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)

In patients who have impaired hepatic reserve, the Warren shunt has been proposed as an effective operation because it decompresses the esophageal varices without disturbing portal perfusion of the liver. However, early reports of high operative mortality and technical difficulties have impeded acceptance of the procedure. The operation was done in a series of 17 patients. All patients in whom elective variceal decompression with a patent splenic vein was required and without clinical ascites were candidates for this operation. Follow-up ranged from 2 to 48 months. Six patients had alcoholic cirrhosis, two had primary biliary cirrhosis and seven had postnecrotic cirrhosis; in two the cause of the liver disease was unknown. Five patients were categorized as Child's class A, nine as class B and three as class C. No intraoperative or early postoperative deaths owing to hemorrhage occurred. However, there was one death two weeks postoperatively from pulmonary sepsis and one death five weeks postoperatively due to antigen-positive hepatitis. Two patients died from hepatic failure six weeks and five months after operation, respectively; in the first of these, chronic active hepatitis was diagnosed at the time of operation. In one patient hemorrhage recurred and transfusion was required. Although ascites, which eventually resolved, developed in eight patients after operation, the results in 76 percent of patients have been good without new episodes of hemorrhage or encephalopathy. We conclude that the Warren shunt is a safe and effective elective operation for the treatment of patients in whom hemorrhage from esophageal varices has occurred.
 ...
PMID:The Warren shunt in treating bleeding esophageal varices. 31 64

The spectrum and incidence of liver disease is described among a large series of patients with inflammatory bowel disease. The incidence of significant liver disease identified by the presence of serial biochemical abnormalities of liver function was 8.2 per cent. Transient peri-operative changes in liver function tests are common and usually relate to underlying intra-abdominal sepsis. Percholangitis, sometimes termed portal triaditis, is one of the commoner lesions, and is usually associated with extensive colitis and improves with resection of the underlying bowel disease. Cirrhosis of the liver is an important but uncommon complication and is usually associated with extensive long-standing disease. Stenosing cholangitis and biliary tract carcinoma are both important though rare associations. They are both associated with extensive disease of long-standing, but resection of the underlying inflammatory bowel disease does not necessarily protect the individual from these complications. Although stenosing cholangitis is a diffuse lesion of the biliary tree it is important to exclude strictures of the extra-hepatic biliary tree which may be amenable to surgical correction. Hepatic dysfunction is rarely the sole indication for advising surgery for the underlying bowel disease but the identification of the nature of the hepati- dysfunction provides a rational basis for such a decision and opportunities for the surgical correction of the hepatic lesion itself.
 ...
PMID:The spectrum of hepatic dysfunction in inflammatory bowel disease. 48 86

In the USA, erythrocytic glutathione reductase (GSSG-R) deficiency is significantly more common, and can be considerably more pronounced in hospitalized patients (118/3198) than in outpatients (37/1639) or in apparently healthy persons (12/849). Retrospective analysis of illnesses found in 118 inpatients with erythrocytic GSSG-R deficiency revealed a striking and previously unsuspected association of the enzyme deficiency with a variety of chemotherapeutically treated hematological or nonhematological malignancies (51/118 patients, 43.2%, or 51/170 diagnoses, 30.0%). The prevalence of erythrocytic GSSG-R deficiency also increased in malnutrition, liver disease, and sepsis. Drugs of the nitrosourea class, particularly BCNU [1, 3-bis(2-chloroethyl)-1-nitrosourea] are causally implicated in the association of GSSG-R deficiency with malignancies. Severe of complete GSSG-R deficiency may handicap host response to infections.
 ...
PMID:Erythrocytic glutathione reductase deficiency in a hospital population in the United States. 60 23

Pasteurella multocida has been the etiologic agent in at least three cases of "spontaneous" bacterial peritonitis (SBP). We report another patient with P. multocida bacteremia and SBP and suggest that there may be more than a chance association between cirrhotic liver disease and this unusual organism which rarely causes sepsis in man.
 ...
PMID:Pasteurella multocida bacteremia associated with peritonitis and cirrhosis. 60 99

Choledochoduodenostomy was performed in 100 patients for calculus related disease of the common bile duct. There were no significant early or late complications of the anastomotic procedure. The 3 per cent mortality was related to antecedent advanced liver disease in two instances and, in one instance, to intra-abdominal sepsis. The surgical bypass has the advantage of circumventing the retained stone problem or the sequelae of benign obstructive disease in the distal part of the choledochus. It permits postoperative roentgenographic and endoscopic evaluation of the anastomotic site. Cholangitis, blind segment disability and malfunction have not been seen with these indications and this technique. When the common bile duct is at least 1.4 centimeters wide, primary or secondary choledochoduodenostomy with a wide anastomosis has significant advantages over T-tube intubation in the therapeutic and prophylactic management of choledocholithiasis.
 ...
PMID:Choledochoduodenostomy as an adjunct to choledocholithotomy. 61 88

Experience with renal transplantation indicates failure of the graft is usually due to immunological rejection. In a previous study of human liver transplantation, rejection was the major cause of transplant failure in 4 of 17 patients )24%); in this review of 76 liver transplantations, 64 of which survived the first postoperative week, rejection was the primary cause of graft failure in only 4 of these 64 cases (6%). The two most common causes of transplant failure were technical difficulties with the operative procedure and sepsis; these accounted for 47 (62%) graft failures of the total of 76 transplants. Biliary obstruction and sepsis are more common causes of liver failure than rejection, and patients with recurrent jaundice are now studied intensively for evidence of obstruction. Only after obstruction is excluded, is immunosuppression intensified. These results are a basis for optimism concerning the future of liver transplantation in management of potentially fatal liver disease.
 ...
PMID:Pathology of liver transplantation. 79 13

In order to determine whether endotoxin is normally found in the portal system, intraoperative samples of portal and peripheral blood were drawn from 34 consecutive elective abdominal surgery patients. The limulus lysate test was used to detect endotoxin. Ninety-seven per cent of patients had a positive limulus test in portal blood. Twelve of these patients were tested for portal bacteremia and only one showed growth. Four patients also had systemic endotoxemia. Three of these had liver disease and one had a gram-negative sepsis. This study demonstrates that endotoxin is a normal constituent of portal venous blood in man and does not represent a pathological process. It is suggested that the Kupffer cells of the liver normally protect the systemic circulation from endotoxin, and that endotoxin is present in systemic blood only when liver function is impaired or gram-negative bacteremia is present.
 ...
PMID:Endotoxin and bacteria in portal blood. 85 72

The value and effects of treating renal failure by dialysis are analyzed in a series of 84 patients with various types of liver disease. Although none of the 25 patients with cirrhosis survived, six of 50 with fulminant hepatic failure recovered completely as did seven of nine patients with renal failure secondary to extrahepatic biliary tract obstruction or with liver and renal damage following episodes of severe hypotension. Dialysis was required for seven weeks before diuresis occurred in one patient in the latter group. Both peritoneal and hemodialysis satisfactorily controlled plasma urea and creatinine levels, except in patients with fulminant hepatic failure in whom this was only achieved by hemodialysis. Complications of dialysis were most common in patients with cirrhosis and fulminant hepatic failure and included hypotension, gastrointestinal bleeding, and intraperitoneal sepsis. Overall, the results show that dialysis is only worth attempting in those patients in whom recovery of the underlying liver lesion is possible, and even then treatment for prolonged periods may be necessary.
 ...
PMID:Dialysis in the treatment of renal failure in patients with liver disease. 88 9

Phlegmonous colitis, regarded as a terminal event in serious liver disease and hepatic coma, can also occur in reversible liver disease and can be the source of gram-negative sepsis. This paper presented such a case. Improved management of serious liver disease and hepatic coma should include consideration of colonic inflammation as another site of infection that must be treated to avoid complications of sepsis or peritonitis. Abdominal pain and loose or diarrheal stools should arouse a suspicion of the presence of phlegmonous colitis, and should be an indication for treating it and preventing sepsis.
 ...
PMID:Liver disease, phlegmonous colitis, and gram-negative sepsis. 109 83

In a study of fifty patients subjected to cardiac surgery nine (18%) had immediate post-operative liver complications. These included persistente jaundice, an increase in hepatomegaly and elevation of the alkaline phosphatase. In these and the rest of the cases there were extra-hepatic complications such as hyposystole, infarct, the post-pericardiotomy syndrome as related to the heart. Pulmonary complications were of infectious nature and a general complication was sepsis. These complications were sufficiently important to relate them etiologically to the hepatic disorder. Especially important is right hyposystole and it or tricuspid insufficiency can be blamed for the hepatic disorder in some of these patient. Nonetheless, these hepatic complications are seen less frequently now that we are giving effective treatment to the tricuspid insufficiency during the surgical intervention. We observed the clinical picture known as "benign postoperative cholestasis" in only two patients. Hepatitis with jaundice was seen in four patients during one to three months postoperatively. This was HB hepatitis and its course was more prolonged than that usually seen in Mexico, and it turned into chronic hepatitis in four patients. Biopsies done in one case a six months and in the other at nine months post-operatively showed the picture of chronic aggresive hepatitis. In those patients who did not have hepatic complications a late liver evaluation showed an improvement as compared to the pre-operative condition which was parallel to the hemodynamic improvement.
 ...
PMID:[Hepatic complications in the postoperative of cardiac surgery]. 123 73


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