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1.
Khirurgiia (Mosk) ; (3): 85-8, 2003.
Article in Russian | MEDLINE | ID: mdl-12698661

ABSTRACT

Three hundred and fifteen patients with necrotic forms of diabetic foot were examined and treated. Neuropathic infected form of diabetic foot was diagnosed in 45.7% patients, neuro-ischemic form--in 54.3%. Mixed aerobic-anaerobic infection in foot's necrotic focus was detected in 87.6% diabetic patients, only aerobic--in 12.4%. High level of intoxication was seen in these patients. Algorithm of complex surgical treatment of different forms of diabetic foot is presented.


Subject(s)
Diabetic Foot/pathology , Diabetic Foot/surgery , Bacterial Infections/pathology , Bacterial Infections/surgery , Diabetic Foot/microbiology , Humans , Retrospective Studies , Surgical Procedures, Operative/methods , Treatment Outcome
2.
Khirurgiia (Mosk) ; (1): 34-5, 2002.
Article in Russian | MEDLINE | ID: mdl-11875946

ABSTRACT

Long-term and severe pyonecrotic processes in diabetic patients testify to severe disorders of immune system in this disease. High titer of antibodies to tested autostrain demonstrated its etiologic role in infectious process. The study group consisted of 29 patients (with diabetic pyonecrotic foot lesions), control group--17 patients with burns of III a, b--IV stage affecting from 20 to 60% of body surface. In diabetic patients antibodies titer to the most encountered infectious agents Staphilococcus aureus and Pseudomonas aeroginosa was lower than in burn patients with immunity deficiency. Decrease of antibodies titer in diabetic patients testifies to high insufficiency of B-immunity.


Subject(s)
Burns/immunology , Diabetes Mellitus, Type 1/immunology , Diabetic Foot/immunology , Leg , Adolescent , Adult , Burns/pathology , Diabetes Mellitus, Type 1/complications , Diabetic Foot/etiology , Diabetic Foot/microbiology , Female , Humans , Leg/pathology , Male , Middle Aged , Necrosis , Pseudomonas Infections/microbiology , Staphylococcal Infections/microbiology
3.
Arkh Patol ; 61(4): 10-4, 1999.
Article in Russian | MEDLINE | ID: mdl-10520421

ABSTRACT

Two groups of patients with a grave form of diabetes mellitus type I and II with diabetic foot syndrome have been examined. Group 1 (21 cases) consisted of patients whose foot was amputated. The cause of the necrotic process was ischemia produced by alteration of the arterial vessels aggravated by infection. Patients of group 2 (18 cases) were treated with resultant wound healing and foot preservation. The material was subdivided into two subgroups: 1) tissue from the "infectious" foot with great amount of bacteria and inflammation reaction; 2) tissue from the "ischemic" foot with considerable alterations of microvessels structure. In both groups well developed granulation tissue was observed after the treatment; almost all the cells of this tissue included 3H-uridin and labelling with 3H-thymidine was increased in fibroblasts, endotheliocytes and pericytes.


Subject(s)
Diabetic Foot/pathology , Adult , Aged , Amputation, Surgical , Autoradiography , Biopsy , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/pathology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/pathology , Diabetic Foot/surgery , Foot/pathology , Humans , Microscopy, Electron , Middle Aged , Necrosis
4.
Antibiot Khimioter ; 44(1): 20-2, 1999.
Article in Russian | MEDLINE | ID: mdl-10095920

ABSTRACT

Pefloxacin was used in the treatment of 25 patients with wound infection in a dose of 400 mg orally twice a day for 10-12 days. As the monotherapy it was applied to 15 patients. 7 patients with clinical signs of non-clostridial anaerobic infection were treated with pefloxacin in combination with intravenous metronidazole. Pefloxacin was highly efficient in 96 per cent of the cases with extensive posttraumatic purulent wounds with and without bone affection, acute purulent wounds of the soft tissue, purulent wounds of the soft tissues in diabetic patients, trophic or decubitus ulcer. 266 clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Enterobacter spp. and Acinetobacter spp, were tested and 75 to 100 per cent of them was shown to be susceptible to pefloxacin and ciprofloxacin. At the same time the isolates of Pseudomonas aeruginosa and Klebsiella spp. were more susceptible to ciprofloxacin. The pathogen eradication and eradication with superinfection in the cases treated with pefloxacin amounted to 92 per cent. The drug tolerance was good. No clinically significant adverse events were recorded.


Subject(s)
Anti-Infective Agents/therapeutic use , Pefloxacin/therapeutic use , Soft Tissue Infections/drug therapy , Wound Infection/drug therapy , Adult , Aged , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged
5.
Antibiot Khimioter ; 41(9): 73-6, 1996.
Article in Russian | MEDLINE | ID: mdl-9005792

ABSTRACT

The experience with ofloxacin used for 10 years from 1986 to 1995 in the complex therapy of 208 patients with wound infection complicated in 51 patients (24.5 per cent) by respiratory tract infection such as purulent tracheobronchitis or pleuropneumonia was generalized. In 28 patients (13.5 per cent) persistent bacteriuria not susceptible to the routine drugs was stated. The clinical and bacteriological efficacies of ofloxacin in the group of the patients with noncomplicated purulent wounds of the soft tissues amounted to 85-91 and 74-80 per cent respectively. In the group of the patients with wound infection complicated by respiratory or urinary tract infection the clinical and bacteriological efficacies equaled 94-100 per cent. The appetite disorder, epigastric pain or nausea were rare. Only in 3 cases the adverse reactions required the treatment discontinuation. Despite the use of ofloxacin for many years, the susceptibility of the main causative agents of surgical infections to the drug remained high: Staphylococcus epidermidis 93.3 per cent, Staph.aureus 94.5 per cent, Pseudomonas aeruginosa 96.5 per cent, Escherichia coll 100 per cent, Proteus spp. 100 per cent, Enterobacter spp. 100 per cent, Acinetobacter spp. 82.3 per cent and Klebsiella spp. 88.8 per cent. The successive use of ofloxacin, at first intravenously for 3-5 days and then orally in the form of tablets for 3-5 days, in the treatment of 15 patients with wound infections of various genesis and localization subjected to osteoplastic reconstructive operations provided positive effects in all the cases and was economically advantageous.


Subject(s)
Anti-Infective Agents/therapeutic use , Bacteriuria/complications , Ofloxacin/therapeutic use , Respiratory Tract Infections/complications , Surgical Wound Infection/drug therapy , Wound Infection/drug therapy , Administration, Oral , Anti-Infective Agents/adverse effects , Drug Administration Schedule , Humans , Infusions, Intravenous , Microbial Sensitivity Tests , Ofloxacin/adverse effects , Retrospective Studies , Treatment Outcome , Wound Infection/complications
6.
Antibiot Khimioter ; 41(12): 24-9, 1996.
Article in Russian | MEDLINE | ID: mdl-9124982

ABSTRACT

The efficacy of cefpirome was estimated in the treatment of 25 patients: 15 patients with pyo-necrotic wounds of the soft tissue of various genesis and localization and 10 patients with deep thermal burns involving 8 to 40 per cent of the body surface. The clinical and bacteriological efficacies of the treatment in the patients with the wound infection amounted to 100 and 80 per cent respectively. In the patients with the burn infection the respective values were 90 and 80 per cent. The drug tolerance was good. Adverse reactions were observed in 1 patient. Bolus intravenous administration of the drug was preferable by comparison with the injections.


Subject(s)
Cephalosporins/therapeutic use , Skin Diseases, Bacterial/drug therapy , Soft Tissue Infections/drug therapy , Wound Infection/drug therapy , Adolescent , Adult , Burns/microbiology , Cephalosporins/adverse effects , Humans , Microbial Sensitivity Tests , Middle Aged , Necrosis , Skin Diseases, Bacterial/microbiology , Soft Tissue Infections/microbiology , Soft Tissue Infections/pathology , Treatment Outcome , Wound Infection/microbiology , Cefpirome
7.
Antibiot Khimioter ; 40(8): 40-2, 1995 Aug.
Article in Russian | MEDLINE | ID: mdl-8713437

ABSTRACT

Microflora of purulent necrotic lesions of the foot in 14 patients with diabetes mellitus was investigated by aerobic and anaerobic procedures. It was shown that the process was due to the same species of pathogenic microorganisms irrespective of the lesion severity. However, the number of the pathogens in the associations and the dissemination level per a patient were higher when the lesions were extended. The tissue microbial dissemination in the purulent foci was also higher in the patients with wounds complicated by marked inflammation of the surrounding tissues and the tissues under the lesion. The time course of the changes in the foot microflora during the target-aimed antibacterial therapy was followed up.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Diabetic Foot/microbiology , Diabetic Foot/pathology , Wound Infection/drug therapy , Female , Follow-Up Studies , Humans , Male , Necrosis
8.
Antibiot Khimioter ; 40(8): 43-5, 1995 Aug.
Article in Russian | MEDLINE | ID: mdl-8713438

ABSTRACT

Pefloxacin (Rhone-Poulenc, France) was used prophylactically and therapeutically in 8 and 21 surgical inpatients respectively. The majority of the Enterobacteriaceae isolates were susceptible to pefloxacin (91 to 100 per cent). The isolates of Acinetobacter spp. and Pseudomonas aeruginosa were less susceptible (77 and 33.3 per cent respectively). The isolates of Staphylococcus aureus and S. epidermidis were mainly susceptible to the drug. The high antimicrobial activity of pefloxacin used therapeutically well correlated with the favourable time course of the main disease. When pefloxacin was used prophylactically the results were positive in all the cases. The drug tolerance in the majority of the cases was good. Only 2 patients developed allergic reactions as multiple minipunctate rash. After discontinuation of the drug use and short-term course of the desensitization the clinical sings of the allergic reactions disappeared in 3 days.


Subject(s)
Anti-Infective Agents/therapeutic use , Pefloxacin/therapeutic use , Surgical Wound Infection/drug therapy , Anti-Infective Agents/adverse effects , Humans , Microbial Sensitivity Tests , Pefloxacin/adverse effects , Surgical Wound Infection/prevention & control , Treatment Outcome
9.
Antibiot Khimioter ; 39(12): 31-4, 1994 Dec.
Article in Russian | MEDLINE | ID: mdl-7733785

ABSTRACT

The clinical efficacy of sulperazone (cefoperazone + sulbactam) manufactured by Pfizer (USA) was studied in the treatment of 25 patients with wound infections. By the disease severity and complications 9 patients belonged to the risk group. Insulators with abacterial media or bandages with ointments on the polyethylene glycol base and drugs stimulating reparative processes (methyl-diadioxylin, dioxyzol, gentacycol) were used for the local treatment of the wounds. The clinical efficacy was stated in 92 per cent of the cases and in 76 per cent of the cases the efficacy was bacteriological. The tolerance of sulperazon was good in all the cases. The signs of the drug intolerance or affection of the hepatic or renal function were not detected. 281 clinical isolates of the aerobic microflora were tested for their antibiotic susceptibility. The highest susceptibility to sulperazone was observed in gram-positive organisms, gram-negative bacilli (Proteus mirabilis, Escherichia coli and Klebsiella spp.) and some nonfermenting bacteria.


Subject(s)
Cefoperazone/therapeutic use , Sulbactam/therapeutic use , Wound Infection/drug therapy , Adolescent , Adult , Aged , Drug Combinations , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged
10.
Antibiot Khimioter ; 39(2-3): 57-60, 1994.
Article in Russian | MEDLINE | ID: mdl-7979798

ABSTRACT

A clinical laboratory investigation of cefoperazon in the treatment of 27 patients with burn traumata and purulent necrotic wounds of the soft tissues of various genesis and localization was carried out. The clinical efficacy of the treatment was 75-86.6 per cent. 4 patients with extended purulent wounds of the soft tissues and bone affections were treated with cefoperazon and local application of gentacicol (a dosage form of gentamicin based on collagen with prolonged action) which provided the clinical effect in all the cases. 226 isolates from the wounds, urine, blood, sputum, pleural fluid and other substrates were tested and a rather high activity of cefoperazon against many strains of gram-positive and gram-negative organisms including Staphylococcus spp., Pseudomonas aeruginosa, Escherichia coli, Providencia sp. and Proteus spp. was revealed. The tolerance of the drug in all the cases was good.


Subject(s)
Burns/complications , Cefoperazone/therapeutic use , Skin Diseases, Bacterial/drug therapy , Soft Tissue Infections/drug therapy , Wound Infection/drug therapy , Adolescent , Adult , Aged , Bacteria/drug effects , Bacteria/isolation & purification , Burns/drug therapy , Burns/microbiology , Cefoperazone/adverse effects , Cefoperazone/pharmacology , Dose-Response Relationship, Drug , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Skin Diseases, Bacterial/microbiology , Soft Tissue Infections/microbiology , Wound Infection/etiology , Wound Infection/microbiology
11.
Antibiot Khimioter ; 36(9): 44-6, 1991 Sep.
Article in Russian | MEDLINE | ID: mdl-1781714

ABSTRACT

A clinico-laboratory study on ciprofloxacin made by Bayer (Germany) was applied to patients with extended posttraumatic wounds and performed with the aim of preventing postoperative purulent complications in patients operated on the organs of the gastrointestinal tract. In the both groups ciprofloxacin was administered orally in doses of 500 and 1000 mg and intravenously in a dose of 200 mg. The results of the assay on ciprofloxacin sensitivity of the isolates from the wound excretion and urine showed that they were more sensitive to ciprofloxacin than to aminoglycosides and cephalosporins. 15 minutes after the intravenous administration the serum concentration of ciprofloxacin amounted to 7.5 +/- 0.9 micrograms/ml and in 6 hours it was equal to 0.45 +/- 0.45 micrograms/ml, the mean concentrations of ciprofloxacin being attained in the bile (8.7 +/- +/- 3.9 micrograms/ml), gallbladder wall (5.5 +/- 3.8 micrograms/g), liver (0.73 micrograms/g), muscles (1.93 micrograms/g) and tendon (0.15 microgram/g). After the oral administration in a dose of 500 mg ciprofloxacin was detected in the blood serum in an amount of 2.0 +/- 0.7 micrograms/ml in 1 hour and in an amount of 0.9 +/- 0.13 micrograms/ml in 6 hours. After the drug oral administration in a dose of 1000 mg the maximum concentrations were: 6.34 +/- 4.2 micrograms/ml on the average and 2.1 +/- 0.8 micrograms/ml in 6 hours (0.4 micrograms/g in the muscles, 1.4 micrograms/g in the skin and 0.34 micrograms/g in the bones). The study showed that ciprofloxacin was a highly efficient antimicrobial agent in the treatment of the complicated wound infections and the prophylaxis of the purulent complications during the postoperative period in the patients operated on gastrointestinal organs.


Subject(s)
Ciprofloxacin/therapeutic use , Surgical Wound Infection/prevention & control , Administration, Oral , Ciprofloxacin/pharmacokinetics , Humans , Injections, Intravenous , Microbial Sensitivity Tests , Surgical Wound Infection/drug therapy , Surgical Wound Infection/metabolism
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