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

Pelvic inflammatory disease (PID) is a spectrum of inflammatory disorders of the female genital tract involving at least the endrometrium and may include the fallopian tubes, ovaries, and pelvic cavity. Over 1 million women each year are treated for PID in the United States, and it is one of the most serious infections diagnosed in women due to its sequelae. Women with PID acutely experience pain and are at risk for sepsis; however, the significant increases in ectopic pregnancy and infertility are the most disturbing long-term complications. It most often is initiated with an infection by a sexually transmitted disease, but can also involve a variety of pathogenic aerobes and anaerobes secondarily.
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PMID:Outpatient management of pelvic inflammatory disease. 1211 50

Female genital mutilation is associated with immediate, long-term, pregnancy-related, and psychosexual complications. Immediate complications can cause death and include severe pain, shock, hemorrhage, tetanus or sepsis, urine retention, ulceration of the genital region, and injury to adjacent tissues. Long-term complications include formation of cysts, abscesses, and keloid scars, damage to the urethra resulting in incontinence, painful sexual intercourse, sexual dysfunction, recurrent urinary tract infections, chronic pelvic inflammatory disease, and infertility. During child birth, survivors of female genital mutilation may require Cesarean section or suffer obstructed labor leading to fetal death and/or vesico-vaginal fistulae and large perineal tears. The psychological consequences of female genital mutilation may involve loss of trust and confidence in care-givers, feelings of incompleteness, anxiety, depression, chronic irritability, and sexual problems. In many women, flashbacks of the infibulation process are triggered by touch. Deinfibulation must be accompanied by adequate pain relief, but the use of local or epidural anesthesia is not appropriate.
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PMID:Consequences of genital mutilation. 1222 23

A prospective analysis was made of the 85 hysterosalpingographies performed at the University Hospital in Kuala Lumpur in a 1-year period in 1985-86. 51 of these procedures were performed through use of the Leech-Wilkinson cannula method; the Foley catheter technique was used in the remaining 34 cases. Secondary infertility was the most common indication for the hysterosalpingography. Comparable results were obtained with both methods in terms of visualization of the uterine cavity and tubal morphology. The Foley catheter technique was superior in the assessment of the cervical canal and the diagnosis of cervical incompetence. Complications recorded in this series included pain, significant bleeding from cervical trauma, and extravasation of dye into the pelvic veins; however, the majority of these complications involved the Leech-Wilkinson cannula technique. These complications caused the procedure to fail or be abandoned in 10 (20%) of the women in the Leech-Wilkinson method group and in 2 (6%) of subjects in the Foley catheter group. There were 2 cases of pelvic sepsis in this series, underscoring the risk of introducing pelvic infection associated with hysterosalpingography. Overall, however, these results indicate that hysterosalpingography has a role to play in the assessment of the functional and mechanical impairment of the fallopian tubes and the uterus.
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PMID:Hysterosalpingography -- a Malaysian experience. 1231 86

Some 250 million cases of sexually transmitted disease (STD) occur each year, and in some countries 1 or even 2 women in every 10 are infected with an STD. STDs are likely to reach an advanced stage before women notice them. The consequences of STDs are devastating, according to a report by the Population Information Program of the Johns Hopkins School of Public Health, and they include stillbirths, blinding eye infections in the newborn, chronic female abdominal pain, ectopic pregnancy, and infertility. There are social consequences for women such as divorce, and husbands may abandon infertile wives. Gonorrhea and chlamydia can cause both severe inflammation of the pelvis with acute pain and possible infertility. Pelvic inflammatory disease can permanently scar the fallopian tubes, increasing the risk of ectopic pregnancy, which can be fatal when the fallopian tube ruptures. Babies born to mothers with gonorrhea and chlamydia are likely to develop eye infections that may make them blind. Chlamydia infection in pregnant women may also cause premature rupture of the membranes, sepsis, and the death of premature neonate. Infection may spread to the lungs of newborns, leading to chlamydial pneumonia. Syphilis can cause spontaneous abortion, stillbirth, neonatal death, or congenital syphilis in the infant. Trichomoniasis and herpes can also be transmitted from mother to fetus. And infection with an STD increases the risk of infection with the human immunodeficiency virus (HIV). The World Health Organization (WHO) recommends that prenatal care should always include checks for STDs. A WHO Technical Working Group on Care of Mother and Baby has stressed the importance of detecting and treating STDs in pregnant women. The working group urged training of health workers to distinguish between STDs and other infections. The group, which met July 5-9, 1993, outlined health center strategies for prevention and treatment.
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PMID:STDs infect 250 million a year. 1234

Pelvic inflammatory disease affects approximately 1 million women per year in the United States alone and has a variety of causative organisms. Because the diagnosis of PID is based on clinical judgment, health care providers need to be guided by the CDC recommendations for diagnosing and treating PID. Because presenting symptoms are often vague, the health care provider should assess female patients for risky behaviors that may lead to PID and should use screening data when making clinical judgments and differential diagnoses. Whenever possible, female patients with PID should be treated as outpatients. If diagnosis and treatment are not performed in a timely manner, PID may cause sepsis, septic shock, and even death. Even if they survive, as many as 15% to 20% of these women experience long-term sequelae of PID, such as ectopic pregnancy, tubo-ovarian abscess, infertility, dyspareunia, and chronic pelvic pain. The best treatments for PID are interventions that lead to prevention and early detection. The critical care nurse has an important role in recognizing the variables that may lead to PID-related sepsis and in encouraging health-seeking and health-maintenance behaviors among women with these diagnoses.
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PMID:Pelvic inflammatory disease and sepsis. 1259 41

Acute appendicitis is the most common acute abdominal condition that results in surgical intervention in childhood. The clinical diagnosis of acute appendicitis in children can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed nonoperatively. Complications associated with delayed diagnosis of this condition include perforation, abscess formation, peritonitis, sepsis, bowel obstruction, infertility, and death. The use of cross sectional imaging has proven useful for the evaluation of suspected acute appendicitis in children. Both graded compression sonography and CT have been widely utilized in the imaging assessment of the condition. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to assess ovarian pathology that can often mimic acute appendicitis in female patients. The principal advantages of CT include less operator dependency than sonography as reflected by a higher diagnostic accuracy, and enhanced delineation of disease extent in perforated appendicitis.
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PMID:Imaging of acute appendicitis in children. 1274 99

Clinical guidelines for managing women who have undergone female genital cutting are essential in providing appropriate and culturally competent care. The objectives of this study were to review the literature, describe the types of female genital cutting, evaluate its immediate and long-term complications, and provide clinical guidelines for managing women who have undergone this procedure. We conducted an extensive literature search on the MEDLINE database (1966-2003) for articles pertaining to female circumcision/genital mutilation/cutting. The search was extended further by citations in these journals not identified in MEDLINE. National and international nongovernmental organizations provided articles not available in American libraries. The author has developed guidelines based on personal experience and recommendations from the literature. The major inclusion criteria limited the search to: 1) English language, 2) medical journals, 3) WHO publications, 4) medical society publications, 5) case studies and statistical data on medical complications, 6) infertility and sexual issues, 7) U.S. legal practice, and 8) deinfibulation. The exclusion criteria pertained to articles: 1) reviewing the literature, 2) lacking epidemiologic data, 3) addressing political and ethical issues, and 4) discussing international concerns. Immediate complications include hemorrhage, infection, urinary dysfunction, shock, or death. Long-term complications include urinary complications, scarring, pain, infection, and infertility. Obstetric complications include lacerations, wound infections, postpartum hemorrhage, and sepsis. Fetal complications are rarely seen in Western countries. Women who have undergone female genital cutting can experience complications. Practitioners must recognize the type of circumcision, ensure cultural competency, and provide appropriate clinical care.
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PMID:Female genital cutting: clinical and cultural guidelines. 1502 27

Given the efficacy and safety of recombinant human activated protein C (rhAPC) in the systemic inflammatory response syndrome (SIRS), this study was designed to review the evidence for rhAPC as a possible therapeutic option in the treatment of severe ovarian hyperstimulation syndrome (OHSS). SIRS, like OHSS, is a proinflammatory and prothrombotic disorder whose cornerstone is endothelial dysfunction in which protein C deficiency is a frequent occurrence. Recently, the use of rhAPC has been shown to be of benefit with a reduction in mortality and an improvement in indicators of inflammation and coagulation. OHSS is typically an iatrogenic disorder resulting from ovarian stimulation as a component of infertility treatment. The pathogenesis of OHSS, like sepsis, is related to endothelial dysfunction and inflammation and can result in significant morbidity including end organ hypoperfusion, disseminated intravascular coagulation (DIC), thrombosis, and occasionally, death. We have performed a review of the literature to identify similarities between these disease processes to develop a theoretical basis for the use of rhAPC in patients with moderate to severe OHSS. Use of rhAPC in this group may attenuate the disease process and reduce the potential morbidity associated with this iatrogenic disorder.
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PMID:Activated protein C and the ovarian hyperstimulation syndrome: possible therapeutic implications. 1643 47

Congenital obstructing lesions of vagina, hydrometrocolpos, and hematocolpos, present at a variable time during early childhood and adolescence to different medical and surgical specialties. Twenty-six cases presenting over an 18-years period (1987-2005) were divided into three groups; Group A: neonates (6), Group B: adolescents (18), and Group C: adults (2). Common presentations in neonates (Group A) were abdominal mass (5), neonatal sepsis (3), and respiratory distress (2); whereas abdominal pain (18), voiding dysfunctions (13), and backache (7) were prevalent in adolescents (Group B). Adults (Group C) presented with inability to consummate and infertility (2). Four patients received erroneous treatment; exploratory laparotomy (1) and appendectomy (3). Urinary symptoms and associated urinary abnormalities were present in more than 50% of cases, especially those with complex anomalies. Management included excision of imperforate hymen (16) and transverse vaginal septum (8) through perineal (20) and abdominoperineal approach (4). Patients with urogenital sinus (1) and cloacal malformation (1) had staged reconstruction at 2.5 years of age following preliminary vesicostomy and colostomy at birth. On follow up (range 1-15 years; mean 7) more than 60% patients have menstrual irregularity (11), endometriosis (5), and infertility (4). In conclusion, rarity and variable presentation of congenital vaginal obstructions can lead to delayed diagnosis and erroneous management. A high index of suspicion and cross-sectional imaging help in early diagnosis and associated renal anomalies. A comprehensive management is imperative to preserve the reproductive potentials, as significant proportion of patients may experience sexual difficulties, menstrual irregularity, and infertility.
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PMID:Congenital vaginal obstructions: varied presentation and outcome. 1687 98

In Africa, infertility constitutes a major gynaecological complaint and causes enormous socio-psychological stress to the patients. This study examined retrospective data at the University of Benin Teaching Hospital, Benin City, Nigeria, over a 5-year period to determine the factors associated with tubal infertility. Tubal infertility was confirmed in 13.5% of the 1181 new cases of infertility over the study period. The mean age of the patients was 33.2+/-9.5 years. Over 65% were nulliparous and all socioeconomic classes were affected. Major associated factors included infections such as post-abortal sepsis, puerperal sepsis and pelvic inflammatory disease (PID). Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID. Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID.
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PMID:Tubal factor infertility in Benin City, Nigeria - sociodemographics of patients and aetiopathogenic factors. 1754 89


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