RESUMEN
Lactate concentration was studied in 383 synovial fluid specimens from patients with various arthritides. The highest concentrations of lactate occurred in non-gonococcal septic synovial fluids. High values were recorded in seropositive rheumatoid arthritis and crystal-induced arthritides, medium values in synovial fluids from seronegative rheumatoid arthritis, seronegative spondylarthritides, gonococcal arthritis and haemarthrosis, and the lowest values in aspirates from osteoarthrotic joints. There was a positive correlation between synovial pH and lactic acid concentration. These data suggest that determination of lactate in synovial fluid can be valuable in the rapid exclusion of septic arthritis. Its value for differentiating between other inflammatory arthritides is discussed.
Asunto(s)
Artritis Infecciosa/metabolismo , Artritis/metabolismo , Lactatos/análisis , Líquido Sinovial/análisis , Artritis Reactiva/metabolismo , Artritis Reumatoide/metabolismo , Gonorrea/metabolismo , Hemartrosis/metabolismo , Humanos , Concentración de Iones de Hidrógeno , Ácido Láctico , Osteoartritis/metabolismo , Espondilitis Anquilosante/metabolismoRESUMEN
Bacampicillin hydrochloride, a pro-drug ester of ampicillin trihydrate which is hydrolysed to ampicillin after absorption, was used in a randomised comparative study of ampicillin 3.5 g and bacampicillin 1.6g (each with probenecid 1 g) in the treatment of uncomplicated gonorrhoea. This dose of bacampicillin was selected because in serum it gives approximately the same peak concentration of ampicillin as 3.5 g of the present drug. Genital, pharyngeal, and anal cultures were performed at the initial visit and at follow up 5-9 days after treatment. There was no statistically significant difference in the microbiological or clinical response of patients with genital gonorrhoea who were treated with ampicilin and those treated with bacampicillin. At 5-9 days after treatment, 93% of the ampicillin-treated patients and 89% of the bacampicillin-treated patients had negative genital, pharyngeal, and anal culture results; furthermore, 87% and 89% respectively had no symptoms of infection. Fewer gastrointestinal side effects were noted in the patients treated with bacampicillin.
Asunto(s)
Ampicilina/análogos & derivados , Ampicilina/uso terapéutico , Gonorrea/tratamiento farmacológico , Adolescente , Adulto , Ampicilina/efectos adversos , Ampicilina/metabolismo , Ensayos Clínicos como Asunto , Femenino , Gonorrea/metabolismo , Gonorrea/microbiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Resistencia a las Penicilinas , Distribución AleatoriaRESUMEN
Lactic acid concentrations in the synovial fluid of 84 patients with acute monoarticular arthritis were determined by gas liquid chromatography. Lactic acid values in 27 cases of nongonococcal septic arthritis were strikingly higher (mean 1170 mg/100ml) than in 45 cases of inflammatory or degenerative arthritis (mean 34 mg/100 ml), as well as in 12 cases of gonococcal arthritis (mean 27 mg/100 ml). With the proper equipment, determination of lactic acid can be a relatively rapid, reliable procedure. Synovial fluid lactic acid concentrations therefore can be used as a rapid, supplemental diagnostic aid in differentiating nongonococcal septic arthritis from both gonococcal and nonseptic acute arthritis.