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PubMed1981

[Cefoxitin in emergency surgery].

In basic pharmacological studies, sodium cefoxitin has proved to possess the following features: a broad action spectrum, resistance to bacterial beta-lactamase, activity against anaerobic species, rapid distribution, rapid serum and bile concentration, rapid, elevated excretion in the urine in active form, and low local and general toxicity. Patients in an Emergency Surgery Department often present the following conditions: highly compromised general situation, serious, often polymicrobic sepsis with aerobic and anaerobic flora, prior treatment without result with various cycles of chemo-antibiotic treatment. The theoretical conditions therefore exist to assess the effectiveness of sodium cefoxitin in patients admitted to an emergency surgery department and presenting serious post-surgical or post-traumatic sepsis, or sepsis due to pathology that can be corrected surgically. A study of 14 patients (3 g i.v. or i.m. for 6 days) showed 71% complete cure, 21% definite improvements and one death (treatment commenced 36 hours prior to death). It is therefore maintained that sodium cefoxitin is particularly indicated as first-choice antibiotic in emergency surgery situations.

Bacterial Infections↗

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[Conservative treatment of chronic obstructive arterial disease with iloprost and physical training: assessment of results in 5 years of a study with 360 patients].

INTRODUCTION: The treatment of patients with Peripheral Arterial Occlusive Disease (P.A.O.D.) is, until now, a therapeutics challenge. The purpose of this study was to confirm the safety of Iloprost infusion, to estimate the results after an Home Exercise Program joined to the therapy and to identify groups of patients with P.A.O.D. that can benefit from Iloprost therapy. MATERIAL AND METHODS: 360 patients with and without diabetic with P.A.O.D. (Peripheral Arterial Occlusive Disease) at the stage of II, III, & IV, with Buerger Syndrome, were treated with Iloprost at the maximum dosage: 2 ng/kg/min for 6 hours a day, for a minimum of 1 week and a maximum of 3 weeks with cycles of therapy every 3, 6 or 12 months. At the end of each cycle of therapy there was assigned an Home Exercise Program. Patients with symptoms of pain are observed in the study and monitored for how long the pain lasted or diminished. The clinical benefit was evaluated on the reduction of the pain and analgesics, on the improvement of the trophics lesions and on the increase of gait's distance. RESULTS: After 5 years of follow up, it was reported 12.2% of major amputations and 3.6% of deads. Over 60% of the patients, that were at risk for amputation at the beginning of the study, were alive. The tolerability of therapy was been very acceptable. CONCLUSIONS: This study, at the end of 5 years, showed that the therapeutic infusion of Iloprost associated with an intensive Home Exercise Program, can, before 12 months, show patient improvement of the gait's distance from 50-200%.

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