Vancomycin prophylaxis in joint arthroplasty.

Postoperative infections in prosthetic surgery still constitute a serious problem, and one that is difficult to treat, because of the occurrence of agglomerates of microbes that are resistant to immune defenses and antibiotics. In nearly all cases, removal of the prosthesis is the only possible means of solving the problem of infection. The systematic use of antibiotic prophylaxis in surgery of this sort offers advantages in terms of a reduction in the risk of infection. The authors present a personal case series relative to the strategies of perioperative antibiotic prophylaxis used in cases of hip and knee arthroplasty; we refer to 233 joint arthroplasties performed between October 1993 and April 1996. In all of the cases, perioperative prophylaxis with vancomycin chlorohydrate at a dose of 1 g i.v. 1 hour prior to surgery, and 6-8 hours after surgery was carried out. The choice of the antibiotic was based on the epidemiological knowledge of the literature and the experience on the ward.

Lowe syndrome: general problems in a female patient.

The authors describe a clinical case of a patient affected with Lowe syndrome. Ocular modifications, as well as those involving the nervous system, renal function, and the locomotor apparatus, typical of the syndrome, are taken into consideration. The problem of axial deformity of the knee, secondary to spontaneous fracture of the femur, a frequent occurrence in these patients, is dealt with.

Agenesia of the pectoral muscle.

Two cases of agenesia of the pectoral muscle are presented. Clinical examination is sufficient for diagnosis. Nonetheless, dosage of LDH and CPK is needed in order to exclude primary myopathy. Surgery is rarely indicated in selected cases of female sex, for cosmetic purposes.