Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis.

BACKGROUND: Acute rhinosinusitis arises as a consequence of viral rhinitis, and bacterial infection can subsequently occur. Intranasal antibiotics as an adjunct to corticosteroids usually demonstrate the greatest symptom relief. AIM: We wanted to clinically evaluate the effects of a topical antibiotic and steroid combination administered intranasally, versus an oral antibiotic alone when treating acute rhinosinusitis. METHOD: Forty patients with acute bacterial rhinosinusitis were divided into two groups. Group A received an antibiotic and steroid combination (ofloxacin 0.26 per cent and dexamethasone 0.053 per cent nasal drops) for 10 days, administered intranasally (5 drops in each nostril/8 hours). Group B, the control group, received an oral antibiotic alone (amoxicillin 90 mg/kg). RESULTS: Eight hours after commencing treatment, facial pain was more severe in group B and nasal obstruction was reduced in both groups. Ten days after commencing treatment, anterior nasal discharge was 0.15 per cent in group A and absent in group B. CONCLUSION: The application of a topical antibiotic and steroid combination into the nasal cavity is an effective way of treating uncomplicated, acute bacterial rhinosinusitis with the theoretical advantages of easy administration, high local drug concentration and minimal systemic adverse effects.

Selective digestive decontamination (SDD) as a tool in the management of bacterial translocation following major burns.

Bacterial translocation after major burns plays an important role in burn sepsis and can be reduced with SDD. 30 patients with burns of 25-50% TBSA were divided into 2 groups. Group I received SDD regimen in the form of amikacin, miconazole, and colistin sulphate. Group II served as a control group. SDD treatment resulted in significant control of infectious episodes and multi-organ dysfunction syndrome (MODS). It also resulted in a reduction of mortality, although this was not statistically significant. Despite the statistical insignificance of the improved mortality rate, SDD treatment seems to be a useful tool in treating this group of highly critical patients.

La translocation bactérienne après des brûlures ha un rôle important dans le sepsis des brûlures et peut être réduite avec la décontamination sélective du tractus digestif (DSTD). 30 patients souffrant de brûlures de 25% à 50% de la surface corporelle totale (SCT) ont été divisés en 2 groupes. Groupe I a reçu DSDT sous la forme de l'amikacine, le miconazole et le sulfate de colistine. Groupe II a servi de groupe témoin. Le traitement DSTD a donné lieu à un contrôle important des épisodes infectieux et le syndrome de dysfonction d'organes multiples. Il a également entraîné une réduction de la mortalité, même si ce n'était pas statistiquement significative. En dépit la manque de la signification statistique du taux de mortalité amélioré, le traitement DSDT semble être utile pour ce groupe de patients très critiques.

Charge response function and a novel plasmon mode in graphene.

Polarizability of noninteracting 2D Dirac electrons has a 1/square root(qv-omega) singularity at the boundary of electron-hole excitations. The screening of this singularity by long-range electron-electron interactions is usually treated within the random phase approximation. The latter is exact only in the limit of N-->infinity, where N is the "color" degeneracy. We find that the ladder-type vertex corrections become crucial close to the threshold as the ratio of the nth order ladder term to the same order random phase approximation contribution is ln(n)|qv-omega|/N(n). We perform an analytical summation of the infinite series of ladder diagrams which describe the excitonic effect. Beyond the threshold, qv>omega, the real part of the polarization operator is found to be positive leading to the appearance of a strong and narrow plasmon resonance.