RESUMO
Research suggests that hyperbaric oxygen therapy may have beneficial effects on ulcer healing and amputation rates in diabetic patients. This paper describes the design of a study that is evaluating its effects on chronic diabetic foot ulcers.
Assuntos
Pé Diabético/terapia , Oxigenoterapia Hiperbárica/métodos , Atividades Cotidianas , Amputação Cirúrgica/estatística & dados numéricos , Atitude Frente a Saúde , Doença Crônica , Pé Diabético/diagnóstico , Pé Diabético/psicologia , Método Duplo-Cego , Teste de Esforço , Humanos , Oxigenoterapia Hiperbárica/psicologia , Ambulatório Hospitalar , Equipe de Assistência ao Paciente/organização & administração , Estudos Prospectivos , Qualidade de Vida/psicologia , Projetos de Pesquisa , Índice de Gravidade de Doença , Inquéritos e Questionários , Suécia , Resultado do Tratamento , Caminhada , CicatrizaçãoRESUMO
In a prospective study, 73 patients with erysipelas were studied bacteriologically, serologically and clinically. Pathogenic bacteria were isolated from 41% of the patients. Group G streptococci (GGS) were found as frequently as group A streptococci (GAS), in 12.5% and 15% of patients, respectively. Staphylococcus aureus was isolated in 10%, and streptococci groups B, C and D were isolated from one case each. Raised ASO titres were found among patients with GAS and GGS, while a rise in ADNase B titre was found only in patients with GAS. Patients with GGS tended to be older than other patients. Otherwise no clinical differences were noticed. The infection was located to the lower extremity in 68%. Predisposing factors were observed in 44% of the patients, predominantly local circulatory insufficiency and malignancies. In 55% a possible portal of entry was present. GGS seems to be a common cause of erysipelas, especially among patients older than 50 years.
Assuntos
Erisipela/microbiologia , Streptococcus/isolamento & purificação , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/análise , Proteínas de Bactérias , Desoxirribonucleases/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Streptococcus/imunologia , Estreptolisinas/imunologiaRESUMO
This double-blind, multicentre study was performed at nine centres on a total of 171 patients who presented with fever (> 38.5 degrees C) and signs of acute pyelonephritis. All were initially treated with intravenous cefuroxime. After 2-3 d, when the fever had subsided and urinary culture had revealed growth of Gram-negative bacteria ( > 10(7) colony-forming units per litre), treatment was changed to oral administration of ceftibuten 200 mg b.i.d. or norfloxacin 400 mg b.i.d. for 10 d. The patients were followed for signs of bacterial or clinical relapse 7-14 d after the end of treatment. The initial clinical and bacteriological cure was excellent in both groups, but there were significantly fewer bacterial relapses after oral treatment with norfloxacin than with ceftibuten in acute febrile pyelonephritis initially treated with intravenous cefuroxime. The causal strain was eradicated in 75% of patients (73% of males, 76% of females) in the ceftibuten group and in 89% of patients (94% of males, 85% of females) in the norfloxacin group. The relative frequency of eradication was 0.84 (p < 0.05; 95%, confidence interval 0.74-0.97). Adverse events were reported by 47% of the patients in the ceftibuten group and by 38% in the norfloxacin group. This difference was not significant, but diarrhoea or loose stools occurred more frequently in the ceftibuten group.