ABSTRACT
The McKittrick-Wheelock syndrome is a very rare complication of rectal villous adenoma, characterized by fluid and electrolyte hypersecretion from a rectal tumour, which can lead to acute renal failure. We present a case review of a 67-year-old male patient hospitalised for profuse secretory diarrhea, with electrolyte dysbalance and progressive renal failure. A rectoscopic finding of massive rectal adenoma contributed to establishing the correct diagnosis. Resection of the affected part of the rectum resulted in rapid restoration from mineral imbalance and improvement of renal functions. The reported case shows the necessity of interdisciplinar management and the importance of surgical treatment in patients with this rare diagnosis.
Subject(s)
Adenoma, Villous/complications , Diarrhea/etiology , Rectal Neoplasms/complications , Renal Insufficiency/etiology , Water-Electrolyte Imbalance/etiology , Aged , History, 20th Century , Humans , Male , SyndromeABSTRACT
Risk factors, mortality and antimicrobial susceptibility of Pseudomonas aeruginosa bacteremias isolated from 148 patients from all University Hospitals in Slovakia were analyzed. Only 1.2% of 169 strains of P. aeruginosa were resistant to meropenem, 4.1% to piperacillin/tazobactam, 7.7% to ceftazidime as well as cefepime and 12% to amikacin. More than 30% of P. aeruginosa were resistant to ciprofloxacin. Our analysis of risk factors for antimicrobial resistance to the particular antimicrobials, indicated no difference in risk factors and outcome in cases infected with P. aeruginosa bacteremias resistant to amikacin, piperacillin/tazobactam or ceftazidime in comparison to episodes caused by P. aeruginosa due to susceptible isolates. When comparing risk factors for P. aeruginosa bacteremia in children vs. adults, cancer vs. non-cancer patients, several differences in risk factors were observed. Neither antimicrobial resistance to amikacin, ceftazidime or piperacillin/tazobactam, nor appropriateness of therapy according to two separate analyses were associated with better outcome.
Subject(s)
Anti-Bacterial Agents/pharmacology , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/pathogenicity , Adult , Age Factors , Bacteremia , Child , Drug Resistance, Bacterial , Female , Humans , Male , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa/isolation & purification , Retrospective Studies , Risk Factors , Slovakia/epidemiologyABSTRACT
Since end 1994 all types of high anorectal fistulas were treated by endorectal advancement flap technique. This technique was adopted to treatment of fistulas identified in ischiorectal abscesses in 1997. Our purpose was to demonstrate early experience with this procedure in study focused on minor incontinence, complication and recurrence rate in patients treated in the years 1995-1997.
Subject(s)
Abscess/surgery , Rectal Diseases/surgery , Rectal Fistula/surgery , Surgical Flaps , Adult , Female , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
Authors quoted some own results and experience with using pharmacology define medicine of enteral nutrition feeding served by puncheon jejunostoming in case of difficult malnutrition caused especially by septical condition and also after larger operation of throat and stomach. They stated, that enteral feeding apply into the upper part of jejuna with thin cattier is physiological, secure and economical effective method of nutrition support. Combination serving of nutrition with enteral and parenteral feeding they find out hyperalimentary effect at examined group of patients which was confirmed by watching the anthropometrical parameters.