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)

Between 1970 and 1982, 147 patients were operated on for obstructing carcinoma of the colon at our institution. Of these, 25 patients with obstructing carcinoma of the left side of the colon were treated by emergency primary resection with colocolostomy. Three patients who had primary resection died postoperatively, two of them from myocardial infarction and one, a 66 year old patient with liver metastasis, from sepsis. One patient had an anastomotic leak and underwent a proximal diverting colostomy. Results of this form of treatment have been good, and we advocate the procedure for selected groups of patients.
 ...
PMID:Primary resection with colocolostomy for obstructive carcinoma of the left side of the colon. 406 34

The hospital and ICU course of 98 patients who required mechanical ventilatory support longer than 72 h was reviewed to determine if mortality rates were influenced by admitting diagnosis. Patients with malignant diagnoses were compared to patients with nonmalignant diagnoses and to those admitted to the ICU after myocardial infarction or cardiorespiratory arrest. Although there was no significant intergroup difference in incidence of multiple organ system failure, age, and length of ICU and hospital stay, there was a much higher incidence of sepsis (p less than .05) and mortality (p less than .01) in the cancer group. Cancer patients and their families should be made aware of the extremely poor prognosis if prolonged acute respiratory failure develops.
 ...
PMID:Acute respiratory failure: mortality associated with underlying disease. 406 9

Between 1970 and 1983, 46 patients were hospitalized in the Vanderbilt University Medical Center and the Metropolitan Nashville General Hospital for treatment of achalasia. All patients had been symptomatic for at least two years. Efforts were made initially to manage most of these patients (40) with periodic esophageal dilatation. This was successful in only six cases (15%). In four instances (10%), patients had esophageal perforation. Thirty patients have had esophagomyotomy (Heller procedure), and 14 of these had an associated antireflux procedure. Three had proximal gastric vagotomy for associated duodenal ulcer disease. Twenty-seven (90%) have had a good result, three died postoperatively, and two elderly patients had postoperative myocardial infarction. The other patient had sepsis after repair of a perforated esophagus. While periodic esophageal dilatation is necessary in patients who may not tolerate an operative procedure, most patients with achalasia are best treated with Heller esophagomyotomy.
 ...
PMID:Surgical management of esophageal achalasia. 407 Nov 36

The authors evaluated the effectiveness of 6% hydroxyethyl starch (hetastarch) solution for treatment of hypovolemia in 46 critically ill patients. Thirty-two of the patients were studied retrospectively and in 14 patients, cardiopulmonary variables were prospectively measured. A total of 29 patients were in shock secondary to hypovolemia (13), sepsis (13), or myocardial infarction (3). Average hetastarch infusion volume was 829 and 842 ml, respectively, in prospectively and retrospectively studied patients, with maximum of 2000-2500 ml infused over 48 h. Approximately 30% of 24 h fluid needs were supplied with colloids. Infusion of 500 ml of hetastarch in 14 prospective study patients was associated with increases in pulmonary artery wedge pressure (WP) from 9 +/- 1.5 to 12 +/- 2.1 mm Hg, cardiac index (CI) from 2.9 +/- 0.2 to 3.5 +/- 0.3 (p less than 0.05) along with an increase in mean arterial pressure (MAP) from 87-99 mm Hg and reduction in arteriovenous O2 difference [C(a-v)O2] from 4.9 to 4.2 ml/dl. Intrapulmonary shunt (Qsp/Qt) was similar (20 vs. 21% as were alveolar-arterial O2 gradient [P(A-a)O2] (164 vs. 158 torr), whereas O2 consumption (VO2) increased from 224 to 247 ml/min. Immediate survival was 90% in shock patients and 100% in nonshock patients, whereas hospital survival was 65.5% and 88%, respectively. The authors conclude that hetastarch is an effective fluid for resuscitation of hypovolemic patients. This synthetic colloid does not appear to adversely affect pulmonary function.
 ...
PMID:Hydroxyethyl starch for resuscitation of patients with hypovolemia and shock. 617 40

The cases of 135 consecutive elderly patients 70 years old or older who had valve replacement and related surgical procedures from October, 1977, through April, 1982, were reviewed. There were 75 men and 60 women. The mean left ventricular ejection fraction was 50.16 +/- 5%. The overall operative mortality was 8% (11 patients). The early operative deaths were related mainly to cardiac failure, low cardiac output, sepsis, and renal and multiorgan failure. To assess the operative risk, these 135 patients were compared with 312 younger patients (less than 70 years old) who had undergone similar procedures during the same period. The operative mortality in this group was 5.2% (16). In-hospital complications included arrhythmia (13%), psychosis (7.4%), respiratory failure (6.7%), renal failure (6.7%), cerebrovascular accident (5.2%), myocardial infarction (4.4%), and reoperation for bleeding (2.2%). Wound dehiscence occurred in 1.5% of the patients, and pulmonary emboli and sepsis developed in 0.7%. Of these complications, only the incidence of cerebrovascular accident appeared to be more common in the elderly group (5.2% versus 2.8%), but it had no statistical significance (p = 0.18). A follow-up of 3,892 patient-months was completed in 98.4% of the survivors. There were 8 late deaths (6.4%). Six were related to the valve or to ongoing cardiovascular disease. Thirty-four patients subsequently required medical attention: 4 had bleeding because of the anticoagulant; 3 required a blood transfusion; and 27 were hospitalized. Six were admitted for related cardiac conditions and 7, for observation of other conditions; 14 underwent surgical procedures not related to the cardiovascular system.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Should valve replacement and related procedures be performed in elderly patients? 633 51

The complement (C) system evolved as a beneficial antimicrobial system. However, when activated during extracorporeal perfusion as with haemodialysis or cardiopulmonary bypass modest pulmonary dysfunction associated with granulocyte aggregation and embolization can occur. When C activation is massive and prolonged, as with severe sepsis, trauma, or acute pancreatitis, severe pulmonary damage which is recognized as shock lung, or adult respiratory distress syndrome, may occur. Since ulcerating atherosclerotic plaques can also activate C, a mechanism by which myocardial infarcts may extend during the first few hours after infarction is also implied. Therapeutic ramifications of these conclusions are evident. Thus, high doses of corticosteroids or of nonsteroidal anti-inflammatory agents such as ibuprofen share the ability to prevent aggregation and embolization of stimulated granulocytes to patent vessels downstream and also inhibit their production of toxic oxygen radicals. These properties suggest the use of these agents in myocardial infarction and shock states, particularly shock lung, and appropriate clinical trials are awaited with interest.
 ...
PMID:Complement-mediated leucoembolization: a mechanism of tissue damage during extracorporeal perfusions, myocardial infarction and in shock--a review. 635 25

In a prospective randomized study of treatment for early-stage Hodgkin's disease presenting above the diaphragm, 76 patients had staging by laparotomy (Group I) and 28 had staging by closed techniques (Group II). Treatment consisted of involved-field radiotherapy alone (44 patients), involved-field radiotherapy followed by chemotherapy (38 patients), total nodal radiotherapy alone (15 patients), or total nodal radiotherapy followed by chemotherapy (seven patients). On presentation, both groups had similar clinical features and similar treatment distribution. With similar follow-up (87 months), no significant differences in remission or survival were observed between Groups I and II: remission 59 versus 68 percent; survival 74 versus 92 percent; p value 0.27 and 0.09, respectively. Multiple areas of relapse were more frequently observed in Group I (11 of 32 had relapse) as compared with Group II (none of nine had relapse, p less than 0.082). In Group I, relapse in the abdomen was observed as an isolated event or as part of disseminated relapse in 12 percent of patients compared with 3 percent (one patient) in Group II with abdominal relapse alone. Seven patients in Group I and two patients in Group II died with Hodgkin's disease. Six other patients in Group I died with complete remission of non-Hodgkin's lymphoma (one patient), leukoencephalopathy (one patient), sepsis during chemotherapy (two patients), myocardial infarction (one patient), and cerebrovascular accident (one patient). Three other patients in this group had other secondary malignancies successfully controlled (histiocytic lymphoma, squamous cell carcinoma of the cervix, and malignant schwannoma). No second primary lesions or death with complete remission were observed in Group II. Staging laparotomy with splenectomy in early-stage Hodgkin's disease did not improve the duration of remission or survival or decrease the number of abdominal relapses compared with closed staging.
 ...
PMID:Staging laparotomy and splenectomy in early Hodgkin's disease. No therapeutic benefit. 638 Feb 86

Intrahepatic cholelithiasis is commonly associated with suppurative cholangitis and occurs equally in males and females. Patients usually present with a history of recurrent symptoms and a differential diagnosis which includes viral hepatitis, pancreatitis, myocardial infarction and perforated ulcer. Cholangiography including stereocholangiography is essential for localizing intrahepatic stones and ductal strictures. The guiding operative principle is to drain all infected bile distal to ducts obstructed with stones or stricture. This may also necessitate a bilioenterostomy with or without partial hepatic resection. Although these procedures are formidable in an acutely ill patient, a more simple but inappropriate choledocholithotomy and t-tube drainage done proximal to an obstructed intrahepatic duct will be ineffective and may result in continued sepsis and death.
 ...
PMID:Twenty-two year experience with the diagnosis and treatment of intrahepatic calculi. 639 Jul 56

The marked conjugated hyperbilirubinemia in a 72-year-old patient with myocardial infarction and sepsis is reported. The serum bilirubin, which was predominantly composed of conjugated bilirubin, was elevated to 21 mg/100 ml, while serum bile acid and alkaline phosphatase levels were normal or slightly elevated. Postmortem examination of the liver revealed slightly proliferated bile ductules and some bile thrombi with little liver cell necrosis.
 ...
PMID:Conjugated hyperbilirubinemia in an autopsy case with myocardial infarction and sepsis. 649 90

During the past five years 75 patients aged 90 years or more had 85 major surgical procedures at the Metropolitan Nashville General and Vanderbilt University hospitals. The most common operation was exploratory laparotomy. The second was lower extremity amputation for peripheral vascular disease and/or gangrene. Fifty-seven percent had general endotracheal anesthesia. Associated medical problems were common, and included congestive heart failure (24%), hypertension (21%), diabetes mellitus (13%), chronic arrhythmias (9%), history of myocardial infarction (8%), and history of cerebrovascular accident (5%). Eleven patients (13.4%), six of whom had general anesthesia, died after operation. Of these, two had postoperative pneumonia, two did not recover from bowel perforation and peritonitis, one had a postoperative myocardial infarction, another had a cerebrovascular accident, and one had sepsis. One patient's sudden death was likely due to myocardial infarction or pulmonary embolus. The other three deaths occurred in patients with extensive carcinomas (gallbladder carcinoma in one and widely metastatic carcinoma of unknown origin in two). These three patients died of the disease for which they were operated upon when the operation failed to alter its course. When surgical procedures are necessary to prolong and/or improve the quality of life in elderly patients, these procedures may be done in most cases with acceptable results.
 ...
PMID:Surgical procedures in patients aged 90 years and older. 649 54


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