RESUMO
The value of serum bactericidal activity (SBA) determination for assessing the effectiveness of antibiotic therapy was evaluated in a retrospective open study in 168 cases of septicemia. Outcomes in a first group (I) of 67 patients with a SBA of at least 1/4 were compared with outcomes in a second group (II) of 101 patients with a SBA below 1/4 or non-determined. Within these groups, outcomes of 37 septicemias due to Gram negative bacilli (subgroup Ia) and 22 staphylococcal septicemias (subgroup Ib) with a SBA greater than or equal to 1/4 were compared with outcomes in 26 septicemias due to Gram negative bacilli (subgroup IIa) and 22 staphylococcal septicemias (subgroup IIb) with a SBA less than 1/4. Statistical analysis of distribution of age, sex, underlying disease, biologic parameters and antibiotics given demonstrated no significant difference between the various groups. 56 patients (86.1%) recovered in group I, against 76 (79.1%) in group II; corresponding figures are 34 (91.1%) and 21 (84%) in subgroups Ia and IIa respectively. These differences are not significant (p greater than 0.05). Our findings suggest that an "effective" SBA fails to correlate with favorable outcome of septicemia.
Assuntos
Antibacterianos/sangue , Sepse/sangue , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Sangue , Feminino , Bactérias Gram-Negativas/efeitos dos fármacos , Humanos , Masculino , Estudos Retrospectivos , Sepse/tratamento farmacológico , Staphylococcus/efeitos dos fármacos , Streptococcus/efeitos dos fármacosRESUMO
Parathyroid carcinoma is rare and hits diagnosis often difficult. A case is reported, remarkable by the age of the patient (17 years), and the main peculiarities of the disease are reviewed: frequency of complete bone syndrome, palpable tumour of the neck, calcemia more than 140 mg/l, occurrence of recurrent palsy; relapsing course, death being dependent on hypercalcemia rather than metastasis; median survival time about five years, non influenced by chemotherapy. Ultrastructural study, previously realized in about thirty cases, is specially evaluated: it seems able to concur on anatomopathologic diagnosis, when assertion of malignancy is difficult.