PubMed Health⌕ Search

Biomedical subjects

A Palmu

Publications and source records attributed to A Palmu.

At least 19 recordsLinked to original sources
PubMed1986

Multiresistant Staphylococcus epidermidis as a pathogen.

The purpose of this study was to examine the occurrence and the present clinical significance of multiresistant strains of Staphylococcus epidermidis (MSE) at the departments of internal medicine, general surgery, neurology and lung diseases of an university hospital. All those 178 consecutive in-patients from whom, during a half-year investigation period, a strain of MSE was isolated, were immediately enrolled in the study. A strain was defined as multiresistant if it was resistant to 3 or more antimicrobial agents. The clinical course of the patients was followed prospectively daily for any sign of infection. The multiresistant strains amounted to 57.9% of all recovered Staph. epidermidis strains. The mean age of the patients was 50.3 years. A chronic underlying disease was present in 97%. There was a clinical infection in 155 patients, and in 115 of these (65% of the total) the MSE very probably was the true pathogen. The distribution of these infections was as follows: wound infection in 49 (43%), urinary tract infection in 43 (37%), local soft tissue infection in 13 (11%) and septicaemia in 10 (9%) patients. In 40 patients (22% of the total) the role of the MSE in the infection remained uncertain and in 23 patients (13%) the finding obviously was an accidental skin contamination.

Adolescent↗
PubMed1986

The prognostic significance of radiologically determined gastric emptying time before proximal gastric vagotomy.

The importance of undisturbed pyloric function is known among surgeons applying proximal gastric vagotomy (PGV) for duodenal ulcer disease. On the other hand, the prognostic significance of subclinically impaired antroduodenal motility is unknown after this operation. Therefore, in the present study 43 PGV patients with normal gastric emptying were compared with 24 PGV patients with prolonged gastric emptying as to the postoperative incidence of ulcer recurrence and symptomatology. Prior to surgery gastric emptying time was determined radiologically in all patients, none of whom had symptoms or signs of gastric outlet obstruction. The duration of postoperative follow-up in the series was 8 to 11 years. The incidence of ulcer recurrence during follow-up was 16% in the whole series, being significantly higher among patients with the primary ulcer in the pyloric or prepyloric area than among those with the lesion in the duodenal bulb. Furthermore, in the patient group with a primary ulcer in the duodenum an excellent operation result was achieved significantly more frequently in the case of preoperatively normal gastric emptying than in the case of delayed emptying. The incidence of ulcer recurrence tended also to be higher among the duodenal ulcer patients with prolonged emptying than among those with normal emptying through the difference between the groups did not reach statistical significance. This study emphasizes the prognostic significance of unimpaired gastric emptying and of even minor subclinical motor dysfunction when electing PGV as the surgical treatment and also that radiologic determination of gastric emptying time before PGV is of value in all patients undergoing the operation, irrespective of the location of the primary ulcer.

Adult↗
PubMed1979

Radiological assessment of nipple-valve insufficienty in Kock's continent reservoir ileostomy.

In a series of 51 continent reservoir ileostomies nipple-valve insufficiency developed in 15 patients who were examined radiographically to find the cause for the loss of continency. The radiological diagnosis was confirmed at reoperation. The causes for nipple-valve insufficiency were a total or partial disappearance of the nipple-valve by sliding of the invaginate (7 cases) and dislocation of an undamaged nipple out of the reservoir (8 cases). In these groups the radiological diagnosis was compatible with the operative findings in all but one case. At reoperation a fistula in the nipple-valve was found in 3 cases, but in no instance had this been diagnosed radiologically. A correct preoperative diagnosis is valuable, especially in cases of dislocation, where a danger exists that the real mechanism of valve insufficiency may remain obscure at operation.

Humans↗
PubMed1979

Ornidazole and anaerobic bacteria: in vitro sensitivity and effects on wound infections after appendectomy.

The sensitivities of 68 clinical isolates of Bacteroides fragilis, 18 of Clostridium perfringens, and 11 of other Clostridium species were tested against ornidazole alone and in combination with ampicillin and gentamicin. A concentration of 3.1 microgram of ornidazole/ml inhibited 98% of the strains of B. fragilis, with greater sensitivity when ampicillin and gentamicin were also present. A concentration of 6.2 microgram of ornidazole/ml inhibited 16 of 18 strains of C. perfringens and all 11 strains of other Clostridium species. Concentrations in serum and tissue were determined after intravenous infusion of 500 mg of ornidazole 15 min prior to appendectomy. During the operation the concentration in serum was 7.90 +/- 0.57 microgram/ml, and in appendix tissue, 5.26 +/- 0.60 microgram/g. In the series of 200 patients undergoing appendectomy, six patients treated with ornidazole and 12 patients treated with placebo developed a wound infection. In patients with perforated appendix, the rate of wound infection was 7.1% in those given ornidazole and 63.6% in those given placebo (P = 0.004). Not a single B. fragilis was isolated from appendix swabs or wound exudates after prophylaxis with ornidazole.

Adult↗
PubMed1978

Antibiotics in acute cholecystitis.

In 460 cholecystectomies performed for acute cholecystitis 215 (47%) positive gallbladder bile cultures were obtained. In 73% of emergency operations bacteria were recovered, in 48% of early operations (p less than 0.001) and in 29% of late operations (p less than 0.001). In vitro concentrations of 8-16 mcg/ml of ampicillin or cephalothin inhibited in most cases the growth of E. coli, Klebsiella and Enterococci, which comprised 75% of all strains isolated. One hour after intravenous infusion of 1 g ampicillin the mean serum level was 21 mcg/ml, the mean common duct level 16 mcg/ml and the mean gallbladder bile level 4.4 mcg/ml. In acute cholecystitis 2 g cephalothin gave mean concentrations of 14, 8, and 1.2 mcg/ml. Most of these patients had cystic duct obstruction both on intravenous cholegraphy and during operation. Control patients with patent cystic ducts who received ampicillin had mean gallbladder and common duct bile levels of 47 and 56 mcg/ml, and those receiving cephalothin 23 and 28 mcg/ml. It appears that adequate gallbladder bile concentrations of antibiotics are not attainable in acute cholecystitis because of the obstruction to the bile flow. The favourable results of prophylactic antibiotic treatment in reducing septic complications seem to depend more on adequate serum and tissue concentrations than on the concentration of antibiotics in the bile.

Acute Disease↗
PubMed1977

Gastric secretion and haematological findings in relation to mucosal atrophy after partial gastrectomy.

Twenty-one patients (4 females and 17 males) were re-examined 20 years after partial gastrectomy for benign peptic ulcer. Different stages of morphological change in the gastric stump mucosa were compared with haematological parameters as well as with gastric acid and IF secretions. Biopsy specimens were taken by the direct vision technique. Haematological values including also serum vitamin B12, folate and Schilling test were determined. Gastric acid and IF secretions were lower in all patients with "selective parietal cell atrophy" in the gastric mucosa compared with those of other patients. Serum B12 and Schilling test values showed the same tendency. The present study indicates that it is possible to determine the gastric function dependent on parietal cells according to morphological criteria.

Atrophy↗
PubMed1975

Non-traumatic chylous effusion in the thorax and abdomen.

A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.

Adult↗
PubMed1973

[Peritonitis].

Explore the source record for details and available documents.

Humans↗