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)

We have found that endotoxemia detected by conventional LCT (limulus colorimetric test) in patients with liver diseases could not be detected by endotoxin-specific LCT at all, and proposed that this beta-glucan like activity (BGLA) should be termed as non-septic endotoxemia, distinguishing it from septic endotoxemia seen in gram-negative sepsis. In this study, we investigated non-septic endotoxemia through the clinical course of 8 cirrhotic patients. Non-septic endotoxemia appeared at the onset of DIC but tended to decline in level in the late terminal stage. This phenomenon cannot be consistent with the "spillover" theory which explains the mechanism of endotoxemia without sepsis in liver disease. We think it is an urgent problem to elucidate the nature of BGLA in liver disease, without recourse to the "spillover" theory.
 ...
PMID:Non-septic endotoxemia in cirrhotic patients. 254 1

Altered clotting encompasses a wide spectrum of clinical conditions ranging from bleeding disorders to abnormal clot formation. DIC is an abnormal overstimulation of the normal coagulation process resulting from several clinical conditions that illustrate these extremes. In orthopaedic patients, DIC can develop following trauma (crush injuries), tissue necrosis, fat embolism, gram-negative or gram-positive sepsis, and venous stasis (bedrest). Because of its occurrence as a secondary process and its subtle development, DIC can elude early recognition, diagnosis, and treatment.
 ...
PMID:Disseminated intravascular coagulation: a nursing challenge. 260 99

Personal experience of 31 patients suffering from intractable ascites due to advanced liver cirrhosis between 1978 and 1987 is reported. Seventeen patients were selected for a peritoneojugular shunt: in 3 patients the Le Veen shunt was performed and in 14 the Denver shunt was preferred. The high postoperative morbidity and mortality due to liver failure, DIC, hepatorenal syndrome, bleeding, sepsis and cerebral thrombosis is pointed out. Careful selection of patients to be submitted to this surgical procedure is essential because of the high morbidity due to ascites reinfusion. DIC has to be diagnosed as soon as possible and, when severe, the prompt interruption of the peritoneojugular shunt is mandatory.
 ...
PMID:[The Denver peritoneojugular shunt. Current indications]. 272 37

Autopsy findings were reviewed in 43 patients clinically diagnosed in the last 12 years as having urogenital malignant tumors. Clinical diagnoses were 14 bladder carcinoma, 11 prostatic carcinoma, 6 renal cell carcinoma, 5 renal pelvic carcinoma, and 7 other malignant tumors. Autopsy showed that 31 cases died due to carcinoma and 12 because of other causes. The most common ultimate causes of death were DIC and infection, especially pneumonia and sepsis. Autopsy showed 36 of the 43 cases (83.7%) with metastasis. Clinical diagnosis showed 34 cases of metastasis, but the number of metastasized organs and lymph-nodes was much lower than in subsequent autopsy findings. Autopsy proved 5 cases of clinical misdiagnosis (11.6%) and 4 of undiagnosed malignant tumors (9.3%). In 15 cases (32.6%) the ultimate cause of death as revealed by autopsy had not been clinically diagnosed. Five cases diagnosed as having died due to cancer in fact were found to have died due to other causes. Recent diagnostic techniques are greatly advanced, yet many findings are still revealed for the first time by autopsy. Autopsy continues to be a very important final arbiter of progress and the effect of malignant tumors, and serves to remind us of the ongoing need for constant vigilance and improvement of clinical diagnostic techniques.
 ...
PMID:[Review of 43 autopsy cases of urogenital malignant tumors]. 273 88

The peculiarities of the diagnosis of sepsis in 24 patients with local purulent processes are presented. The DIC-syndrome, pulmonary syndrome, toxic nephropathy are of most importance in diagnosis of the disease.
 ...
PMID:[Diagnosis of infection]. 273 63

Factors contributing to the high prevalence of immunodeficiency in the PICU population include conditions that lead to frequent requirement of intensive care, suppression of immunity secondary to an acute insult, and iatrogenic measures. The immunodeficiency observed in the critically ill correlates well with their susceptibility to infection and explains the high prevalence of nosocomial sepsis in the PICU--a major cause of morbidity and mortality in critically ill children. Dysactivation of the immune system during an acute insult, with the subsequent release of humoral mediators from activated immune cells, leads to tissue injury and may be involved in the pathogenesis of ARDS, DIC, capillary leak syndrome, and to the development of multiple organ system failure. Suggested approaches to correct the immunodeficiency in the critically ill include reconstitutional immunotherapy, mediator-inhibiting drugs, and mediator removal by plasma exchange. Intensivists should be aware of the phenomenon of immunodeficiency in the critically ill, be accordingly aggressive in diagnosing and treating infections, and avoid, as much as possible, measures that further suppress immunity.
 ...
PMID:Immune dysfunction in the critically ill infant and child. 305 6

The regimen of doxorubicin (DOX), ifosfamide (IFF), and dacarbazine (DTIC) (AID) for previously untreated inoperable or metastatic sarcoma has acceptable toxicity with significant activity. Twenty patients received 79 courses of DOX (60-75 mg/m2) with or without DTIC (900 mg/m2) by continuous infusion over 72 hours with escalating doses of IFF and mesna uroprotection. Nineteen patients were evaluable for toxicity. Myelosuppression was dose-limiting. The maximum tolerated dose was DOX at 60 mg/m2, DTIC at 900 mg/m2, and IFF at 7500 mg/m2 per course. Of the 79 courses analyzed, 33 (42%) resulted in wbc counts less than 1000/microliter; 14 (18%) were complicated by fever and neutropenia, and three by sepsis. There were no toxic deaths. Relative platelet sparing was observed and nadirs were brief. In contrast to bolus-dose DTIC divided over 5 days, DTIC by continuous infusion did not add significantly to gastrointestinal toxicity. Nausea and vomiting was well controlled by antiemetics. Mucositis occurred sporadically. Unlike our phase II study of IFF alone, no CNS or renal toxicity was observed. No cardiac toxicity was encountered, although only four patients have received greater than 450 mg/m2 of cumulative DOX. One episode of DOX extravasation occurred despite a long iv line that extended to the axilla. No serious tissue damage was observed, perhaps due to the dilute solutions of DOX used. Partial responses were seen in eight of 18 evaluable patients (44%) and in six of 11 patients at or near the phase II level. Two additional patients with minimal response have continued tumor regression. The median number of courses before partial response was four (range, one to five). The median duration of response has not been reached (3+ to 10+ months). An inoperable primary has been rendered surgically resectable in one patient. Activity in previously untreated sarcomas should be further evaluated in a randomized phase III study against a standard DOX-containing combination.
 ...
PMID:Doxorubicin, ifosfamide, and dacarbazine (AID) with mesna uroprotection for advanced untreated sarcoma: a phase I study. 308 17

Group B beta hemolytic streptococcal sepsis has many of the characteristics of gram negative sepsis (Hellerqvist, et al., 1981). This is further shown in the model developed for this study. The newborn piglet septic model developed for this study appears to be an adequate model for group B, beta-streptococcal sepsis characterized by the development of significant hypotension by six hours. As with human sepsis, this model develops hypoglycemia, hemoconcentration as noted by the increased hematocrit, thrombocytopenia and a significant drop in WBC with an increase in immature forms (Wilson, 1986). The only finding not correlated to the septic newborn is the development of DIC as characterized by an increased PT/PTT and increased FSP. As with other animal models for both gram positive and negative sepsis, the cyclooxygenase inhibitor, indomethacin significantly increased survival out to 72 hours. Previous studies with thromboxane synthetase inhibitors have not shown increased survival, but shunting into the prostacyclin pathway has occurred and the effect of this on survival could not be ruled out (Short, et al., 1983). The use of a thromboxane receptor site antagonist should not cause this shunt, and thus may help to evaluate the effect of thromboxane blockade. In this model no effect of the receptor site antagonist was noted, but due to the short half-life of this compound, a different dosing schedule may be needed before its efficacy can be determined. In summary, the cyclooxygenase inhibitors do appear to have a protective effect in gram positive sepsis, but the mechanisms of action are still to be determined.
 ...
PMID:Group B streptococcal (GBSS) newborn septic shock model: the role of prostaglandins. 313 20

CYVADIC (cyclophosphamide + vincristine + adriamycin + dacarbazine = DTIC) is frequently used in the treatment of patients with soft tissue sarcomas or malignant mesotheliomas. As a modification of the protocol originally published by Gottlieb, the interval between two cycles was extended to 4 weeks for better bone marrow regeneration and vincristine was given only once instead of twice per cycle. A total of 237 cycles of this modified CYVADIC protocol resulted in tolerable toxicity (except nausea and vomiting) and therapeutic results comparable to the original protocol (6/22 complete remissions and 6/22 partial remissions in sarcomas; 1/5 partial remission in mesotheliomas). Hematotoxicity was cumulative after 6 CYVADIC cycles. In contrast to the original Gottlieb scheme there were no severe infections such as pneumonia or sepsis. Neurotoxicity was weak and reversible; cardiotoxicity was not observed. Compared to the protocol originally suggested by Gottlieb, the modified CYVADIC regimen appears to be as effective but less toxic.
 ...
PMID:[Toxicity of the CYVADIC modification in patients with soft tissue sarcomas or malignant mesotheliomas]. 331 70

The toxicity of a new chemotherapeutic regimen for CNS tumors using eight anticancer agents administered in a 12-hour period was evaluated in 34 children with newly diagnosed and recurrent tumors treated at the Children's Hospital and Medical Center in Seattle. The chemotherapy included methylprednisolone, vincristine, lomustine (CCNU), procarbazine, hydroxyurea, cisplatin (CDDP), and either cyclophosphamide or imidazole carboximide (DTIC). The first five patients additionally received high-dose methotrexate (HDMTX), but because of excessive toxicity this was replaced by cytarabine. Of 125 courses administered without HDMTX, red cell transfusions were required in 15% of the courses and platelet transfusions were required in 8%. Hospitalization for empiric treatment of fever associated with neutropenia occurred in 6% of courses. Three episodes of documented sepsis occurred. Virtually all hematologic toxicity occurred in patients with recurrent disease. Renal toxicity occurred in 14% of patient courses. One patient died of renal failure and sepsis following therapy. Neurologic and hepatic complications were infrequent. High-frequency hearing loss above the voice range was common, but clinically significant hearing loss occurred in only three patients. Severe nausea and vomiting were infrequent. Overall, the toxicity of "eight in one" chemotherapy in newly diagnosed patients was minimal; toxicity was greater in patients with recurrent disease.
 ...
PMID:Eight drugs in one day chemotherapy in children with brain tumors: a critical toxicity appraisal. 337 69


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>