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PubMed2004

[Surgical policy in acute purulent pyelonephritis in patients with diabetes].

Efficacy of treatment of 208 diabetic patients with acute pyelonephritis was analyzed. Surgical treatment was performed in 58 patients (43 with insulin-non-depended and 15 with insulin-depended types). All the patients were divided into 4 groups depending on forms of pyelonephritis: non-destructive (116 patients), purulent-destructive (58), calcllious (34), purulent-calculous (10). Algorithm of differential diagnosis between non-destructive and purulent-destructive forms of acute pyelonephritis in diabetic patients are presented. It is demonstrated that surgical treatment is the main method in complex therapy of purulent-destructive forms. Rational surgical policy is substantiated. In patient with diabetes and purulent pyelonephritis nephrectomy is more expediently. Nephrostomy may be used only in light forms of diabetes with local destructive forms ofapostematosic nephritis. Radical surgical policy permitted to achieve positive result of treatment in majority of patients. Lethal outcomes were seen in two-sided lesion of kidneys with apostems, and carbuncles.

Acute Disease↗

PubMed2000

[Dermatological diseases and treatment described in the Turkish manuscripts (XIV-XVth centuries)].

This study deals with skin diseases described in the earliest compiled or translated Turkish medical manuscripts of the 14th and 15th centuries in Anatolia. The manuscripts studies are: Müntehab-i Sifa, Edviye-i Müfrede, Tervihü'l-Ervah, Yadigâr, Cerrahiyyetü'l-Haniyye, Kamilü's-Sinaatü't-Tibbiye Tercü-mesi, Kitab-i Müntehab-i fi't-Tibb, Haza'inü's-Sa'adat, Akrabadin Tercümesi, Mücerrebname, Müfredât-Ibn-i Baytar Tercümesi, Tuhfe-i Mübarizi, Tuhfe-i Muradi. The skin disease know at that time are studied under the following topics: Cüderi (Ciçek, Variola, Small-pox); Hasbe (Kizamik, Rubeola, Measles); Cüzzam (Lepra, Leprosy, Hansen's disease); Demregü (Temriye, Dermatophtosis, Tinea coproris); Behak (There are two types: the white and the black; the black is Addison's disease ); Baras (Ala, Vitilio); Nemle (Isirga, Makül); Ateş paresi (Nar-i farisi, frunculosis); Cemre (Kara kabarcik, Sirpenşe, Karbonkül, Carbuncle); Caversiye (Kabarcik hastaliği, blisters disease); Sivilceler (Various types of pimples; Humre: Yilancik, Erizipel, Erysipelas, St. Anthony's fire; Başbert: Ciban, Fronkül, Boil, Fruncle; Dümmel: Kan çibani, Abse, Abscess); Abile (Kabarcik, Bule); Seretan (Kanser, Cancer); Hanaziz (Siraca, Scrofuloderma); Akile (Yinürbaş, Gangren); Kurdeşen (Urtiker, Urticeria); Uyuz (Gale, Scabies); Giciyik (Kaşinti, Prutitus); Sa'fe (Konak, Seboreik dermatit, Scurf); Kel (Aloposi, Favus); Evram (Sişler, Urlar, Tumours); Yara (Karha, Cerahat, Wound). The terminology and symptoms of these diseases are studied and tired to find their equivalents of today. The causes and the treatment of the skin diseases known then are presented.

Dermatology↗

PubMedDate not supplied

Update on treating uncomplicated skin and skin structure infections.

Dermatologists treat a variety of uncomplicated skin and skin structure infections (uSSSIs) such as folliculitis, impetigo, erysipelas, cellulitis, furuncles, carbuncles, and non-perirectal abscesses. Most uSSSIs are caused by Staphylococcus aureus and Streptococcus pyogenes. The new extended-spectrum cephalosporins (cefdinir, cefpodoxime) offer efficacy against most Gram-positive and Gram-negative pathogens. Despite recently published guidelines, many physicians do not prescribe cephalosporins for uSSSIs out of concern that these agents will produce a hypersensitivity reaction in patients allergic to penicillin. Although the rate of cephalosporin reaction in penicillin-allergic patients is often quoted as up to 10%, this rate does not take into account the 1% to 3% risk for allergy to cephalosporin alone and the nonspecific increased risk of penicillin-allergic patients to develop hypersensitivity to other drugs. When these additional risks are considered, the likelihood of a reaction in known penicillin-allergic patients, especially to most third-generation and extended spectrum cephalosporins, becomes less than 1%. Cephalosporins with side chains unlike those of penicillin or ampicillin side chains are less likely to result in an allergic reaction in penicillin or ampicillin-allergic patients than cephalosporins with similar side chains. Although both cefdinir and cefpodoxime are considered to carry a very low risk of cross reactivity with penicillin or ampicillin, the former demonstrates better activity against S. aureus. Among the late-generation cephalosporins, cefdinir is the most potent oral agent when tested against oxacillin-susceptible staphylococci, 4- to 16-fold more active than cefprozil and cephalexin, respectively.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Doppler technologies in combined diagnosis of acute pyelonephritis].

We studied diagnostic potentialities of conventional clinical, device, x-ray and ultrasonic methods including current Doppler technology in differentiation of serous and purulent stages of acute pyelonephritis (AP) in 50 patients (mean age 25.5 +/- 5.5 years). Energetic dopplerangiography (EDA) showed the highest diagnostic significance. EDA was highly informative in renal carbuncle and total purulent destruction of the kidney and low informative in serous and apostematous AP, renal abscess. Conventional ultrasonic, x-ray, clinical and device investigations as well as impulse dopplerography and color Doppler mapping of blood flow are of secondary importance in AP.

Acute Disease↗

PubMed2005

Adolpho Lutz and the origins of medical entomology in Brazil.

Adolpho Lutz (1855-1940) formed a bridge between the Bahian Tropicalist School and post-Mansonian medicine. Before taking over as head of the São Paulo Bacteriological Institute (1893), Lutz traveled through a variety of regions and delved into various disciplines. In the 1880s, he was already arguing that leprosy was transmitted by mosquitoes. Carbuncles, cholera, and typhoid fever were then the accepted models for investigating the etiology of infectious diseases. Following the discovery of how malaria was transmitted, attention turned to hematophagous diptera. Physicians, bacteriologists, zoologists, and veterinarians reshaped the network of actors involved in the 'hunt' for the agents and transmitters of diseases, as they began relying on analogies with malaria and yellow fever. Edwin Ray Lankester, director of the British Museum (Natural History), launched then a worldwide investigation into species that might be linked to human disease. The species described by Lutz and his proposed classification system were vital to Frederick Theobald's fundamental work in medical entomology, published in the early twentieth century. In 1908, Lutz brought with him to the Oswaldo Cruz Institute a remarkable quantity of research and experiments in all branches of the newly created "tropical medicine," devoted especially to entomology.

Animals↗

PubMed1991

Changes in practice morbidity between the 1970 and 1981 national morbidity surveys.

The primary aim of the study was to evaluate practice differences in reported morbidity in the second and third national morbidity surveys (1970/71, 1981/82) and to discuss their cause. A secondary aim concerned the validation of trends identified from analysis of the data from the total populations in the practices. Altogether 19 practices participated in both surveys. Annual prevalences (that is, the number of patients attending the general practitioner with a condition per 1000 persons at risk) were examined for: all conditions; each of three categories of seriousness of disease; diseases aggregated by chapter of the International classification of diseases; and each of 130 rubrics of the disease classification. Annual prevalence for 'all conditions' was approximately the same for males in both surveys, whereas for females there was an increase. In both sexes, annual prevalence for 'serious conditions' increased slightly and for 'trivial conditions' increased substantially. For 'intermediate conditions', there was a modest decrease in males. In the analysis at ICD chapter level, substantial increases in prevalence occurred in infectious diseases, nervous system diseases, circulatory diseases, genitourinary diseases, musculoskeletal diseases, symptoms, signs and ill-defined conditions, injuries and poisonings. Decreases were found in blood diseases, mental disorders and digestive diseases. Among 130 individual conditions examined, increased annual prevalence was found for mumps, fungal infections, hypothyroidism, diabetes, gout, senile dementia, angina, left heart failure, catarrh, hay fever and asthma, orchitis, acne, osteoarthritis and for some symptoms. Decreases were found for iron deficiency anaemia, anxiety state, refractive errors, haemorrhoids, chronic bronchitis, functional disorders of the stomach, carbuncle and skin infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

[Etiology, diagnosis and therapy of soft tissue infections].

Soft tissue infections are caused by a multitude of bacteria. Their pathogenicity depends on the ability to adhere to surfaces, certain characteristics of the cell wall, exoenzymes or exotoxins, and endotoxins. Because etiologic classification of soft tissue infections is not satisfactory, we propose a clinical classification. 1. Abscesses are caused by staphylococci (carbuncle or suppurative hydroadenitis) or by polymicrobial infections (most subcutaneous abscesses). They are treated by incision and drainage and primary closure of the skin after drainage and curettage is often successful. Only in special cases are antibiotics indicated. 2. Cellulitis mostly caused by streptococci responds well to antibiotic therapy without surgery. 3. Ulcerative lesions i.e. pseudomonal gangrene and Meleney's gangrene need specific antibiotic therapy and complete excision with delayed grafting.

Abscess↗

PubMed1990

[Fibronectin binding to Staphylococcus aureus in experimental staphylococcal skin infection in mice].

Staphylococcus aureus infection of skin was produced in cyclophosphamide-treated mice by intracutaneous inoculation of a strain in this organism clinically isolated from a carbuncle. Deposition and binding of fibronectin in initial stage of the infection were followed by immunohistochemistry and immunoelectron microscopy. Fibronectin began to deposit in a fine granular pattern in the dermis and musculocutaneous layer at 2 minutes after the inoculation and gradually increased with time. Fibronectin binding on the surface of staphylococcal cells was seen after 12 hours of inoculation. At 24 hours two patterns of binding were seen. In one pattern, fibronectin was bound to a part of the cell surface of the microorganisms. The fibronectin binding parts were seen very close or attached to the fibrin-like-structure and dermal connective tissues. This suggests that fibronectin helped staphylococcus cells to attach to fibrin or connective tissues. The other pattern of fibronectin binding was the binding of fibronectin all around the cells. This pattern could be interpreted as inhibition by fibronectin of staphylococcus attachment to the fibrins and the tissues.

Animals↗

PubMed1990

[A clinical study on S6472, sustained release preparation of cefaclor, dermatological area].

We conducted a clinical investigation on the use of S6472, an sustained release preparation of cefaclor, in the dermatological area. Thirty-two patients serving as subjects were divided into group I (14 cases, including folliculitis and acne pustulora), group II (16 cases, including furuncle, furunculosis and carbuncle) and others (2 cases). One or 2 wrappers (375 or 750 mg) of S6472 were orally administered to patients twice daily after meals. In group I, the efficacy rate was 100%. Clinical results were as follows: Excellent (6 cases), good (8 cases), fair (0), and poor (0). In group II, the efficacy rate was 93.8%: Excellent (10 cases), good (5 cases), fair (1 case), and poor (0). A decrease of the bacteriological effect was observed in 1 case with Staphylococcus epidermidis. A superinfection was noted in 1 case Staphylococcus aureus. The causative bacteria were all eradicated in the remaining 24 cases. No side effects were detected. From the above results, S6472 appears to be a useful preparation, twice daily oral administration has excellent effects against dermatological infections.

Administration, Oral↗

PubMed1989

Bacteriology of pyodermas and antibiograms of pathogens.

One hundred and seventy six cases of various clinical types of pyodermas were investigated to find the causative organism of the disease. Folliculitis formed the largest clinical group followed by infectious eczematoid dermatitis, secondary infection, furuncles, impetigo, ecthyma and carbuncle in descending order of frequency. A total of 189 micro-organisms were isolated from the specimens examined. A single infecting organism was isolated from 74.43% and more than one type of organism from 16.48% of cases. Coagulase positive staphylococcus (73.02%) was the predominant species followed by beta-haemolytic streptococcus (26.98%). Coagulase positive staphylococcus was isolated from 109 (61.93%), beta-haemolytic streptococcus from 22 (12.5%) and both these organisms from 29 (16.48%) cases. The antibiotic resistance pattern showed maximum resistance to penicillin followed by ampicillin. None of the strain was found to be resistant to kanamycin. Low percentage of strains were found to be resistant to streptomycin, oxytetracycline, trimethoprim, cloxacillin, erythromycin, chloramphenicol, cephalexin, gentamycin and neomycin.

Ampicillin↗

PubMed1985

[Clinical and bacteriological evaluation of TMS-19-Q in superficial suppurative skin and soft tissue infection].

Clinical effectiveness of TMS-19-Q, a new macrolide antibiotic, was evaluated in superficial infectious diseases classified into 6 groups at 13 departments of dermatology. The results obtained were as follows: Final global improvement rating in 311 cases were excellent in 91, good in 158, fair in 45 and poor in 17 and the effective rate was 80.1%. Effective rates in each group were 71.1% in 1st group (folliculitis and acne pustulosa), 78.6% in 2nd group (furuncle, furunculosis and carbuncle), 100% in 3rd group (impetigo), 76.9% in 4th group (phlegmone, superficial lymphangitis, erysipelas and infectious paronychia), 88.7% in 5th group (inflammatory atheroma, subcutaneous abscess, hidradenitis suppurative and acne conglobata) and 77.3% in 6th group (secondary infection). Dominant strains isolated were S. aureus (40.7%), S. epidermidis (26.9%) and anaerobic bacteria (20.8%). S. aureus was frequently isolated from most of all disease. On the other hand, S. epidermidis and anaerobic bacteria were isolated mainly from 1st and 5th group. Optimum daily doses would be over 600 mg. Slight adverse reactions such as gastrointestinal disorders, eruption and malaise were observed in 12 cases.

Adolescent↗

PubMed1983

Bacterial infections of the skin. I: primary and secondary infections.

Bacterial skin infections are important to recognize because we have the means to eradicate almost all of them. Primary skin infections are mainly caused by staphylococci or streptococci. Staphylococci infections present as furuncles and carbuncles, superficial folliculitis, impetigo or rarely the Scalded Skin Syndrome. Streptococcal infections present as impetigo, ecthyma, erysipelas or cellulitis. Corynebacteria causes erythrasma, trichomycosis or pitted keratolysis. Gram-negative primary skin infections, although uncommon, may occur; bacterial cultures are generally necessary for diagnosis. Secondary bacterial infections of pre-existing wounds, burns, dermatitic skin, or retention cysts are common events.

Anti-Bacterial Agents↗

PubMed1980

[Case of recurrent human anthrax occurring several weeks after the primary disease].

The carbuncle was located on the back of the right hand in the primary anthrax infection and on the lower third of the right leg in the secondary infection. In both cases the diagnosis of anthrax was confirmed bacteriologically and by the anthraxin test. The course of the secondary infection was less severe. The conclusion on the possibility for rare cases of anthrax recurring has been made. This fact may be important for the assessment of immunity.

Anthrax↗

PubMed1995

[Results and substantiation of surgical strategy in acute suppurative-destructive pyelonephritis in pregnant women].

The effectiveness of treatment of acute purulent pyelonephritis in 2.256 pregnant women from 1986 to 1992 was analysed. 95-97% of them had diffuse purulent (nondestructive) pyelonephritis which was cured by drug treatment. Pyodestructive manifestations (apostematosis, carbuncle, abscess of the kidney) of uni- (84.8%) and bilateral (15.2%) pyelonephritis were found in 85 (3.8%) of the patients. Signs of pyoseptic intoxication predominated in the clinical picture. Antibacterial and detoxification therapy was applied in the pre- and postoperative periods. The choice of the surgical tactics and operative method was based on the peculiarities of the clinical course, the revealed complications, and the anatomical changes in the kidney. Nephrostomy and antibacterial therapy are sufficient for curing the apostematic form. Patients with a bilateral affection were treated by operative stage-by-stage kidney drainage (nephrostomy). When economical operations were ineffective clinically (9.4%), secondary nephrectomy was indicated. Primary nephrectomy is an adequate surgical intervention in cases of a total destructive process in the kidney, grave septic manifestations, and a toxic response of the liver. The high proportion of nephrectomies (37.6%) is explained by the clinicoanatomical severity of focal-purulent pyelonephritis and its complications (sepsis) which hazard the life in pregnancy. Pliant surgical tactics in the treatment of severe forms of pyodestructive pyelonephritis ensured clinical cure of 96.5% of patients and uneventful delivery in 91.8% of cases. Death occurred from sepsis and bacteriotoxic shock which developed due to purulent pyelonephritis of pregnancy.

Acute Disease↗

PubMed1995

[Organ-preserving surgeries and nephrectomy in pregnant women with severe forms of acute suppurative destructive pyelonephritis].

The results of surgical treatment of pyodestructive pyelonephritis in 105 (4.2%) pregnant women and puerperae out of 2506 ones treated in the urology department from 1986 to 1994 are analyzed. Uni- and bilateral apostematous nephritis, carbuncle and abscess of the kidney were diagnosed in 89 and 16 patients, respectively. Nephrostomy was the principal method of treatment of focal suppurative forms of acute pyelonephritis. Bilateral nephrostomy was carried out in 12 pregnant patients, in 3 of them secondary nephrectomy was performed. Nephrectomy is indicated in total destruction of the kidneys, it was made in 37 (35.2%) pregnant women and puerperae. Introduction of radical surgery into practical treatment of neglected forms of pyodestructive pyelonephritis led to almost total liquidation of postoperative mortality in pregnant women. The efficacy of treatment of pregnant women is provided by varying in extension surgical interventions on the kidneys. Organ-sparing and radical operations in grave purulent pyelonephritis were effective in 97.2% of pregnant patients.

Acute Disease↗

PubMed1995

Bacterial urinary tract infections in diabetes.

Bacterial UTIs are a common problem in patients with diabetes mellitus. Bacteriuria is more common in diabetic women than in non-diabetics owing to a combination of host and local risk factors. Upper tract disease is also more common in this group. Diabetics are at higher risk for intrarenal abscess, with a spectrum of disease ranging from acute focal bacterial pyelonephritis to renal corticomedullary abscess to the renal carbuncle. A number of uncommon complicated UTIs, such as emphysematous pyelonephritis and emphysematous pyelitis, occur more frequently in diabetics. Because of the frequency and severity of UTI in diabetics, prompt diagnosis and early therapy is warranted.

Abscess↗

PubMedDate not supplied

[The role of ultrasonic scanning in optimizing the therapy of gestational pyelonephritis].

Urinary tracts were examined by ultrasonic scanning (US) of the kidneys in 130 patients with gestational pyelonephritis. The scanning provided a rapid diagnosis of parenchymal and paranephric fat lesions, of urinary tract occlusion, location of concrements, congenital and acquired renal defects, abscesses, carbuncles. The follow-up US controls the inflammation, permitting differential treatment under reduced exposure to x-rays and radionuclides.

Combined Modality Therapy↗

PubMedDate not supplied

[Clinical effectiveness of pefloxacin (abaktal)in the treatment of inflammatory diseases of the kidneys, urinary tracts and genital organs].

Pefloxacin (Abaktal) was used in treatment of 83 patients: 14 patients with acute pyelonephritis, 5 patients with carbuncle of the kidney, 17 patients with postoperative acute pyelonephritis, 3 patients with urosepsis, 7 patients with acute prostatitis, 18 patients with chronic pyelonephritis in the phase of active inflammation, 9 patients with exacerbation of chronic prostatitis, 3 patients with acute cystitis, 2 patients with acute urethritis and 5 patients with epididymo-orchitis. Two dosage forms of pefloxacin were used i.e. tablets of 400 mg and ampoules of 5 ml containing 400 mg of the active substance. The treatment course amounted to 7-14 days. In the patients with inflammatory infectious diseases of the lower urinary tracts (cystitis and urethritis) the treatment course amounted up to 5 days. The results of the treatment with the ampoule solutions were good and satisfactory. With the use of the tablets the results were unsatisfactory in 3 patients (8.1 per cent). Satisfactory bacteriological efficacy of the treatment was stated in 89.5 per cent of the cases. The adverse reactions such as nausea, vomiting, diarrhea and skin eruption were recorded in 5 patients (6 per cent).

Bacterial Infections↗