Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new antibiotic drug of oxacephem, with marked resistance to beta-lactamase, 6059-S for parenteral use was tested in 10 patients with acute peritonitis. In 4 cases with appendicitis, 6059-S in a dose of 500 mg was given intramuscularly before operation. In 2 cases with perforate MECKEL'S diverticulitis and intestinal obstruction for right femoral hernia, 6059-S in a dose of 1 g was given by intravenous injection or intravenous drip infusion before or during operation. And in a case with peritonitis after gastrectomy for gastric cancer, 6059-S in a dose of 2 g was given by intravenous drip infusion. Tissue specimens of different sites or body fluids were taken during the operation and from the removed organs. The materials or purulent ascites were subsequently taken at intervals. Determination of 6059-S concentration was performed according to plate agar well bioassay method with Escherichia coli 7437 strain. The peak of 6059-S concentration in purulent ascites of patient with peritonitis for perforate MECKEL'S diverticulitis was 30.5 mcg/ml at 50 min. after 1 g intravenous administration. Concentration of 6059-S in drained pus was 8.38 mcg/ml soon after intravenous drip infusion (2 g, for 2 hrs.). In 10 patients with peritonitis, 6 patients were given 6059-S in a dose of 500 mg by intramuscular administration twice a day, and the serious 4 patients were given in a dose of 1 to 2 g by intravenous drip infusion 1 to 2 times a day. Clinical response was excellent in 6 cases, good in 3 cases, fair in 1 case and poor was none. Any clinical adverse effect was not recognized. On the 6059-S concentration in patients with peritonitis, the concentration in purulent ascites, drained pus and infected tissues were observed higher than the MIC of 6059-S against Escherichia coli and Klebsiella pneumoniae. Therefore 6059-S will be a very useful drug when used for chemotherapy of acute or subacute peritonitis.
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PMID:[Clinical studies on 6059-S for acute peritonitis. Clinical effect and tissue concentration (author's transl)]. 645 71

Nosocomial central nervous system infections constitute 0.4% of all nosocomial infections. The responsible pathogens of nosocomial meningitis are quite different from community-acquired meningitis with high rates of morbidity and mortality. The most important prognostic factor is the appropriate choice of pathogen-specific antibacterial therapy. In this report, a 64 years old woman with nosocomial meningitis caused by Klebsiella pneumoniae and Acinetobacter spp. after lumbar disc hernia operation, has been presented. The risk factors were detected as recent history of neurosurgical operation for three times and long term (29 days) use of external ventricular drainaige (EVD) catheter. Empirical meropenem (3 x 2 g, IV) and vancomycin (2 x 1 g, IV) therapy was initiated upon the diagnosis of nosocomial meningitis based on the clinical and laboratory findings on the postoperative fifth day. Extended-spectrum beta-lactamase (ESBL) producing K. pneumoniae (susceptible to amikacin, imipenem, meropenem, cefoxitine, ciprofloxacin, piperasillin-tazobactam and trimethoprim/sulfamethoxazole) was recovered from cerebrospinal fluid (CSF) and blood samples obtained on the same day. There was no change in the status of the patient on the eighth day of meropenem therapy, with high leukocyte number (1300/mm3) and presence of gram-negative bacilli in CSF, and ESBL positive K. pneumoniae (antibiotic susceptibility pattern same with the previous isolate) growth in CSF culture. Thereupon intravenous ciprofloxacin (3 x 400 mg) was added to the therapy and her EVD has been changed. However, ESBL positive K. pneumoniae (antibiotic susceptibility pattern same with the previous isolate) together with Acinetobacter spp. (susceptible to gentamycin, tobramycin, netilmicin, ciprofloxacin, levofloxacin and cefepime) were isolated from CSF and blood cultures obtained on the 13th day of meropenem and fifth day of ciprofloxacin therapy. Therefore intraventricular and intravenous gentamicin (15 mg/days and 3 x 120 mg, respectively) were added to the therapy. The patient recovered at the end of three weeks treatment without any additional sequela other than her primary illness. This case was the first case of nosocomial meningitis due to ESBL positive K. pneumoniae together with Acinetobacter spp. in the available literature.
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PMID:[Nosocomial meningitis with dual agents and treatment with intraventricular gentamicin]. 1882 95

Infections in lower extremities are sometimes concerned with systemic immunological disorders such as idiopathic thrombocytopenic purpura and systemic lupus erythematosus, which are treated with systemic steroids. Steroid therapy impairs the epithelial wound healing and with systemic condition, especially with systemic lupus erythematosus, the wound is susceptible for infection. Even a pyoderma gangrenosum sometimes occurs in a patient with idiopathic thrombocytopenic purpura with an incisional wound of hernia. The severe signs and symptoms are the deep skin and soft tissue infections, mainly caused by group A streptococcus, composed of necrotizing fasciitis and muscle necrosis. Medically suspected necrotizing fasciitis patients should be empirically and immediately administered with broad-spectrum antibiotics, which may cover the common suspected pathogens. In type I (polymicrobial) infection, the selection of antimicrobial should be based on medical history and Gram staining and culture. The coverage against anaerobes is important in type I infection. Metronidazole, clindamycin, or beta-lactams with beta-lactamase inhibitor or carbapenems are the treatment of choice against anaerobes, while early surgical debridement-wide enough and deep enough-is the core treatment of necrotizing fasciitis and results in significantly better mortality compared with those who underwent surgery after a few hours of delay. When necrotizing fasciitis is considered and the patient is brought to the operation room, aggressive and extensive surgical debridement is explored. Tissue involved should be completely removed until no further evidence of infection is seen. When further debridement is required, the patient must return to the operating room immediately. In this context, the temporal coverage using the artificial dermis after debridement is useful because there is no loss of the patient's own tissue and yet it is easier for "second-look" surgery or secondary reconstruction, and extensive enough debridement is always the mainstay of the therapy.
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PMID:Lower Extremity Wounds in Patients With Idiopathic Thrombocytopenic Purpura and Systemic Lupus Erythematosus. 2635 24