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)

The clinical course of 37 patients who underwent 46 liver transplantations for primary (n = 33) and secondary (n = 4) sclerosing cholangitis was reviewed. The median follow-up was 37 months. The patient and graft survivals for patients with primary sclerosing cholangitis at 1, 2, and 5 years were 96.9%, 91.6%, 87.9%, and 83.1%, 74.2%, 65.2%, respectively. In the patients with primary sclerosing cholangitis (PSC), prior surgery except for simple cholecystectomy was associated with significantly greater operative time and blood loss. No cholangiocarcinoma was identified at the time of transplantation. Human leukocyte antigen typing for PSC patients was heavily weighed toward B8 (58.8%) compared with control (11.8%). Sixty-two percent of patients with PSC also had inflammatory bowel disease. Moderate or severe rejection requiring OKT3, "rescue therapy" with FK506, or retransplantation was relatively higher in patients with inflammatory bowel disease (70%) versus patients without inflammatory bowel disease (36.4%) and a matched control group (37.5%). Progressive inflammatory bowel disease was seen in 6 of 19 patients, with 3 developing cancer and a dysplasia. Two patients in the entire group died of sepsis and 3 of colon cancer (2 recurrent and 1 primary). These data demonstrate that excellent survival results can be achieved in this group of patients. Rejection is frequent and often severe and steroid refractory. Colon cancer represents the most frequent cause of death in PSC patients after liver transplantation and demands constant attention.
 ...
PMID:Liver transplantation for sclerosing cholangitis. 763 12

The authors present a review of 431 children biopsied and studied with the following histochemical and immunohistochemical techniques: 1) acetylcholinesterase activity; 2) alphanaphthylesterase activity; 3) S-100 protein immunohistochemical technique; 4) glyoxylic acid method. Two hundred forty-eight patients of our series presented different forms of dysganglionosis, 12 of them (4.8%) presenting neuronal intestinal dysplasia type B. In 7 cases, NID type B was diffuse, whereas in 5 recto-colonic NID type B was confined to the splenic flexure. Male:female ratio was 9:3. Familial recurrence was present in 2 of the 12 cases of our series, affected by severe neuronal intestinal dysplasia extended to the small intestine, associated with intestinal malrotation and short bowel syndrome. Four of the 7 cases of diffuse NID type B and 2 of the 5 cases of rectocolonic NID type B were surgically treated. Three patients with diffuse NID died from sepsis within the 2nd year of life. This study confirms that NID type B is a form of dysganglionosis which can be diagnosed in a Mediterranean country if histochemical techniques are applied in the study of a large series of constipated and pseudo-Hirschsprung patients. From a pathogenetic point of view, the authors compared the histochemical findings of biopsies from their series of NID patients with those of recto-colonic biopsies from patients with MEN II B syndrome. The similarity of GI symptoms in MEN II B and NID pediatric patients suggests that the two disorders could be the result of mutations affecting the same domain of the RET proto-oncogene.
 ...
PMID:Neuronal intestinal dysplasia: clinical experience in Italian patients. 785 85

The indications to surgical treatment of the ulcerative colitis (RCU) are a discuss argument to date, for etiopathogenetic uncertain still being. The problems of treatment are expressed by A.G. Parks and J.H. Pemberton very well, who said that "... Its treatment, both medical or surgical, is empirical", and "... The patients with chronic ulcerative colitis heal with proctocolectomy". From 1980 to 1992 we observed 65 cases of URC. 21 (32%) of these were treated by surgery. The indications to surgical treatment were: unsuccessful of medical therapy (14 cases), toxic megacolon (3 cases), severe dysplasia (2 cases), perforation (2 cases). We have submitted 5 patients to colectomy with ileostomy, 13 patients to colectomy with ileorecto-anastomosis and 3 to proctocolectomy with definitive ileostomy. Morbidity was 14.2% (anastomotic linkage, bronchopneumonia sepsis, wound sepsis). Mortality was 4.7% for a case of large bowel multiple perforations. The treatment of the URC is a difficult choice for surgeon, because he must decide the surgery timing. To different of the Crohn's disease, that is not heal with surgery, today URC allows more surgical aggressive attitude.
 ...
PMID:[Indications for surgical treatment of ulcerative rectocolitis]. 801 May 79

In order to precise the indications and results of this procedure, we assessed 11 cases of transformation of ileorectal anastomosis (IRA) to ileal pouch-anal anastomosis (IPAA) in ulcerative colitis (UC). These 5 men and 6 women had undergone IRA at a mean age of 31 years, 33 months after the diagnosis of UC (range 3-120). Four of these IRA, excluded by an ileostomy, had never been in function: the cause was severe persistent proctitis in 2 cases and anastomotic leakage and peritonitis in 2 cases. The other 7 IRA had been in function during a mean period of 25 months (range 6-45) and were reoperated because of anal sepsis (1 case), low rectal stenosis (1 case), disabling proctitis (4 cases) and rectal dysplasia (1 case). No patient had specific pathologic signs of Crohn's disease. The 11 IPAA were complicated by pelvic sepsis in 3 cases; surgical drainage succeeded in 1 case, but the 2 others needed pouch excision and terminal ileostomy. The diagnosis of Crohn's disease was eventually made in these 2 patients. The 9 patients with functioning IPAA, at a mean follow-up of 40 months (range 12-60), had 5.2 stools per 24 h (range 2-12), 5 patients had no nocturnal stooling, and 6 had a perfect continence. One patient had disabling chronic pouchitis. In conclusion, proctectomy with IPAA is always feasible when a previous IRA for UC had failed or offers poor results, but should be rejected in case of anal involvement, as that may suggest Crohn's disease. This procedure is followed by similar functional results than after primary IPAA.
 ...
PMID:[Transformations of ileo-rectal anastomosis into ileo-anal anastomosis in hemorrhagic rectocolitis. Indications and results]. 816 Nov 27

We reviewed the data of 42 consecutive patients (mean age 55 +/- 12 years) who underwent surgery for control of recurrent drug-refractory ventricular arrhythmia. A history of myocardial infarction was present in 38 patients, 4 patients had congenital heart disease (2 aneurysms, 1 right ventricular dysplasia, 1 hamartoma). The mean LV ejection fraction was 40 +/- 14%. At preoperative electrophysiologic study, ventricular tachycardia was inducible in 32 of 33 patients. The mean heart rate was 188/min. A mean of 3.3 +/- 2.1 antiarrhythmic drug trials were ineffective. The most frequently performed surgical procedure (n = 36) was visually guided subendocardial resection, alone or in combination with cryothermal ablation. In 30 patients additional aneurysmectomy was performed. A mean of 1.9 +/- 1.4 coronary arteries in 32 patients were bypassed. The overall in-hospital mortality (30 days) was 9.5% (1 arrhythmic death, 1 pump failure, 1 sepsis, 1 hemorrhagic shock). We found 2 significant (p < 0.05) predictors of perioperative mortality: recent myocardial infarction and patient's age. During a mean follow-up of 33 months (range 1 to 90), there were 3 sudden cardiac deaths and 6 nonfatal recurrences of ventricular tachycardia which were subsequently prevented with antiarrhythmic drug therapy. Thus, the overall success in control of arrhythmia was 92%, in 59% by surgery alone. Survival was 79% at 2 years after surgery and 63% at 5 years. We conclude that patients who have successful subendocardial resection and aneurysmectomy for control of ventricular arrhythmia have an excellent chance of arrhythmia-free survival and a relatively good prognosis.
 ...
PMID:[Surgery for arrhythmia in patients with therapy-resistant ventricular tachycardia]. 821 Oct 13

Hemofiltration is accepted management for acute renal failure in critically ill patients. However, in infants, obtaining arterial access or adequate flow through the access is often difficult. We report our technique and experience with pump-assisted hemofiltration (PAHF) in ten infants with acute renal failure. In five patients, double-lumen venous catheters provided access, while two catheters at separate sites were used in the remaining patients. In all patients, hemofilters were used with standard intravenous tubing added to pre-filter tubing and placed through a standard volumetric infusion pump for regulation of blood flow. The infants, aged 5-575 days, weighed from 2.8 to 11.4 kg and had primary diagnoses of post-operative congenital heart disease in five, sepsis in four, and renal dysplasia in one. The duration of PAHF averaged 158 +/- 115 h (range 20-332 h). Complications included bleeding at a catheter or surgical site in one patient each and asymptomatic hyponatremia in five patients. Thus, with adequate nurse training, PAHF using a volumetric infusion pump for blood regulation can be acceptable therapy in acute renal failure in infants.
 ...
PMID:Pump-assisted hemofiltration in infants with acute renal failure. 839 55

Nitric oxide production appears to be decreased in infants with persistent pulmonary hypertension (PPHN). Inhaled nitric oxide may improve oxygenation by two mechanisms: increased pulmonary blood flow and improved ventilation-perfusion matching. Nitric oxide inhalation has been tested in newborns with PPHN, congenital heart diseases, and bronchopulmonary dysplasia. We present a review of the articles concerning inhaled nitric oxide for infants with PPHN. Overall, 59% of the neonates had an initial improvement in oxygenation in response to nitric oxide inhalation. A sustained response was observed in 60% of the infants. Patients with extrapulmonary shunting, clear chest radiographs, and adequate lung volume seem to have a better response, whereas patients with congenital diaphragmatic hernia, severe sepsis, and alveolar capillary dysplasia are more likely to fail. To define the benefit-risk ratio, six prospective randomized trials are currently in progress.
 ...
PMID:The role of nitric oxide in the treatment of neonatal pulmonary hypertension. 872 5

Hip arthrodesis remains an option for treatment of severe arthritis in young persons resulting primarily from osteonecrosis, congenital dysplasia, and joint sepsis. The authors reviewed six patients who underwent fusions as young adults (average age: 30.8 years) with an average follow-up period of 11.7 years. Solid arthrodesis without infection was noted in all cases. Patients who worked returned to prior employment without limitation. All patients complained of symptomatic low back pain and felt ambulation was limited by ipsilateral knee pain. Five of six noted impaired sexual function; although childbearing was not affected in one case. Four of six were satisfied with the operation, but only three of six would undergo it again given the alternative of total joint arthroplasty.
 ...
PMID:Hip fusion in young adults. 878 20

This report describes outcomes for all infants with birth weight 501-1750 grams born in the three major maternity hospitals in Dublin between 1.1.90 to 31.12.91. 37,958 mothers delivered 38,498 infants during this period, consisting of approximately 36% of all deliveries in Ireland. 633 (1.6%) of all infants born weighed 501-1750 grms. 102 (16%) were stillborn and 28 of the 531 live born infants had lethal malformations. 30% of women received two or more doses of antenatal steroids before delivery and a highly significant negative correlation occurred between the need for ventilation after birth and antenatal steroids. 56.4% of babies were delivered by caesarean section as compared with 10.8% of the hospital population. Of 503 liveborn infants without lethal malformation. 426 (85%) survived to 28 days and 419 (83%) to discharge home. 15% were growth retarded. 46% of infants were ventilated, mean duration of ventilation was 7 days. 25% of infants had an intraventricular haemorrhage, 10% necrotising enterocolitis and 19% culture proven sepsis. 15% of survivors developed broncho pulmonary dysplasia and 12% retinopathy of prematurity. This paper describes important information for mortality, morbidity and interventions among a large population of low birth weight infants in Ireland and can be used as a basis against which to compare future alterations in practice. It demonstrates a clear benefit for antenatal steroids in decreasing the need for ventilation and the importance of ensuring their utilisation antenatally where possible.
 ...
PMID:The Dublin outcome for low birth-weight infants. 893 44

Children and adolescents with colitis present specific problems for surgeons. There has been a fashion, particularly in North America, for restoring continuity after colectomy by a direct ileo-anal anastomosis. The authors reviewed their experience with restorative proctocolectomy with ileal reservoir (RPC) in patients under 18 years of age to evaluate the outcome and to discuss the problems and challenges associated with the procedure in this age group. Fifteen patients (6 boys, 9 girls) were operated on between 1984 and 1995. The diagnoses included 12 patients with ulcerative colitis (UC), two with familial adenomatous polyposis (FAP), and one with total colonic neuronal dysplasia. The median age of the patients at the time of ileal pouch formation was 15 years, and follow-up data were available for all patients at a median of 43 months. Ten patients with UC underwent pouch surgery 4 to 14 months after initial total abdominal colectomy (7 for acute severe disease, 3 for chronic disease). Four patients (2 with chronic UC, 2 with FAP) underwent primary RPC. There were no deaths in this series. Three (20%) patients suffered serious early morbidity (pouch hemorrhage, pelvic sepsis, severe psychological crisis). Late morbidity included three patients who had small bowel obstruction, one who required laparotomy, two who required pouch revision, and five of 12 (42%) patients with UC who presented with a documented episode of pouchitis between 2 and 72 months after ileostomy closure. All patients had acceptable bowel frequency and quality of continence. This experience suggests that RPC provides an important surgical option for children and adolescents with UC or FAP.
 ...
PMID:Restorative proctocolectomy in children and adolescents. 898 80


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