[Results of infection prevention in hip joint alloarthroplasty with cefamandole]. / Ergebnisse der Infektionsprophylaxe bei Hüftgelenksalloarthroplastik mit Cefamandol.

With regard to the unsatisfactory number of infections after total hip replacement operated in conventional operating rooms the problems of antibiotic prophylaxis has been discussed for years but has remained contested until today. We tested the efficiency of a peri- and postoperative prophylaxis of Cefamandole (Mandokef) on a non selected collective of 384 patients undergoing total hip replacement during a period of exactly two years. The results of these patients were compared to those of a preceded comparable collective of 319 patients who did not have a perioperative antibiotic prophylaxis. Cefamandole was given 4.6 postoperative days on the average. Compared to the collective of 319 patients there was a significant reduction of secondary healing in the "cefamandole-collective" from 3.1% to 0.8%. The number of deep infections were reduced from 3.8% to 0.8%. Allergic side effects of the antibiotic could be reduced from 12.5% ("secondary" prophylaxis sometimes applied to patients of the first collective) to 1.3% ("cefamandole-group"), the mycosis rate was reduced from 3.8% to 1.8%. There were no grave complications of the cefamandole-prophylaxis, not even effects on the microclimate of the hospital. Two of the three infected hip arthroplasties (prophylaxis-group) could be saved by a second operation when putting a through-drainage and giving a special antibiotic treatment. The prosthesis had to be removed only in one single case (0.3%). Beside the importance of a prophylactic antibiotic treatment we point out the efficiency of a clean air system, furthermore, these two procedures are economically justifiable.

[Short- and long-term prognosis of cardiac arrest in acute myocardial infarction (author's transl)]. / Kurz- und Langzeitprognose des Kreislaufstillstandes bei akutem Myokardinfarkt.

Of 80 patients with acute myocardial infarction who had a cardiac arrest without shock 42 (52.5%) were resuscitated in a cardiological intensive care unit. Twenty-six were finally discharged from hospital. After an average of four years, 21 patients were still alive. Prognosis of primary ventricular fibrillation, the most frequent cause of circulatory arrest (51) was more favourable than that of primary asystole (23 patients). The younger the patient the better the prognosis: the average age of the 21 who survived for several years was 12 years less than those who had died. Follow-up examination indicated that 13 had signs of heart failure. Ventricular extrasystoles were demonstrated by ECG in 11. Eight had depressive episodes. It is likely that a further decrease in death-rate can be achieved only if the interval between onset of infarction and admission to an intensive care unit can be shortened.