RESUMEN
Eighty-five patients were randomly allocated to receive either piperacillin (n = 38) or cefuroxime plus metronidazole (n = 45) after surgical treatment of diffuse peritonitis; 78 were evaluable. A mean of 1.5 (piperacillin group) and 1.7 (cefuroxime/metronidazole group) pathogens/patient were identified. Twenty-seven patients (71%) were successfully treated in the piperacillin group compared with 29 (64%) in the cefuroxime/metronidazole group. These data suggest that piperacillin was neither better nor worse than cefuroxime/metronidazole in diffuse, secondary peritonitis.
Asunto(s)
Cefuroxima/administración & dosificación , Metronidazol/administración & dosificación , Peritonitis/tratamiento farmacológico , Piperacilina/uso terapéutico , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cefuroxima/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Masculino , Metronidazol/uso terapéutico , Persona de Mediana EdadRESUMEN
20 patients who underwent thoracotomy and lung operations mainly for lung cancer, were given oral doxycycline (DC) 100-4-- mg the previous evening. Blood samples were taken for the fluorometric assay of DC before the anaesthetic, during the operation, and 2-3 hours postoperatively. Serum DC levels during the operation correlated approximately with the dose of DC, and they were parallel to the DC concentrations measured in pulmonary or/and bronchial tissue, 11 out of 20 patients showed elevated serum DC levels during recovery, non-specific fluorescence being excluded. This phenomenon was ot seen in experiments with rabbits in which the decline of the blood DC levels was assessed after the intravenous injection of DC. Possible causes for elevated serum DC are discussed.
Asunto(s)
Doxiciclina/metabolismo , Neumonectomía , Administración Oral , Adulto , Anciano , Animales , Doxiciclina/sangre , Femenino , Humanos , Inyecciones Intravenosas , Pulmón/metabolismo , Masculino , Persona de Mediana Edad , Conejos , Factores de Tiempo , Distribución TisularRESUMEN
Doxycycline levels were measured fluorimetrically in the serum and pulmonary tissue of 36 patients undergoing a pulmonary operation. Doxycycline 200 mg was given intravenously 20 hours before operation. The doxycycline concentration in pulmonary tissue (1.03 to 12.30 mug/g) were as high or higher than the serum doxycycline levels (0.94 to 7.82 mug/ml) in the majority of cases. This is possible as the lung has an ample blood supply and doxycycline is a lipophilic drug. There were large variations in the results, which was probably related to the underlying illness and to an altered blood circulation. The side effects were minimal. The daily infusions of doxycycline were continued over 5 days, no conclusions could be drawn about its possible prophylactic effect on postoperative infections.
Asunto(s)
Doxiciclina/análisis , Adolescente , Adulto , Anciano , Doxiciclina/administración & dosificación , Doxiciclina/efectos adversos , Doxiciclina/sangre , Femenino , Fluorometría , Humanos , Inyecciones Intravenosas , Pulmón/análisis , Pulmón/cirugía , Masculino , Persona de Mediana EdadRESUMEN
A report is made of a case of left diaphragmatic and pericardial rupture with luxation of the heart from the pericardial sac, resulting from a steering wheel injury. The patient was successfully treated surgically. In the treatment of this injury, correcting the hemodynamic derangement caused by incarceration and torsion of the heart is stressed. A review of the literature on pericardial ruptures is presented.