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)

Chronic neutrophilic leukemia is a rare, infrequently recognized, myeloproliferative disorder. It usually manifests as a leukemoid reaction, with mostly mature granulocytes in the peripheral blood, with rare to occasional immature forms, and sometimes with normoblasts. The clinical manifestations also include hepatosplenomegaly, elevated leukocytic alkaline phosphatase, elevated serum vitamin B12 and serum vitamin B12 binder ("R" fraction), and elevated serum uric acid. Distinction from a leukemegaly, the absence of sepsis, usually normal erythrocytic sedimentation, and the absence of fever. Leukemoid reactions may be associated with elevated serum vitamin B12 and uric acid, but the levels are usually lower than those found in chronic neutrophilic leukemia. Many patients have gouty symptoms, especially after treatment with Busulfan, and many have an unexplained hemorrhagic tendency, making major operations a risk. The authors add two cases to the 11 previously described.
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PMID:Chronic neutrophilic leukemia. Report of two cases and review of the literature. 28 88

Thirteen patients with significant hemorrhage, severe thrombocytopenia, and megaloblastic bone marrows are described. Unusual features of this problem included its acute onset, frequent absence of the typical peripheral blood changes of megaloblastic anemia, normal serum B12 levels, and serum folates which were often not clearly abnormal. Most patients were critically ill and common clinical features included reduced dietary intake, renal failure, renal dialysis, the postoperative state, and sepsis. These clinical features, the laboratory findings, and a platelet increase in most patients after folate therapy lead to the conclusion that this problem is probably due to acute folic acid deficiency. Possible explanations for the atypical laboratory findings include the acuteness of onset, recent blood transfusion therapy, and impaired folate utilization. This problem may be relatively common. Because of its potential clinical importance, rapid onset, and attendent diagnostic difficulties, prophylactic folic acid is recommended in the clinical setting described.
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PMID:Severe thrombocytopenia probably due to acute folic acid deficiency. 45 4

Immune status has been studied in the course of intensive care in 48 patients. It has been established that hemosorption may enhance already existing changes in immune homeostasis in patients with sepsis. Therefore, immunostimulating therapy with tactivin and group B vitamins (B1, B6, B12) or ultraviolet (UV) blood irradiation in combination with group B vitamins administration have been included into therapy. Simultaneous use of tactivin, group B vitamins and UV blood irradiation was not advisable due to reduction of immunostimulating effect. Consecutive use of the immunity-stimulating methods seems expedient.
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PMID:[Immunologic indices in patients with sepsis and their changes in response to complex intensive therapy]. 141

The effect of hemosorption on adrenal steroidogenic reactions has been studied in 75 patients with sepsis. Different variants of steroidogenesis optimization have been used. Hemosorption led to an increase in the level of steroid hormones, with this background retained throughout the whole treatment period. The most effective of all the variants of stress adrenal steroidogenic reactions optimization was the application of B, B1, B6, B12 vitamin complex and taktivin. The least effective was the application of B vitamin complex, taktivin and ultraviolet blood irradiation. The technique elaborated makes it possible to avoid an increase in steroid blood level during treatment, which must have a favorable effect on the recovery of immune homeostasis in the patients.
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PMID:[Optimization of the functional activity of the adrenal cortex in patients with sepsis]. 189 97

It is recognised that prolonged anaesthesia with nitrous oxide (N2O) induces megaloblastic anaemia by oxidising vitamin B12. To determine whether sepsis aggravates the effect of N2O on haemopoiesis 5 patients with severe sepsis, who required surgery and were exposed to short-term (45-105 minutes) N2O anaesthesia, were studied. None had evidence of pre-operative vitamin B12 or folate deficiency. The effect of the combination of N2O anaesthesia and sepsis on DNA synthesis in bone marrow cells was assessed morphologically, and by the deoxyuridine suppression test. In 3 patients exposed to the longest duration (75-105 minutes) of N2O, addition of folinic acid and vitamin B12 partially improved the utilisation of deoxyuridine in vitro. No patient had evidence of megaloblastic haemopoiesis as judged by bone marrow morphology. It is concluded that prolonged N2O anaesthesia in patients with severe sepsis may adversely affect DNA synthesis. Although this effect did not manifest as overt megaloblastic erythropoiesis, it may be prudent to avoid N2O in such patients.
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PMID:The effect of sepsis and short-term exposure to nitrous oxide on the bone marrow and the metabolism of vitamin B12 and folate. 239 22

Of 72 patients who underwent jejunoileal bypass because of morbid obesity, 69 could be evaluated with special reference to long-term (median 11 years) results. One of the other three had fatal anastomotic leakage, one underwent resection and reversal of shunt because of postoperative gangrene in the bypassed segment, and one died of sepsis and liver failure following cholecystectomy 6 months after bypass. The median body mass index (kg/m2) fell from 45.4 preoperatively to 33.2 after 16 years. Shunt-related complications in early and late follow-up were diarrhoea (n = 15), anal/perianal disorders (15), arthralgia (15), urinary calculi (16), cholelithiasis (5), severe flatulence (7), liver cirrhosis (5), intestinal tuberculosis (1), ileitis (1), severe electrolyte disturbance (4), hypomagnesaemia (22), hypokalaemia (8), and deficiency of vitamin B12 (24), iron (24) and folate (17). Although jejunal bypass effectively reduces weight, the patients are at continuous risk of many complications. However, the improvement in quality of life should not be underestimated.
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PMID:Jejunoileal bypass for morbid obesity. Report of a series with long-term results. 259 48

The preleukemic syndrome occurs mainly after middle age. We report 11 patients, aged 62 to 92 years, who presented with weakness, fatigue, malaise and pallor. Eight patients died; survival from the time of diagnosis was between 2 and 21 months. Two of them developed acute myelomonocytic leukemia. A third patient developed Philadelphia chromosome-negative chronic myeloid leukemia within 9 months. Serum unsaturated B12 binding capacity and transcobalamin I were elevated in this patient, preceding the transformation to chronic myeloid leukemia. Five other patients died from sepsis or pneumonia. All patients were anemic, and 10 were leukopenic. Bone marrow was hypocellular in 1 and hypercellular in 10 cases. Chromosomal studies were performed in five patients, with three showing abnormal findings: 47xx, trisomy 8 and a tetraploid karyotype 92xxyy5q-. No cytotoxic treatment should be given during the preleukemic phase until transformation to acute leukemia occurs. Since preleukemic patients are very susceptible to infections, early diagnosis of the condition is important, as is supportive care in the case of surgery.
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PMID:Preleukemic syndrome in elderly patients--report of 11 cases. 385 73

The incidence of malnutrition and the effect of hospitalization was evaluated in 100 consecutive admissions to the Clinical Pathology R Department of the University of Genoa. Nutritional deficiencies were evaluated at the time of admission and discharge from the Hospital, among patients hospitalized 2 weeks or longer, using the following nutrition-related parameters: body fat, muscle proteins, weigh, rate of weight loss plasma proteins level, vitamin B12 and folic acid plasma level, plasma iron and ferritin. We also considered the nutritional alterations in malnourished patients with relation to appetite decrease and to pathological status. At the admission to the hospital, the findings showed a high incidence (79%) of alterations in some nutritional parameters. In patients with nutritional impairments we observed a worsening of most of the nutritional parameters during hospitalization, especially in patients with severe appetite decrease and those affected by sepsis, neoplastic, gastric and renal diseases.
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PMID:Hospital malnutrition: incidence and prospective evaluation of general medical patients during hospitalization. 653 69

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

Various nutritional disorders can occur in patients with advanced or recurrent carcinoma of the gastrointestinal tract due to the disease itself or the absence of the organs after surgery. Routine parenteral nutrition for cancer patients who undergo chemotherapy results in no benefit and troublesome complications such as catheter sepsis. Consequently, it is important to provide sufficient and proper specialized nutritional support to patients who need it, taking into account the pathologic status resulting from malignant disease. Patients with advanced or recurrent carcinoma of the gastrointestinal tract are likely to be deficient in folate and/or vitamin B12 for various reasons. Neurological disorders in vitamin B12 deficiency should worsen when folate is administered without supplementation of vitamin B12. This phenomenon should be avoided when 5-fluorouracil is used with reduced folate in cancer chemotherapy. The indications for specialized nutritional support for patients with advanced or recurrent carcinoma of the gastrointestinal tract are the same as for malnourished patients without cancer. The initial dose and formula of nutrition for cancer patients with malnutrition and various metabolic disorders should be calculated to avoid overloading. The oral intake of normal food is desirable for such patients. The placement of a central venous catheter to prevent the toxicity of chemotherapy or for venous access is contraindicated. Jejunal feeding or percutaneous endoscopic gastrostomy is performed in patients who cannot eat even a liquid diet. Total parenteral nutrition should be introduced when these accesses cannot be used. If any bowel obstruction occurs in the small intestine and/or colon, it is necessary to discuss the efficacy of surgery to resolve the obstruction.
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PMID:[Specialized nutrition support for the patients with advanced or recurrent carcinoma of the gastrointestinal tract]. 1502 66


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