RESUMO
Results of clinico-microbiological examinations of 147 patients with peritonitis were analyzed. Strict anaerobic technique was used. It was established that in most cases peritonitis represented a mixed anaerobic aerobic infection (59.2%). The coliform microorganisms were dominating among aerobic ones, bacteroids-among anaerobic ones. The microbic character of inflammation (from abacterial to mixed forms) is dependent on the level (localization) of the inflammation source, duration of the inflammatory process. Mixed aerobic-anaerobic peritonitis has characteristic clinical features and requires an adequate antibacterial therapy.
Assuntos
Infecções por Bacteroides/complicações , Infecções por Escherichia coli/complicações , Peritonite/etiologia , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Peritonite/microbiologiaRESUMO
An analysis of clinical observations shows the successful treatment of most patients with open pneumothorax to be possible under conditions of urgent suturing of the wound defect of the chest, drainage of the pleural cavity and antishock therapy. Thoracotomy is necessary for a small amount of the patients.
Assuntos
Pleura/lesões , Pneumotórax/cirurgia , Ferimentos por Arma de Fogo/complicações , Drenagem/métodos , Humanos , Pleura/cirurgia , Pneumotórax/etiologia , Choque Traumático/prevenção & controle , Técnicas de SuturaRESUMO
Exact indications for urgent, early and late thoracotomy are given on the basis of a great clinical experience of the authors. Specific features of the operation, principles of the management of postoperative patients are described. The general postoperative lethality from chest injuries of the patients was 9.5%.
Assuntos
Traumatismos Torácicos/cirurgia , Ferimentos Penetrantes/cirurgia , Emergências , Hemotórax/cirurgia , Humanos , Pneumotórax/cirurgia , Cuidados Pós-Operatórios , Infecção da Ferida Cirúrgica/prevenção & controle , Traumatismos Torácicos/complicações , Fatores de Tempo , Ferimentos Penetrantes/complicaçõesRESUMO
Skin tests with a complex of antigens have revealed anergy in the postoperative period in 17 out of 116 patients with acquired heart diseases. Postoperative purulent complications were observed in 13 out of them. They were effectively treated by repeated transfusions of concentrations of the donor compatible leukocytes.
Assuntos
Transfusão de Sangue , Cardiopatias/cirurgia , Transfusão de Leucócitos , Linfopenia/terapia , Infecção da Ferida Cirúrgica/terapia , Cardiopatias/imunologia , Humanos , Tolerância Imunológica , Infecção da Ferida Cirúrgica/etiologiaRESUMO
Bacteriological examinations of 65 patients with abscesses of lungs and pleuritis have shown that non-sporulating anaerobic bacteria were isolated in 85% of purulent foci (without a concomitant aerobic microflora). Express-methods of diagnosis taking only 30-40 minutes give opportunities for early etiotropic therapy. Best results of treatment of anaerobic abscesses of lungs and pleuritis were obtained by a combination of sufficient drainage with the purposeful antianaerobic therapy.
Assuntos
Abscesso Pulmonar/diagnóstico , Pleurisia/diagnóstico , Adulto , Idoso , Bactérias Anaeróbias , Cloranfenicol/análogos & derivados , Cloranfenicol/uso terapêutico , Terapia Combinada , Feminino , Humanos , Lincomicina/uso terapêutico , Abscesso Pulmonar/terapia , Masculino , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Penicilinas/uso terapêutico , Pleurisia/terapiaRESUMO
The article analyzes scientific problems for studying infection. Attention is paid to another role than that attributed by surgeons to staphylococci, gram-negative bacillus flora and anaerobes. A revision of the routinely used classification of surgical infections is shown to be necessary since their traditional division into purulent, putrifactive, anaerobic and specific ones is not up to the present state of science. It is noted that anaerobes take part in the appearance of 87% of postoperative complications and similar hospital infections.
Assuntos
Infecções Bacterianas/epidemiologia , Infecção Hospitalar/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Bactérias Aeróbias , Bactérias Anaeróbias , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/etiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/etiologia , Bactérias Gram-Negativas , Humanos , Risco , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologiaRESUMO
An analysis of results of intracutaneous tests with a set of microbe allergens in 121 patients has shown that absence of a skin reaction to all the allergens under test demonstrates a disturbed immune response (incidence of infectious complications was 77%, both lethal outcomes included). The selective hypersensitivity to the injection of certain allergens was due to the carrier state. The normal reaction of slow type hypersensitivity was found in 101 patients (86,4%) and showed no disorders in immune reactivity which was confirmed by the postoperative course without complications. The test of the slow type hypersensitivity is considered to be highly informative and to allow prognosis of postoperative complications.
Assuntos
Antígenos de Bactérias , Infecção da Ferida Cirúrgica/diagnóstico , Linfócitos B/imunologia , Humanos , Imunidade Celular , Imunoglobulinas/análise , Contagem de Leucócitos , Prognóstico , Testes Cutâneos , Infecção da Ferida Cirúrgica/imunologia , Linfócitos T/imunologiaRESUMO
On the basis of their experience with the treatment of such patients the authors describe modern principles of the treatment of penetrating wounds of the breast with special reference to indications for thoracotomy, treatment of lung contusion, posttraumatic empyema of the pleura.
Assuntos
Lesão Pulmonar , Ferimentos por Arma de Fogo/cirurgia , Desbridamento , Drenagem , Empiema/cirurgia , Hemopneumotórax/cirurgia , Hemotórax/cirurgia , Humanos , Pleura/cirurgia , Cirurgia Torácica/métodos , Ferimentos por Arma de Fogo/complicaçõesRESUMO
The effect of lasting peripheral counterpulsation upon the haemodynamics and the main biochemical factors of the blood was studied in 14 dogs with intact hearts. In cases of significant tachycardia counterpulsation in a 1:2 regimen results in only a partial reduction of the resistance to the cardiac output. This does not always permit to prevent the formation of the phenomenon of an elevated myocardial contractility. The haemodynamic conditions are most optimal in a 1:1 regimen of counterpulsation. Slowing down of the cardiac rhythm was achieved by means of hypothermia.