Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical studies have been conducted on BRL 28500 (a formulation containing 15 parts ticarcillin (TIPC) plus 1 part clavulanic acid (CVA]. BRL 28500 was administered at doses of 1.6 g or 3.2 g b.i.d., generally for 10 days by drip infusion to patients with intraperitoneal infections or biliary tract infections. Drug concentrations in the ascites were determined. A total of 76 cases was treated with BRL 28500. These cases included 49 intraperitoneal infections (suppurative peritonitis 29, postoperative peritonitis 20) and 18 biliary tract infections (cholecystitis 5, cholangitis 13). Nine cases were excluded from evaluation according to the committee's assessment. The clinical improvement as assessed by surgeons in charge increased with the duration of continued treatment and efficacies were assessed as 57.1% on day 5, 63.1% on day 7 and 77.8% on day 10 in intraperitoneal infections. Corresponding results in biliary tract infections were 38.9%, 40.0% and 42.9%, respectively. From these results, it is clear that the degree of improvement is related to the duration of treatment. The clinical usefulness as assessed by surgeons in charge of the study was 63.8% in intraperitoneal infections (suppurative peritonitis 75.0%, postoperative peritonitis 47.4%) and 58.8% in biliary tract infections (cholecystitis 100%, cholangitis 41.7%). The overall rate of usefulness was 62.5%. The clinical efficacy rates as assessed by the committee were 81.6% in intraperitoneal infections (suppurative peritonitis 93.1%, postoperative peritonitis 65.0%) and 66.7% in biliary tract infections (cholecystitis 100%, cholangitis 53.8%). In cases where causative organisms were isolated, the efficacies were 92.9% in suppurative peritonitis, 58.8% in postoperative peritonitis, 50.0% in cholangitis and overall, 69.2%. In cases from which TIPC-resistant organisms were isolated, the overall efficacy rate was 65.4% (suppurative peritonitis 88.9%, postoperative peritonitis 58.3% and cholangitis 40.0%). Regarding bacteriological effect as assessed by the committee, the eradication rate was 76.9% in intraperitoneal infections and 40.0% in biliary tract infections (71.0% overall). In cases from whom ticarcillin-resistant organisms were isolated the corresponding rates were 68.4% and 33.3% respectively, (63.6% overall). In 4 patients with peritonitis drug levels in the ascites were determined following administration of BRL 28500 by drip infusion. Good levels of both TIPC and CVA were detected 1 to 3.5 hours after administration.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Clinical studies of BRL 28500 (clavulanic acid/ticarcillin) in the treatment of intraperitoneal infections and biliary tract infections]. 330 45

From January 1989 through June 1996, 29 patients underwent surgical repair of type A acute aortic dissection. Mean age was 59 +/- 13.5 years (range 25-76 yrs) and 21 patients (72.4%) were male. Nineteen patients (65.5%) had systemic hypertension and 3 (10.3%) Marfan syndrome. One patient (3.4%) had prior surgical repair of descending aortic dissection and CABG. Six patients (20.7%) were operated on in shock. The dissection was limited to the ascending aorta (DeBakey type II) in 12 patients (41.4%). Eleven patients (37.9%) had severe aortic regurgitation. Replacement of the ascending aorta was performed in all cases and extended to include the transverse arch in one. Twenty-three patients (79.3%) were operated upon using a tubular graft (sacron-21, homograft-2) with aortic valve resuspension. In the remaining 6 (20.7%) the aortic valve and root were replaced using a Bentall procedure, modified with a homograft in 3 cases. Five patients (17.2%) had associated surgery: CABG (4) and closure of aortic-atrial fistula (1). Mean cardiopulmonary bypass time was 134 minutes (range 70 to 285 min) and aortic cross-clamp time was 58 minutes (range 23 to 93 min). Hypothermic circulatory arrest for open distal anastomosis was used in 26 patients (89.7%) (mean time 22 min; range 10 to 32 min), with retrograde cerebral perfusion in the last 4 years (18 cases; 62.1%). Hospital mortality was 17.2% (5 patients). Eight patients (27.6%) had hospital morbidity: reexploration for bleeding (4 cases), CVA (3), A-V block necessitating permanent pacemaker (1). The mean time of hospitalization was 18 days (range 9 to 81 days). In the follow-up period (mean 38 mths; range 4 to 94 mths), 2 patients died (CVA and gastrointestinal bleeding) and 4 required hospitalization (perforated duodenal ulcer, peritonitis, suspected endocarditis, supraventricular tachyarrhythmia-1 patient each). All 22 survivors (75.9%) returned to the functional status they had prior to the dissection and 18 of them (81.8%) are in NYHA functional class I. Type A acute aortic dissection is a complex pathology and the postoperative mortality remains significant, but surgery permits good functional recovery and an active life for the survivors.
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PMID:[Surgery for acute type-A aortic dissection]. 930 6