Cefpodoxime proxetil in the treatment of skin and soft tissue infections.

Patients with skin and soft tissue infections were enrolled in a study comparing 2 dosage regimens of orally administered cefpodoxime proxetil; 204 patients with mild to moderate infections received cefpodoxime proxetil 200mg twice daily and 47 patients with severe infections received 400mg twice daily. Both dosage regimens were given for 7 to 14 days. 132 of 142 (93.0%) evaluable patients in the 200mg group and 22 of 29 (75.9%) in the 400mg group were clinically cured post-therapy, the remainder in both groups being classified as improved. The pathogen eradication rate at the end of therapy in the 200mg group was 161 of 165 (97.6%), and 38 of 38 (100%) in the 400mg group. Adverse reactions (drug-related) were reported by 20 (8.0%) patients overall, and there was no apparent relationship between the dosage group and the incidence of adverse reactions. The most commonly reported reactions involved the gastrointestinal tract (diarrhoea) or female genital tract (vaginitis). Cefpodoxime proxetil appears to be a useful and safe agent in the therapy of skin and soft tissue infections.

Recurrent villous adenoma of the duodenum.

A patient is presented who in 1977 had a villous adenoma of the duodenum presenting with a diarrheal syndrome. Surgical removal of the polypoid mass lesion, which was pathologically a benign villous adenoma, resulted in resolution of her diarrhea. She remained asymptomatic until 6.5 yr later when diarrhea recurred. Radiographic and endoscopic examinations revealed a large villous adenoma within the proximal duodenum. After endoscopic polypectomy, her diarrhea promptly ceased. This is the first reported case of diarrhea associated with a villous adenoma of the duodenum.

Flexible sigmoidoscopy for screening in primary practice. A key to improved survival in colon cancer.

Numerous recommendations have been made in recent years regarding periodic screening for colon disease, specifically cancer. Early detection and treatment are essential for improved survival rates, and patient education is the key to success. Important factors in a screening test are reasonable cost and ease of performance. Testing for fecal occult blood fulfills these requisites but lacks specificity. Digital rectal examination should be done regularly but has limitations. Because flexible fiberoptic sigmoidoscopy has a high acceptance rate, low complication rate, and high yield and is relatively easy to perform, this procedure should be in the diagnostic armamentarium of all primary care physicians. Results of 129 flexible sigmoidoscopies performed by primary care physicians at Scripps Clinic indicate the usefulness of this procedure as a screening test for colon cancer.