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)

Chronic bacterial tonsillitis can be validly supported etiologically by quantitative bacteriologic methods. The following observations are based on a recognition that the mere presence of bacteria is much less significant than the level of bacteria present. The chronically infected adult patient may be characterized by tonsils subclinically harboring greater than 10(5) bacteria/gm as opposed to the control patient with 10(3) bacteria/gm. Useful features in predicting high bacterial levels are (1) low number of crypts, (2) presence of nodal hypertrophy, and (3) tonsils small by actual size. Estimated tonsil size, determined preoperatively, shows no statistically significant correlation with either actual size or degree of tonsil sepsis.
 ...
PMID:Chronic bacterial tonsillitis: fact or fiction. 11 43

The occurrence of sepsis due to Streptococcus pneumoniae and Hemophilus influenza and of herpes zoster (HZ) was reviewed in a series of 72 consecutive, previously untreated children and adolescents with Hodgkin disease. There was not a statistically significant difference in the risk of developing sepsis within five years of diagnosis between patients who had (16.6%) or had not (6.2%) undergone splenectomy. Sepsis occurred most frequently among patients treated initially with total nodal irradiation and combination chemotherapy. The estimated risk of HZ during the first five years after diagnosis was 34%. Patients treated initially with irradiation and combination chemotherapy had a significantly greater risk of developing HZ than patients treated initially with only irradiation (P less than 0.05). Although trends were present which suggested that splenectomy and the extent of disease at diagnosis may influence the occurrence of HZ, these did not achieve statistical significance. Survival was not influenced by the occurrence of HZ.
 ...
PMID:The incidence of post-splenectomy sepsis and herpes zoster in children and adolescents with Hodgkin disease. 31 50

Of 14 splenectomized patients with Hodgkin's disease who were treated with total nodal irradiation and combination chemotherapy (MOPP), fulminant sepsis developed in three (21.4 per cent) while they were in remission; two died within hours. Similar cases were not observed in a larger group of 146 patients with Hodgkin's disease (including 104 splenectomized patients who were treated less intensely). Our experience indicates the need for caution when asplenic persons are aggressively treated with both radiation and drugs.
 ...
PMID:Fulminant sepsis after the successful treatment of Hodgkin's disease. 40 71

Nineteen patients aged 1 month to 18 years underwent implantation of a cardiac pacemaker and were followed up for up to 9 years (average duration of pacing 54 months). Complete heart block was present in 16 patients and sinus nodal dysfunction in 3. Heart block was presumably of congenital orgin in eight, secendary to cardiac surgery in seven and subsequent to cardiac catheterization in one. Sinus nodal dysfunction was of presumed congenital origin in one and occurred after cardiac surgery in two. Pacing was required because of syncopal attacks in eight patients, three of whom had congestive heart failure or low cardiac output on physiologic studies. It was required in four because of congestive heart failure, in two because of low cardiac output (one with a wide QRS complex), and in five for postoperative rhythm control. With return of sinus rhythm after 2 and 3 months, respectively, pacing was discontinued in two patients. One child was partially corrected disease died within 3 months, one died of wound breakdown and sepsis after 10 months of pacing and one died suddenly 4 years after implantation. All others have returned to normal activity; only one requires cardiac medication. The degree of emotional stability has been striking. Asynchronous and atrial synchronous pacing are of equal therapeutic value. The very small radiofrequency implanted receiver has been useful in younger children. The major problems have been caused by the large size and short longevity of the generators and the child's growth stressing the lead system. Transvenously implanted pacemakers have presented no greater management problems than those placed during thoracotomy.
 ...
PMID:Cardiac pacing in children and adolescents. 84 40

Lymphadenopathy is an uncommon finding in hairy cell leukaemia (HCL). We report 12 HCL patients in whom relapse was associated with massive abdominal lymphadenopathy. All but one had long-standing HCL (range 3-25 years; median 10 years); in one it was discovered at presentation. Nine patients had been splenectomized and seven had previously been treated with 2'deoxycoformycin (DCF) and/or alpha-interferon (alpha IFN): three had achieved complete remission and four a partial response. The computerized tomography (CT) scan appearances were similar in all cases with a primary lymph node mass centred around the coeliac axis and involving upper para-aortic and retropancreatic regions. Histology and/or cytology confirmed nodal involvement by HCL in six patients. Large immature hairy cells were seen in both lymph nodes and bone marrow, suggesting a degree of transformation. Nine patients were treated with DCF: one had complete resolution, six responded with 50-90% reduction of the lymphadenopathy, one did not respond and one is still on treatment; alpha-IFN was used concomitantly or sequentially in two of the responders. One responding patient died of sepsis after four injections of DCF. Three patients received either alpha- or beta-IFN alone with no response. One elderly patient was not treated. Abdominal lymphadenopathy could be part of the natural history of HCL and/or may represent a transformation analogous to that seen in other low-grade lymphoproliferative disorders. Routine abdominal CT scanning should be part of the work up of all patients with HCL.
 ...
PMID:Massive abdominal lymphadenopathy in hairy cell leukaemia: a report of 12 cases. 128 78

To determine the extent of progress in the treatment of sacrococcygeal teratomas (SCTs), we evaluated the experience with 73 patients over 40 years. The medical records of the children were reviewed for demographics, histology, clinical course, and outcome. Therapy differed depending on the type of SCT, histology, and decade of diagnosis. The female:male ratio was 4.2:1 and did not vary significantly with the histology of the tumor. Fifty-seven patients presented with benign disease. There were five recurrences in this group, only one of which did not have an initial coccygectomy. One tumor, originally thought to be benign with immature elements, had a local recurrence at 7 months, 10 months, and 16 months after the original operation and was discovered to have embryonal carcinoma with nodal involvement. This child was treated with chemotherapy and is disease-free at 7 years. Morbidity in the benign group included 3 postoperative wound infections. Three infants died, one before operation with beta-hemolytic Streptococcus sepsis. Two neonates died in the early postoperative period, one on day 1 with a ruptured subcapsular hematoma of the liver, and the second on day 2 with disseminated intravascular coagulation/sepsis. Benign SCT occurs at a younger age than malignant tumors. The average age of presentation of benign tumors is 20 days versus 468 days in children with malignant disease. The technique of wide resection of benign lesions with coccygectomy is helpful in preventing recurrence and has changed little over the last four decades. Malignant SCT occurred in 16 children (22%).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Sacrococcygeal teratoma: the experience of four decades. 140 40

Twenty patients with relapsed Hodgkin's disease have been treated with a weekly regimen of chemotherapy (VAPEC-B) comprising Adriamycin 35 mg/m2 i.v. weeks 1, 3, 5, 7, 9, 11; cyclophosphamide 350 mg/m2 i.v. weeks 1, 5, 9; etoposide 100 mg/m2 p.o. daily for 5 days, weeks 3, 7, 11; vincristine 1.4 mg/m2 i.v. weeks 2, 4, 6, 8, 10; bleomycin 10 mg/m2 i.v. weeks 2, 6, 10 and prednisolone 50 mg p.o. daily weeks 1-5, 25 mg p.o. daily weeks 6-11. All had previously received an Adriamycin containing combination and in nine cases this was for relapse following MVPP. In all but one case relapse occurred less than one year after the completion of previous treatment and in 14 cases, disease recurred within 24 weeks. Thirteen patients had extra-nodal involvement. Following six weeks of treatment 14 patients had responded (6 CR; 4 CR, uncertain; 4 PR), four had stable disease, one had progressed and one had died of sepsis. Fourteen patients proceeded to high dose cyclophosphamide and BCNU with autologous bone marrow rescue and seven of these are progression free between 4 and 156 weeks later. High dose therapy was not possible in five patients, three of whom achieved CR. Of these, two (one with bulky nodal disease and skin infiltration; one with extensive bone marrow involvement) are alive and relapse free without further treatment at 95 and 114 weeks. Overall, the regimen was well tolerated but haematological toxicity was moderate or severe in ten patients and four were admitted to hospital for treatment of suspected or confirmed septicaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Treatment of relapsed Hodgkin's disease using a weekly chemotherapy of short duration: results of a pilot study in 20 patients. 191 58

Four hundred fifteen patients with early-stage cervical carcinoma were explored via a transperitoneal approach for radical hysterectomy at the Hospital of the University of Pennsylvania between January 1, 1960, and December 31, 1985. Twenty-four of these patients were found to have histologic documentation of para-aortic lymph node metastases. Twenty-one patients (88%) were treated primarily with extended-field radiotherapy. Forty-eight percent of these patients have survived greater than 5 years from diagnosis. Six patients have been followed more than 10 years after initial treatment. All six are alive although one patient has recurrent disease that was diagnosed at 164 months. Patients with adenocarcinoma or adenosquamous carcinoma had a survival significantly lower than that of those with squamous cell cancers (p = 0.022). Complications included one treatment-related death from multiple fistulas and sepsis, one vesicovaginal fistula, two enteric fistulas, and two small bowel obstructions. The major morbidity rate was 19%. Extended-field radiation is effective therapy for para-aortic nodal metastasis associated with early-stage squamous cell carcinomas of the cervix but carries a considerable morbidity rate. Other modalities such as combined chemotherapy and radiation may be necessary for adenocarcinoma.
 ...
PMID:Extended-field radiation therapy in early-stage cervical carcinoma: survival and complications. 195 88

Complete data concerning long-term results of transcatheter electrical ablation of the atrioventricular junction is not available. At the request of the French Cardiac Arrhythmia Working group we undertook an inquiry in October 1983. All centers potentially able to perform such procedures were asked to report their experience. Eight centers have performed one case or more, over a period of 3 years, for a total of 91 patients. The mean follow-up completed in all patients in April 1986 was 12 +/- 10 months. The procedure was indicated for a supraventricular arrhythmia resistant to a mean of 3.9 +/- 1.3 classes of antiarrhythmic agents. Atrial flutter or fibrillation in 54 (59%) and atrioventricular nodal reentry in 17 (18%) were the most common arrhythmias. A mean of 2.6 +/- 2.3 electrical shocks (range 1-14 shocks) with a stored energy of 130-400 joules was delivered during 1-5 sessions. Complete heart block was obtained in 83 patients and persisted at the time of discharge from the hospital in 46 patients (50.5%). The immediate complication (within 24 hours after the procedure) included ventricular fibrillation successfully converted (one patient) and nonsustained ventricular tachycardia (three patients). Late complications included one death 3 days after the procedure, in a patient in whom sustained ventricular tachycardia was documented, nonsustained ventricular tachycardia in two patients, sepsis in three patients and pericardial effusion in one patient. At the time of the follow-up, there were three additional deaths related to sepsis due to pacemaker pocket infection in one patient and to preexisting congestive heart failure in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Long-term follow-up of atrioventricular junctional transcatheter electrical ablation. 245 67

Staging laparotomy in patients with Hodgkin's disease continues to be a controversial procedure in their management. Between 1970 and 1986, 67 patients up to 18 years of age were seen with Hodgkin's disease. The results of staging laparotomy performed on 39 of these children are reviewed. The clinical stage was changed as a result of laparotomy in 43.6% of cases, with 12.8% of cases upstaged and 30.8% of cases downstaged. All changes in stage modified the proposed treatment for the patient. In 20.5% of patients the laparotomy was positive, and in all cases the spleen was involved. Preoperative lymphangiography did not accurately identify nodal disease. Of the patients with negative laparotomies, 10% developed relapse in the abdomen. Major complications included three episodes of bacterial sepsis, with one death due to Streptococcal pneumonia and one to Neisseria gonorrhea. All septic events occurred prior to the use of pneumococcal vaccine and prophylactic antibiotics. One patient required reoperation for intestinal obstruction with bowel resection. None of the currently used noninvasive tests accurately identifies intraabdominal disease. Therefore, staging laparotomy continues to play an important role in the early management of Hodgkin's disease.
 ...
PMID:Staging laparotomy for Hodgkin's disease in children. 317 39


1 2 3 4 5 Next >>