Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
Collection
Publisher
Years
  • 1
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Bien qu'un seul antibiotique avec un large spectre couvrant les germes aérobies et anaérobies soit reconnu comme efficace dans l'appendicite, beaucoup de chirurgiens continuent d'utiliser une polyantibiothérapie. Dans un essai contrôlé en double aveugle, nous avons testé la corrélation clinique avec la sensibilité in vitro d'une association de plusieurs antibiotiques comme traitement complémentaire chez 114 patients ayant eu une appendicite compliquée. Quatre-vingt pour-cent (36/40) des patients ayant eu du céfotétan et 86% (31/36) des patients ayant eu l'association clindamycine/amikacíne n'ont pas eu de complications infectieuses postopératoires (p=0.11). II a été nécessaire de changer les antibiotiques en raison d'une complication postopératoire plus souvent chez les patients ayant eu l'association clindamycine/amikacine, 5 (12%) comparé à 1 (2%) dans le groupe céfotétan (p=0.07). On a identifié des organismes Bacteroides fragilis résistants au céfotétane mais aucun n'était responsable d'infection postopératoire. II y a eu des effets secondaires non désirables, essentiellement une perturbation des tests de la fonction hépatique, chez 28% et chez 26% des patients ayant pris respectivement du céfotétane et l'assocíation clindamycine/amikacine, respectivement. Une monothérapie avec une céphalosporine de deuxième génération du type céfotétan, donnée deux fois par jour, est ffficace et économique dans le traitement de l'appendicite compliquée mais opéréc. Les aminosides et les autres antibiotiques plus puissants doivent être réservés pour les germes résistants ou les infections nosocomiales.
    Abstract: Resumen Aunque los antibióticos únicos de amplio espectro de cobertura aeróbica y anaeróbica son eficaces en la apendicitis, muchos cirujanos continúan utilizando agentes múltiples. Se diseñó un ensayo clínico prospectivo, doble ciego y aleatorizado con el fin de correlacionar la susceptibilidad in vitro de agentes antimicrobianos múltiples como terapia adyuvante en el manejo de 114 pacientes sometidos a operación por apendicitis complicada. 90% (36/40) de los pacientes en el Grupo de cefotetan y 86% (31/36) en el Grupo que recibió clindamicina/amikacina tuvieron resolución clínica de sus infecciones intraabdominales sin recurrencia de complicaciones sépticas postoperatorias (P=0.11). El número de pacientes que tuvieron cambio en la terapia antibiótica por complicaciones postoperatorias fue más alto en el Grupo clindamicina/amikacina, 5 (12%) comparados con 1 (2%) en el Grupo cefotetan (P=0.07). Aunque se identifícaron microorganismos del Grupo de los Bacteroides fragilis resistentes a cefotetan, ninguno fue responsable de infecciones postoperatorias. Se presentaron reacciones farmacológicas adversas en 28% del Grupo cefotetan y en 26% del Grupo clindamicina/amikacina, las cuales consistieron primordialmente en elevaciones pasajeras de los valores de las pruebas de función hepática. La monoterapia con una cefalosporina de amplio espectro de segunda generación, tal como el cefotetan, administrado en dos dosis diarias constituye un régimen económico y eficaz en la apendicitis complicada en la cual la cirugía representa el tratamiento definitivo. Los aminoglucósidos y otros agentes antimicrobianos más potentes deben ser reservados para el tratamiento de infecciones nosocomiales por microorganismos resistentes.
    Notes: Abstract Although single antimicrobials with broad-spectrum aerobic and anaerobic coverage are effective in patients with appendicitis, many general surgeons continue to use multiple agents. A prospective, doubleblind, randomized trial was designed to detect any clinical correlate of in vitro susceptibility advantage of multiple antimicrobials as adjunctive therapy for 114 patients undergoing operation for complicated appendicitis. There was clinical resolution of intraabdominal infections with no occurrence of postoperative infectious complications in 90% (36 of 40) of the cefotetan group and 86% (31 of 36) of the clindamycin/amikacin group (p=0.11). The number of patients who had changes in antibiotic therapy due to postoperative complications was higher in the clindamycin/amikacin group: five (12.5%), compared to one (2.8%) in the cefotetan group (p=0.07). Although Bacteroides fragilis group organisms resistant to cefotetan were identified, none was responsible for the postoperative infections. Adverse drug events in 28% of the cefotetan group and 26% of the clindamycin/amikacin group consisted primarily of transient elevations of liver function tests. Monotherapy with a second-generation, broad-spectrum cephalosporin, such as cefotetan, given twice a day is an economical and effective adjunctive regimen in patients with complicated appendicitis for which operation is the definitive treatment. Aminoglycosides and other, more potent antimicrobials should be reserved for resistant organisms or nosocomial infections.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: t -test was used to compare groups. Primary and secondary patency rates at 1 year were 43% and 64%. Venous line pressures tended to rise over time. Recirculation values and blood flow rates during dialysis showed no correlation to graft patency. These results show that ePTFE provides a suitable secondary choice for vascular access for end-stage renal disease patients in whom an autogenous fistula is not possible. Thrombosis and anastomotic stenosis are common and should be aggressively identified and treated to prolong overall graft survival.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1573-7373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a murine model system, pyridoxine has demonstrated protective properties during administration of lethal doses of vincristine (VCR). Subsequently, pyridoxine has been evaluated in patients receiving VCR during an adjuvant chemotherapy program for stage II carcinoma of the breast. The toxicities, cumulative VCR dosage, and percentage of ideal dosage observed in 24 patients receiving pyridoxine have been compared to those observed in 88 patients who previously received VCR without pyridoxine in the same chemotherapy program. All patients ideally were to receive VCR 1.0 mg/m2 weekly for 6-weeks with dose modification for neurotoxicity. Treatment patients received pyridoxine 1.5 grams p.o. daily in three divided doses during the 6-week course. The degree of neurotoxic manifestations of VCR was similar in the treatment and comparison patients. Absent to mild neurotoxicity was observed in approximately 70% of patients in both groups; moderate or greater neurotoxicity occurred in about 30% of patients in both groups. Full dosage (6.0 mg/m2) was attained in 8 (33%) treatment patients and 18 (24%) comparison patients (p=0.28). The mean percentage of ideal dosage of VCR was 84.6±10.8 in patients receiving pyridoxine and 81.9±21.6 in those given only VCR (p=0.59). Gastrointestinal and hematologic toxicities were similar in both groups. Pyridoxine in this dose and schedule afforded no protection from the neurotoxic side effects of VCR.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...