RESUMO
No disponible
Assuntos
Masculino , Adulto , Humanos , Isquemia Miocárdica/complicações , Distrofia Miotônica/complicações , Isquemia Miocárdica/diagnóstico , Distrofia Miotônica/diagnóstico , Tomografia Computadorizada de Emissão de Fóton ÚnicoAssuntos
Soropositividade para HIV/complicações , Doenças dos Seios Paranasais/complicações , Sinusite/complicações , Humanos , Imunoglobulina G/imunologia , Complexo Mycobacterium avium/isolamento & purificação , Doenças dos Seios Paranasais/fisiopatologia , Sinusite/microbiologia , Sinusite/fisiopatologiaRESUMO
The role of ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SMZ) was evaluated in empiric treatment of uncomplicated Salmonella enteritis in a comparative, double-blind trial. Patients were randomized to receive ciprofloxacin (500 mg), TMP-SMZ (160/800 mg), or placebo orally twice daily for 5 days. There were 65 evaluatable patients with acute, uncomplicated, culture-confirmed Salmonella enteritis. Duration of diarrhea, abdominal pain, or vomiting and time to defervescence were not significantly different for patients treated with ciprofloxacin, TMP-SMZ, or placebo; there also were no significant differences with respect to full resolution of symptoms for ciprofloxacin versus placebo (point estimate, 0.2 days; 95% confidence interval [CI], -0.5 to 0.9 days) or for TMP-SMZ versus placebo (point estimate, 0.2 days; 95% CI, -1.0 to 0.6 days). The rate of clearance of salmonellae from stools was not significantly different among the groups.
Assuntos
Ciprofloxacina/uso terapêutico , Enterite/tratamento farmacológico , Infecções por Salmonella/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Doença Aguda , Adulto , Método Duplo-Cego , Combinação de Medicamentos , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We prospectively evaluated 61 episodes of bacteremia in 54 patients with hepatic cirrhosis, representing 9% of the overall number of bacteremic episodes in adult patients seen in our center during the study period. Spontaneous bacteremia represented 46% of all episodes (virtually always in patients with ascites), followed by the urinary origin (30%). Gram negative organisms were isolated in 71% of episodes. 43% of these were hospital-acquired 25% of patients had spontaneous peritonitis. Among other complications of bacteremia there were shock (28%), renal failure (24%), and disseminated intravascular coagulation (6%). The mortality rate due to sepsis was 28%, that due to complications of cirrhosis by itself was 20%, and that of nonrelated diseases was 8%. Shock and renal failure secondary to bacteremia were independent predictors of a poor prognosis.
Assuntos
Cirrose Hepática/complicações , Sepse/epidemiologia , Injúria Renal Aguda/etiologia , Adulto , Idoso , Infecção Hospitalar/epidemiologia , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Cirrose Hepática/mortalidade , Masculino , Pessoa de Meia-Idade , Peritonite/complicações , Peritonite/epidemiologia , Estudos Prospectivos , Fatores de Risco , Sepse/complicações , Sepse/microbiologia , Sepse/mortalidade , Choque Séptico/etiologia , Choque Séptico/mortalidadeRESUMO
A 67-yr-old woman was admitted with dyspnoea, chest and neck pain and swelling of both supraclavicular fossae and the neck. Chest X-ray showed bilateral pleural effusions. Thoracocentesis yielded a milky fluid with a high triglyceride level. Four previously published cases had similar clinical manifestations. The pathophysiology is discussed.