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

Ninety-one children that were subjected to transabdominal radical nephrectomy are reviewed. The patients' ages ranged from 20 days to 10 years. Forty cases had a right side tumor and 44 a left side tumor; bilateral tumor incidence was 7.70% (7 cases). The tumor weight incidence was 75% for greater than or equal to 500 g and 37.5% for greater than or equal to 1,000 g. Incidence of local extension of the disease was 21.98%. Intraoperative complications were 12 ruptures of the kidney capsule, 1 laceration of the cecum, 1 opening of the pleura, 1 section of the superior mesenteric artery, and 1 section of the right common iliac artery. The mortality rate in unilateral surgery, because of intraoperative massive hemorrhage, was 3/83 (3.61%). One patient with bilateral tumor died because of acute renal insufficiency and sepsis. One patient with caval thrombus which extended up to the right atrium died because of intraoperative massive pulmonary embolism.
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PMID:Transabdominal radical nephrectomy in ninety-one consecutive patients with Wilms' tumor. 216 9

A group of 212 patients operated upon for Crohn's disease were studied and the early postoperative complications with related problems were assessed. The morbidity was 28.3 per cent, 60 patients had at least one complication, mainly of septic nature. The mortality was 3.3 per cent (7 patients), sepsis and deep vein thrombosis with pulmonary embolism were the most common causes of death. Postoperative complications were significantly higher (39.7%) (p less than 0.001) in patients with a pre-operative nutritional deficit and in those who had urgent surgery (44.4%) (p less than 0.001). Among patients with pre-operative sepsis, the morbidity was also higher (34.6%), but was not significant. Peri-anastomotic complications (dehiscence, abscess, fistula, bleeding) were apparently more frequent (45.4%) in patients with histological residual Crohn's disease at macroscopically free resection margins although this contrasts with previous series. A proper pre-operative diagnostic approach, adequate peri-operative protein-caloric repletion, antibiotic therapy, prevention of thromboembolism and elective surgery, are still the primary tools in reducing the morbidity and mortality after surgery for Crohn's disease.
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PMID:Early complications after surgery for Crohn's disease. 221 4

Two methods of serial electrophysiologic testing are in widespread use. Most commonly, the electrode catheter is removed after each study and a new catheter reinserted through the femoral vein for every subsequent test. An alternative method employs an electrode catheter that remains in place during several days of serial testing. Little is known about differences between these two methods with respect to the likelihood of induction of arrhythmia or the frequency of complications. To determine whether inducibility of sustained arrhythmia is altered or if the frequency of complications is unacceptably high with use of an indwelling catheter, a prospective randomized study was conducted in 78 patients. Each patient underwent baseline testing, several days of electropharmacologic testing with an indwelling catheter, a 24 h drug elimination period and placement of a new electrode catheter. Ventricular stimulation studies were then performed in each patient with both the indwelling and new electrode catheters. No differences were found between the indwelling and new catheter tests with respect to induction of arrhythmia, number of extrastimuli required to induce arrhythmia, rate of arrhythmia or requirement for cardioversion. Ventricular pacing thresholds were higher and effective refractory periods were slightly longer when measured with the indwelling catheter. Complications related to the 156 catheter insertions included two that may have been related to the indwelling catheter (one episode of staphylococcal sepsis and one presumed pulmonary embolism) and four that were related to invasive procedures (pneumothorax in all). There were no long-term adverse sequelae of these complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of ventricular arrhythmia induction with use of an indwelling electrode catheter and a newly inserted catheter. 222 65

Deep venous thrombosis and its complication pulmonary embolism are responsible for more than 50,000 deaths annually in the US, 2/3 of which occur postoperatively. Nearly 75% of such deaths could be avoided by adequate prophylaxis. All forms of surgery entail some risk of deep venous thrombosis, ranging from 10% after endoscopic prostate resection to over 50% for total hip replacement. 1.6 of thromboses will embolize and 1/4 of pulmonary emboli are fatal. The goal of prevention is to decrease the incidence of fatal pulmonary emboli while limiting the risks related to prevention. A secondary goal is to reduce the frequency of postthrombotic syndrome, a late complication of deep venous thrombosis which frequently causes invalidism. A preoperative evaluation of risks of deep venous thrombosis and of the likelihood of bleeding problems should be followed by selection of appropriate preventive measures. The evaluation should be repeated postoperatively, taking into account such factors as the duration of the intervention, the diagnosis, and the predicted duration of bed rest. Evaluation of the risk of deep venous thrombosis requires knowledge of its etiopathogenesis. Deep venous thrombosis results from a multifactorial process involving venous stasis, lesion of the vascular wall, and anomalies of blood composition. All the clinical risk factors for deep venous thrombosis are related to 1 or more of these elements. Risk factors related to stasis include immobilization, postoperative or postpartum status, pregnancy, and Cockett's syndrome. Risk factors related to lesions of the vascular wall include hip surgery, trauma, age, sepsis, varices and obesity, and postthrombotic syndrome. Risk factors related to blood anomaly include postoperative status, pregnancy, oral contraceptive use, cancer, nephrotic syndrome, hypercoagulability, trauma, and heredity. The most common clinical risk factors for deep venous thrombosis are age, surgical intervention, trauma, burns, cancer, pregnancy and delivery, oral contraceptive use, varices, obesity, and postthrombotic syndrome. The relative risk of deep venous thrombosis among OC users is 4.0 overall and higher for those with type A blood. The pathogenic mechanisms are similar to those of pregnancy except that the fibrinolytic capacity is not change. The principal mechanism is perhaps the declining level of antithrombin III, observed with estrogens and some progestins. Among methods of prevention are different forms of compression, use of heparin alone or in combination with other drugs, and oral anticoagulants.
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PMID:[Epidemiology and etiopathogenesis of deep venous thrombosis of the lower limbs]. 224 Apr 6

In 126 consecutive patients operated on for carcinoma of the lower two-thirds of the rectum, a consistent policy of sphincter preservation resulted in 100 (79 per cent) having anterior resection and 22 (17 per cent) abdominoperineal resection. Perioperative complications in the anterior resection group were: death (two patients), clinical leakage (three patients), pulmonary embolism (five patients), pelvic haematoma (one patient), small bowel obstruction (one patient) and wound sepsis (six patients). Of 55 patients who had a potentially curative anterior resection with follow-up of at least 2 years, one developed local recurrence. Five per cent of patients had significant continence problems. Low anterior resection for carcinoma is associated with low perioperative morbidity, satisfactory functional results and acceptable local recurrence rates.
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PMID:Declining indications for abdominoperineal resection. 259 51

The availability of a safe, effective, and easily introducible percutaneous vena cava filter is crucial in the management of certain patients with pulmonary embolism. If thrombolytic or anticoagulant therapy for pulmonary embolism is contraindicated or fails, interruption of the inferior vena cava (IVC) blood flow is the logical alternative. Indications for filter insertion include a contraindication to anticoagulation, or recurrent pulmonary embolism despite adequate anticoagulation therapy. Common routes of filter insertion are from the right internal jugular vein, or the right or left femoral veins. The Mobin-Uddin umbrella filter (no longer available in the USA) and the Kimray-Greenfield filters have been the most widely used. Complications of vena cava filters include malpositioning, migration, venous thrombosis proximal or distal to the filter, hemorrhage at the percutaneous site of insertion, or sepsis. Despite these problems, IVC filters have been extremely useful in the management of pulmonary embolism among certain subsets of patients. Percutaneously inserted filters have now superseded surgical vena caval interruption in most US centers. Newer filters are currently under development in the US and Europe, and feature improved filtering function, anti-tilt abilities, retrievability, memory wire properties, and improved ease of insertion.
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PMID:Interruption of the inferior vena cava for prevention of pulmonary embolism: transvenous filter devices. 266 87

Thrombophlebitis is defined as thrombotic inflammation of a previously healthy superficial vein, varicophlebitis as that occurring in varicosities. The latter appears responsible for the majority of thrombotic venous occlusions. In contrast to venous thrombosis, the thrombotic involvement of deep veins, thrombophlebitis usually resolves without sequel and, in general, thrombophlebitis nor varicophlebitis are associated with the risk of pulmonary embolism. The clinical presentation of thrombophlebitis is that of a tender, hardened superficial vein which, in the presence of inflammation, may be very painful. The lower extremities are most frequently involved. Differential diagnostic considerations include bacterial cellulitis and lymphangitis. The cause of thrombophlebitis, which is rare without precipitating factors, may be a mechanical lesion such as kinking of the vein or trauma to the wall of the vein as well as other primary disease such as auto-immune afflictions, endangiitis obliterans or malignancy; in particular, with localization in the area of the rump, with concomitant occurrence in various regions or extending phlebitis, paraneoplastic syndromes and hemoblastoses should be ruled out. Rarely, phlebitis may be associated with tuberculosis and syphilis. Thrombophlebitis may be caused iatrogenically by improper application of chemical substances which cause damage to the venous walls as well as by indwelling catheters or cannulas. This form can progress to sepsis and pulmonary embolism may be incurred. Varicophlebitis, in contrast, accounts for about 90% of all cases of phlebitis and can be regarded as a typical late complication of varicosities in the superficial venous system.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pathogenesis, diagnosis and therapy of thrombophlebitis and varicophlebitis]. 268 Aug 51

In a review of 37,012 autopsies over the last 20 years 202 deceased adults who had had a splenectomy were investigated. The incidence of infections and thromboembolic complications related to death in these patients was compared with that of a matched deceased population (n = 403) who had not undergone splenectomy. Death-related pneumonia was diagnosed frequently in the splenectomy group and to a lesser extent in the control group (57.9 versus 24.1 per cent, P less than 0.001). Lethal sepsis with multiple organ failure occurred in 6.9 per cent of the splenectomy group and in 1.5 per cent of the controls (P less than 0.001). Purulent pyelonephritis was observed in 7.9 per cent of the splenectomy group and was significantly more frequent than in the control group with its rate of 2.2 per cent (P less than 0.001). Finally, pulmonary embolism was the major or a contributory cause of death more often in the splenectomy group than in the control group (35.6 versus 9.7 per cent, P less than 0.001). We conclude that splenectomy generates a considerable life-long risk of severe infection and of thromboembolism.
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PMID:Incidence of septic and thromboembolic-related deaths after splenectomy in adults. 273 68

We treated 41 patients with transitional cell carcinoma with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy. Median patient age was 56 years. Of the patients 33 had either distant metastases or locoregional disease that could not be cured by an operation or radiation. Of these patients 30 had measurable disease and 12 responded (4 complete and 8 partial responses, response rate 40 per cent, 95 per cent confidence limits 23 to 59 per cent). Only 2 of these patients remain with an unmaintained complete response at 34 and 52 months. Of 5 patients 3 responded who were treated with neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin for locally advanced bladder cancer before radiation or cystectomy, and only 1 of these patients is free of disease. The remaining 3 patients were treated postoperatively because they were at high risk for recurrence and all are well. Toxicity of the regimen was severe: 41 per cent of the patients experienced neutropenic sepsis and 54 per cent required hospitalization for management of toxic complications. Three patients experienced pulmonary embolism and 1 had deep vein thrombosis. There was 1 drug-related death of sepsis. Although a patient occasionally may have long-term benefit from this chemotherapy our results suggest caution in the widespread application of this protocol.
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PMID:M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for transitional cell carcinoma: the Princess Margaret Hospital experience. 274 45

Maternal mortality, i.e., death during pregnancy or within 42 days of an abortion or delivery, has declined in Hong Kong from .45/1000 births in 1961 to .05/1000 births in 1985. 68% of all maternal deaths during this period were due to hemorrhage (34%), pre-eclampsia (20%), and ectopic pregnancy (14%). The number of legal abortions, on the other hand, increased from 184 in 1973 to 15,411 in 1985, but no maternal deaths were associated with legal abortion. The major cause of the declining maternal mortality is a decline in known risk factors. High parity is associated with maternal mortality, and parity in Hong Kong has steadily decreased. Another risk factor is maternal age. Births to women over 35 constituted 16.2% of total births between 1962 and 1970 but only 8.6% of the total between 1971 and 1985. Adverse living conditions due to poverty are another high risk factor. Between 1966 and 1985, the gross domestic product rose 14-fold, and the maternal mortality rate dropped 9-fold. Other factors are the fact that all deliveries occur in institutions, and adequate prenatal care is available, as are transfusions and oxytocics. Pulmonary embolism and sepsis, which cause many maternal deaths in developing countries, are rare in Hong Kong.
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PMID:Maternal mortality in Hong Kong 1961-1985. 278 26


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