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sepsis acid base history

J Simar, L Belkhir, B Tombal, E André
BACKGROUND: Adjuvant therapy with bacillus Calmette-Guerin (BCG), a live attenuated strain of Mycobacterium bovis, has become the treatment of choice for low-risk superficial bladder carcinoma following transurethral resection of the bladder. Complications following vesical BCG instillations are uncommon but, in some cases, severe side-effects can occur such as sepsis or mycotic aneurysm. Besides usual laboratory techniques used for the diagnosis of Mycobacterium tuberculosis complex (MTBC) infections (smear microscopy and cultures), commercial immunochromatographic assays detecting MBP64, a 24 kDa M...
January 26, 2017: BMC Research Notes
Jonathan A Becker, Jennifer P Daily, Katherine M Pohlgeers
Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities. A delay in diagnosis and treatment, particularly in septic arthritis, can have catastrophic results including sepsis, bacteremia, joint destruction, or death. The history and physical examination can help guide the use of laboratory and imaging studies...
November 15, 2016: American Family Physician
Martin Christensen, Fiona Chen
INTRODUCTION: The admission to the intensive care unit with a diagnosis of sepsis and/or septic shock is not uncommon. The aim of this article is to present a nursing case review of a patient admitted to the intensive care unit with a diagnosis of septic shock and the use of bedside acid-base formulae to inform clinical decision making. METHOD: We chose to use a case review. This method is useful in reporting unusual or rare cases and is typically seen more in medicine than in nursing...
April 2013: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Dolunay Gülmez, Sehnaz Alp, Arzu Topeli İskit, Murat Akova, Gülşen Hasçelik
Fusobacterium necrophorum is a non-spore-forming gram-negative anaerobic bacillus that may be the causative agent of localized or severe systemic infections. Systemic infections due to F.necrophorum are known as Lemierre's syndrome, postanginal sepsis or necrobacillosis. The most common clinical course of severe infections in humans is a progressive illness from tonsillitis to septicemia in previously healthy young adults. A septic thrombophlebitis arising from the tonsillar veins and extending into the internal jugular vein leads to septicemia and septic emboli contributing to the development of necrotic abscesses especially in lungs and other tissues such as liver, bone and joints...
October 2011: Mikrobiyoloji Bülteni
Mateus Demarchi Gonsalves, Yasser Sakr
Early diagnosis is crucial to reduce morbidity and mortality from sepsis. Clinical suspicion is the first step to diagnosis, and necessitates meticulous history taking and complete clinical examination. Special attention should be paid to identifying foci of infection. Biomarkers of host response-including acute phase proteins, procalcitonin, and various cytokines-may be useful in the diagnosis and management of patients with sepsis. Rapid and reliable detection of pathogens and their antibiotic susceptibility patterns is also of utmost importance...
September 2010: Current Infectious Disease Reports
Walid Baz, Raymond El-Soueidi, Fadi Nakhl, Nelly Aoun, Nena Chin, Meeko Dhar
Desmoplastic small round-cell tumor is an uncommon, highly aggressive tumor with a predilection for pediatric age groups and young adults. It is very unusual in the elderly population. Although Agent Orange has been associated with soft-tissue sarcoma, an association with desmoplastic small round-cell tumor has not been reported. A 52-year-old male presented with abdominal distention, dyspnea, and a 9 kg weight loss. Prior history was significant for hepatitis C and diabetes. He was a Vietnam veteran and he admitted being exposed to Agent Orange...
June 2010: Japanese Journal of Clinical Oncology
Tansu Sipahi, Ayça Kuybulu, Aysenur Ozturk, Nejat Akar
The aim of the study is to investigate whether the presence of a protein Z polymorphism is a risk factor for the development and outcome of sepsis. Sepsis is a clinical syndrome characterized by the presence of systemic signs and symptoms of inflammation. When sepsis leads to organ failure, the term severe sepsis and septic shock is used. The genetic causes of severe sepsis are not fully explained. Protein Z is a vitamin K- dependent glycoprotein and a member of the coagulation cascade. The study included 53 patients with severe sepsis and 70 control healthy volunteers without a familial history of thrombosis...
June 2010: Clinical and Applied Thrombosis/hemostasis
Albert R Zink, Waltraud Grabner, Andreas G Nerlich
We describe the molecular identification of the M. tuberculosis complex DNA in bone tissue samples from recent and historic populations. In a first set, archival paraffin material from vertebral bodies of 12 recent cases with clinically/microbiologically proven tuberculosis was compared to 12 further cases without tuberculosis. While eight TB cases revealed a specific mycobacterial amplification product, none of the controls was positive. Interestingly, one case with tuberculous sepsis (Landouzy sepsis), five cases with tuberculous spread beyond the primarily affected organ (i...
January 2005: American Journal of Physical Anthropology
Claude Bachmann
UNLABELLED: With regard to the principles established for neonatal population screening, the question arises whether for patients with urea cycle disorders there is an accepted treatment which really affects the disease course and prognosis as compared to the natural history of these diseases. A retrospective study of 88 patients was performed. Based on questionnaires, the survival rate and neurodevelopmental outcome of patients treated with protein restriction alone was compared to the new therapy introduced in the 1980s with added citrulline/arginine, essential amino acids for improving the amino acid composition of the restricted natural protein and benzoate...
December 2003: European Journal of Pediatrics
Peter Faybik, Hubert Hetz, Claus-Georg Krenn, Amir Baker, Peter Germann, Gabriela Berlakovich, Rudolf Steininger, Heinz Steltzer
Acute liver failure (ALF) is a rare clinical syndrome associated with a mortality of up to 80% and its management remains an interdisciplinary challenge. Despite recent improvements in intensive care management, the mortality of patients with ALF remains high and is related to complications such as cerebral edema, sepsis and multiple organ failure. Emergency orthotopic liver transplantation (OLT) is currently the only effective treatment for those patients who are unlikely to recover spontaneously. Nevertheless, OLT is not always possible because of the shortage of the organs and/or complications related to ALF...
September 15, 2003: Wiener Klinische Wochenschrift
D A Moneret-Vautrin
The necessity to optimise the management of atopic dermatitis of infants needs knowledge of three components: increase of prevalence, extreme frequency of food allergy and increase in the frequency of the syndrome of multiple allergies, that frequently develops into asthmatic disease. Management of DA in infancy (first year of life) is based on the global strategy of understanding the physiological Th2 polarisation at birth, that does not allow a re-equilibration of the Th1-Th2 balance that progresses in the first six months of life (in normal infants) making in this period a window of opportunity for sensitizations...
November 2002: Allergie et Immunologie
Leandro Cordero, Christopher J Timan, Heather H Waters, Larry A Sachs
OBJECTIVE: To determine mean arterial pressure values during the first 24 hours for "stable" and "unstable" extremely low birth weight (ELBW) infants and to ascertain its association with perinatal factors. BACKGROUND: In ELBW infants, hypotension is diagnosed by nonspecific clinical signs together with reference arterial pressure values extrapolated from regression models or from scarce actual observations. DESIGN: Retrospective cohort study...
July 2002: Journal of Perinatology: Official Journal of the California Perinatal Association
M D Fabrizio, M B Chancellor, D A Rivas, M D Richard, C M Intenzo
PURPOSE: We attempted to differentiate pyelonephritis, defined as upper urinary tract parenchymal infection, from fever due to other sources in patients with spinal cord injury by radioisotope renal scintigraphy. MATERIALS AND METHODS: A total of 13 consecutive spinal cord injury patients 21 to 54 years old (level of injury C4 to cauda equina) was hospitalized with urosepsis. The diagnosis was based on medical history, physical examination and laboratory evaluation, including blood, urine, sputum and wound fluid culture and sensitivity, and a 99mtechnetium glucoheptonate renal scan for pyelonephritis...
November 1996: Journal of Urology
P W Stacpoole, E C Wright, T G Baumgartner, R M Bersin, S Buchalter, S H Curry, C Duncan, E M Harman, G N Henderson, S Jenkinson
STUDY OBJECTIVE: To determine the pathogenesis and clinical course of lactic acidosis in adults receiving standard medical care. DESIGN: Placebo arm of a 5-year prospective, randomized, blinded study comparing placebo and dichloroacetate as specific lactate-lowering therapy. Each patient received intravenous saline placebo in addition to conventional therapy. SETTING: Intensive care units of 10 tertiary care hospitals in North America. PATIENTS: One hundred twenty-six patients with lactic acidosis, defined as arterial blood lactate greater than or equal to 5 mmol/L and either arterial pH of less than or equal to 7...
July 1994: American Journal of Medicine
R S Koff
The diagnosis of acute viral hepatitis is based on a thorough history (with a detailed review of possible modes of transmission), consistent physical findings (in which stigmata of chronic liver disease are absent), and laboratory tests confirming the presence of acute hepatocyte damage. Specific etiologic entities can be identified by serologic testing. In some cases, infection by more than one hepatitis virus may be revealed. The occurrence of HBV/HDV coinfection may lead to typical, uncomplicated acute hepatitis...
November 15, 1987: Hospital Practice
K D Wrenn, C M Slovis, G E Minion, R Rutkowski
PURPOSE: To further elucidate the clinical spectrum of alcoholic ketoacidosis (AKA). PATIENTS AND METHODS: A case series of 74 patients with AKA defined as a wide anion gap metabolic acidosis unexplained by any other disorder or toxin, including any patient with a history of chronic alcohol abuse. The setting was the Medical Emergency Department at Grady Memorial Hospital in Atlanta, Georgia, a university-affiliated inner-city hospital. RESULTS: AKA is a common disorder in the emergency department, more common than previously thought...
August 1991: American Journal of Medicine
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