Total hip prosthesis complication, periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report.

INTRODUCTION: The Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%. CASE PRESENTATION: A 76year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma. After an episode of dislocation of the prosthetic implant, in September 2014, she underwent a surgical operation to implant the acetabular component. A month later not in our facility, following a re-hospitalization for the dislocation of the arthroprosthesis, an infection from E. cloacae complex was discovered. After 2 years of chronic infection she came to our attention; the clinical picture featured coxalgia and secreting fistula in the surgical wound. Following a specific antibiotic therapy, carried out intravenously over the course of a month, we decided to intervene removing the left hip arthroprosthesis and placing an antibiotic spacer following the direction deduced from the antibiogram study of August 2016. CONCLUSION: The patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later.

Paracelsin E, a new peptaibol from Trichoderma saturnisporum.

The structure of paracelsin E, a new peptaibol from Trichoderma saturnisporum, has been determined primarily by fabms. The well-known paracelsins A, B, C, and D were also found in a culture of this organism.

[One-year therapy with dihydroergocristine for treatment of impaired alertness and memory in elderly patients. Placebo-controlled multicenter study]. / Einjährige Therapie mit Dihydroergocristin zur Behandlung von Aufmerksamkeits- und Gedächtnisstörungen bei älteren Patienten. Plazebo-kontrollierte multizentrische Studie.

This double-blind study of dihydroergocristine (DHEC, CAS 17479-19-5) versus placebo was performed in 240 elderly patients affected by chronic cerebrovascular disease or organic brain syndrome. The therapy was carried on for one year. Results pointed out a decrease of SCAG total score and a significant improvement of the target items "confusion, mental alertness and memory performance" after DHEC versus placebo. Furthermore the data show that DHEC maintained its activity throughout the 12-month trial period. Very few and mild side-effects were reported for both groups, thus confirming the well known good safety of the compound. Based on results of this 1-year investigation, it is concluded that DHEC treatment should not be abruptly interrupted, but continued for as long as possible.

Therapeutic usefulness of a corticosteroid, antibacterial and antifungal combination in skin diseases of various origins.

Forty-one patients with skin diseases of various origins were treated with an extempore combination of three creams containing clobetasone butyrate, sodium fusidate and ketoconazole. A mixture of the creams was applied once to 3-times daily for periods ranging from 5 to 15 days (mean 8.5 days). Assessments were made before, during and at the end of the treatment period using a symptom severity rating scale. The results showed that all symptoms regressed to a significant extent and by the end of the treatment period there had been complete disappearance or improvement with satisfactory remission in 97.6% of the patients. Local tolerance was excellent or good in all patients and there were no reports of any side-effects.

[Study of the tolerability and effectiveness of a new sleep-inducing preparation]. / Studio di tollerabilità e di efficacia su un nuovo preparato ipnoinducente

Flurazepam hydrochloride was experimented on 43 patients aged 33-83 yr with various forms of insomnia over a period of 4 to 23 days (mean 11.66). There were no changes in the laboratory data and gastroenteric tolerance was also excellent. Chi-square analysis showed that both the quantity and quality of sleep were significantly improved (P less than 0,001). There was no evidence of assuefaction or withdrawal symptoms.