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

Of 611 prospectively studied patients in a surgical intensive care unit, 177 developed hospital infections (29%): urinary tract infections (37.2%), pneumonia (22.5%), sepsis (19.7%), wound infections (9.6%), etc. The commonest pathogens were Pseud. aeruginosa, E. coli, Staph. aureus, enterococci, Klebsiella pneumoniae and Proteus mirabilis. In preventing and combating hospital infections in intensive care units, priority should be given not to antibiotics but to hygiene in the hospital. Systemic antibiotic prophylaxis prevents neither hospital-contracted pneumonia, sepsis nor urinary tract infections. There is an urgent need for controlled studies on the necessity and selection of locally active antibacterial and antimycotic substances to prevent germ ascension in vein and bladder catheters.
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PMID:[Antibiotic prophylaxis in intensive care]. 72 86

Review of 112 renal transplants in 95 patients with end-stage renal disease revealed a wound infection rate of 18 percent. The incidence of infection was unquestionably greater if drains were placed in the wound. An 8.8 per cent incidence of pulmonary infection was represented by lung abscess, bronchopneumonia and necrotizing pneumonitis. Three deaths were attributable to fungal infections-candida sepsis, cryptococcal sepsis, and Nocardia brain abscess. In 14 per cent of this series vascular anastomotic complications occurred, and were attributable to stenosis, thrombosis, or hemorrhage. The complications of ureterovesical anastomosis include urinary fistulas and ureteral obstruction.
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PMID:Renal transplantation: an analysis of operative complications. 76 18

A retrospective review of 149 patients receiving 162 renal transplants showed that 83% of these patients developed one or more infections during a follow-up period averaging one year. In 32 (73%) of 44 deaths, infection was an important contributing cause. In only four (9%) of the deaths were the patients free of infection at the time of death. The Klebsiella-Enterobacter group was the most common agent causing pneumonitis and sepsis. Cryptococcus neoformans caused seven of 11 cases of meningitis. Pseudomonas was the most frequent agent associated with infections documented during postmortem examinations. In a short-term controlled study comparing daily and alternate daily therapy with prednisone, the alternate daily group had significantly (P less than .05) more infections per patient, especially in patients who had no evidence of rejection (P less than .025).
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PMID:Factors affecting the frequency infection in renal transplant recipients. 77 10

When the late Dr. John F. Fulton contracted severe pulmonary coccidioidomycosis in January, 1942, a metastatic lesion posed the threat of further progression and fatal dissemination. The possibility that an untested and generally unavailable antibiotic, penicillin, might be of value in Fulton's illness led his physician, Dr. John Bumstead, to appeal directly to Fulton to obtain this antibiotic, but ostensibly for the benefit of another patient succumbing to hemolytic streptococcal infection. While of no value for Fulton, penicillin was highly successful in the treatment of his other patient and soon of a second one with staphylococcal sepsis and pneumonia. This penicillin, administered in March, 1942, was the first clinical trial of penicillin under the control of the Office of Scientific Research and Development. The unique contribution of Dr. Fulton and of his illness to this event is described.
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PMID:John F. Fulton, coccidioidomycosis, and penicillin. 79 4

For various reasons extensive resection of the intestine had to be undertaken in five neonates. The lengths of the residual intestine were 33, 40, 49, 60 and 65 cm. Two children died of sepsis, one of pneumonia, one is still living after six years and one is still alive after four months. There is a danger that the cava catheter may give rise to sepsis.
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PMID:[Extensive resection of the small intestine, (case report)]. 80 72

A randomized, prospective study of the relative effectiveness of broad-spectrum versus specific antistaphylococal antibiotic prophylaxis in patients having open-heart surgery was performed between May, 1972, and June, 1973. All patients undergoing open-heart surgery was assigned randomly (by hospital number) to receive either methicillin or cephalothin beginning the night before operation. There were 132 patients in the cephalothin group and 129 in the methicillin group. There was no statistically significant differences in age or duration of hospitalization, cardiopulmonary bypass, urinary tract drainage, or postoperative fever. There was a significant difference in the ratio of male to total patients (cephalothin group, 0.67; methicillin group, 0.52; p less than 0.02) and duration of operation (cephalothin group, 4.27 hours; methicillin group, 3.87 hours; p less than 0.05). The methicillin group had a statistically significant higher rate of urinary tract infection (cephalothin group, 3 cases; emthicillin group, 22 cases, p less than 0.05), pneumonia (cephalothin group, no cases; methicillin group, 9 cases; p less than 0.01), and episodes of sepsis and prosthetic valve endocarditis (cephalothin group, no cases; methicillin group, 11 cases, p less than 0.001). The incidence of wound infections and positive blood cultures from blood obtained immediately after termination of cardiopulmonary bypass was not significantly different between the two groups. Cephalothin has replaced methicillin as the routine prophylaxis for open-heart surgery at our institution.
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PMID:Antibiotic prophylaxis for open-heart surgery. 83 52

Causes of death of 260 tumorous patients autopsied in 1974 were analyzed. Most common causes were inflammation and tumorous and non-tumorous organ insufficiencies; the others, in order of decreasing incidence, massive tumorous dissemination, infarct and haemorrhage. Pneumonia was predominating over the inflammatory causes although peritonitis and sepsis were also not rarely encountered. Death due to inflammation occurred most frequently in cases of myeloid-lymphoid, urogenital and gastro-intestinal tumours and in postoperative states. The incidence of insufficiencies due to tumorous or non-tumorous origin differed but slightly. Of the various organ insufficiencies, massive hepatic metastases, occlusion of the biliary duct and cardiac failure were the most common. In cases of tumors of the small pelvis, compression of the ureters led most often to death. Massive dissemination was observed most of all in breast and ovarian carcinomas. Myeloid-lymphoid tumors led to death through extensive organ infiltration in about one thirds of the cases. After hearth infarction, venous thrombosis was often followed by pulmonary embolism, however, coronary occlusion was also not rare. Death due to haemorrhage originated from acute or chronic ulcers of the gastrointestinal tract or from vascular invasion of tumors in the head and neck regions or from thrombocytopaenia induced by cytostatics.
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PMID:[Causes of death in cancer patients]. 92 45

Combination chemotherapy with adriamycin and DTIC was used in 102 evaluable patients under 15 years of age who had previously treated metastatic solid tumors. Responses, defined as 50% or more reduction in all tumor masses, occurred in 10 out of 27 patients with neuroblastoma, 3 out of 8 patients with Wilms tumor, 7 out 15 patients with Ewing sarcoma, 2 out of 6 patients with osteosarcoma, 5 out of 13 patients with rhabdomyosarcoma, and 15 out of 33 patients with miscellaneous tumors which included a patient who had a complete regression of an extensive juvenile angiofibroma. Response rate to combination chemotherapy with adriamycin and DTIC in patients with Ewing sarcoma was significantly superior to the response rate obtained with adriamycin alone in another Southwest Oncology Group Study. Major toxicity included nausea, vomiting, myelosuppression, high incidence of pneumocystis carinii pneumonia (5 patients) and congestive heart failure (4 patients). There was 7 drug-associated deaths due to sepsis (1), pneumocystis carinii pneumonia (4), and congestive heart failure (2).
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PMID:Combination chemotherapy with adramycin (NSC-123127) and dimethyl triazeno imidazole carboxamide (DTIC) (NSC-45388) in children with metastatic solid tumors. 95 60

Twelve patients with acute or chronic pneumonia due mainly to gram-negative bacilli, two patients with pseudomonas endocarditis, and two patients with seratia sepsis were treated with 80-160 mg of tobramycin in two daily doses. Fourteen infected patients with underlying leukemia or lymphoma received this dose of tobramycin combined with cefazolin or penicillin. Most respiratory infections were cured or markedly improved. with eradication or significant reduction in the number of infecting organisms. One case of pseudomonas endocarditis and both cases of serratia sepsis were also cured. Combined treatment with tobramycin and beta-lactam antibiotics resulted in clinical and bacteriological improvement in 50% of systemic immunodepressed patients with sepsis and/or pneumonia.
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PMID:Clinical evaluation of tobramycin in respiratory and systemic infections in immunodepressed and normal patients. 97 80

Neutrophil granulocyte function was determined in three patients with systemic staphylococcal infection, clinical manifestations of generalized allergic disease, and hyperimmunoglobulinemia E. Each of the patients had urticarial skin rashes before or at the time of development of staphylococcal suppurative lymphadenitis, pneumonia, or sepsis. Neutrophil chemotaxis, random migration, phagocytosis, and bactericidal capacity were assessed to determine if an abnormality in these functions might have contributed to the development of severe staphylococcal infections. Each of the three patients with generalized urticaria was found to have a marked defect in neutrophil chemotaxis. The mean chemotactic index of the patients was 12 +/- 4, whereas that of 20 controls was 72 +/- 11. Neutrophil random migration, phagocytosis, and bactericidal capacity were normal in each patient. The serum or plasma of the patients did not inhibit chemotaxis of control neutrophils and did not contain an increased concentration of the chemotactic-factor inactivator found in normal serum. Treatment of the neutrophils of these three patients with the competitive histamine H2 receptor blocking agent, burimamide, produced a significant increase in chemotactic responsiveness. These studies suggest the possibility of pharmacologic modification of neutrophil granulocyte function.
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PMID:Severe staphylococcal disease associated with allergic manifestations, hyperimmunoglobulinemia E, and defective neutrophil chemotaxis. 97 42


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