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At least 901 records · Page 50Linked to original sources
PubMed1997

Improvement of host response to sepsis by photobiomodulation.

BACKGROUND AND OBJECTIVE: Late sepsis causes immunosuppression and is associated with energy depletion in lymphocytes. Adjuvant treatment with ATP-MgCL2 appears to improve cellular energetics and decrease mortality. Laser irradiation can promote cell proliferation and increase cellular ATP synthesis, which may improve the host immune response in sepsis. The purpose of this study was to determine whether laser irradiation (LI) has a stimulatory effect on the immune response in sepsis using an animal model. STUDY DESIGN/MATERIALS AND METHODS: The cecal ligation and puncture (CLP) rat model was used. Thirty-six SD rats were divided equally among four groups: control (nonoperative), sham operation, CLP treated with laser irradiation, and CLP without laser irradiation. The peritoneal cavity of each animal in CLP/laser group was irradiated immediately after CLP using an Argon-dye laser at a wavelength of 630 nm and at a fluence of 5 J/cm2. Some animals were euthanized 24 hr following CLP and were used to evaluate the immune response (lymphocyte proliferation). In a separate experiment, the survival of septic rats was observed for 60 days. Lymphocytes isolated from normal rat spleens were used to observe for biostimulatory effects in vitro. RESULTS: LI significantly improved ex-vivo lymphocyte proliferation of cells from septic rats (179.7 +/- 17.2 vs. 129.5 +/- 7.8; P < 0.01) and enhanced survival in septic rats (79% vs. 42%; P < 0.001). LI significantly stimulated lymphocyte proliferation in the presence of mitogenic stimuli and enhanced lymphocyte ATP synthesis (P < 0.05). CONCLUSION: LI improves the host immune response and survival rate in sepsis in an animal model. Our studies suggest that LI may be useful as an adjuvant therapy for sepsis.

Adenosine Triphosphate↗
PubMed1997

Acute lymphoblastic leukemia presenting with typhlitis.

We report an unusual case of acute lymphoblastic leukemia (ALL) that presented as right lower quadrant pain in a 17-year-old boy. Ultrasonographic findings were consistent with typhlitis. The clinical and imaging symptoms resolved upon treatment with antibiotics and conservative care, only to recur after initiation of chemotherapy. Familiarity with the clinical presentation and imaging findings of typhlitis is important for its correct diagnosis and management.

Adolescent↗
PubMed1997

Abdominal ultrasound findings during and after treatment of childhood acute lymphoblastic leukemia.

BACKGROUND: The treatment of acute leukemia in childhood has been increasingly successful. Concurrently, severe leukemia-related gastrointestinal complications have become more common. METHODS: We evaluated the findings of the abdominal ultrasound (US) examinations of 52 children with acute lymphoblastic leukemia (ALL) who had severe clinical symptoms indicating infection or abdominal complication during chemotherapy treatment or after the cessation of such treatment and assessed the impact of these findings on patients' subsequent treatment and survival. RESULTS: Our study presents ten cases of typhlitis with a prevalence of 9%, all of which were rapidly diagnosed by US and had a favourable outcome. We also found focal intra-abdominal parenchymal lesions in six children, five of them due to fungal infection and one due to leukemic infiltration. Several other intra-abdominal pathologies significant for the patients' treatment are also reported. DISCUSSION: We believe that abdominal US is a useful, rapid, safe, and accurate imaging method for children with ALL suspected to suffer from leukemia- or chemotherapy-related gastrointestinal complications. More invasive imaging methods are seldom needed. CONCLUSIONS: According to our results, abdominal US gives the necessary information in most of the cases and provides prompt diagnosis, which may prevent possible fatal complications.

Abdomen↗
PubMedDate not supplied

Sonographic diagnosis of intussusception of the appendix vermiformis.

We present 2 cases of intussusception of the appendix vermiformis (IAV) in children. Sonographic examination demonstrated a lead point within a characteristic multiconcentric ring sign, and longitudinal sonograms showed the inverted appendix protruding into the cecal lumen. A contrast-enema study, using a water-soluble contrast medium, was performed in each case, and a "coiled-spring" sign or "spiral shell" appearance confirmed the diagnosis. A surgical reduction of the appendix and an appendectomy were performed in each case.

Appendectomy↗
PubMedDate not supplied

Gray-scale and color Doppler sonographic diagnosis of epiploic appendagitis.

Depending on its location, epiploic appendagitis may mimic nearly any acute abdominal condition. We present the case of a patient with left lower quadrant pain. Sonography demonstrated an ovoid, hyperechoic, noncompressible lesion at the point of tenderness but no inflammatory changes in the adjacent colonic wall. Color Doppler sonography showed no flow in the lesion. Based on the sonographic diagnosis of epiploic appendagitis, conservative treatment was given, with complete recovery in 5 days. Awareness of these sonographic findings may aid in the early diagnosis of epiploic appendagitis and avoid unnecessary treatment.

Abdominal Pain↗
PubMed1979

Typhlitis in acute leukemia: successful treatment by early surgical intervention.

Inflammation of the cecum ("typhlitis") has been an unusual, but generally fatal complication of severe granulocytopenia and immunosuppression, occurring during the therapy of hematological malignancies. The diagnosis has usually been made only at autopsy, and early surgical intervention has often been withheld because of the patient's precarious hematological status. We report here a patient in whom the clinical diagnosis of typhlitis led to early operation, with intensive blood component support. The successful outcome suggests that such an approach might improve the usually grim prognosis in patients whose underlying malignancy offers a clear chance for remission.

Agranulocytosis↗
PubMed1990

Typhlitis. An 18-year experience and postmortem review.

A review of pediatric autopsy results at the Texas Children's Hospital, Baylor College of Medicine from 1970 through 1987 was conducted. Thirty-three cases of typhlitis were identified in patients with acute leukemia and two cases each in patients with lymphoblastic lymphoma and aplastic anemia. Patients ranged in age from 10 months to 17 years. Fifty-seven percent were male and 43% were female. All were myelosuppressed. A postmortem incidence rate of 24% was determined for patients with acute leukemia. Common symptoms included abdominal pain and distention in 78% of patients and acute lower gastrointestinal bleeding in 35%. Abdominal radiographs varied in spectrum from a nonspecific bowel gas pattern to frank right colonic pneumatosis intestinalis. Thirty-three patients received chemotherapy within 30 days before onset of abdominal symptoms. All patients were febrile (greater than 38.5 degrees C), and 33 received broad-spectrum antibiotics. Three patients received amphotericin B. Premortem, 84% of organisms cultured from blood were bacterial whereas 16% were fungal. Fungal pathogens accounted for 53% of new microorganisms seen at autopsy. Postmortem examination showed typhlitis in the following anatomic distributions: (1) confined to the cecum; (2) involving the cecum and ileum; (3) involving the cecum, ileum, and ascending colon; or (4) involving the cecum, with sporadic ulcers throughout the intestine. This review includes clinical and postmortem features of typhlitis and current strategies for diagnosis and management.

Adolescent↗
PubMed1993

Typhlitis resulting from treatment with taxol and doxorubicin in patients with metastatic breast cancer.

BACKGROUND: Typhlitis is being recognized with increasing frequency as a serious complication of aggressive chemotherapy for hematologic and solid malignancies. METHODS: In this report the authors describe two cases of typhlitis in patients with metastatic breast cancer treated with taxol and doxorubicin. RESULTS: Both cases occurred during the first cycle of treatment with taxol (180 mg/m2) and doxorubicin (75 mg/m2), being given simultaneously as 72-hour continuous intravenous infusions. CONCLUSION: Two cases of typhlitis have occurred after combined treatment with taxol and doxorubicin, while typhlitis has not been described after treatment with either drug alone.

Adult↗