One hundred consecutive thymectomies for myasthenia gravis.

BACKGROUND: Between June 1997 and November 1993, 100 consecutive thymectomies for myasthenia gravis were performed at University of North Carolina Hospitals in Chapel Hill. METHODS: A consistent, planned protocol involving preoperative, intraoperative, and postoperative care was followed. All thymectomies were performed through a median sternotomy with removal of all visible thymus and perithymic fat in the anterior mediastinum. RESULTS: There was no perioperative mortality or longterm morbidity. Mean postoperative hospital stay was 6.3 days (range, 3 to 18 days). Ninety-six percent of the patients were extubated the day of the operation, and all patients were extubated within 24 hours. Mean postoperative intensive care unit stay was 1.2 days (range, 1 to 4 days). After a mean follow-up of 65 months (range, 1 to 199 months), 78% of all patients are improved by at least one modified Osserman classification when their current status is compared with their worst preoperative disease severity. In fact, 69% of patients with mild disease preoperatively (class I, II, or III maximal severity) are in pharmacologic remission (asymptomatic without regular medication), whereas 29% of patients with severe disease (class IV or V) are in remission (p = 0.0001). CONCLUSIONS: Our programmatic approach to thymectomy through a sternotomy has shown minimal morbidity and mortality. It is beneficial to myasthenics at both ends of the age and severity spectrum.

[Clinical evaluation of norfloxacin preparation in treatment of bacterial infections of the urinary tract in patients with various kidney diseases]. / Kliniczna ocena preparatu norfloksacyna w leczeniu bakteryjnych zakazen ukladu moczowego u chorych z róznymi chorobami nerek.

Norfloxacin (Nolicin Krka) has been administered to 22 patients with urinary tract infections. The drug has been administered in daily dose of 800 mg for 10 days. An ultimate result has been evaluated after 3 months. Sterile urine cultures or less that 10,000 cells per millilitre have been achieved in 13 (59%) patients. Relapse of infection with other strain have been found in 9 (41%) patients. No adverse reactions which required cessation of therapy have been noted. An examination of isolates sensitivity to norfloxacin in vitro has shown that the drug is active against Gram-negative Enterobacteriaceae, P. aeruginosa, and Gram-positive staphylococci. Various strains of streptococci have been insensitive to norfloxacin. The obtained results suggest that norfloxacin is useful antibacterial agent and produces both clinical and bacteriological improvement in about 60% of patients with urinary tract infections.

[Urinary tract infections in the first three months following kidney transplantation]. / Zakazenia ukladu moczowego w pierwszych trzech miesiacach po przeszczepieniu nerki.

Eighty kidney transplants were examined. During the first three months following transplantation, urinary tract infections occurred in 68 patients (85%). Fifty patients (74%) have had a few episodes of infections in the form of either suprainfection or recurrence whereas in the remaining patients there was only one episode of urinary infection. No difference in infection incidence was noted in both men and women. Ninety percent of urinary infections occurred within the first 4 weeks following transplantation. The most frequent cause of the urinary tract infections were gram-negative bacilli of Enterobacteriaceae family. In case of multiple infections there was a high percentage of gram-positive cocci.

[Susceptibility in vitro to certain quinolines of gram-negative bacteria and gram-positive cocci causing urinary tract infections]. / Wrazliwosc in vitro na niektóre chinolony Gram-ujemnych paleczek i Gram-dodatnich ziarenkowców powodujacych zakazenia ukladu moczowego.

Susceptibility to norfloxacin, ofloxacin, pipemidic acid and nalidixic acid of 848 bacterial strains isolated from urine of patients treated in 1989-1992 in Wroclaw hospitals was investigated. The study, performed by the disc diffusion methods, concerned 568 Enterobacteriaceae strains, 147 Gram-negative non-fermenting bacteria and 133 strains of staphylococci. Highest percentage (90-100%) of susceptibility to all used antimicrobial agents was detected among Escherichia, Proteus, Morganella and Citrobacter. Less frequent susceptibility (30-70%) was observed among Klebsiella, Enterobacter and Serratia. Among strains of P. aeruginosa susceptible to norfloxacin and ofloxacin were, respectively, 61.4 and 22.2% isolates. Over 95% of strains of P. aeruginosa were resistant to nalidixic acid. Among other non-fermenting Gram-negative bacteria, over 50% were resistant to norfloxacin and ofloxacin. Both S. aureus and S. epidermidis were susceptible to ofloxacin and norfloxacin in 81-93% of tested strains. They were 2-3 times less frequently susceptible to pipemidic and nalidixic acid.