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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with refractory ascites and HRS should be considered to present an urgent indication for peritoneovenous shunting. The shunt offers a method of continuous reinfusion of ascitic fluid which corrects avid sodium retention, oliguria and azotemia. Severe encephalopathy, jaundice or peritoneal sepsis--common complications of cirrhosis--contraindicate installation of the shunt before improvement occurs. Associated cardiac disease does not contraindicate the use of the shunt provided that ascitic fluid is removed at the time of operation and large amounts of diuretics are used. This operation has also proved useful in ascites attributed to causes other than cirrhosis. The main complications include disseminated intravascular coagulopathy, hepatic coma and sepsis in a few patients. Results of a randomized prospective study indicate that the shunt should probably be considered in patients with diet-resistant massive ascites even before they prove to be refractory to diuretic therapy.
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PMID:Ascites: its correction by peritoneovenous shunting. 37 15

A full-term infant became ill at 16--24 h of age following an uncomplicated pregnancy, labor, and delivery. The clinical course (absence of prenatal warning, rapidly progressive respiratory distress, apnea, shock, and coagulopathy) terminated fatally and resembled that seen in neonatal 'early onset' group B streptococcal sepsis. Previous cases of neonatal group G streptococcal disease are briefly reviewed.
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PMID:Fatal group G streptococcal sepsis in a neonate. 41 76

We conclude that DIC can occur as a result of sickle cell crisis in the absence of sepsis and we recommend that patients with sickle cell disease, particularly those with hemoglobin SC disease, presenting in crisis should be considered at risk for the development of disseminated intravascular coagulation. With symptomatic treatment and improvement of the crisis, our patient's coagulopathy resolved.
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PMID:Disseminated intravascular coagulation in sickle cell crisis. 43

A previously healthy woman with a Shirodkar cerclage for cervical incompetence had a spontaneous rupture of the membranes at the 37th week of pregnancy. Three days later after a short period of weak labor pains, she developed a severe sepsis, uterine rupture and coagulopathy leading to renal failure, beta-hemolytic streptococcus group B and peptostreptococcous could be cultured from the amniotic fluid immediately after rupture of the membranes and from the uterus and placenta.
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PMID:Maternal sepsis, uterine rupture and coagulopathy complicating cervical cerclage. 48 26

A prospective randomized matched pair study was designed to test the efficacy of the peritoneovenous (LeVeen) shunt as a treatment for massive cirrhotic ascites compared with traditional medical therapy. Patients who failed to lose weight while on a low salt diet and fluids restricted to 1000 ml daily were placed in the study group. Weight loss, decrease in abdominal girth and diuresis were significantly greater (P less than 0.01) for surgical patients than for their medically treated counterparts. The surgical technique is simple, quick and inexpensive. The surgical patients outlived their matched partners in 12 of 14 pairs where a definitive comparison was possible (P less than 0.02). The median stay in hospital after randomization was shortened from 32 days with medical therapy to 15 days for those undergoing the shunt operation. Those treated medically experienced a significant rise in mean blood urea nitrogen and K+ (P less than 0.02). Patients with alcoholic hepatitis, hyperbilirubinaemia (bilirubin greater than 154 mumol/l), peritoneal sepsis, severe coagulopathy and those who had recently bled from oesophageal varices are poor risks for the surgical procedure.
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PMID:Randomized prospective matched pair study comparing peritoneovenous shunt and conventional therapy in massive ascites. 49 60

Skin allografts and xenografts are routinely used as dressings to control infection, pain and fluid loss from the burn wound. The procedure for preparing and storing grafts will be reviewed and suggested indications for use will be considered. A method for preparing porcine xenograft will be discussed in some detail. Skin banking by low temperature preservation including conditions and processing necessary for obtaining viable grafts will be discussed. The use of tissue typing matching procedures for obtaining prolonged survival will be considered. Possible harmful effects of grafts will be reviewed. The use of blood and blood products for resuscitation of burn patients is of primary importance in burn patients. The literature will be reviewed concerning a variety of blood and blood products including a consideration of washed cells, single donoplasma, serum albumin and purified blood components for treatment of burned patients. The use and indications for hyper-immune serum and gammu-globulin will be considered. Coagulopathy syndromes, burn wound sepsis, and support of immunologically deficient patients will be discussed on the basis of current literature.
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PMID:Burn wounds: selection and preservation of skin, natural products, blood, and blood products for burn therapy. 82 97

A case of pneumococcal sepsis with DIC is reported. The patient had hyposplenism from thorium dioxide administration 23 years previously. Evidences of consumptive coagulopathy were verified by clinical manifestations of shock, generalized petechiae, abnormal hemostatic studies, and autopsy findings. The possible pathogenetic mechanism(s) of DIC in hyposplenism and pneumococcemia are reviewed.
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PMID:Hyposplenism and disseminated intravascular coagulation (DIC) in fulminant pneumococcal sepsis. 88 88

The general features and problems of renal vein thrombosis in children are first discussed. The records of 11 children with this condition, 7 ill neonates and 4 older children with burns, are then reviewed, indicating the clinical course of the disease, how they were treated, the results, and pathological findings. From this study, the natural history is assembled and a protocol for treatment is proposed. Supportive therapy is necessary in all cases to correct dehydration and sepsis. Many children will develop a consumptive coagulopathy. Others will develop pulmonary emboli associated with thrombosis of the inferior vena cava. Anticoagulation should be achieved for these two conditions. Nonvisualization of affected renal units upon initial urographic examination virtually assures an atrophic, functionless kidney later. Nephrectomy will be required because of hypertension, persistent infection, and scarring. Thrombectomy may be attempted when bilateral nonvisualization on urography is associated with a positive venacavogram.
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PMID:Natural history and treatment of renal vein thrombosis in children. 91 51

Acute renal failure of obstetric origin is common among North Indian patients and comprised 72 (22.1%) of 325 patients undergoing dialysis over an 11-year period. Of these, 46 gravidas had developed renal failure following abortion, and 29 cases were due to complications of late pregnancy. The most striking feature of this study was a high incidence of irreversible renal lesions of bilateral diffuse cortical necrosis in early (18.6%) as well as late pregnancy (37.8%). Overall incidence of diffuse cortical necrosis was 25%. In the remainder, acute tubular necrosis was seen in 52 (72.2%), patchy cortical necrosis in 1 (1.4%), and tubular necrosis along with glomerular involvement in 1 patient (1.4%). Pathogenetic factors which contributed to the development of renal failure, either singly or in combination, were loss of blood failure, either singly or in combination, were loss of blood (79.1%), septicemia (31.9%), hypotension due th hemorrhagic and septicemic shock (51.4%), eclamptic toxemia (11.1%), and disseminated intravascular coagulation in 12.5% patients. Infrequent occurrence of disseminated intravascular coagulation in the septic anc eclamptic patients who developed diffuse cortical necrosis was an interesting finding, as was the fact that coagulopathy was more frequently observed in acute tubular necrosis. Late referral, frequent sepsis, and high incidence of bilateral diffuse cortical necrosis contributed significantly to a high mortality (55.3%).
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PMID:Acute renal failure of obstetric origin. 108 92

The operative management and clinical course of 17 patients treated for severe pancreatico-duodenal injuries from 1983 to 1990 was reviewed. The etiology of these injuries was gunshot wound in 15 patients; stab wound in 1 patient; and a motor vehicle accident in 1 patient. Seven patients presented in shock with a systolic blood pressure of less than 80. At exploration, 57 associated injuries were found in the 17 patients including 16 major vascular injuries. All patients were treated with pyloric exclusion and drainage. Vagotomy was performed in eight patients. None of these 17 patients were felt to have extensive enough damage to require pancreatico-duodenectomy. Two patients died in the immediate postoperative period of severe coagulopathy and two patients died of sepsis. Seven patients had complications related to the pancreatico-duodenal injury. All seven developed pancreatic fistulas; three also had pancreatitis and two developed multiple enterocutaneous fistulas. Systemic complications included pulmonary complications in eight patients and sepsis in five patients, including two patients with abdominal abscesses. Six patients bled in the immediate postoperative period secondary to coagulopathy. Three patients had complications related to pyloric exclusion. One developed afferent loop syndrome necessitating reoperation. The other two had marginal ulcers, which either perforated or bled and required reoperation. Of interest, neither of these two patients had vagotomy initially. The results of this series confirm the effectiveness of pyloric exclusion with vagotomy for severe pancreatico-duodenal injury.
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PMID:Severe pancreatico-duodenal injuries: the effectiveness of pyloric exclusion with vagotomy. 138 82


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