Biomedical subjects
Publications and source records attributed to S A Shliapnikov.
Under observation there were 72 patients with primary and recurring forms of erysipelatous inflammation. The data obtained have shown the reliable (p<0.001) effectiveness of antimitotic treatment with terbinaphin hydrochloride (lamizil) for prophylactics of recurrences of erysipelatous inflammation: the frequency of recurrences in the group of the treatment was 7.1%, in the control group it was 45.5%.
A randomized comparative investigation was carried out in two equal groups of patients with pyo-inflammatory diseases of lower extremities (the total number 50 patients) in order to study effectiveness and tolerance to Netilmycin (1st group) and Gentamycin (2nd group) given in combination with Cefasolin. Clinical symptoms were estimated immediately after operation, in 3, 6 and 10-12 days after it. Bacteriological investigations were fulfilled immediately after operation, in 72 h and in 6-10 days after the beginning of antibacterial therapy. Clinical and biochemical investigations of blood were fulfilled before and in 10 days after the beginning of the treatment. Effectiveness of the treatment in the first group was 100%, in the second group--80%. In the second group the antibiotics were changed in 20% of cases and the average duration of hospitalization among the patients of this group was reliably longer that in the first group. The eradication rating of Netilmycin was higher than that of Gentamycin (25 strains from 25 and 20 from 25 respectively). Gentamycin had a pronounced nephrotoxic effect (elevation of the level of creatinin and urea of blood in dynamics by 21% and 32%), as compared with Netilmycin (9% and 3%). Total expenses to antibiotic therapy in the first group made up 97,650 rub, and in the second group 106,245 rub. Netilmycin in combination with Cefasolin was more effective for acute pyo-inflammatory diseases of lower extremities than a combination of Gentamycin with Cefasolin, it more rapidly resulted in reduction of clinical signs of inflammation, was better endured and more economical.
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Cefepime (Maxipime) was used in the management of 22 patients at the age of 18 to 73 years with the surgical sepsis syndrome (SAPS > 15). In 16 patients surgical sepsis was due to pancreatitis, appendititis, abdominal wound or trauma or complications after planned surgical interventions on the organs of the abdominal cavity. In the other 6 patients surgical sepsis was due to inflammatory processes in soft tissues after minor trauma. In 10 patients (group 1) cefepime was used after the pathogen verification and antibioticogram examination. In 12 patients (group 2) the antibiotic was used in the empirical therapy as the first line drug after the patients acceptance from another unit when the pathogen nature was obscure. Cefepime was administered intravenously in a dose of 2.0 g twice daily for 7 to 10 days in combination with metronidazole in a dose of 0.5 g thrice daily. After 5-6 days of the treatment the patients of group 1 were switched to the cefepime intramuscular regimen. The lethality totaled 18 per cent (4 patients). Three of them were from group 2. The patients died of progressive polyorgan insufficiency. It is characteristic that in no cases cefepime induced septic shock due to the endotoxin escape. No septicopyemia was as well observed even in the patients with verified bacteremia due to Staphylococcus aureus.
Based upon 11 personal observations and data of literature the authors describe etiopathogenesis, clinical picture, diagnosis and treatment of pseudomembranous colitis. The recommended complex therapy resulted in the recovery of all the patients.
The results of using recombinant interleukin-2 from yeast for the treatment of patients with the sepsis syndrome are discussed. It is noted that there was a marked immunomodulating effect, the amount of endogenous interleukin-2 increased. The patients' state was shown to become less severe (according to the SAPS criterion), the patients felt better. A conclusion is made of the possibility in principle and expediency of using cytokines for the treatment of patients with the sepsis syndrome.
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A present-day view on the problem of wound infection is analyzed with special reference to recent data. Active surgical approach in combination with many-component antibacterial and correcting treatment still remains important in prevention and treatment of wound infection.