[Confidentiality of computerized medical records systems].
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Biomedical subjects
Publications and source records attributed to G Eliasson.
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Anaerobic micro-organisms are important agents in chronic bone infections. Their pathogenic role, however, is still unclear partly because of methodological reasons. In this paper an experimental model of osteomyelitis is used for studies of metronidazole treatment of bone infections induced by Bacteroides fragilis. The proximal tibial metaphyses of ten New Zealand white rabbits were excavated and filled with sheets of polyvinyl alcohol, into which a suspension of B. fragilis cells was injected on the right side, while saline was used on the left side. Within a month the animals showed immunological and radiological signs of an established bone infection. After 25 weeks of observation, four animals were treated with subcutaneous injections of metronidazole at a dosage of 10 mg/kg body weight twice daily for three weeks and five animals received saline. After 37 weeks the animals were killed. Radiological, histological and microbiological evaluation showed bilateral osteomyelitis in all animals. Prolonged raised titres of antibodies suggested an established infection, and not merely a colonization. There were no differences between the animals treated with metronidazole and the animals not treated.
Experimental studies of osteomyelitis have been hampered by methodologic problems. For inducing experimental anaerobic osteomyelitis, the medullary cavity of the proximal tibial metaphysis of five New Zealand white rabbits was excavated and filled with a polyvinyl alcohol sponge. On the right side, 1 ml of a suspension containing Bacteroides fragilis (10(7) colony-forming units/ml) was injected, while on the left side, Ringer's solution was used as a control substance. Within five weeks, all animals developed clinical signs of osteomyelitis. The findings were verified by roentgenograms and bone scans. There was a significant rise in titers against the inoculated B. fragilis strain in every rabbit, and when killed at 18 weeks after the bacterial inoculation cultures containing the inoculated strain were obtained from all animals. No other bacterial strains were isolated. With one exception, cultures were positive in samples from both the inoculated and the control side, indicating hematogenous seeding. In one animal, the cultures from the inoculated side were negative, whereas on the control side, there was significant growth of the inoculated strain. Histologic examination of the infection sites showed low-grade chronic osteitis. In contrast to previous studies, which have indicated severe difficulty in obtaining a single-strain anaerobic osteomyelitis, the present method gives a high infection rate with reproducible immunologic, roentgenographic, and histologic reactions.
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Knife conization was performed in 2,099 cases with abnormal vaginal smears. The frequency of complications was low. Carcinoma in situ was diagnosed in 1,500 cases and follow-up showed that conization was curative in 87%. The curative rate was depending on whether the resection margins were free of pathologic epithelium or not. If smears were repeatedly negative the first year after conization a new diagnosis of cancer was made in 0.4%. It was not possible to decide whether these lesions were residual changes or true recurrences. Treatment of carcinoma in situ by conization has so far reduced the frequency of invasive cervical cancer by 60%.
The effects of cefazolin were studied in 15 hospital patients (average age, 67) with respiratory-tract infections. The infections were chiefly bronchopneumonia caused by organisms such as D. pneumoniae, Staph. aureus, or E. coli. In 13 of the 15 patients the results were excellent to good (eradication of the primary pathogen and clinical improvement); in the other 2 patients the response was fair. Intramuscular injection was well tolerated and only one patient complained of pain at the site of injection; no other adverse clinical effects were observed. In the laboratory determinations, including liver and kidney function tests, the only abnormalities were 2 cases in which the Coombs' test gave positive results without hemolysis. Cefazolin seems to be a safe and effective antibiotic for the treatment of respiratory-tract infections caused by cefazolin-susceptible organisms.
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