capsules containing feces (10(7) bacteria per milliliter) and barium sulfate at various dilutions were placed into the abdomen; in the second experimental group, a solution of cryoprecipitate, thrombin, and calcium was sprayed diffusely into the peritoneal cavity after similar fecal contamination. Fecal inocula with low bacterial concentrations (0.01, 0.1, and 0.15 mL) caused few deaths from peritonitis or abscess formation in either group. Heavy peritoneal contamination (0.25, 0.3, and 0.5 mL) caused early deaths from peritonitis in both groups, with 80% of the deaths due to sepsis in the first 48 hours. However, in the moderately contaminated rats (0.2 mL of fecal inoculate), fibrin aerosol reduced the 10-day mortality from 80% to 10%. In all survivors in the fibrin-treated group, intraperitoneal abscesses developed. With intraperitoneal bacterial concentrations of 2 x 10(6) organisms, early acute mortality from fibrinopurulent peritonitis is decreased at the expense of late, localized, nonlethal abscess formation. Aerosolized fibrin solution must be used with caution in contaminated surgery.
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PMID:Effect of aerosolized fibrin solution on intraperitoneal contamination. 198 38

The presence of HPVG has been said to constitute a mandatory indication for exploratory laparotomy, given the high incidence of concomitant bowel necrosis and abdominal sepsis. HPVG has also been associated with increased intraluminal pressure in the absence of bowel ischemia. Most cases are iatrogenic, usually due to barium enema or colonoscopy in patients with inflammatory bowel disease, but in a few cases, HPVG is associated with simple intestinal or gastric distention. The English literature on the subject describes only eight such cases. We recently treated a patient in whom HPVG was caused by intestinal pseudo-obstruction. Such an etiologic mechanism has not been previously reported. The relevance of this observation and a reassessment of the absolute obligation to operate prompted this review.
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PMID:Does the presence of hepatic portal venous gas mandate an operation? A reassessment. 218 76

Impaired mental status is a poorly understood manifestation of sepsis and may be associated with altered permeability of the blood-brain barrier. To examine the possibility that sepsis affects permeability of the blood-brain barrier, rats were infected with a peritoneal implant consisting of sterilized feces, barium sulfate, and 10(8) colony forming units (CFU) of Escherichia coli. Using this model, reproducible episodes of peritonitis with bacteremia resulted. Rats were sacrificed hourly after 5 min circulation of 100 mg horseradish peroxidase. Animals were perfused-fixed and the brains removed. Representative coronal sections were stained for peroxidase reaction product and cerebral blood vessels were examined microscopically for evidence of HRP staining and extravasation. The number of stained cerebral vessels from infected rats was increased at all times compared to uninfected control rats. Extravasation of horseradish peroxide within neuropil was significantly higher in hours 1, 4 and 5 as compared to controls. The lack of significant increase in hours 2 and 3 may suggest transient closing or repair of the tight junctions. We conclude that peritonitis and bacteremia are associated with increased permeability of the blood-brain barrier.
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PMID:E. coli peritonitis and bacteremia cause increased blood-brain barrier permeability. 241 52

A 64-year-old man with Crohn's disease who had undergone repair of an ileovesical fistula and ileoileostomy had numerous postoperative complications related to sepsis and wound healing. Subsequently, upper gastrointestinal bleeding developed, and the site was identified as a duodenal sinus. Medical management was unsuccessful in controlling the bleeding. Because of the considerable risk associated with reoperation in this seriously ill patient, approval was obtained from the Food and Drug Administration to use fibrin glue in an attempt to prevent further bleeding. The glue was mixed with barium and placed in the duodenal sinus under endoscopic guidance. The barium-impregnated glue facilitated follow-up surveillance with abdominal roentgenography. The patient had no further gastrointestinal bleeding. Further clinical and experimental studies should be conducted to determine the mechanism of action and the efficacy of this application of fibrin glue.
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PMID:Barium-impregnated fibrin glue: application to a bleeding duodenal sinus. 243 12

Immunodepression associated with a variety of situations such as cancer or any of its major modalities of treatment (surgery, irradiation, or chemotherapy) has been effectively alleviated with Imunovir (inosine pranobex-BAN), and this has been associated with demonstrable clinical benefit to these patients. One hundred and six immunodepressed patients with solid tumors undergoing radiotherapy were treated with either Imunovir or placebo; 64% of Imunovir-treated patients were immunorestored after 3 months compared to 23% in the placebo group. Imunovir was also effectively used in 75 patients with malignant hematological disorders both as an immunorestorative agent given prophylactically to prevent infection and as a therapeutic agent to treat infections in these immunodepressed patients. In different studies involving surgical patients treated with either Imunovir or placebo, 70-81% of hypoergic or anergic patients in the Imunovir group became normoergic by day 14 of treatment compared to 5-17% of the placebo group, and this enhanced immunorestoration was associated with lower incidence of local sepsis (P less than 0.05), systemic sepsis (P less than 0.025), and postoperative mortality (P less than 0.05).
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PMID:Imunovir in the treatment of immunodepression of diverse etiology. 244 57

The authors report the case of a patient who developed a Streptococcus Bovis septicemia in the post-operative course of a surgical cure of an incarcerated umbilical hernia. There were no other complaints. A barium enema showed a malignant tumor of the descending colon. There were hepatic metastases. No complementary treatment was undertaken. The patient died shortly after. In the literature colonic proliferative lesions in association with this germ is reported in a total of 36% of proliferative lesions (15% of cancers and 21% of adenomas). It is concluded that the discovery of a malignant or premalignant proliferative lesion in one third of the cases justifies the exploration of the colon by barium enema and/or colonoscopy in the case of Streptococcus Bovis septicemia. The discovery of other digestive lesions (malignant or not) seems to be coincidental.
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PMID:[Streptococcus bovis septicemia and colonic cancer]. 249 13

The authors used microcholangiography to demonstrate the feasibility of the technique and the features of the normal and the obstructed biliary systems. Furthermore, they attempted to explain the pathophysiology of cholangiography-related septicemia with this technique. Extrahepatic bile ducts (EHBD) of 40 rabbits were ligated, and microcholangiography was carried out with infusion of barium suspension immediately as well as one, three, and five days after ligation. Microradiographic technique was used and the findings were correlated with histopathologic features. The intrahepatic microbiliary system such as interlobular bile ducts and ductules were well visualized. After EHBD ligation, ductules were tortuously dilated. The histologically observed ductular proliferation in many hepatobiliary diseases could be attributed in part to the tortuosity of bile ductules, particularly when biliary obstruction is present. Regurgitation of barium into hepatic sinusoids was demonstrated in 36 rabbits (90%) and probably was caused by rupture of interlobular bile ducts and ductules.
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PMID:Microcholangiography. Normal microbiliary system and its alteration after extrahepatic bile duct obstruction. 252 Nov 26

The pathogenicity of enterococci in intraabdominal sepsis has not been clarified. Therefore, fecal-type peritonitis was induced in rats by intraperitoneal injection of barium sulfate along with a bacterial inoculum consisting of Escherichia coli, Bacteroides fragilis, and Clostridium perfringens with or without Streptococcus faecalis. Mortality at 19 d and characteristics of intraabdominal abscesses in survivors at 19 d were analyzed. The presence of S. faecalis in the original inoculum was significantly associated with death or large (greater than 20 mm) abscess formation when these two end points were examined together. S. faecalis may synergize with other bacteria in intraabdominal sepsis to augment morbidity and possibly mortality.
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PMID:Pathogenicity of enterococci in a rat model of fecal peritonitis. 254 7

Streptococcus bovis septicemia is a relatively uncommon entity that is associated with an increased incidence of colonic neoplasms. Three of four patients with S. bovis endocarditis subsequent to septicemia underwent colonoscopy. The fourth patient underwent a barium enema and a proctoscopic examination. Polyps were found in three patients, and adenocarcinoma of the colon in one. Patients with S. bovis endocarditis should be considered at high risk for colonic neoplasms. Screening colonoscopy is recommended for these patients, and follow-up colonoscopy may be warranted.
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PMID:Streptococcus bovis septicemia and large bowel neoplasia. 265 May 6

Diverticulitis represents a spectrum of clinical entities ranging from minimal pericolitis in the adjacent mesentery to uncontrolled intra-abdominal sepsis and septic shock. The presentation most often described is left lower quadrant abdominal pain, fever, chills, and left lower quadrant tenderness associated with a mass. Unusual presentations occur when infection tracts to distant locations. Diverticulitis is a common cause of intra-abdominal sepsis associated with high morbidity and mortality. The pathogenesis of intra-abdominal sepsis is not well understood, but likely involves circulating host inflammatory mediators. The role of computed tomography in the early diagnosis of diverticulitis is increasing and supersedes barium enema in the assessment of the extracolonic extent of disease. Also, computed tomographic-directed percutaneous drainage of intra-abdominal abscesses is, in most cases, as effective as surgical drainage. Predictably, the micro-organisms involved are representatives from the commensal flora of the lower gastrointestinal tract. These bacteria are usually sensitive to a wide range of antimicrobial agents that are effective against facultative and obligate anaerobic gram-negative bacilli. Surgical intervention is reserved for those individuals who do not respond to therapy, or for generalized peritonitis, uncontrolled sepsis, free viscus perforation, and fistulas.
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PMID:Diverticulitis. 304 50


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