|
|
|
|
|
|
Scand J Infect Dis Suppl, 1980, Suppl 23, 181 - 5 Netilmicin therapy of patients with septicaemia and other severe infections; Brandenhoff P et al.; 25 patients were treated with netilmicin because of suspected or verified septicaemia or other severe infections . Netilmicin was administered intramuscularly in a dose of 2 mg/kg body weight every 8 hours . For patients with elevated plasma creatinine the dosage was reduced according to the degree of elevation . Average length of treatment was 7 days (3-12 days) . In 22 patients all symptoms and signs of infection disappeared . In one patient antibiotic treatment had to be changed and in two patients abscesses had to be surgically drained . Kidney function was monitored during and after treatment by plasma creatinine measurements and 51Cr-EDTA clearance . Netilmicin was discontinued in 4 patients because of an increase in plasma creatinine but little or no drug related nephrotoxicity was observed . Audio-vestibular function was monitored during and after treatment . Netilmicin was discontinued in one patient because of slight subjective loss of hearing . Subsequent audio-vestibular examination was normal. Appl Environ Microbiol, 1980 Jan, 39(1), 141 - 52 Improved method and test strategy for recovery of enteric viruses from shellfish; Metcalf TG et al.; An improved recovery method and testing strategy were devised for recovery of low numbers of enteric viruses from each of three commercially important shellfish species . Effective recovery of virus depended as much upon details of the test strategy adopted for use of the improved method with each species as on the method itself . The most important test details involved sample composition, pool size, and method of use of cell cultures . Recovery sensitivity measured permitted detection of 25 to 3 plaque-forming units of enteroviruses and 100 to 27 plaque-forming units of reovirus through their recovery in cell culture, with effectivenesses averaging 64 and 46%, respectively . Test samples prepared by the improved recovery method were virtually cytotoxicity free . Optimal recovery of virus on 45-cm2 cell culture monolayers was obtained with 1-ml inocula adsorbed for 2 h . The most effective recovery of virus from shellfish samples was made by a sequential adsorption procedure which allowed equal exposure of an entire sample to each of two or more cell cultures . Removal of nonviral contaminants from test samples by antibiotic treatment was preferable to the use of ether or membrane filtration procedures. Acta Derm Venereol Suppl (Stockh), 1980, Suppl 89, 57 - 63 Benzoyl peroxide; Cotterill JA; The mode of action of benzoyl peroxide in acne is three-fold, i.e . sebostatic, comedolytic and inhibitory to P . acnes in-vivo . Benzoyl peroxide is the topical treatment of choice in acne vulgaris . This agent is well tolerated by most patients . Primary irritant dermatitis can be avoided by less frequent application and the true incidence of contact sensitivity is low . The gel preparation has achieved a high degree of cosmetic acceptability . A synergistic effect with retinoic acid can be demonstrated . Tolerance to benzoyl peroxide develops in most subjects necessitating more vigorous therapy, usually after two or three weeks of treatment . Many acne sufferers with mild or moderate disease can avoid long-term oral antibiotic treatment by the judicious use of benzoyl peroxide topically. Int J Pediatr Otorhinolaryngol, 1979 Dec, 1(3), 211 - 9 The occurrence of negative middle ear pressure in children: an analysis of supposed associated factors; Lildholdt T et al.; This study analyzed the occurrence of negative middle ear pressure in various groups of children by comparing them with control groups . A screening procedure recording middle ear pressure and screening audiogram was performed several times throughout the year in an unselected group of 352 seven-year-old children . From about 4000 measurements of middle ear pressure an average value for each child was calculated . By applying thresholds of pathology of -160 mm H2( and -240 mm H2O, the occurrence of pathology in the different groups was analyzed . A medical history of each child was obtained by questionnaires answered by parents, giving information concerning allergy, previous adenoidectomy, previous exposure to respiratory tract infections and the social group of the family . A score of dental caries was obtained in each child . Furthermore, the relationship to antibiotic treatment and the child's use of swimming pools was analyzed, based on single measurements . The use of swimming pools seems to be beneficial to children suffering from a negative middle ear pressure . However, the other variables showed no relationship to negative middle ear pressure . It is concluded that other unknown factors must be involved in the development of negative middle ear pressure and chronic OME in children. Helv Chir Acta, 1979 Dec, 46(4), 657 - 63 {Indications and technic of subphrenic percutaneous drainage}; Klaiber C et al.; Introduction of percutaneous drainage (pcd) of subphrenic space in early subphrenic abscesses or fluid collections (e.g . bile) seems to be an alternative to common surgical treatment, if the indication is restricted to single contaminated abscesses . Septicemia, continued contamination, hematomas and multiple abscesses are contraindications . Method: A modified angiocatheter is placed directly or by a Seldinger technique . Adjunct antibiotic treatment is important . The advantages of subphrenic pcd are: simple low risk procedure in local anesthesia, rapid improvement of associated respiratory symptoms, no further contamination of the abdomen . 4 of 6 patients were treated successfully by this procedure. Gut, 1979 Nov, 20(11), 1008 - 11 Breath hydrogen in pneumatosis cystoides intestinalis; Gillon J et al.; Pneumatosis cystoides intestinalis (PCI) is an uncommon condition of unknown aetiology . Bacterial gas production may be an important aetiological factor, but experimental evidence in humans has been lacking . We have studied breath hydrogen excretion as an index of bacterial gas production in 12 patients with PCI and have shown that four out of five with demonstrable cysts produced unusually high levels of hydrogen while fasting . This abnormality has not been previously reported . One patient showed resolution of PCI after antibiotic treatment . These findings confirm the importance of bacterial gas production in the pathogenesis of PCI. Am J Vet Res, 1979 Nov, 40(11), 1537 - 52 Pathologic features of adriamycin toxicosis in young pigs: nonskeletal lesions; Van Vleet JF et al.; In ten experiments, 53 castrated male 4- to 8-week-old weanling pigs were given adriamycin (ADR) IV at mean dosages of 0.64, 1.0, 1.6, 3.2, or 6.4 mg/kg/week at various frequencies for up to 20 weeks . Mortalities in pigs given these dosages were 0% after 112 days, 100% after 134 days (survival time was 48 to 134 days), 91% after 75 days (survival time was 5 to 75 days), 100% after 28 days (survival time was 23 to 28 days), and 100% after 14 days (survival time was 10 to 14 days), respectively . Survival time was prolonged in younger pigs and in pigs given smaller but more frequent dosages of ADR . Characteristic gross and histopathologic alterations of ADR toxicosis were observed in pigs given 1.0, 1.6, 3.2, or 6.4 mg/kg/week mean dosages . The most frequent lesions were in the alimentary tract, myeloid and lymphoid tissues, skin, and perivascular tissues at injection sites . Alimentary tract lesions were mucosal epithelial atrophy, with secondary fibrinonecrotic inflammation in the oral cavity and large intestine . Marked hypoplasia was seen in bone marrow and lymphoid tissues, with frequent terminal hemorrhagic diathesis and septicemia . Several days before death, the pigs developed severe dermatitis over the ventral portion of the abdomen and inner surfaces of the limbs . Perivascular necrosis and cellulitis produced by extravasation of ADR was a frequent complication of treatment . Terminal severe acute pneumonia occurred in most pigs . Pericarditis or cardiomyopathy (or both) developed in 14 pigs, given 0.64, 1.0, or 1.6 mg/kg each week (mean cumulative dosage 520.5 mg/m2 of body surface) . Characteristic histopathologic and ultrastructural alterations in affected cardiac muscle cells were vacuolar degeneration, myocytolysis, and hyaline necrosis . Nephrotoxicosis also was in pigs with chronic ADR toxicosis . Systemic antibiotic treatment did not prolong survival of ADR-treated pigs in two experiments, but did in one other experiment. HNO, 1979 Nov, 27(11), 368 - 70 {Perennial rhinitis due to bacterial allergy (author's transl)}; Kellerhals B et al.; Bacterial allergy causing perennial rhinitis remains a controversial nosological entity . Clinically, however, many cases of perennial rhinopathy do fit into the definition of this disease, and may represent a late stage of earlier inhalant allergy . It is characterized by positive delayed (type IV) skin tests with bacterial extracts as well as by a pronounced tendency to oedema and polyp formation . Topically applied steroids seem to provide sufficient prophylactic protection . Acute bacterial infections or any nasal surgery, however, require antibiotic treatment. J Trop Med Hyg, 1979 Nov-Dec, 82(11-12), 229 - 36 Alpha-chain disease--a report of eleven patients from Iran; Mir-Madjlessi SH et al.; About one hundred cases of alpha-chain disease have been reported to date from various Mediterranean and Middle-Eastern countries . We report eleven Iranian patients with primary lymphoma of the duodenum and upper small intestine and positive alpha-chain protein in their sera . The clinical, laboratory and pathological findings in these patients are discussed . The initial favourable response of some of these patients to antibiotic treatment is noted . It is concluded that the optimal treatment of alpha-chain disease is not yet well established, and the clinical improvement might not coincide with histological and immunological remission. Med Klin, 1979 Oct 26, 74(43), 1589 - 92 {Prophylactic treatment of pancreatitis with antibiotics? (author's transl)}; Fleischer K; In acute pancreatitis the standard treatment is with antibiotics given prophylactically . Available studies indicate that the usefulness of such chemotherapy in the milder form of the disease (degree of severity I) has not yet been fully established . In the absence of contradictory results, prophylactic antibiotic treatment can, however, be recommended in severe pancreatitis (degrees II and III) and in those conditions induced by ethyl or of idiopathic origin . In all forms showing underlying biliary tract disease and in pancreatitis complicated by infection, antibiotic treatment should invariably be administered . Administration of broad-spectrum antibiotics which can be excreted via the bile duct, e.g . ampicillin or tetracycline, is preferable. Arch Otolaryngol, 1979 Oct, 105(10), 582 - 8 Etiologic factors in secretory otitis; Tos M et al.; We investigated the possible etiologic factors of secretory otitis and dysfunction of the Eustachian tube in 278 healthy 2-year-old children based on screening tympanometry and medical history . We found that catarrhalia was the most frequent etiologic factor, with acute otitis being the second most frequent factor . It was demonstrated that secretory otitis may develop without a preceding infection of the middle ear . It is probable that dysfunction of the tube plays a primary role in the development of secretory otitis . Allergy did not seem to be an etiologic factor . Antibiotic treatment does not promote the development of secretory otitis, but is probably unable to prevent it . Parental disposition could not be related to the children's ear diseases. Hum Genet, 1979 Oct 1, 51(2), 127 - 37 Multibranched chromosomes 1, 9, and 16 in a patient with combined IgA and IgE deficiency; Tiepolo L et al.; Instability of the centromeric region of chromosome 1 and multibranched configurations formed by different numbers and combinations of arms of chromosomes 1, 9, and 16 were found in cultured lymphocytes of a 12-year-old male with combined IgA and IgE deficiency . No chromosome abnormalities were found in fibroblast cultures from the patient or in blood cultures from his parents . A possible effect on the frequency of the abnormalities of the almost continuous antibiotic treatment received by the patient was found both in vivo and in vitro, but no abnormalities were found in blood cultures from control subjects who received similar treatment . Interphase association of chromosomes 1, 9, and 16 and a high frequency of interchanges among the centromeric regions of these chromosomes due to the presence of a fragile site is assumed to be the cause of the abnormalities. Med Clin (Barc), 1979 Sep 15, 73(5), 183 - 5 {Antibiotic treatment of pneumococcal meningitis (author's transl)}; Benedito J et al.; Pneumococcal meningitis, which represents the third in frequency among the purulent forms of meningitis, continues to be, in spite of antibiotic therapy, a serious problem due to its high mortality rate, which reaches 50 per cent in patients of advanced age . The antibiotic treatment of choice is penicillin G, using chloramphenicol as the substitute antibiotic and the cephalosporins in other instances . This article is a review of the cases of pneumococcal meningitis which were admitted to our hospital in the period between 1969-1977, placing especial stress on the therapy followed . Our experience in the treatment of 28 patients affected with this condition indicates therapeutic success in 45 per cent of the cases treated with penicillin G, and a rate of 70 per cent using cephaloridine . In view of these results we believe that cephaloridine should be considered an important alternative antibiotic in the therapy of pneumococcal meningitis. Dtsch Med Wochenschr, 1979 Aug 3, 104(31), 1095 - 9 {Necrotizing fascitis (author's transl)}; Galosi AF et al.; Necrotizing fasciitis is a rare and little known infectious disease of the skin with a mortality, despite modern antibiotic treatment, of 25--50% . A case of the disease in a 63-year-old woman is described . Treatment consisted of wide incision and drainage of the subcutaneous abscess, with regression of the clinical signs and symptoms . There has been no recurrence . Determination of the anti-DN-ase-B titre was of diagnostic value in this instance. Clin Chem, 1979 Aug, 25(8), 1368 - 9 Liquid-chromatographic measurement of taurine in cerebrospinal fluid of normal individuals and patients with meningitis; Shihabi ZK et al.; Taurine was measured in cerebrospinal fluid by reacting it with fluorescamine to form a fluorescent derivative, followed by separation on a reversed-phase column and fluorometric detection and evaluation . The assay is rapid (17 min) and sensitive to as little as 1 mumol/L . The mean value for 27 cerebrospinal fluid samples collected from patients free from meningitis and aneurysm was 5.7 +/- 1.8 mumol/L . Twenty-two patients with bacterial meningitis showed a 0- to 20-fold increase in cerebrospinal fluid taurine, with a return to normal values after antibiotic treatment. Int Surg, 1979 Aug-Oct, 64(5), 45 - 7 Sequelae of mid-trimester abortions induced by extra-amniotic drip infusion of normal saline; Blum M; The results of a survey conducted in a group of 60 women, three years after they underwent induction of mid-trimester abortion by extra-amniotic infusion of isotonic saline solution, are presented . The aim of this method for induction of abortion can affect the patients' fertility and the outcome of their subsequent pregnancies and deliveries . In the group we recorded 39 pregnancies, of which 9 were undesired . Of the 30 women who wished for another pregnancy, 29 became pregnant without difficulty and one after treatment for intrauterine adhesions . Twenty-four (80%) of the pregnancies ended with spontaneous deliveries, five of which (16.6%) were premature deliveries, 4 (13.3%) by spontaneous abortions and in one case (6.7%) a cesarean section was performed . The results obtained using our procedure are similar to those reported for other methods for induction of abortion, and especially by the intra-amniotic infusion of hypertonic saline . In our series we have recorded no immediate complications . All patients received preventive antibiotic treatment and in all of them a manual exploration of the uterine cavity was performed in order to avoid the formation of intrauterine adhesions. Arch Intern Med, 1979 Jul, 139(7), 827 - 8 Leukopenia due to penicillin and cephalosporin homologues; Homayouni H et al.; Leukopenia is an infrequently recognized complication of penicillin-related antibiotic and cephalosporin therapy . We describe our experience with nine individuals and reviewed reports of 11 cases from the literature . Seventy-six percent of cases occurred in individuals receiving 150 mg/kg/day or more of the various penicillin and cephalosporin homologues; 67% received these high doses for two or more weeks before the onset of leukopenia . Leukopenia was unusual within the first week of antibiotic treatment . Standard medical texts often recommend blind administration with 12 to 23 g/day of these antibiotics regardless of weight . It is suggested that these antibiotics be administered according to a maximum milligram per kilogram per day dosage as is done in children . Beyond the first week of administration, careful monitoring of the blood cell count should be conducted for those receiving high doses of these antibiotics. Dtsch Zahnarztl Z, 1979 Jun, 34(6), 506 - 10 {Therapeutic and diagnostic problems of generalized acute suppurative periodontitis marginalis profunda}; Schroder H; Generalized periodontal abscesses with considerable increase in the volume and sensitivity of the gingiva, tooth loosening, and malaise accompanied by fever and weight loss were observed in 22 of 35 patients studied . The symptoms developed after antibiotic treatment for another disease . Local therapeutic measures alone were successful . Success was obtained only after institution of directed antibiotic therapy. Sem Hop, 1979 May 8-15, 55(17-18), 931 - 4 {A controlled clinical study of Pneumorel Retard tablets in the treatment of chronic bronchitis (author's transl)}; Olivieri D et al.; The authors studied the action of Pneumorel retard tablets in the treatment of chronic bronchitis, comparing 2 groups of 20 patients each, one group was prescribed 1 pneumorel retard tablet in the morning and evening and the other group was treated with a speciality associating proteolytic enzymes and balsamics; the 2 groups also received an antibiotic treatment . The duration of the treatments was 20 days, with controls at entry, 10 days and 20 days later . Pneumorel retard showed to be significantly more active on the criteria studied (cough, dyspnea, expectoration, signs of auscultation) and this more often than not from the 10th day of treatment . Clinical and biological tolerance was perfect concerning the hepatic sphere, gastrointestinal, renal or cardiovascular systems . The convenience of the use of Pneumorel retard is particularly indicated in the thorough long-term treatment of chronic bronchitis, in preventing episodes of over-infection, worsening the disease. Z Hautkr, 1979 May 1, 54(9), 408 - 14 {Levamisole therapy under different dermatological indications}; Haneke E; More than 180 patients were treated for immunostimulation with levamisole within three and a half years . The results were statistically evaluated in 128 subjects . A highly significant improvement was noted in 44 patients suffering from recurrent herpes simplex labialis, facialis and oralis . 14 patients with recurrent herpes genitalis, lumbalis and glutaealis only experienced a reduction of the recurrence frequency . Aphthae in 16 subjects became less frequent and pain was reduced . Levamisole should be tried in recalcitrant chronic candidoses and bacterial infections not responding to specific antibiotic treatment . Slight side effects are relatively frequent, but severe ones are only rarely observed. Br Med J, 1979 Apr 28, 1(6171), 1109 - 10 Prevalence of facial acne vulgaris in late adolescence and in adults; Cunliffe WJ et al.; A survey of 1066 healthy women and 1089 healthy men aged 18-70 years, performed to determine the prevalence of facial acne, showed that clinical acne was not confined to adolescents . Though it was more prevalent among men than women at 18, beyond the age of 23 clinical acne was more prevalent among women as the prevalence in men gradually declined . At 40-49 years 3% of men and 5% of women still had definite, albeit mild, clinical acne, and at 50-59 years 6% of men and 8% of women had physiological acne . The surprisingly high prevalence of acne in adults may be related to antibiotic treatment or, in women, to the use of oral contraceptives or cosmetics, though this survey did not study their influence . Further studies in different populations are needed to establish the prevalence of acne in the community, and its distribution. Med Interne, 1979 Apr-Jun, 17(2), 187 - 9 Subphrenic abscess simulating metastatic carcinoma; Sidi Y et al.; Subphrenic abscess is reported in two patients, one previously operated on for pancreatic carcinoma and the other for clear cell carcinoma of the left kidney . The subphrenic abscess presented with cachexia and low grade fever six months and one year after surgery . Metastatic carcinoma was erroneously diagnosed in both patients . Despite massive antibiotic treatment, both patients succumbed to sepsis . Because of the inherent diagnostic challenge, delineation of a subphrenic abscess in cancer patients without clear-cut evidence of a metastatic spread is crucial. Br J Vener Dis, 1979 Apr, 55(2), 110 - 5 Therapeutic effect of oral doxycycline on syphilis; Onoda Y; Fifty-one patients with syphilis were treated with oral doxycycline . A course of the antibiotic treatment consisted of 200 mg of doxycycline daily in two divided doses for 28 days . The courses were repeated three to four times a year with an interval of several months . Quantitative Venereal Disease Research Laboratory (VDRL), Wassermann reaction (WR), and Treponema pallidum haemagglutination assay (TPHA) tests were performed monthly to evaluate the therapeutic effect of doxycycline treatment . The response rate was 100% for primary, 90% for early, 68% for late, and 90% for congenital syphilis in adults . No notable side effects were encountered except for epigastric fullness in one patient, which did not require the treatment to be discontinued . No abnormalities were detected in the results of laboratory tests. Biochemistry, 1979 Mar 6, 18(5), 739 - 45 Effect of polyene antibiotics on the lectin-induced agglutination of transformed and untransformed cell lines; Hatten ME et al.; Treatment of transformed Py3T3, SV101-3T3, and L1210 cells, as well as mitotic and Pronase-treated untransformed 3T3 cells, with the polyene antibiotics filipin, nystatin, and amphotericin B inhibited agglutination by wheat germ agglutinin . The effect of polyene antibiotic treatment was lectin and cell specific . Concanavalin A induced agglutination was not inhibited, wheat germ agglutination induced agglutination of untransformed 3T3 interphase cells was not influenced, and other aggregation phenomena, including those of erythrocytes with blood group specific antibodies or divalent cations, were unaffected by polyene treatments . This suggests that the formation of polyene-cholesterol complexes in transformed and erythrocyte cell membranes may specifically affect wheat germ agglutinin receptors and/or secondary events necessary for wheat germ agglutinin induced agglutination . Fluorescence studies of membrane filipin-cholesterol complexes showed that pretreating the cells with wheat germ agglutinin, but not concanavalin A, perturbed the fluorescence properties of filipin . Electron spin resonance studies with spin-labeled fatty acids revealed at best only a slight decrease in fatty acyl chain flexibility following filipin treatment . These studies indicate that there are not only quantitative differences between the agglutinability of transformed and untransformed cells with wheat germ agglutinin but that qualitative differences exist as well. Acta Otolaryngol, 1979 Mar-Apr, 87(3-4), 353 - 61 {The condition of the Eustachian tube and its influence on the middle ear}; Zechner G; Any functional disturbance in the auditory tube may be documented morphologically . We demonstrated in case of a block changes within the tubal mucosa and in the adjacent salivary glands . Complete obliteration of the lumen is a very rare instance caused only by severe trauma or as a possible result of heavy inflammatory damage to the mucosa . A lack of ventilation produces in the tympanic cleft a vacuum, followed by a typical effusion out of the altered mucosa . Anaerobic conditions favour hyper and metaplastic transformation of the epithelium . The clinical picture resembles the non-purulent, closed form of otitis, serous otitis media . The missing clearance makes the discharge within the tympanic cleft a great challenge to the mucosa . Granulation tissue proliferates, an enzyme production is initiated and phagocytes help to eliminate or to organize the middle ear content . The clinical picture corresponds to otitis media adhaesiva . If the auditory tube is blocked long enough, the healing result leads to the atelectatic tympanon caused by scare tissue, dystrophic calcification, fatty degeneration of granulation tissue, fibrocystic transformation of the mucosa . The ossicular chain, if not destroyed or interrupted, is fixed . A very dangerous condition is caused by retractionpockets within the ear drum membrane . They give rise to secondary acquired cholesteatoma . In the beginning of the whole process we see the nonfunctioning auditory tube, provoked by an infection . The development of the tubal tonsil and the perivascular aggregations of immunocompetent cells lead to the opinion, that the tube is an immunological not only a mechanical barrier against ascending infections . Favoured by antibiotic treatment the inflammation is localized by the body's own defence within the tympanic tube and causes the blockage, the loss of function, which influences heavily the middle ear and its lining. Obstet Gynecol, 1979 Feb, 53(2), 162 - 5 The effect of prophylactic antibiotics on febrile morbidity following cesarean section; Itskovitz J et al.; One hundred fifty patients undergoing cesarean section were evaluated prospectively for the effect of prophylactic antibiotics on postoperative morbidity . The postoperative infection rate was significantly reduced, being 30%, 16%, and 50% in the ampicillin, the cephalothin, and the control groups, respectively . The results are favorably compared with the results achieved in previously reported studies where the antibiotic treatment was started preoperatively . Our study confirms experimental studies that postoperative infection can be reduced by using prophylactic antibiotics in the immediate postoperative period . By this regimen, undesired placental transfer of the antibiotics to the fetus can be avoided. Am J Med, 1979 Feb, 66(2), 277 - 82 Fate of circulating immune complexes in infective endocarditis; Cabane J et al.; To examine the role of circulating immune complexes (CIC) in infective endocarditis, we studied 64 patients with infective endocarditis for the presence of CIC by the polyethylene-glycol (PEG)-precipitation test and the Clq binding test . This study was repeated during the course of the disease in 23 patients . CIC were found in 84 per cent of patients (66 per cent with acute infective endocarditis, 89 per cent with subacute infective endocarditis) during the active phase of the disease . Higer PEG precipitates were associated with typical cutaneous signs, cryoglobulins and nonstreptococcic culture-positive infective endocarditis . Under appropriate antibiotic treatment, the PEG precipitate levels of 17 patients fell within 1 month to the normal range, with a concomitant drop in cryoglobulinemia and rheumatoid factor . Conversely, uncontrolled sepsis always (six of six) yielded a rising level of CIC . These findings support the hypothesis that CIC may be important in the pathogenesis of peripheral lesions in infective endocarditis. Br Med J, 1979 Jan 13, 1(6156), 85 - 6 Value of examining buffy coats for intragranulocytic micro-organisms in patients with fever; Studer JP et al.; To determine the significance of the presence of intragranulocytic micro-organisms in the blood buffy coat in patients with suspected infection, buffy coat examination and blood cultures were simultaneously performed in 455 consecutive patients with fever . There was no general correlation between the finding of intragranulocytic micro-organisms in the buffy coat and positive blood cultures . Patients with persistent bacteraemia and sterile blood cultures were, however, shown to have persistently positive buffy coat findings on repeated examination . These patients, who had culture-negative endocarditis or catheter-associated infections, had sterile blood cultures because of antibiotic treatment . Repeated positive findings in the buffy coat may therefore be valuable in detecting patients with persistent bacteraemia, but sporadic findings of micro-organisms in the buffy coats of acutely ill patients seem to have little diagnostic value. Ann Immunol Hung, 1979, 19, 85 - 92 Fluctuations of the bile oxytetracyclin level on regional administration of the antibiotic; Farkas A et al.; The elimination of oxytetracyclin on regional administration was studied . The time course of the appearance of the antibiotic in different body fluids determined by a microbological assay method . On the data reported here it is assumed that regional antibiotic treatment can efficiently applied in bacterial cholangitis therapy. Helv Paediatr Acta, 1979, 34(6), 577 - 81 Nonsurgical treatment of interhemispheric subdural empyemas; Rosazza A et al.; Interhemispheric subdural empyema complicating sinusitis was diagnosed in two children by CAT scan . One of them presented with intracranial hypertension and paresis of one foot (syndrome of the falx cerebri) . Antibiotic treatment alone without surgery (in one case with brief initial steroid therapy) brought rapid and complete clinical and radiological cure . A nonsurgical approach can now be considered in certain cases of intracranial local suppurations, given the possibility of earlier and more precise initial diagnosis and follow-up with CAT scan. Prog Clin Biol Res, 1979, 35, 53 - 7 CSF shunt infection management in adult age; Princi L et al.; This retrospective study of nine patients in whom infection developed following operation for placement of an extrathecal drainage shunt, although it is not a complete biometric evaluation, shows an incidence of infection (10.5%) that corresponds with averages reported from other centers {7, 15--17} . Furthermore, it points out the limitations of antibiotic treatment when three significant aspects of therapy are not considered fully: 1) sensitivity of the identified organism, 2) CSF level of drug that can be achieved, and 3) pharmacokinetic action of drug in CSF. Poumon Coeur, 1979, 35(5), 255 - 60 {Current persistance of pleural empyema . Study of 31 observations (author's transl)}; Cordier JF et al.; Antibiotic treatment of pleuro-pulmonary infectious diseases with ordinary germs brought a notable decrease in the frequency of pleural empyema without preventing them completely . The authors report 31 cases observed over the last 10 years . The initial signs corresponded to the classical picture but were rapidly masked by antibiotic treatment; it resulted in delay in hospital admission of over one month for more than half of the cases, for diagnosis was overlooked for a long time . In 19 patients, the pleural liquid was aseptic probably because of the antibiotics and of the lack of identification of anaerobic germs . The authors insist on the practical modalities of a medical treatment by puncture-lavage which, when associated with general antibiotic treatment, cured patients in 22 cases . On the other hand, the existence of bronchopleural fistula entailed surgery. Chemotherapy, 1979, 25(6), 356 - 61 Cephalexin therapy for infections complicated by age and concurrent diseases . A study in general practice; Cooke DM; A broad spectrum antibiotic, cephalexin, was used to treat 64 patients in whom the problems of age, underlying conditions and multiple drug therapy could adversely affect the outcome of antibiotic treatment . The majority of patients were given the antibiotic for a lower respiratory tract infection . Treatment was successful in 50 patients after 5 days, and in a further 3 after 10 days . In 25 patients another antibiotic had been used unsuccessfully to treat infection: 19 of these patients responded to cephalexin therapy . Minor gastro-intestinal side effects were reported in 4 patients. Avian Dis, 1979 Jan-Mar, 23(1), 88 - 94 Prevention of egg transmission of Mycoplasma meleagridis by antibiotic treatment of naturally and experimentally infected turkey eggs; Elmahi MM et al.; Turkey eggs infected naturally and experimentally and treated with 1 mg of tylosin or gentamicin before incubation produced progeny with less infection with Mycoplasma meleagridis than did infected but untreated eggs . Higher doses of gentamicin eliminated infection, as indicated by an absence of M . meleagridis antibodies in poults tested at 3 weeks and retested at 5 weeks of age . The rate of reduction or elimination of egg transmission was correlated negatively with the incidence of M . meleagridis infection in untreated controls . Hatchability was reduced by gentamicin, especially at doses of 1.75 and 2 mg, whereas tylosin at 1 mg/egg improved hatchability. Digestion, 1979, 19(4), 267 - 76 The cholyl glycine-1-14C breath test in various gastrointestinal disorders; Peled Y et al.; The cholyl glycine-1-14C breath test was evaluated in a variety of gastrointestinal disorders . 138 tests were performed in 106 patients . Methods of data expression were evaluated and the cumulative 8-hour value was used . In 27 control patients the upper limit of the normal was found to be 78 . A good correlation was found between the peak values and the cumulative 8-hour values (r = 0.95, p less than 0.01) . The reproducibility of the test was good (r = 0.985, p less than 0.05) . Abnormal results were found in 12 out of 13 cases with resection of the ileum and 11 out of 14 cases with Crohn's disease of the distal small bowel . The test was normal in cases with diseases of the proximal small bowel (celiac, Whipple's and Chron's diseases) . The test was also normal in patients with colitis . It was abnormal in some of the cases after cholecystectomy and in most cases with carcinoma of the pancreas . The breath test was useful in monitoring the results of treatment in bacterial overgrowth of the small bowel . False negative results were observed after antibiotic treatment . The method seems to be more sensitive than the Schilling test in diagnosing disease of the distal small bowel. Ann Chir Gynaecol, 1979, 68(3), 90 - 3 Pyogenic spondylitis . Analysis of three surgically treated cases; Lindholm TS; During a period of 10 years (1964--1973) three patients developing pyogenic spondylitis were operated on . The patients suffered from severe localized back pain and showed sings of infection, as elevation of temperature and raised ESR . The earliest radiological changes were diagnosed on the average after 3 months . As treatment with antibiotics could not cure the infection, the patients were operated on by evacuation of a vertebral focus, and this measure was complemented with bone transplantation . All patients were cured from the fulminant spondylitis, and two of them returned to regular work . No recurrence was noted during an observation period averaging 8 years . Surgery seems to be indicated in some cases of nonspecific spondylitis, especially when a paravertebral spread of the infection is recorded and antibiotic treatment does not primarily show sufficient effect. Rev Stomatol Chir Maxillofac, 1979, 80(3), 122 - 4 {Dental problems before irradiation (author's transl)}; Szpirglas H et al.; Before antitumoral facial irradiation, those teeth that cannot be conserved for a sufficiently long post-irradiation period of at least two years should be extracted . Teeth that are less affected, in patients given palliative treatment and in whom the prognosis is better, can be conserved . The conserved teeth are protected from destruction by the application of a fluoride gel . Dental reconstruction is ensured by the conventional methods, including the fixed prosthesis . The arches can be restored with atraumatic fixed prostheses but prudence is required . If extraction is necessary, a strict procedure must be employed and sufficient antibiotic treatment prescribed. Zahn Mund Kieferheilkd Zentralbl, 1979, 67(8), 802 - 14 {Abnormal courses of acute pyogenic soft-part infections in the maxillofacial and cervical regions (author's transl)}; Schulz S; The etiology and therapy of abnormal causes of pyogenic soft-part infections in the maxillofacial and cervical regions are discussed by reference to five case reports . Such clinical pictures usually result from a misinterpretation by the initially attending physician and consequent errors in treatment, from the indolence of patients, and from complicating conditions which are due especially to the particular disease agents involved, with one factor generally affecting the other . Today, even most serious disease pictures can be seen ruled to surgical and antibiotic treatment . In cases of doubt, tracheotomy should be performed before surgical cuts into abscesses are made especially where extensive suppuration involves the floor of the mouth, the parapharyngeal space, and the cervicovascular space. Exp Pathol (Jena), 1979, 17(5), 249 - 63 Repeated light- and electron microscopic studies of the small-bowel mucosa in Whipple's disease; Balazs M; The small-bowel mucosa of a patient with Whipple's disease in the florid state and one year after starting antibiotic treatment, in complete clinical remission was examined by the author . As a result of treatment, light-microscopic changes led to total regression . Electronmicroscopically, in the florid state, destruction of small-bowel epithelial cells was observed, mostly in the Lieberkuhn's crypts . The changes of epithelial cells regressed after one year of treatment . In the lamina propria, a large amount of macrophages containing characteristic inclusions were found which persisted even after treatment . The composition of inclusions has, however, changed . The macrophages were cells poor in organelles and of a primitive differentiation . Presumably, this morphological picture is associated with the digestion incapability of cells and this may lead to the development of "acquired storage disease". Sem Hop, 1978 Dec 8-15, 54(43-44), 1373 - 7 {Does mastoiditis still exist? (author's transl)}; Paquelin F; The authors report 382 cases of mastoidectomy verified by histological examination and draw certain conclusions: There were 5 errors in diagnosis, i.e . 1.3 per cent . Most cases were aged between 4 and 12 months . Below the age of two years it was usually bilateral, exceptionally so after the age of two years . Diagnosis was mainly clinical and based on the following axiom: "All infants with acute otitis who, in spite of proper medical treatment, have at the end of one month of a weight curve either stationary or falling, and eardrums not strictly normal, have mastoiditis" . This therefore implies close and prolonged supervision by the same observer throughout the period antibiotic treatment and at least one week after stopping the latter . The treatment is still mastoidectomy and not antrotomy but one may hope with more accurate diagnosis that new methods of treatment may be developed to the extent where immediate and long term supervision of the child may be ensured. Arq Neuropsiquiatr, 1978 Dec, 36(4), 357 - 64 {Extensive cerebellar necrosis in sickle cell anemia . Report of a case}; Queiroz Lde C et al.; A 6 month-old mulatto boy was admitted on account of acute gastroenteritis, malnutrition and dehydration . In the hospital, the child developed septicemia, and temperature reached up to 38.6 degrees C . Despite intensive antibiotic treatment the patient died 12 days after admission . Necropsy disclosed bilateral bronchopneumonia, bilateral fronto-parietal subarachnoid hemorrhage, and extensive necrosis of the inferior half of both cerebellar hemispheres . On histopathological examination of the necrotic cerebellar cortex, numerous sickled erythrocytes were observed in petechial hemorrhages, and, in lesser quantities, inside capillaries . Lesions of the central nervous system in sickle cell anemia most often involve the cerebral cortex, and a single extensive cerebellar infarction as present in this case seems extremely rare . The pathogenetic mechanism of the necrosis is unclear, since thrombosis was not observed either in large blood vessels or in capillaries . Possible contributory factors were the infectious condition (septicemia), fever, and anoxia caused by the extensive bronchopneumonia. Br J Surg, 1978 Dec, 65(12), 834 - 8 Management of abdominal aortic aneurysm; Gordon-Smith IC et al.; A series of 245 patients was operated upon for abdominal aortic aneurysm during the years 1969-77, of whom 162 were elective cases while in 83 the aneurysm was leaking or had ruptured . The hospital mortality for the latter group fell from 77 per cent at the beginning of the study period to 30 per cent at the end . For elective operations, hospital mortality averaged 9.3 per cent, though during the last 2 years there were no deaths in the 51 consecutive cases . Operative methods and postoperative treatment changed during the years of the study, with few excision-replacement grafts and greater use of the inlay technique, most of the latter being simple unbranched Dacron tubes . Early graft infection, the most important and serious surgical complication, caused 9 deaths, an overall incidence of 3.7 per cent, of which 8 were in patients who received no perioperative antibiotics and only 1 among the patients who did receive them . All deaths were in the inlay group . The reasons for this are discussed . Since July 1976 perioperative antibiotic treatment has been routine for all arterial prosthetic graft patients in our hospital. J Bone Joint Surg Am, 1978 Dec, 60(8), 1059 - 64 Revision with gentamicin-impregnated cement for deep infections in total hip arthroplasties; Carlsson AS et al.; Seventy-seven total hip arthroplasties complicated by deep infection were treated by reoperation and fixation of a new prosthesis with gentamicin-containing cement . The infection was proved in each case by positive bacterial cultures . Systemic antibiotic treatment was continued for six months postoperatively . Sixty hips were considered healed; the patients had no pain and had normal sedimentation rates and roentgenograms . Nine still had pain or an abnormal sedimentation rate and were classified as doubtful with regard to eradication of the infection . Eight were still infected . The patients were followed for six months to three and one-half years after reoperation. Int J Oral Surg, 1978 Dec, 7(6), 580 - 4 Necrotizing sialometaplasia; Nilsen R et al.; Two cases of necrotizing sialometaplasia are reported together with a review of the literature . This self-limiting benign lesion is easily confused with malignant tumors . The lesions are characterized histologically by an extensive necrosis of the salivary gland tissue together with squamous metaplasia of the ducts . The present report of two females who had intense pain in the initial phase differs from previous reports concerning age and symptoms . The importance of rather extensive biopsy specimens is stressed . Antibiotic treatment appears to be insignificant . A clinical history of allergy and a dominance of eosinophilic granulocytes in the inflammatory exudate in both cases may indicate an allergic etiology. Obstet Gynecol, 1978 Nov, 52(5), 588 - 90 Irrigation technique for detection of Mycoplasma intrauterine infection in infertile patients; Koren Z et al.; To improve the method for identification of Mycoplasma as a cause of unexplained infertility and to test whether mycoplasmal endometritis could be responsible for reproductive failure, successful endometrial jet washing technique was performed on 59 infertile patients . Sixteen patients (27%) showed positive Mycoplasma growth . Five patients (31%) from this group became pregnant within a few months following an antibiotic treatment . These results were compared with 50 control patients and only 3 (6%) showed positive Mycoplasma growth from endometrial washings . The data reported in this paper support the concept that endometritis due to Mycoplasma of T-strain or hominis can be a cause of infertility. Clin Otolaryngol, 1978 Nov, 3(4), 491 - 3 Middle ear and eustachian tube lining in chronic otitis media; Zechner G; By means of histological observations we have tried to find morphological data on which to classify non-suppurative and suppurative chronic otitis media . There was also evidence of pathophysiological features which may have direct influence upon the development and behaviour of chronic inflammations of the tympanic cleft, such as disorders of ventilation and reaction of the mucoperiosteal layer . Local defence mechanisms, the species and virulence of infection also play an important role . It appears that the Eustachian tube is a very effective mechanical and immunological barrier against ascending infection which may perhaps be assisted by antibiotic treatment . Certainly non-suppurative chronic otitis media is more frequent now than in pre-antibiotic days. JACEP, 1978 Nov, 7(11), 397 - 400 Airless paint gun injuries: an update; Edlich RF et al.; The airless paint gun delivers paint at pressures approximating 3,000 psi . Paint accidently injected into the skin under this pressure causes a devastating injury which is a result of the paint material, the level of bacterial contamination, and the pressure at which the paint is delivered . The time interval between injury and treatment seems a critical determinant of outcome . Decompression of the closed vascular compartments of the hand must be begun immediately to release the underlying tissue distended by the injected paint . Judicious wound debridement must be performed . Immediate antibiotic treatment is indicated in all patients . Studies seem to indicate that steroids limit the severity of inflammatory response . A regimen of hydrocortisone sodium succinate, 100 mg IV, administered immediately before surgery should be followed by a seven-day tapering course of oral prednisone starting with 40 mg on the first postoperative day . Recent safety measures and consumer warnings through the Consumer Product Safety Commission may reduce the number of airless paint gun injuries. Tijdschr Diergeneeskd, 1978 Oct 15, 103(20), 1139 - 44 Pyogranulomatous swellings in the submandibular region of the dog, caused by Actinomyces spp; Staman J et al.; Seven dogs with actinomycotic submandibular abscess, probably caused by penetrating wounds in the oral cavity, are described . Antibiotic treatment alone, or in combination with paracentesis, failed in all cases . Recurrences and dissemination were avoided in five of the seven cases by complete removal of the abscess, long-term drainage, flushing with 1% Polyvidon iodine and long-term antibiotic treatment . The main difficulty was a poorly defined margin of the abscess; this made complete removal impossible in three cases . In two of these there were recurrences, but in the third there was complete healing after the second treatment. Thorax, 1978 Oct, 33(5), 638 - 45 Storage of heart valve allografts in glycerol with subsequent antibiotic sterilisation; Parker R et al.; Fresh allograft valves stored in a nutrient medium at +4 degrees C have a limited storage time of eight weeks . Dura mater has been stored in glycerol for longer periods, and this paper presents work on the glycerol storage of allograft heart valves . The elastic properties of the valve cusps showed a fall during storage in glycerol that was associated with an altered histological appearance of the cusp tissue . The loss in nuclearity in the histological sections of stored tissue was partially responsible for the observed decrease in viability during storage . All these changes during storage in glycerol, or glycerol and subsequent antibiotic treatment, were similar to the changes seen in valves stored in a nutrient medium . Glycerol therefore offers an alternative storage system to the cold nutrient medium but has no practical advantages . Glycerol alone will not sterilise the allograft tissue, and a post-storage treatment with antibiotics is essential. Lab Anim Sci, 1978 Oct, 28(5), 587 - 90 A fatal enteric syndrome in Mystromys albicaudatus (white tailed rat) following topical antibiotic treatment; LaRegina M et al.; Heavy death losses (59%) occurred in adult Mystromys 3--14 days after muscle biopsies were taken from their rear legs . Clinical signs included anorexia, depression, and rough hair coat . Predominant necropsy findings were hrmorrhagic typhlitis and colitis . Results of studies evaluating the roles of the anesthetic and the tropical antibiotic ointment suggested that the deaths were caused by ingestion of the topically applied antibiotic. N Engl J Med, 1978 Sep 21, 299(12), 624 - 7 Efficacy of chest physiotherapy and intermittent positive-pressure breathing in the resolution of pneumonia; Graham WG et al.; We undertook a randomized clinical trial to evaluate the efficacy of chest physiotherapy and intermittent positive-pressure breathing in the treatment of pneumonia . The diagnosis of pneumonia required a compatible clinical history and x-ray confirmation . A total of 54 patients were assigned to treatment and control groups and were similar in age, smoking history, underlying lung disease and prior antibiotic treatment . Antibiotic therapy, guided by Gram stain and sputum and blood cultures, was similar in both groups . Chest physiotherapy, consisting of postural drainage, percussion and vibration, was given concurrently with intermittent positive-pressure breathing with use of racemic epinephrine every four hours . There was no statistically significant difference in duration of fever, extent of radiographic clearing, duration of hospital stay and mortality between the control and treated groups . Chest physiotherapy and intermittent positive-pressure breathing do not hasten the resolution of pneumonia. Ann Otolaryngol Chir Cervicofac, 1978 Sep, 95(9), 577 - 83 {Assessment of a thirty year long experience in treatment of esophageal caustic stenosis (author's transl)}; Autier C et al.; Among 457 esophageal stenosis treated between 1954 and 1977, 258 (56%) were caustic stenosis . The treatment of those is the most difficult . Functionnal healding was satisfactory in 93% of the treated cases by dilatations . Four strict rules ought to be observed in the management of this cases . Immediate and long terme antibiotic treatment of the corrosive esophagitis . X rays are the only means to be used during evolution of corrosive esophagitis . No instrumental performance until sufficient cicatrization . Retrograde dilatations after gastrostomy shall be prefered in serious cases . Gastro-esophageal reflux may complicate this evolution and require surgery . Total esophageal replacement can be averted in most cases. Am J Surg, 1978 Sep, 136(3), 379 - 82 Mechanisms by which proteolytic enzymes prolong the golden period of antibiotic action; Rodeheaver GT et al.; These experimental studies provide an explanation for the therapeutic value of proteolytic enzymes as adjuncts to antibiotic treatment of contaminated wounds . After wounding, a fibrinous coagulum develops on the wound surface . This coagulum surrounds the bacteria and protects them from contact with sustemically or topically administered antibiotics . Treatment of the wound surface with proteolytic enzymes disrupts the coagulum and exposes the bacteria to the action of the antibiotic . The topical use of enzymes is also associated with significant increases in the concentration of antibiotic at the wound and thus a decrease in the rate of infection. Fertil Steril, 1978 Sep, 30(3), 293 - 6 On the etiologic role of ureaplasma urealyticum (T-mycoplasma) infection in infertility; Idriss WM et al.; Two hundred consecutive infertility patients and sixty-seven controls subjects were studied for the incidence of infection with Ureaplasma urealyticum (T-mycoplasma) . On the basis of a complete infertility investigation, the infertility patients were subdivided into those with explained infertility and those with unexplained infertility . Of the patients with unexplained infertility, 55% had a positive culture for T-mycoplasma as compared with a 32% incidence of positive cultures in the control population . The differences were statistically significant . The 6-month pregnancy rate following successful antibiotic treatment in patients with unexplained infertility was 42% . The 6-month pregnancy rate in a comparable group of patients with unexplained infertility, seen during a 3-year period prior to mycoplasma culture and treatment, was 32% . The difference in pregnancy rates between the two groups was not statistically significant . No correlation was found between a poor postcoital test and the presence of T-mycoplasma infection nor between T-mycoplasma infection and poor cervical mucus . The role of T-mycoplasma infection in infertility was neither proven nor disproven by this study. Acta Cytol, 1978 Sep-Oct, 22(5), 281 - 2 Actinomycetes and the IUD: an update; Gupta PK et al.; PIP: To date, actinomycetes have been identified in 540 vagino-pancervical (Fast) smears from 520 women . In each case, a foreign body has been present, usually an IUD (517 cases) . The Dalkon Shield preponderates, perhaps reflecting physician preference at the center . IUD usage duration has varied from 6 weeks to 13 years . Approximately 25% of symptomatic IUD users requesting treatment have cytologic evidence of actinomycetes . The preoperative diagnosis of pelvic actinomycetes was suggested in most cases based on cytologic evidence alone . Immunofluorescent studies have been performed in 266 cases with species-specific antisera, and Actinomyces israelii identified in 250 . Protozoal organisms in the Fast smears have been noted in 8 cases (1.5%) and are commonly intimately associated with Actinomyces . It is agreed that the oropharnyx serves as the possible source of lower genital tract Actinomyces infection . In such cases, IUD removal and antibiotic treatment are recommended . Schweiz Med Wochenschr, 1978 Aug 19, 108(33), 1262 - 70 {Diagnosis of latent late infections following total hip replacement}; Albrecht HU et al.; The etiology, diagnosis and elucidation of non-manifest late infection following total hip joint replacement surgery are discussed on the basis of 22 patients who underwent further surgery in our clinic due to an infected prosthesis from 1974 to 1976 . Non-manifest late infection is usually the result of contamination of the hip before, during or after surgery; only in a few isolated cases can the infection be considered to have originated from the bloodstream . There is a higher risk of infection in patients who have undergone previous hip surgery . The principal symptom of late infection is pain; as a rule there are no other clinical signs of inflammation . The generally increased blood sedimentation rate is the only laboratory test of diagnostic value . An important aid is x-ray of the hip, in which the infection is manifested by osteitis and loosening of the prosthesis . Arthrocentesis should be carried out in case of doubt and when systemic antibiotic treatment is envisaged . Special diagnostic procedures such as arthrography and scintigraphy cannot be recommended for routine examination. J Pediatr, 1978 Aug, 93(2), 227 - 31 Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris; Bjorksten B et al.; Based on nine patients 4 to 26 years of age, we describe the clinical characteristics of chronic recurrent multifocal osteomyelitis . This disorder was characterized by an insidious onset of fever, local swelling and pain in affected bones, and radiologic findings suggesting osteomyelitis . The lesions were mainly localized to the clavicles and the metaphyses of tubular bones . The clinical course was characterized by intermittent periods of exacerbation and improvement over several years . Six of the patients had recurrent pustulosis palmaris and plantaris, which closely parallelled the exacerbations of the bone lesions . Biopsies from the bone lesions showed nonspecific inflammatory changes with granulocytic infiltration . Repeated bacterial and fungal cultivations from blood, bone biopsies, and pustules were negative . Immunologic investigation revealed no abnormality common to the patients . There was no indications of a genetic etiology . The pathogenesis of the disorder is unknown . Antibiotic treatment had no obvious effect but corticosteroid therapy appeared to be of benefit in some patients . The long-term prognosis appears to be relatively good. J Trauma, 1978 Jul, 18(7), 548 - 9 Survival following a gunshot wound of the abdominal aorta and inferior vena cava; Rudich MD et al.; A case with survival following a point-blank .32 caliber gunshot wound of the abdominal aorta and inferior vena cava is presented . The patient, a young male also had multiple other abdominal injuries . A Dacron graft was used in the aorta, lateral suture in the vena cava, other injuries were repaired, and antibiotic treatment and irrigation performed . Packed red blood cells, Ringer's lactate, Plasmanate and nutritional support with medium chain triglycerides and ketones by mouth and amino acids by IV were given. JAMA, 1978 Jun 30, 239(26), 2763 - 5 Rocky mountain spotted fever caused by blood transfusion; Wells GM et al.; Transfusion of 500 ml of blood, contributed by a donor three days before the onset of Rocky Mountain spotted fever and refrigerated for nine days, caused this disease in the recipient . The blood donor died of Rocky Mountain spotted fever after six days; rickettsia were identified in various tissues by immunofluorescence techniques . The recipient of the blood became mildly ill and recovered fully; specific antibiotic treatment was initiated on the fourth day of illness . Diagnosis of Rocky Mountain spotted fever was confirmed in the recipient by positive serologic reactions and isolation of Rickettsia rickettsii from blood after inoculation in animals and tissue culture. Ann Med Interne (Paris), 1978 Jun-Jul, 129(6-7), 387 - 97 {Circulating immuns complexes and infections endocarditis . 64 cases (author's transl)}; Herreman G et al.; An immunological study, with examination for circulating immune complexes (CIC) by precipitation by polyethylene-glycol (PEG) and by fixation of labelled C1q, was carried out in 64 patients with infectious endocarditis (IE) . One or more complementary studies during the course of the illness were possible in 23 . CIC were found in 84 p . 100 of cases (66 p . 100 of acute IE and 89 p . 100 of subacute IE), during the active phase of the disease . High levels of PEG precipitate were correlated with typical cutaneous signs (including Osler's nodes), with the presence of cryoglobulins . With effective antibiotic treatment, the level of PEG precipitate (17 patients) returned to normal within one month, in parallel with a fall in rheumatoid factor and in cryoglobulins . By contrast, ineffective treatment was invariably reflected (6 patients) by a rise in levels of PEG precipitate . The estimation of CIC using the PEG technique during IE would already appear to be a value aid in cases of difficult diagnosis, and a research area worthy of further exploration within the context of IE. Acta Hepatogastroenterol (Stuttg), 1978 Jun, 25(3), 238 - 42 A case of whipple's disease with repeated operations for ileus and complete cure; Lukacs G et al.; The authors make a case report of a male patient, 58 of age, whose complaints started 37 years ago; inspite of an operation, repeated medical check-ups and treatment, they had no other choice but to perform a further laparotomy when the patient presented himself with progressive cachexia and signs of an acute abdomen . Taking the history, the operative and histological findings of the patient into consideration, the correct diagnosis could be made: Whipple's disease . The presence of this condition was also proven by postoperative X-rays and immunological examinations . The patient has been restored to health after a year's antibiotic treatment . An impaired defensive ability, mainly of the immune and macrophage system can be proven to exist in Whipple's disease . Two main tasks are essential: 1) to hold the patient under constant control and 2) to continue research with the aim of finding ways of immunocorrection. Invest Radiol, 1978 May-Jun, 13(3), 241 - 6 Observation on the metabolism of iopanoyl (Telepaque) glucuronide in dogs treated with antibiotics; Thoeni RF et al.; The purpose of our investigation was to determine whether iopanoyl glucuronide, the major metabolite of iopanoic acid (Telepaque), undergoes hydrolysis by bacterial beta-glucuronidase in dogs . The conjugated compound was identified and quantitated by elemental analysis, fluorescent excitation analysis, thin-layer chromatography, and high pressure liquid chromatography . The experiments were performed before and after combined antibiotic treatment with neomycin and vancomycin . It was first determined that reabsorption and excretion of sodium iopanoate was only minimally diminished during antibiotic treatment . Known amounts of iopanoyl glucuronide were infused into the small bowel of 4 awake dogs with chronic bile fistula, and bile was collected for 5--8 hours . The excretion of the recirculated conjugated compound was 4--5 times lower during antibiotic treatment . Incubation of ileal fluid with bile containing iopanoyl glucuronide suggested that beta-glucuronidase hydrolyzes the conjugated compound . Hydrolysis was markedly decreased after pretreatment with antibiotics . These findings suggest that the beta-glucuronidase produced by bacteria may be a major mechanism in enterohepatic recirculation of iopanoyl glucuronide . Mechanisms and possible implications are discussed. Am Surg, 1978 May, 44(5), 267 - 71 Management of colon ischemia following colon interposition for esophageal substitution; Bernstein JB et al.; During the past four years three patients have been seen with ischemia of the colon segment following colon interposition . Colon interposition was done for esophageal cancer in two patients and for esophageal stricture following ingestion of lye . Colon ischemia was manifested as early as two weeks in one patient and as late as eight weeks in the others . Colon ischemia presented a frank gangrene with cervical fistula or as dysphagia due to stricture formation . Dysphagia in two patients prompted mechanical dilatation of the colon segment which led to perforation in both cases . All three patients had empyemas . The management of these patients includes proper diagnosis, drainage of abscesses and antibiotic treatment, hyperalimentation and visceral arteriography to delineate the residual colon for reinterposition . Two of the three patients in the series are long-term survivors and are well. Med J Aust, 1978 Apr 8, 1(7), 378 - 83 Laboratory support in the management of syphilis; Morton RS et al.; Recent developments in syphilis serology are set down . The approach today is more rational as it has some basis in immunological understandings . In spite of improvements, syphilis serology continues to have limitations, and differentiating active from inactive cases remains taxing . In primary and secondary syphilis, dark-ground microscopy is still the quickest and surest way to make the diagnosis . In latent syphilis and in late and congenital cases, as well as in instances of other treponemal infections, serological evidence of disease needs to be considered along with each patient's medical, social and sexual history, when and why they may have been given antibiotic treatment, and the results of radiological studies and cerebrospinal fluid examination . For some syphilitics, the decision to treat or not to treat remains a matter of art rather than science. Ann Surg, 1978 Apr, 187(4), 430 - 4 Diagnosis and thereapy of necrotizing soft tissue infections of the perineum; Rosenberg PH et al.; Nine patients with necrotizing soft tissue infection of the perineum and adjacent areas developed following perirectal absecess, retroperitoneal infection, local trauma or apparently spontaneously . Skin changes and crepitus were often present but severe local pain was the only indication of infection in three patients . Repeated surgery or in one case, a necropsy, were required to uncover the extensive, dissecting, purulent and necrotizing subcutaneous process . Myonecrosis had occurred in three cases . Operation was often delayed for several days because of the difficulty in recognizing the presence of infection or because the urgency for treating an already apparent infection was not appreciated . The mortality was high (5/9 cases) . The bacterial isolates were predominantly of a mixed aerobic-anaerobic nature . Needle aspiration of suspicious areas, even where classic signs of inflammation are lacking and Gram staining of exudate are valuable procedures for diagnosis and institution of appropriate presumptive antibiotic treatment . Thorough surgical exploration and debridement must be performed promptly to maximize chances for survival. Lancet, 1978 Jan 28, 1(8057), 175 - 8 Antibiotic treatment of guinea-pigs infected with agent of Legionnaires' disease; Fraser DW et al.; Erythromycin and rifampicin (rifampin) were able to prevent death of guineapigs given intraperitoneal injections of the agent causing legionnaires' disease . Penicillin, chloramphenicol, tetracycline, and gentamicin showed no significant effect . On the basis of clinical experience and experimental observations, erythromycin is recommended for patients suspected to have legionnaires' disease . Combined therapy with erythromycin and rifampicin may be justified in patients with confirmed legionnaires' disease who are not responding to erythromycin alone or as part of a controlled antibiotic trial among suspected cases during an outbreak of legionnaires' disease. Acta Med Iran, 1978, 21(1), 53 - 67 Consultant report: Incomplete abortions treated at Jahanshah Saleh Hospital in Tehran, Iran from May 14, 1973 to April 30, 1974; Behjatnia Y; PIP: At the Jahanshah Saleh Hospital of the University of Tehran School of Medicine 100 patients were admitted from May 1973 to April 1974 with a threatened, inevitable, or incomplete abortion between 4-28 weeks of gestation . The women were primarily Muslim, married, unemployed, and uneducated with a mean parity of 3.2 . 98% of the patients were treated by dilatation and curettage and 2 by vacuum aspiration . No concurrent surgery was performed and none of the abortions were repeated . The most common complications included blood loss over 100 ml, fever requiring antibiotics, and pelvic infection . 24% of the women experienced at least 1 complication; however, only 11 patients were hospitalized overnight . Resuscitation, 1978, 6(3), 155 - 61 Prevention, diagnosis and treatment of carbon monoxide poisoning in an East-Slovakian ironworks; Sedlak J et al.; The development of industry brings an increase in number of industrial poisonings by carbon monoxide . To treat these the East-Slovakian Ironworks has organised preventive measures . Instructive cases are illustrated . Measurement of carbon monoxide--haemoglobin in the laboratory gives an objective index for the degree of poisoning and the progress of treatment . The authors used cobaltous nitrate (0.13 mol/l) for control of the method . The best treatment was found to be hyperbaric oxygen in combination with multi-vitamin treatment . In some cases cardiorespiratory and antibiotic treatment is also necessary. Arch Chir Neerl, 1978, 30(4), 245 - 50 Costochondritis of the costal arch; Leguit P Jr et al.; Costochondritis is a rare and symptom-poor affliction which often remains unrecognized for a long time . The diagnosis depends upon the patient's history and the physician's acquaintance with the disease . Body temperature, X-ray examination including sinography, WBC count and bacterial examination may be non-informative . Local resection of the affected cartilage, excochleation, cauterisation, irrigation and antibiotic treatment most often lead only to recurrence of the ailment . The definitive treatment consists of total resection of one or both costal cartilaginous arches . The cases of two patients are described. Zentralbl Gynakol, 1978, 100(3), 179 - 82 {Tubal actinomycosis as a complication of intrauterine contraception}; Kohoutek M et al.; PIP: Tubal actinomycosis was diagnosed in a 29-year-old patient, 1 month after insertion of a Dana super IUD . The patient presented with lower abdominal pain, and was treated on an outpatient basis . She was admitted to hospital when symptoms did not improve, and was treated with antibiotics . Symptoms improved, and the patient was released, but she was readmitted 2 months later with a diagnosis of acute pelviperitonitis and pyosalpinx . She was treated with chloramphenicol and antibiotics; pyosalpinx was drained twice . Laparotomy revealed bilateral pyosalpinx and right ovarian infection . Both Fallopian tubes and the right ovary were removed . Actinomycosis was identified in the post-operative tissue examination . Clin Exp Immunol, 1978 Jan, 31(1), 100 - 3 IgG rheumatoid factor in subacute bacterial endocarditis: relationship to IgM rheumatoid factor and circulating immune complexes; Carson DA et al.; With recently developed radioimmunoassays, we have been able to study the levels and properties of IgG rheumatoid factor (IgG RF) and IgM rheumatoid factor (IgM RF) in patients with subacute bacterial endocarditis (SBE), as well as the relationship of these autoantibodies to circulating immune complexes . We found significantly elevated amounts of IgG RF and IgM RF in SBE sera . The IgG RF chromatographed on Sepharose 6B as an intermediate complex, indistinguishable from the pattern seen in rheumatoid arthritis . RF levels peaked later in the course of SBE than did levels of circulating immune complexes . With antibiotic treatment RF levels declined, although not as fast nor as completely as circulating immune complexes . These results suggest that both IgG RF and IgM RF in SBE may be part of a polyvalent antibody response to elevated levels of circulating immune complexes which do not themselves contain RF. Acta Med Scand, 1978, 203(1-2), 71 - 4 Cerebrospinal fluid lysozyme in bacterial and viral meningitis; Klockars M et al.; The concentration of lysozyme (LZM) in cerebrospinal fluid was determined in 25 patients with bacterial meningitis, in 18 patients with viral meningitis and in 25 control patients who had other fibrile illnesses . The concentration of LZM was less than 1.5 microgram/ml in all control patients, and slightly to markedly raised in 10 patients with viral meningitis and in 11 out of 13 patients with untreated bacterial meningitis . The concentration of LZM was significantly different in the viral and bacterial meningitis patients (p less than 0.001) . Most raised concentrations of cerebrospinal fluid LZM persisted for at least one week after the start of antibiotic treatment . The concentrations of LZM correlated well with concentrations of lactic dehydrogenase . These results show that the determination of cerebrospinal fluid LZM is a useful tool in the differential diagnosis of meningitis, particularly when the prehospital treatment with antibiotics may be responsible for a diagnostically misleading negative bacterial culture of the cerebrospinal fluid and altered cerebrospinal fluid cytology. Scand J Infect Dis Suppl, 1978, (13), 64 - 6 The correlation of in-vitro susceptibility tests with in-vivo results of antibiotic treatment; Williams JD; The reason why the results of the clinical response to therapy do not always correspond to antibiotic laboratory testing include errors in performance or interpretation of test results, imprecise definition of resistance and host factors which influence the outcome of treatment regardless of the antibiotic being used . These factors are reviewed . Cephalosporins and penicillins pose problems because the prime effects of enzymes in influencing the outcome of treatment are not always clear in standard tests for susceptibility . Inter-laboratory differences in interpretation of tests makes comparisons of tests between centres difficult and the use of reference strains for validation of testing is proposed. Infection, 1978, 6(5), 228 - 30 Effect of erythromycin and amoxycillin on Bordetella pertussis in the nasopharynx; Trollfors B; The effectiveness of oral erythromycin and amoxycillin in eradicating Bordetella pertussis from the nasopharynx was compared . Erythromycin in a dosage of 40--50 mg/kg/day was significantly more effective than amoxycillin in a dosage of 25--30 mg/kg/day . The organism did not disappear in three cases receiving a lower dosage of erythromycin . As antibiotic treatment does not affect the clinical course of fully-developed whooping cough, erythromycin is indicated primarily when particularly susceptible individuals are threatened by exposure . In such cases erythromycin should be given as soon as whooping cough is suspected.
|
© 2005
Transgalactic Ltd (manufacturer of Bioscreen C software) |
Privacy Statement | P.O. Box
1393, 00101 Helsinki, Finland,
Last modified: May 25, 2005
| ||||||
