ABSTRACT
The efficiency of vancomycin hydrochloride in the treatment of septicemia due to polyresistant aureus staphylococcus is illustrated by the observation of a patient affected with a necrotic and hemorrhagic acute pancreatitis and post-operative septicemic syndrome, which has been cured after a one-month treatment with a daily dose of two grammes. The vancomycin hydrochloride, because of its potential toxicity on the kidneys and cochlea should be reserved to the treatment of major staphylococcic infections. It could be prescribed either alone or in association, with a mean daily dose of 30 milligrammes a kilo, slowly administered by intravenous way. The side effects are prevented by adjusting the doses in case of renal insufficiency and by controlling the serous concentrations in case of a long continued treatment.
Subject(s)
Sepsis/drug therapy , Staphylococcal Infections/drug therapy , Vancomycin/therapeutic use , Adult , Drug Resistance, Microbial , Humans , Male , Sepsis/etiology , Staphylococcus aureus/drug effects , Vancomycin/adverse effectsABSTRACT
Rupture of the stomach occurred after insertion of a Linton-Nachlas sound in a 91-year-old patient. Possible mechanisms for the lesion were increased pressure from accumulation of blood in the stomach or the herniation of the balloon of the sound. Recovery was uneventful after intensive care therapy and suture of the wound. The possibility of such an accident should not discredit the use of hemostatic sounds.
Subject(s)
Catheterization/adverse effects , Hemostatic Techniques/adverse effects , Stomach Rupture/etiology , Aged , Catheterization/instrumentation , Female , Hemostatic Techniques/instrumentation , HumansABSTRACT
Normal surveillance was extended to include respiratory function tests (Vital capacity, FEV1, Maximum Breathing Capacity) on 40 post-operative patients. The reduction relative to pre-operative values on the 1st day after operation was of the order of 60 p. 100 for high abdominal incisions, 35 p. 100 for low abdominal incisions and 15 p. 100 for non abdominal incisions. A return to preoperative values was obtained on the 15th, the 6th and the 4th post-operative days respectively. These changes are found to be well correlated to the limitation of diaphragmatic movement in high incisions. As a result, there is a hypoventilation of the lower lobes of the lungs and a shunt effect which lead to hypoxaemia. The reduction in respiratory function in those subjects without an abdominal incision demonstrated that other factors, particularly the influence of a general anaesthesia, need to be taken into account. Numerous clinical observations show that a reduction in respiratory volumes and capacities do not spare the young subjects and may be dramatic in certain cases. These indicate that a daily assessment of respiratory function at the bedside may provide a simple means for early recognition of intercurrent complications.
