Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to observe the prevalence of hypocholesterolaemia in a hospital population and also the causes and clinical outcome of this condition. Fifty-seven patients were found with a plasma cholesterol of < or = 3.0 mmol/L, which was less than 0.50% of all plasma cholesterol requests; there were 39 men and 18 women (P < 0.05, Chi-squared test). The mean age was 53.8 [21.3] (range 3-83 years). The mean plasma cholesterol concentration was 2.28 [0.56] mmol/L (1.16-3.0) and the mean triglyceride concentration was 1.58 [1.09] mmol/L (0.49-7.35). There was a significant correlation between plasma cholesterol concentration and plasma albumin (Rs = 0.48, P < 0.01) and between plasma total protein concentration (Rs = 0.49, P < 0.01). However, there was no relationship between the concentrations of plasma cholesterol and triglyceride (Rs = 0.10, P > 0.05). Eighteen per cent of patients with hypocholesterolaemia died during their hospitalization. Thirty-nine per cent of those who had a plasma cholesterol of < or = 2.0 mmol/L died whereas 71% of those who had a plasma cholesterol concentration of < 1.5 mmol/L died. Hypocholesterolaemia was more commonly seen in the intensive care unit and in post-operative patients, those with malignancy, sepsis, acute myocardial infarction, those who had inflammatory bowel disease and diabetics on insulin. Hypocholesterolaemia may be a useful predictor of mortality in hospital patients.
 ...
PMID:Hypocholesterolaemia in a hospital population. 1050 11

In adults, toxic megacolon is a relatively uncommon but potentially lethal complication of inflammatory bowel disease (IBD), infectious colitis, or ischemic colitis caused by cancer chemotherapeutic agents. Patients have distension of the colon and signs of toxicity such as elevated temperature, hypotension, decreased level of consciousness and electrolyte imbalances. Factors thought to increase the risk include premature discontinuation of IBD medications; procedures that increase colon trauma, such as barium enema and colonoscopy; medications that decrease gastrointestinal motility; and electrolyte imbalances, especially hypokalemia. Differential diagnosis is made based on the patient's history and results of stool cultures and assay for Clostridium difficile toxin. Medical management in the intensive care unit includes careful monitoring, fluid volume and electrolyte replacement, bowel rest and decompression, antibiotic therapy, and cessation of medications that slow gastric motility. Surgical management may be necessary if there are signs of deterioration, perforation, hemorrhage, or sepsis.
 ...
PMID:Toxic megacolon: diagnosis and treatment challenges. 1086 33

Inflammation is a complex reaction of the organism which develops as a response to invasion of an infectious subject or as a response to injury to cells or tissues. Correct and early localization of infection or an inflammatory lesion allows removing the inflammatory cause quickly. Over the recent thirty years, a wide range of radiopharmaceuticals, more or less applicable in scintigraphic imaging of inflammatory and infectious diseases, have been developed. The aim has been to develop new substances that are non-toxic, do not provoke immune reactions, and produce a minimal absorbed radioactive dose. Furthermore, these substances should accumulate significantly in the target tissue (i.e. in inflammation), while the accumulation in non-target tissues should be minimal or the elimination of radiopharmaceuticals from non-target tissues must be quick. The goal is that these substances may also be easily available and inexpensive. Another purpose is to develop such substances that could possess not only sufficient sensitivity but also specificity in relation to certain types of inflammation and infection. The main indications for radionuclide imaging are as follows: inflammatory bowel disease, soft tissue sepsis, predominantly abdominal sepsis, musculoskeletal infection, and fever of unknown origin.
 ...
PMID:[A review of radiodiagnosis of inflammations]. 1124 30

Despite improvements in the supportive care of immunosuppressed patients controversy still surrounds the surgical management and outcome of anorectal sepsis in these patients. We reviewed 83 immunocompromised patients with diagnosis of perianal sepsis from 1995 to 1997. Sixty-six patients (80%) were followed for a mean of 15 months. Mean age was 44 years and 76 per cent were males. Twenty-eight per cent were HIV+, 34 per cent had inflammatory bowel disease on steroids, 20 per cent had malignancies, and 18 per cent had diabetes. Twenty-eight per cent had anal fistula, 2 per cent had perianal abscess, and 40 per cent had both. Primary sites of fistula were: transsphincteric (38%), intersphincteric (33%), superficial (20%), and suprasphincteric (3%), and multiple tracks (6%). Horseshoeing was present in 14 per cent of cases. The most commonly practiced surgical procedures were primary fistulotomy (n = 23) and fistulotomy plus drainage (n = 28). Seven patients underwent fistulotomy and ostomy and eight patients were treated with fistulectomy plus drainage. Most wounds (91%) healed within 8 weeks. Incontinence (6%) and recurrence (7%) were the most commonly observed complications. These results are similar to those seen in the general population. Perianal sepsis can be safely managed in immunocompromised patients, with high rates of healing and low complication rates. An aggressive sphincter-preserving approach in the management of these patients may be undertaken.
 ...
PMID:Management of perianal sepsis in immunosuppressed patients. 1137 55

Patients with a wide variety of anorectal lesions present to family physicians. Most can be successfully managed in the office setting. A high index of suspicion for cancer should be maintained and all patients should be questioned about relevant family history or other indications for cancer screening. Patients with condylomata acuminata must be examined for human papillomavirus infection elsewhere after treatment of the presenting lesions. Their sexual partners should also be counseled and screened. Both surgical and nonsurgical treatments are available for the pain of anal fissure. Infection in the anorectal area may present as different types of abscesses, cryptitis, fistulae or perineal sepsis. Fistulae may result from localized infection or indicate inflammatory bowel disease. Protrusion of tissue through the anus may be due to hemorrhoids, mucosal prolapse, polyps or other lesions.
 ...
PMID:Common anorectal conditions: Part II. Lesions. 1145 37

Patients with a wide variety of anorectal lesions present to family physicians. Most can be successfully managed in the office setting. A high index of suspicion for cancer should be maintained and all patients should be questioned about relevant family history or other indications for cancer screening. Patients with condylomata acuminata must be examined for human papillomavirus infection elsewhere after treatment of the presenting lesions. Their sexual partners should also be counseled and screened. Both surgical and nonsurgical treatments are available for the pain of anal fissure. Infection in the anorectal area may present as different types of abscesses, cryptitis, fistulae or perineal sepsis. Fistulae may result from localized infection or indicate inflammatory bowel disease. Protrusion of tissue through the anus may be due to hemorrhoids, mucosal prolapse, polyps or other lesions.
 ...
PMID:Common anorectal conditions. 1175 66

Gastrointestinal fistulae most frequently occur as complications after abdominal surgery (75-85%) although they can also occur spontaneously--for example, in patients with inflammatory bowel disease (IBD) such as diverticulitis or following radiation therapy. Abdominal trauma can also lead to fistula formation although this is rare. Postoperative gastrointestinal fistulae can occur after any abdominal procedure in which the gastrointestinal tract is manipulated. Regardless of the cause, leakage of intestinal juices initiates a cascade of events: localised infection, abscess formation and, as a result of a septic focus, fistulae formation. The nature of the underlying disease may also be important, with some studies showing that fistula formation is more frequent following surgery for cancer than for benign disease. Fistula formation can result in a number of serious or debilitating complications, ranging from disturbance of fluid and electrolyte balance to sepsis and even death. The patient will almost always suffer from severe discomfort and pain. They may also have psychological problems, including anxiety over the course of their disease, and a poor body image due to the malodorous drainage fluid. Postoperative fistula formation often results in prolonged hospitalisation, patient disability, and enormous cost. Therapy has improved over time with the introduction of parental nutrition, intensive postoperative care, and advanced surgical techniques, which has reduced mortality rates. However, the number of patients suffering from gastrointestinal fistulae has not declined substantially. This can partially be explained by the fact that with improved care, more complex surgery is being performed on patients with more advanced or complicated disease who are generally at higher risk. Therefore, gastrointestinal fistulae remain an important complication following gastrointestinal surgery.
 ...
PMID:The relevance of gastrointestinal fistulae in clinical practice: a review. 1187 90

Two young women, aged 19 and 25 years, suffered from persistent perianal sepsis after local drainage of unusual gluteal abscesses. Preoperative CT scanning showed unrecognised and inadequately treated abscesses and signs of inflammatory bowel disease. Both patients underwent a reoperation: affected bowel segments were removed, stomas were created and abscesses were drained. In the case of unusual perianal abscesses the diagnosis 'Crohn's disease' must be considered. Preoperative examinations should include CT or MRI scans of the abdomen and pelvis. Intraoperative colonoscopy can often be helpful in assessing the extent of the affected bowel segment.
 ...
PMID:[Gluteal abscess complicated by sepsis as the expression of Crohn's disease]. 1209 13

We report a patient with longstanding Crohn's disease (CD) developing recurrent sepsis and impaired neutrophil function tests. His inflammatory bowel disease was controlled with local steroids and sulfasalazine with only short exposure to azathioprine. His blood counts remained within normal range, but the marrow showed mild dysplasia. Repeated cytogenetic examinations revealed trisomies 8 and 9, which are typical for therapy related myelodysplasia. Fluorescent in situ hybridization (FISH) study showed stable persistent trisomies, confined to the myeloid lineage, one year after discontinuation of sulfasalazine. The long-term use of immunodulating agents in patients with CD is not without risks, and early therapy related myelodysplasia might not be easily detected by blood count and morphology assessment alone.
 ...
PMID:Clonal marrow abnormalities after azathioprine and sulfasalazine exposure in Crohn's disease: a cautionary tale. 1240 Jun 12

Excessive inflammation and tumour-necrosis factor (TNF) synthesis cause morbidity and mortality in diverse human diseases including endotoxaemia, sepsis, rheumatoid arthritis and inflammatory bowel disease. Highly conserved, endogenous mechanisms normally regulate the magnitude of innate immune responses and prevent excessive inflammation. The nervous system, through the vagus nerve, can inhibit significantly and rapidly the release of macrophage TNF, and attenuate systemic inflammatory responses. This physiological mechanism, termed the 'cholinergic anti-inflammatory pathway' has major implications in immunology and in therapeutics; however, the identity of the essential macrophage acetylcholine-mediated (cholinergic) receptor that responds to vagus nerve signals was previously unknown. Here we report that the nicotinic acetylcholine receptor alpha7 subunit is required for acetylcholine inhibition of macrophage TNF release. Electrical stimulation of the vagus nerve inhibits TNF synthesis in wild-type mice, but fails to inhibit TNF synthesis in alpha7-deficient mice. Thus, the nicotinic acetylcholine receptor alpha7 subunit is essential for inhibiting cytokine synthesis by the cholinergic anti-inflammatory pathway.
 ...
PMID:Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. 1462 36


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>