ABSTRACT
In this limited series of 23 patients suffering from severe or life-threatening intra-abdominal infection, piperacillin + tazobactam, together with adequate surgical drainage and resections, cured 78% of our patients and eradicated almost all the pathogens. Side effects included essentially eosinophilia and elevation of transaminases but was never severe. Piperacillin + tazobactam seem thus to be an acceptable treatment, associated with correct surgical drainage. This regimen has to be compared in appropriate trial versus gold standard therapy, such as imipenem, a beta-lactam with aminoglucoside and imidazole or clindamycin or with broad spectrum beta-lactam and other inhibitors or beta-lactamases, but our rate of cure is impressive in such a population.
Subject(s)
Drug Therapy, Combination/therapeutic use , Gram-Negative Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/drug therapy , Penicillanic Acid/analogs & derivatives , Piperacillin/administration & dosage , Abdomen/surgery , Adult , Aged , Drainage , Eosinophilia/chemically induced , Female , Gram-Negative Bacterial Infections/surgery , Gram-Positive Bacterial Infections/surgery , Humans , Male , Middle Aged , Penicillanic Acid/administration & dosage , Penicillanic Acid/adverse effects , Piperacillin/adverse effects , Tazobactam , beta-Lactamase InhibitorsSubject(s)
Abdomen, Acute/diagnosis , Amylases/metabolism , Creatinine/metabolism , Pancreatitis/diagnosis , Abdomen, Acute/blood , Abdomen, Acute/enzymology , Abdomen, Acute/urine , Acute Disease , Amylases/blood , Amylases/urine , Creatinine/urine , Diagnosis, Differential , Female , Humans , Male , Pancreatitis/blood , Pancreatitis/enzymology , Pancreatitis/urineABSTRACT
Seventy patients admitted for abdominal surgery requiring short-term perioperative prophylaxis were randomized to receive minocycline + gentamicin or metronidazole + gentamicin. Thirty patients were considered to be infected at the time of surgery and were treated with the same regimen. In the prophylactic cohort, one patient from each group developed postoperative fever. One patient receiving minocycline developed a wound infection. The overall infection rate was 2.6%. In the treatment cohort, it appeared that the patients receiving metronidazole had more severe underlying diseases than those receiving minocycline. Consequently, more postoperative non-infectious complications were observed in the former. Minocycline + gentamicin appeared at least as effective than metronidazole + gentamicin in preventing postoperative infectious complications associated with abdominal surgery or in treating intra-abdominal infections.
Subject(s)
Bacterial Infections/prevention & control , Gentamicins/therapeutic use , Metronidazole/therapeutic use , Minocycline/therapeutic use , Postoperative Complications/drug therapy , Premedication , Tetracyclines/therapeutic use , Abdomen/surgery , Adult , Aged , Bacterial Infections/drug therapy , Bacterial Infections/etiology , Drug Therapy, Combination , Female , Humans , Male , Metronidazole/adverse effects , Middle Aged , Minocycline/adverse effects , Postoperative Complications/prevention & control , Random AllocationSubject(s)
Colonic Diseases/etiology , Intestinal Perforation/etiology , Pancreatitis/complications , Acute Disease , Adult , Female , Humans , Male , Middle Aged , Necrosis , Pancreatitis/pathologyABSTRACT
The decision to perform a lumbar sympathectomy in cases of severe distal arteritis should be made according to an objective selection method. The mixed active hyperemia test meets that condition.
Subject(s)
Arteritis/therapy , Hyperemia/diagnosis , Sympathectomy/methods , Adult , Aged , Ankle/blood supply , Arteritis/diagnosis , Female , Humans , Lumbosacral Region , Male , Middle Aged , Regional Blood FlowABSTRACT
Two cases of male breast cancer are presented. The patients underwent a modified radical mastectomy with immediate closure of the defect using a triple L-shaped transposition flap. We briefly recall the behaviour of these tumors and the applied surgical principles to define better the value of this plastic procedure. A variety of surgical plastic techniques are described and compared. The triple L-shaped Limberg flap, very well adapted to the treatment of male breast cancer, is described in detail. The results are gratifying both from the plastic and cancerologic view-point.
