[Arterial diseases of the lower extremity].
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Biomedical subjects
Publications and source records attributed to M Pertkiewicz.
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The clinical efficacy and safety of intravenously administered imipenem/cilastatin in the treatment of 45 patients with severe bacterial septicemia due to intra-abdominal abscesses, respiratory and urinary tract as well as skin, soft tissue and bone infections was studied in the prospective and open trial. The in vitro antimicrobial activity of imipenem has been assessed on the basis of 909 bacterial strains isolated from patients treated and non-treated with imipenem/cilastatin. Among them were 526 Gram-negative, 370 Gram-positive aerobic bacteria and 13 Gram-negative anaerobic bacteria (Bacteroides sp.). Pathogen susceptibility to imipenem was determined with a disc-diffusion technique using Merck, Sharp Dohme sensitive discs containing 10 mcg of imipenem. Highly sensitive to imipenem were 96.8% of Gram-negative 82.7% of Gram-positive aerobic bacteria and 100% of Bacteroides sp. All patients, in whom evident foci of infection e.g. intra-abdominal abscesses were discovered, were operated on. The dosage of imipenem/cilastatin ranged from 1.5 to 2.0 g/24 h. Clinical cure and bacteriological elimination was achieved in 39 (86.7%) of patients while 6 (13.3%) showed marked clinical improvement. Before and during therapy, aerobic and anaerobic cultures were taken from accessible sites. All specimens were worked up using conventional bacteriological techniques. Before during and after therapy, samples for hematology, biochemistry and urinanalysis were obtained. Adverse clinical effects were noted in 2 (4.4%) patients. One had nausea and vomiting which were probably related to rapid infusion and disappeared after increasing the administration time, and one had transient diarrhea. In conclusion, imipenem/cilastatin was a well tolerated and effective drug in the treatment of life-threatening surgical infections.
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The authors discuss their own 14-year experience with surgical treatment of the chronic pancreatitis. They treated 64 patients of a mean age of 43 years. An abdominal pain, persisting in all patients, constituted the main indication to surgery. Forty patients underwent pancreatic enterostomy with Puestow technique, 19 patients resections of various extension, and 5 patients underwent pancreatic duodenostomy. Mortality rate in pancreatic enterostomy and pancreatic duodenostomy was 2.5% whereas mortality rate in resections was 5.3%. Complications were noted in 27.5% and 36.8% of patients, respectively. Pain was completely abolished or markedly reduced in 90% of patients. Forty eight (77.4%) out of 62 patients were identified and followed up. According to commonly used criteria, positive late results were achieved in 56.2% of patients, moderate in 29.2%, and poor result in 14.6% of the treated patients.
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