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)

Eighteen evaluable patients with previously untreated Stage III and IV ovarian carcinoma were treated with six cycles of intraperitoneal cisplatin with intravenous cyclophosphamide and doxorubicin. Significant chemotherapy-related toxicities were observed, including one patient with fatal neutropenia and sepsis, two patients with transient severe nephrotoxicity, one patient with severe autonomic and motor neuropathy, and one patient with generalized debility. One patient had Tenckhoff catheter-related peritonitis, but no other morbidity was associated with the peritoneal catheters. Three of eight patients with optimal tumor bulk and none of 10 patients with suboptimal tumor bulk achieved pathologic complete response. The overall estimated median survival is 22 months. This treatment approach is associated with formidable toxicity, and the contribution of intraperitoneal cisplatin to the treatment of newly diagnosed ovarian carcinoma patients must be evaluated in randomized trials.
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PMID:Intraperitoneal cisplatin with intravenous cyclophosphamide and doxorubicin for previously untreated stage III and IV ovarian carcinoma. 263 12

We studied 14 patients with neuromuscular disorders and concomitant infection with human immunodeficiency virus to define clinical syndromes and prognosis. Eight patients had painful sensorimotor peripheral neuropathy; two, chronic inflammatory demyelinating polyneuropathy; two, mononeuropathy or mononeuropathy multiplex; one, recurrent myoglobinuria; and one, chronic proximal weakness and elevated creatine kinase levels. All eight patients with painful neuropathy had overt symptoms of acquired immunodeficiency syndrome. Chronic inflammatory demyelinating polyneuropathy was the first manifestation of acquired immunodeficiency syndrome in both patients with this syndrome. Both died from overwhelming sepsis within six months of the neuropathy's onset. Patients with mononeuropathy multiplex had a variable course. Immunosuppressant medication had no effect in two patients.
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PMID:The neuromuscular manifestations of human immunodeficiency virus infections. 284 98

Four cases of a polyneuropathy associated with pancreatitis and pancreatic pseudocyst formation are reported. Electrophysiological investigation showed the peripheral neuropathy to be predominantly axonal in type. These patients were all seriously ill and many factors may have been involved in the pathogenesis of their neuropathy. They had all received parenteral nutrition and multiple drug therapy including metronidazole, and all had severe sepsis. There was evidence that insufficient vitamin replacement had been given during total parenteral nutrition. It was not possible to decide whether the polyneuropathy resulted from the summation of these factors, is similar to what has been called the polyneuropathy of the critically ill, or is a new association with pancreatic disease.
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PMID:Peripheral neuropathy complicating pancreatitis and major pancreatic surgery. 285 12

Treatment results remain very poor for some clinical and histopathologic subsets of patients with aggressive non-Hodgkin's lymphoma. We treated 21 such patients with a high-dose combination chemotherapy regimen [Mega-COMLA (cyclophosphamide, cytarabine, vincristine, and methotrexate followed by leucovorin and prednisone) + CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)] in an attempt to improve disease-free survival. Neoplasms were classified using the Lukes-Collins system. Eight patients had T-cell lymphomas (convoluted lymphocytic lymphoma, four patients; T-cell lymphoma/leukemia, one; and peripheral T-cell lymphoma, three), eight had B-cell lymphomas (immunoblastic sarcoma, five patients; small noncleaved follicular center cell, one; and large noncleaved follicular center cell, two), and five had nontypable large noncleaved cell lymphomas. All patients were previously untreated; 18 of 21 patients had clinical stage III or IV disease. Following induction therapy (4-8 weeks' duration), 16 patients (76%) achieved complete remission, while three had partial remission. Two patients died of sepsis during induction therapy. Eleven of 16 complete responders (69%) remain in complete remission after a median follow-up of 35 months. The actuarial 3-year survival rate is 51% for the entire group. Myelosuppression with this regimen was severe and prolonged, with a median duration of neutropenia (less than 500 cells/microliter) of 14 days. Seven patients (33%) developed severe neuropathy following induction treatment. High-dose induction therapy with this regimen resulted in a high complete remission rate with manageable toxicity. Survival results are encouraging when compared retrospectively to our patients with similar poor-prognosis histologies treated with standard combination chemotherapy. However, the value of this intensive therapy, relative to newer ("third-generation") regimens, can only be established by prospective randomized studies.
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PMID:Effects of Mega-COMLA (cyclophosphamide, cytarabine, vincristine, and methotrexate followed by leucovorin and prednisone) plus CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) in the treatment of lymphoid neoplasms with very poor prognosis. 301 6

Twenty patients with stage III and IV diffuse well-differentiated lymphocytic lymphoma were treated with combination chemotherapy consisting of BCNU, cyclophosphamide, vincristine, melphalan and prednisone (M-2). Treatment was given every 5 weeks for 11 cycles in responding patients. The median age of the patients was 62 years (range 45-76). There were 12 complete remissions and 6 partial remissions for an overall response rate of 90%. The median duration of remission was 24 months (range 12-79 months) and was identical for complete responders and partial responders. All but 2 responding patients have been subsequently retreated for relapse. The median survival was 84 months (range 1-108 months). Myelosuppression was mild. Nausea/vomiting, neuropathy, alopecia and gastrointestinal symptoms from prednisone were seen in the minority of patients. One patient expired from sepsis/neutropenia during the first cycle of therapy. The M-2 protocol produces effective remissions in diffuse well-differentiated lymphocytic lymphoma. The relapse and survival pattern are similar to the results achieved with other chemotherapy regimens in low-grade lymphoma.
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PMID:Diffuse well-differentiated lymphocytic lymphoma: chemotherapy with BCNU, cyclophosphamide, vincristine, melphalan and prednisone. 305 72

Neuropathy, peripheral ischemia, and an altered host defense make the diabetic patient particularly prone to the development of infected foot ulcers. Successful treatment must be directed at these three primary pathologic situations. Since a limb-threatening infection carries a 25% risk of major amputation, early and prompt recognition and reporting of all foot problems are essential. Neuropathy requires total rest of the injured part. An altered host defense requires knowledge of the bacteria involved and proper use of antibiotics. It requires strict adherence to sound surgical principles that ensure debridement of all necrotic material and adequate dependent drainage of the wound while conserving as much viable skin and tissue for later revision or conservative amputations. Once sepsis is controlled, ischemic extremities can be revascularized. Because of the peculiar nature of the diabetic's vascular disease, revascularization procedures require the maximum skill and experience of the operating vascular surgeon. After revascularization, revisions or more conservative distal amputations can be achieved. Patient and physician education and understanding still remain essential not only to prevention but to successful management of all diabetic foot-related problems.
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PMID:The diabetic foot: amputations and drainage of infection. 355 24

The possibility of bilateral femoral neuropathy after microsurgical tuboplasty for the reversal of sterilization is possible. There seems to be little awareness of this condition by gynecologists and fertility surgeons. This type of femoral neuropathy has an excellent prognosis and only physiotherapy is necessary to aid muscular function. Some cases have been reported where recovery has been extremely slow, normal functions had taken months, and some disability lasted years. The femoral nerve is not included in the pelvis, therefore injury through operative procedures are unlikely. The self-retaining retractors were used in all reported cases and verified through clinical experience. There are 2 types of injury to the femoral nerve: Direct pressure on the nerve itself by retractor blades, and impingement of the psoas muscle and the nerve against the lateral pelvic muscle. Factors that increase the possibility of this condition include diabetes mellitus, rheumatism, gout, alcoholism, malnutrition, syphilis, tuberculosis, typhoid fever, tetanus, liver abscesses, sepsis of distal parts of the body, polyarteritis nodosa, anticoagulants, and bleeding diseases. Femoral neuropathy has been observed after using self-retaining retractors such as O'Connor, O'Sullivan, Mann, Collin and Balfour. The preventive measures suggested are to use a retractor with appropriate blade depth.
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PMID:Bilateral femoral neuropathy after microsurgical reversal of tubal sterilization: case report and analysis of contributing factors. 362 33

From 1969 to 31 March 1982, 1,769 organ transplants were performed by the University of Minnesota Transplant Service. Fifty-one patients had severe osteonecrosis develop requiring 83 total joint arthroplasties. Patients with diabetes were underrepresented in the arthroplasty population; this may be due to neuropathy masking some disease. All of the patients received dramatic relief from pain and experienced improved function. Only one surgical mortality occurred--a patient with sepsis. To minimize complications, prophylactic antibiotics were used, and most patients did not undergo prophylactic anticoagulation. The most common complication was dislocation of the hip, at five to eight times the rate of those in the nontransplant arthroplasty population. These can be minimized by avoiding the posterior lateral surgical approach and by meticulous capsular repair. Despite the youth and activity of these patients, component wear was not a problem. However, because of the multicentric nature of this disease, components and surgical approach should be chosen carefully. Incidence of severe osteonecrosis was highest among cadaver kidney recipients. No HLA identical kidney recipient had severe osteonecrosis develop. Consequently, we concur with previous authors that osteonecrosis may be caused by the higher dosages of immunosuppressive agents required to prevent rejection of HLA nonidentical organs.
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PMID:Osteonecrosis in the transplant recipient. 648 89

A new inherited neuromuscular disease was identified in 4 patients (1 male, 3 females), offspring of consanguineous marriages, belonging to the same kindred. The proband was a 24-year-old female with history of ptosis and ophthalmoplegia since childhood and progressive intestinal pseudo-obstruction for the last 4 years of her life. A sural nerve biopsy showed axonal and demyelinating neuropathy. Muscle biopsies of pectoral and gastrocnemius revealed myopathic alterations with marked variation in muscle fiber size, atrophy of both fiber types and normal mitochondria. An upper gastrointestinal study showed barium in the stomach after 8 h and jejunal diverticula. Tests for absorption of fat, protein, carbohydrate, folic acid and vitamin B12 were normal. Serum levels of vitamin A and lipoproteins were also normal. The patient underwent partial gastrectomy and gastrojejunostomy. Postoperatively, she developed severe pancreatitis, sepsis, peritonitis and expired. Tissue samples from the proband and from her brother, revealed normal mucosa, but degeneration of smooth muscle of the stomach and small intestine. The myenteric plexus and vagus nerves were normal. The biochemical studies of contractile proteins (myosin, actin, tropomyosin) in the fresh and cultured smooth muscle cells of the proband obtained at the time of gastrectomy showed a 50-75% decrease in the synthesis of different contractile proteins. Turnover of contractile proteins and synthesis and turnover of collagen showed normal values. The reduction in synthesis of contractile proteins may account for the weak peristalsis and be a factor in the pathogenesis of the intestinal pseudo-obstruction.
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PMID:Inherited ophthalmoplegia with intestinal pseudo-obstruction. 668 98

Between 1977 and 1983, 105 patients had a postanal repair for the treatment of faecal incontinence. All except 8 patients were women. The principal reasons for operation were: persistent incontinence after rectopexy (n = 25), obstetric trauma (n = 18), anal dilatation (n = 12) and pelvic floor neuropathy (n = 41). One patient died after operation. Of 89 patients followed up for at least six months after operation, 56 (63%) have complete control of faeces and flatus, but 19 have control of solid faeces only and 14 are no better. The poor results were associated with wound sepsis and previous operations particularly in men.
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PMID:Postanal repair for faecal incontinence. 671 79


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