RESUMEN
No disponible
Asunto(s)
Masculino , Adulto , Humanos , Isquemia Miocárdica/complicaciones , Distrofia Miotónica/complicaciones , Isquemia Miocárdica/diagnóstico , Distrofia Miotónica/diagnóstico , Tomografía Computarizada de Emisión de Fotón ÚnicoAsunto(s)
Seropositividad para VIH/complicaciones , Enfermedades de los Senos Paranasales/complicaciones , Sinusitis/complicaciones , Humanos , Inmunoglobulina G/inmunología , Complejo Mycobacterium avium/aislamiento & purificación , Enfermedades de los Senos Paranasales/fisiopatología , Sinusitis/microbiología , Sinusitis/fisiopatologíaRESUMEN
The role of ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SMZ) was evaluated in empiric treatment of uncomplicated Salmonella enteritis in a comparative, double-blind trial. Patients were randomized to receive ciprofloxacin (500 mg), TMP-SMZ (160/800 mg), or placebo orally twice daily for 5 days. There were 65 evaluatable patients with acute, uncomplicated, culture-confirmed Salmonella enteritis. Duration of diarrhea, abdominal pain, or vomiting and time to defervescence were not significantly different for patients treated with ciprofloxacin, TMP-SMZ, or placebo; there also were no significant differences with respect to full resolution of symptoms for ciprofloxacin versus placebo (point estimate, 0.2 days; 95% confidence interval [CI], -0.5 to 0.9 days) or for TMP-SMZ versus placebo (point estimate, 0.2 days; 95% CI, -1.0 to 0.6 days). The rate of clearance of salmonellae from stools was not significantly different among the groups.
Asunto(s)
Ciprofloxacina/uso terapéutico , Enteritis/tratamiento farmacológico , Infecciones por Salmonella/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Enfermedad Aguda , Adulto , Método Doble Ciego , Combinación de Medicamentos , Heces/microbiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We prospectively evaluated 61 episodes of bacteremia in 54 patients with hepatic cirrhosis, representing 9% of the overall number of bacteremic episodes in adult patients seen in our center during the study period. Spontaneous bacteremia represented 46% of all episodes (virtually always in patients with ascites), followed by the urinary origin (30%). Gram negative organisms were isolated in 71% of episodes. 43% of these were hospital-acquired 25% of patients had spontaneous peritonitis. Among other complications of bacteremia there were shock (28%), renal failure (24%), and disseminated intravascular coagulation (6%). The mortality rate due to sepsis was 28%, that due to complications of cirrhosis by itself was 20%, and that of nonrelated diseases was 8%. Shock and renal failure secondary to bacteremia were independent predictors of a poor prognosis.
Asunto(s)
Cirrosis Hepática/complicaciones , Sepsis/epidemiología , Lesión Renal Aguda/etiología , Adulto , Anciano , Infección Hospitalaria/epidemiología , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Humanos , Cirrosis Hepática/mortalidad , Masculino , Persona de Mediana Edad , Peritonitis/complicaciones , Peritonitis/epidemiología , Estudios Prospectivos , Factores de Riesgo , Sepsis/complicaciones , Sepsis/microbiología , Sepsis/mortalidad , Choque Séptico/etiología , Choque Séptico/mortalidadRESUMEN
A 67-yr-old woman was admitted with dyspnoea, chest and neck pain and swelling of both supraclavicular fossae and the neck. Chest X-ray showed bilateral pleural effusions. Thoracocentesis yielded a milky fluid with a high triglyceride level. Four previously published cases had similar clinical manifestations. The pathophysiology is discussed.