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The use of proteolytic enzymes and ectericide in treatment of patients with suppurative processes yielded positive results. The duration of the treatment and terms of patients incapacity are shortened.
The paper presents the results of surgical treatment of pyodestructive pyelonephritis diagnosed in 111 puerperae and gravidae. Suppurative nephritis, carbuncle and abscess of the kidney ran as unilateral (94 patients, 84.7%) or bilateral (16 patients, 14.4%) process. The diagnosis of pyodestructive pyelonephritis of the solitary kidney was made in 1 gravida. The outcomes of pyodestructive pyelonephritis in puerperae and gravidae depend primarily on individual approach to therapy. Different operative interventions warranted a complete response in 97.3% of the gravidae. 96 of 108 gravidae operated on the kidneys delivered viable neonates. Early operative interventions in many cases preserved the kidney and prevented septic complications. Pyodestructive changes restricted to 1-2 segments of the kidney were effectively treated by nephrostomy. Bilateral pyodestructive pyelonephritis should be managed step-by-step starting at the side of the most evident symptoms. Two-stage bilateral lumbotomy with nephrostomy in combination with antibacterial therapy and plasmapheresis eliminated septic complications thus allowing normal development of the fetus. Nephrectomy is the best treatment in advanced pyodestructive lesion with severe life-threatening septic intoxication.
The purpose of this study was to review recent African literature on suppurative intracranial infection and its implications for neurosurgery. In order of decreasing frequency the main lesions are brain abscess, subdural empyema, and epidural abscess. Despite progress in diagnostic imaging and availability of antibiotic therapy, these lesions still cause disturbingly high morbidity and mortality especially in sub-Saharan Africa where diagnosis is often delayed. The male-to-female ratio was 3.6:1 and 70 to 80% of patients were under the age of 20 years. Spread from the paranasal sinus or ear was the most common mechanism of infection. Hematogenous processes accounted for 22% of cases and the origin was undetermined in 11% to 26% of cases. Staphylococcus aureus and enteric gram-negative bacilli were the most common bacteria identified but cultures were reported as sterile in 30% to 50% of cases. While ultrasonography can be useful in newborns with an open fontanelle, arteriography is often the only feasible procedure for diagnosis in Black Africa. The diagnostic modality of choice is computed tomography which allows precise mapping prior to neurosurgery. Introduction of computed tomography in some African cities has led to a decrease in mortality ranging from 4.7% to 43%. The most effective treatment is a combination of appropriate antimicrobial therapy and surgical decompression of expanding lesions. The main procedures are aspiration through burr holes and craniotomy. Use of this combined strategy requires close cooperation between the neurosurgeon, infectious disease specialist, and microbiologist. Therapeutic indications are discussed within the context of Black Africa.
In 60 patients with severe form of peritonitis, treated with peritoneostomy application, were studied up the peculiarities of the abdominal wall postoperative wounds suppuration concerning its clinical course and treatment. For the local treatment of purulent wounds the electrochemically activated potassium chloride solution anolyte fraction (EHAR-anolyte) was applied.
One hundred and forty-seven patients with acute suppurative otitis media, were divided into three groups and treated with antibiotics (azidocillin, ampicillin, and cephalexin). The therapeutic effect was assessed bacterioloically by swabbing from the aural discharge and from the nasopharynx on the first, second, third, and seventh day after initiation of treatment. In addition, the concentration of antibiotic in the aural discharge and in the nasopharynx was determined. As compared with other published materials, there was a common occurrence of Haemophilus influenzae and S. Aureus. Hemolytic streptococci are less common than prior to the advent of antibiotics. Pneumococci disappeared in all cases from the aural discharge in the course of the first three days. The effect upon Haemophilus was slower. In the nasopharynx the effect was questionable, and no effect was obtained upon other bacteria. The clinical course could not be correlated to the bacterial findings except that resistant bacteria were found in all cases with persisting discharge.
A 22-year-old thoroughbred gelding was presented for evaluation and treatment of chronic dental disease. The horse had a history of quidding and abnormal bite behavior. Intraoral examination revealed signs of chronic generalized gingival inflammation and severe dental caries affecting the maxillary and mandibular incisor teeth. Treatment was provided on two separate visits over an interval of four months. The first visit consisted of the surgical extraction of three unrestorable incisor teeth and restoration of six carious maxillary incisor teeth. The second visit consisted of conventional endodontic therapy on the remaining mandibular incisor teeth and the surgical removal of a chronic suppurative osteomyelitic lesion. Immediate and long term improvements in eating habits were noted. Three month follow-up examinations following completion of treatment have shown the teeth to be in functional position, the restorations intact, and the surgical site well healed.
An obese woman aged 18 years had been suffering for several years from axillary hidradenitis suppurativa. Repeated incision and drainage never gave lasting results and the patient became socially isolated. Hidradenitis suppurativa is a chronic suppurative inflammation of skin areas containing apocrine glands: the skin of the axillae, of the breasts and of the anogenital region. Treatment in the first instance consists of general hygienic measures. Pharmaceuticals used include antibiotics, antiandrogens and oestrogens. Surgery is performed when the condition is at an advanced stage, with cellulitis and scarring; ample excision is necessary to reduce the risk of recurrence. CO2 laser therapy is a new method of treatment that shows good results in incipient and advanced lesions.
The AA. present a study microbiologic and auditive as well about chronic, suppurative otitis media non cholesteatomatous, before and after topical treatment. They contemplate 178 samples of chronic discharging ears which were treated with gentamycin 0.3 %, instillation 5 drops every 8 hours, during 10 days. Twelve days later were newly assessed both the otorrhea and the cochleovestibular picture. Germs most frequently detected: Gram-negative 61.6 %, Gram-positive 19.8 %, associated flora 6.4 % and mycosis 2.2 %, among other. Clinic healing accounted for 97.29 % and not significative differences scored pre--and post-treatment.
As opposed to acute or subacute orificial localizations, suppurative parietal endocarditis is a very rare entity (5 cases in 3,900 autopsies). More readily localized in the left heart and being generators of systemic emboli, they remain latent until anatomically verified. Two circumstances promote their occurrence : the focal point caused by the mural thrombus of a recent myocardial infarction ; septicemic infections with pulmonary localization and neighbouring thrombophlebitis within the context of intense depression of immunity.
The results of treatment of 34 patients with suppurative residual cavities in the liver (SRCL) after echinococcectomy are analyzed. New method of elimination of SRCL consisted in transcutaneous puncture and drainage of the infected cavity followed by transdrainage laser irradiation of its walls by Nitrogen UV laser and Helium-Neon laser of visible spectrum, was applied in 31 patients. Transdrainage irradiation was carried out at the background of daily procedures of transcutaneous laser radiation of the liver (Arsenid-Gallium infrared laser). Minimal traumatism of transcutaneous interventions and pronounced antibacterial, antiinflammatory and stimulating influence of low-energy lasers made it possible to improve significantly the results of treatment of SRCL patients.
The work was undertaken to study late results of surgical treatment of suppurative lung diseases during 1950-1974. Questionaries were sent to 420 operated patients. Answers were received from 328 (78%) patients, 86% of them were examined clinically, 14%--were estimated according to questionaries and their physician findings. 50 per cent of patients were followed up for 10-24 years. A positive effect was gained in 94.8%. 82 per cent of the operated patients have practically recovered well. The causes of poor issues are described, and trends for their improvement are delineated.
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