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

The triennial Confidential Enquiries into Maternal Deaths in England and Wales report 235 maternal deaths directly due to pregnancy or childbirth in 1973-75. The inquiry covers 94% of maternal deaths, and the figure is 4 times lower than the 1950s report. 37 deaths were attributed to obstetric anesthesia, some of which could have been prevented if the practising house officer had been more knowledgeable. Amniotic fluid deaths numbered 15 and were largely unpreventable. While maternal mortality rates have declined, amniotic fluid embolisms have remained steady since the 1960s. From 1973-75 the causes of death were as follows: hypertensive disease of pregnancy, 47; pulmonary embolism, 61; abortion, 81; sepsis, 70; ectopic pregnancy, 34; uterine hemorrhage, 27.
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PMID:George Stroh. 9 Mar 22

39 instances of mural thrombosis of the right side of the heart were observed among 2000 cases of post-mortem examinations. The right atrium was the most frequent site of thrombosis; the right ventricle was involved in 8 cases. The relationships between right sided thrombosis and rhythm disturbances, myocardial or valvular disease, myocardial infarction, pulmonary disease, neoplasm, sepsis and disturbance of coagulation are discussed. The high incidence of pulmonary embolism and their relationship with thrombosis of the right side of the heart are emphasized.
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PMID:[Mural thromboses of the right heart. Clinico-pathological study]. 31 49

The maternal deaths occurring in the Kilimanjaro Christian Medical Center (KCMC), which serves as a supraregional reference hospital for the 5 regions of Northern and Central Tanzania, are reviewed for the 1971-1977 period and avoidable factors are discussed. All deaths occurring within the hospital during pregnancy or the first 6 weeks of the puerperium were included in this survey. Postmortem examination was performed in 35% of the cases. In the remaining cases the diagnosis was made on clinical grounds. During the period under review, there were 10 deaths among 83 cases, a mortality of 12%. The major cause of rupture was obstructed labor associated with a contracted pelvis or abnormal lie. 25% of the patients had had a previous cesarean section scar give way. 2 other deaths were attributed to anesthetic accidents and 1 was probably due to pulmonary embolism. The primary cause of death in the 7 remaining cases was hemorrhage (4) and sepsis (3). If deaths from ruptured uterus are to be avoided, early diagnosis is essential. 1044 cases of moderate and severe EPH gestosis (preeclampsia) were treated in KCMC during the period under review together with 54 cases of eclampsia. There were 5 deaths among the patients with eclampsia, a mortality of 9%. In addition to the 11 sepsis deaths there were 3 others included among the cases of ruptured uterus. There were 4 cases of septic abortion and 3 of those admitted to criminal interference. Preexisting anemia was a complicating factor in 5 cases, all of whom died within 15 minutes of arrival. There were 4 deaths among 251 cases of ruptured ectopic pregnancy. There were 10 deaths associated with cesarean section among 1271 sections peformed during the period under review. Deaths from associated diseases included the following: enterocolitis (12 deaths); renal and hypertensive disease (4 deaths); cardiac disease (2 deaths); anemia (2 deaths); malaria (2 deaths); tuberculous meningitis (2 deaths); and miscellaneous associated conditions (11 deaths).
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PMID:Maternal deaths in the Kilimanjaro region of Tanzania. 47 24

Very significant morbidity and mortality continue to accompany lower extremity amputations. In this study 90 patients underwent 110 amputations over a 4 year period. The overall complication rate was 40 per cent and the overall mortality rate 12.2 per cent. The patients at greatest risk were the above knee amputees greater than 60 years of age with peripheral vascular disease. Amputation of the lower extremity must be recognized as a major, life-threatening procedure. Careful preoperative evaluation of cardiac, pulmonary, and nutritional status along with efforts to prevent sepsis, pneumonia, pulmonary embolism, gastrointestinal ulceration, and renal failure are necessary if the mortality accompanying these procedures is to be reduced.
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PMID:Lower extremity amputation: review of 110 cases. 50 12

In the period 1953 - 1977 there were 223 maternal deaths among 291 800 patients delivered in hospitals under the aegis of the Department of Obstetrics and Gynaecology of the University of Cape Town. A sudden decrease in the maternal mortality rate to below 100/100,000 deliveries occurred in 1956, largely due to the greater use of the obstetric 'flying squad'. Since 1975 maternal mortality rates have been available for the various ethnic groups. For the period 1975 - 1977 the rates were 69/100,000 for Blacks, 40/100,000 for Coloureds and 27/100000 for Whites. Of the deaths, 48% occurred in women aged 21 - 30 years and 29% in those aged 35 years or more. While 28% of deaths were associated with the first pregnancy, grand multiparity (parity 5 or more) accounted for 39%. Nearly half of the patients who died were unbooked. The 7 commonest causes (grouped) of maternal deaths (obstetric as well as non-obstetric) were, in rank order: proteinuric hypertension, haemorrhage, cardiac disease, pulmonary embolism, sepsis, trauma and anaesthetic complications. Proteinuric hypertension is the most important obstetric problem in Cape Town, in terms of numbers of patients, maternal and perinatal deaths, and socio-economic implications for the community. Slightly more than 33% of the infants whose mothers died also succumbed. Major avoidable factors associated with maternal deaths were booking status, grand multiparity, cardiac disease and late or incorrect use of the 'flying squad'.
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PMID:Trends in maternal mortality in Cape Town, 1953-1977. 55 Mar 98

During the period 1957 - 1977 there were 421 deaths recorded in the gynaecological wards of Groote Schuur Hospital, Cape Town. Nearly 50% of the patients were Coloureds, 25% were Whites, and 14% were Blacks; in 14% the ethnic group was not stated. Seventy-four per cent were more than 40 years and 25% were more than 70 years of age. The causes of death in order of frequency were: malignant disease of the cervix (30%), malignant disease of the ovary (17%), incomplete abortion (15%), non-gynaecological conditions (11%), malignant disease of the corpus uteri (8%), intra-abdominal malignancy (6%), pulmonary embolism (3%), sepsis not associated with abortion (3%), malignant disease of the vulva (2%), and other conditions (5%). The six commonest causes of death varied in the three ethnic groups.
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PMID:Deaths in gynaecological wards at Groote Schuur Hospital, Cape Town, 1957 - 1977. 55 Mar 99

Detailed analysis of the clinical data and autopsy material of 100 consecutive renal transplant recipients revealed significant thromboembolic disease in 25 patients and a total of 41 complications. In six of them, thromboembolism was associated with sepsis. Nine patients died (20% of total number of deaths) due to a primary thromboembolic event. The incidence of pulmonary embolism was 14%; myocardial infarction, 3%; cerebrovascular disease, 4%; renal artery thrombosis, 2%; renal vein thrombosis, 3%; thrombophlebitis/deep vein thrombosis, 13%; and miscellaneous, 2%. The incidence of thromboembolism was higher in patients older than 40 years of age (P = .02) and during the earlier months after transplantation. We summarize the general incidence and mortality related to thromboembolism and discuss the factors predisposing the graft recipient to thromboembolic disease. Prevention and therapy of this complication should decrease the morbidity and mortality in graft recipients and enhance the success of renal transplantation.
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PMID:Thromboembolic disease in renal allograft recipients. What is its clinical significance? 78 76

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

In 112 patients receiving inferior vena caval, serrated, Teflon clips over a 7 year period beginning Jan. 1, 1966, the operative mortality rate was 6 percent (seven patients) and the 1 to 12 month mortality rate was 9 percent (10 patients). Patients with severe heart disease accounted for eight of these 17 deaths. The mortaligy rate was zero in patients who were free of heart disease, malignancy, sepsis, or massive pulmonary embolism. Recurrent pulmonary embolism was suspected, but not lethal, in four patients and was proved in two. Patients who had leg swelling preoperatively were more likely to have swelling postoperatively than those who were initially free of swelling. Postoperative anticoagulation was ineffective in preventing edema and carried the risk of wound hemorrhage. Twelve months after operation, 12 of the 83 patients available for follow-up had severe lower extremity symptoms and 23 had milder, easily controlled edema. Late stasis changes, therefore, appeared at an acceptably low frequency and could reasonably be expected for patients with lower extremity phlebothrombosis. There was no instance of fatal pulmonary embolism in the follow-up period extending from 1 to 6 years.
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PMID:Mortality and morbidity rates after inferior vena caval clipping. 110 11

An unexplained increase in the frequency of pyogenic liver abscesses of unknown etiology has, fourtunately, been paralleled by significant advances in diagnostic and therapeutic methods. This report reviews experience with 14 patients operated upon at NYU Medical Center since 1971. Eight cases (57%) were cryptogenic. Other abscesses were associated with biliary disease (3); abdominal sepsis (2); and trauma (1). Abscesses were present on hospitalization in 12 patients. Clinical findings included fever (101-108 F); 100%; leucocytosis, 71%; anorexia and vomiting, 50%; localized tenderness and hepatomegaly, 50%; hypoalbuminemia, 86%; hypocholesterolemia, 78%; elevated SGOT, 71%; and elevated aikaline phosphatase, 43%. Technetium hepatic scintiscans showed focal defects in 10 of 12 patients (83%), but did not detect multiple abscesses in 2 of these. Hepatic arteriography performed in 10 patients was highly accurate, outlining single abscesses in 6 and multiple abscesses in 4. Furthermore, in one patient a false positive scintiscan was demonstrated by negative arteriography, confirmed by autopsy. In 4 patients, arteriography indicated an abscess in the posterior-superior area of the right hepatic lobe. With precise anatomical localization, a trans-thoracic approach permitted uncomplicated drainage in each case. This approach provides excellent exposure and direct drainage for abscesses in this area. An additional therapeutic adjunct in two patients, with 4 and 11 abscesses each, was postoperative intraportal infusion of antibiotics through the umbilical vein. Thirteen patients (83%) recovered, one dying from pulmonary embolism. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. The methods described allow more precise preoperative diagnosis and direct surgical drainage.
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PMID:New diagnostic and therapeutic techniques in the management of pyogenic liver abscesses. 113 Aug 69


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