Short-term antibiotic prophylaxis was studied in 80 patients undergoing biliary or gastric surgery. The patients were randomized to receive 1 g of aztreonam or 80 mg of gentamicin intravenously 30 minutes before surgery and 8 and 16 hours after surgery. Of samples taken from the abdominal cavity for bacteriologic study, 53% were culture positive. Wound infections developed in two (4.5%) of 44 patients receiving aztreonam and in seven (19.4%) of 36 patients treated with gentamicin. Staphylococcus epidermidis and Enterobacter species were isolated from sites of wound infection in the aztreonam group; Escherichia coli (two isolates), Pseudomonas aeruginosa (two isolates), Enterobacter species, Klebsiella species, Enterococcus faecalis, and Aeromonas hydrophila were isolated from the gentamicin group. Our data indicate that aztreonam is safe and effective for the prevention of infections following biliary and gastric surgery.

Adult↗

PubMedDate not supplied

[Pseudomyxoma peritonei with appendiceal and ovarian mucinous cystadenoma. A case report. Correlations with synchronous or metachronous colorectal carcinomas].

Mucocele is a rare pathology which is difficult to diagnose prior to surgery. The clinical symptoms are aspecific. Diagnosis is generally made at the time of surgery. Explorative laparoscopy is not advised owing to the possibility of encouraging metastatic diffusion. Surgery associated with ex tempore freezer tests must be carried out with the greatest caution to avoid rupture of organs and the spread of mucin. Appendectomy and removal of the adnexa is recommended in benign forms, with or without omentectomy. Omentectomy is necessary together with hystero-adnexectomy and right hemicolectomy in malignant forms, as well as lymph node cleaning and removal of all mucin in pseudomyxoma peritonei.

Appendectomy↗

PubMedDate not supplied

[Surgical chemoprophylaxis with ceftriaxone].

UNLABELLED: Ceftriaxone is a cephalosporin of third generation. It is characterized by a broad spectrum, a long half-life and a good capacity of diffusion in tissue. We have studied 67 patients. Age ratio was 44 years. 25 patients did not receive short term prophylaxis; 42 patients did (2 gr iv of ceftriaxone one hour before the operation). In clean surgery, only patients immunodepressed or malnourished received chemoprophylaxis. Patients who received 2 gr iv of ceftriaxone one hour before incision, received antibiotic therapy only on the appearance of septic complications. RESULTS: two patients submitted to chemoprophylaxis (4.8%) showed complications (cystitis and bronchial pneumonia). In the control group antibiotic therapy was undertaken only if septic complication appeared. 19 patients (76%) did not showed any complications. 6 patients (24%) showed surgical wound infection, acute pharyngo-tracheitis, cystitis. Finally, wound infections were limited exclusively to the control group. The ratio of respiratory infections was not statistically significant in the two groups; cystitis resulted more frequent in the control group than in the prophylaxis group. Prophylaxis with 2 gr single dose of ceftriaxone intravenously is effective in reducing the influence of infective complications in clean/contaminated surgery and clean risk surgery.

Adult↗

PubMedDate not supplied

[Benign tumors of the small intestine. Personal observations].

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

[Peritoneal mesothelioma. A case report].

Peritoneal mesothelioma is a rare neoplasm (annual incidence: 1-2 cases per million in the general population) and forms about 10% of all mesotheliomas. The authors report a case of malignant mesothelioma of the peritoneum in a male, 61 years old. After laparotomy the patient was treated with intraperitoneal administration of cisplatin (40 mg/m2 day 1-2-3-29-30-31) and intravenous administration of mitomycin C (10 mg/m2 day 1). The renal toxicity was avoided with the GSH and with prehydration before and after administration of the cisplatin. The bone marrow toxicity was avoided with the subcutaneous administration of G-CSF (300 mg three times each week) and erythropoietin (10.000 U three times a week). After the first cycle, with the reduction of the ascites, the cisplatin was administered intravenously too. After six cycles of chemotherapy (18 months after laparotomy) the patient is alive and he has a performance status of 1 (ECOG/WHO). The chemotherapy with cisplatin and mitomycin C must be preferred to the anthracycline in all the patient with cardiologic involvement. The cisplatin administered by intracavitary route give a quick response with less systemic toxicity. A review of the literature confirms the rarity of this pathology, linked epidemiologically with exposure to asbestos, and the difficulty of the preoperative diagnosis: in fact cytologic assay and ultrasonographic and TC scan always don't permit to discover a mesothelioma. The laparotomy and the laparoscopy are useful in the P.M. for the possibility of the biopsies and the apposition of the catheters for intracavitary therapy. The response of peritoneal mesothelioma to treatment is poor. The median survival after the appearance of the symptom is less than 18 months.

Antibiotics, Antineoplastic↗

PubMedDate not supplied

[Ileal and axillary metastasis of primary unknown site melanoma. Clinical case].

The incidence of Cutaneous Melanoma is 4-5% of all the tumors of the skin. This incidence increases several folds in the last years. Metastases of Melanoma involve lungs, skin, soft tissue, liver, bone, brain, but in 20-30% of the patients involve gastrointestinal (GI) tract. In 60-70% of the cases GI metastases involve small bowel, in 15-20% stomach, in 10-20% large bowel, in 5% esophagus. In 8% of the patients the primary cutaneous melanoma is not known. The prognosis of the patients with metastatic melanoma is poor with an average survival of 5 months. One patient male, 51 years old, underwent surgery for metastases from melanoma in the lymph nodes of the right axilla and in the gastrointestinal tract (ileum). An ileo-ileo anastomosis and a lymphoadenectomy of the nodes of the right axilla were performed. After a first chemotherapy with DTIC (800 mg/m2) + a-IFN(3MU three times every week) and another with CDDP (30 mg/m2 day 1-3), DTIC (250 mg/m2 day 1-3) and VDS (2.5 mg/m2 day 1) with no response, the patient was treated with chemo-immunotherapy sec. Bernengo, slightly modified: CDDP 75 mg/m2; IL-2 18 MU (9MU b.d.) day 3-6 and 17-21; a-IFN 5MU three times every week. This therapy had a partial response of short-course (three months) and the patient died 15 months after surgery. The authors hope that immunotherapy and genetic therapy improve the survival of the patients with metastatic melanoma in the next years.

Axilla↗