Cerebral involvement in primary mixed cryoglobulinaemia.
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Biomedical subjects
Publications and source records attributed to A Pines.
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A 19-year-old soldier developed multifocal neuropathy following an infection with tick-borne Borrelia. He suffered from involvement of the right accessory nerve, the right brachial plexus and the left recurrent laryngeal nerve. As was expected, all these complications were reversible. In contrast to louse-borne relapsing fever, neurological manifestations in the tick-borne variants are not common. To the best of our knowledge, vocal cord paralysis has never been described before.
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Cefamandole 3 g daily gave poor results in the treatment of severe purulent respiratory infections in 50 patients. A further 71 patients were treated with 4 g daily and the results were excellent with 86% clinical success. Apart from muscle pain with the injection, side-effects were minimal.
Cefuroxime and ampicillin were compared in a randomized double-blind trial in the treatment of severe lower respiratory tract infections. 750 mg of cefuroxime were given to 57 patients and 500 mg of ampicillin to 54 patients by intramuscular injection three times daily for 7-10 days. The patients had acute exacerbations of chronic bronchitis with or without pneumonia, a few had bronchiectasis and an underlying bronchial carcinoma was present in nearly a quarter. By the end of treatment the sputum, initially always mucopurulent, had become mucoid in 87.7% of patients receiving cefuroxime in comparison to 48.1% of those receiving ampicillin. A satisfactory clinical response was observed in 94.7 and 68.5%, respectively. Both these differences between cefuroxime and ampicillin are statistically significant (p less than 0.001).
The efficacy of parenteral mecillinam was evaluated in 105 elderly patients with lower respiratory tract infections or urinary tract infections. Another antibiotic, usually amoxycillin, was given concurrently in cases of respiratory infection. An adequate response was note in 86% of chest infections and in all of the urinary tract infections assessed. Mecillinam proved to have a low toxicity profile and intramuscular injections were very well tolerated.
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Cefuroxime is a very effective agent for the treatment of severe purulent respiratory infections. 190 patients with purulent exacerbations of bronchitis or bronchiectasis, pneumonia or secondarily infected lung cancer received 2.25--3.0 g cefuroxime daily for an average of 9 days. A good clinical response was seen in 91% of 184 assessable patients. A remarkable improvement in sputum purulence was observed and side-effects to cefuroxime were minimal.
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Cefuroxime, a new cephalosporin, was given in doses of 750 mg and 1000 mg three times daily for 10 days to 99 patients in a double-blind comparison. Patients were moderately or severely ill with exacerbations of chronic bronchitis, often accompanied by pneumonia. Both doses were equally efficacious in improving the clinical state and sputum purulence and in maintaining the improvement.
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