Treatment of postpneumonectomy empyema with or without bronchopleural fistula.

Bronchopleural fistula with empyema is an uncommon but tragic complication after pulmonary resection. The possible therapeutic procedures are discussed. The patient often requires multiple surgical interventions and prolonged hospitalisation. According to the literature, open window thoracostomy (OWT) and even mutilating interventions such as myoplasty or thoracoplasty have to be performed when simple chest-tube drainage and antibiotic therapy do not suffice as illustrated by the present case.

[Effectiveness of ofloxacin in the treatment of wound infections]. / Wirksamkeit von Ofloxacin bei der Behandlung von Wundinfektionen.

Ofloxacin (OFX) and doxycycline (D) were compared in an open randomized study in the treatment of wound infections, including soft tissue, traumatic and postoperative wound infections caused by gram-positive as well as gram-negative pathogens. Doses were 2 X 200 mg/day of OFX (n = 21) and 2 X 100 mg/day of D (n = 20). In three cases from the OFX group, the daily dose was successfully increased to 2 X 300 mg. Clinical cure was observed in 20 of 21 patients on OFX and in 12 of 20 patients on D. One patient who failed to respond clinically in the OFX group showed moderately severe gastric pain (possibly drug-related), but by the time this adverse effect became evident, the wound exudate had already cleared bacteriologically. In this study OFX proved to be highly effective in the treatment of wound infections, and it was also well tolerated. Not only did symptoms disappear more frequently under OFX than under D, but they also disappeared more quickly.

Trental 400 in the treatment of intermittent claudication: results of long-term, placebo-controlled administration.

A double-blind, randomized, placebo-controlled long-term clinical study of Trental 400 was carried out, partly under cross-over design, partly as a parallel-group study, in 36 patients suffering from chronic arterial obstructive disorders in the lower limbs, associated with intermittent claudication, in order to evaluate the effectiveness and the safety of this drug administered t.i.d. over a period of 6 months. This controlled period was preceded by a placebo run-in period of 3 months. The clinical results under Trental 400 showed a statistically significant within group improvement of painfree and maximum walking parameters (p less than 0.05) corresponding to an increase to baseline by +96% to +139% respectively and also in comparison to placebo (p less than 0.05). The alterations of walking parameters within the placebo groups, ranging between -25% and +28% were not significant. The subjective parameters (rest pain, paraesthesias, muscular cramps and sensation of heaviness in the legs) paralleled the course of the walking parameters. Under Trental 400, 24 out of 36 patients reported an improvement of these symptoms compared to 7 under placebo. Trental 400 was well tolerated. Minor side effects were mentioned by 7 out of 36 patients. One patient had to stop the drug treatment because of persisting prickling sensation and subsequent insomnia. Drug-related changes in the laboratory findings could not be detected; vital signs varied in function of age, concomitant drug treatments and seasonal factors. The results obtained in these studies suggest Trental 400 as a drug of choice for treating patients with intermittent claudication due to peripheral arterial obstruction according to stage II or III after Fontaine.