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PubMedDate not supplied

Multicenter, comparative study of enoxacin and ceftriaxone for treatment of uncomplicated gonorrhea.

The efficacy of single dose enoxacin, 400 mg was compared to ceftriaxone, 250 mg IM for therapy of uncomplicated gonorrhea in 152 evaluable patients attending sexually transmitted disease clinics in Baltimore, Indianapolis and Seattle. Anogenital gonorrhea was cured in 75 (99%) of 76 patients treated with enoxacin and 73 (97%) of 75 patients treated with ceftriaxone. Three of three patients with pharyngeal gonorrhea were not cured by enoxacin while all three ceftriaxone treated cases of pharyngeal gonorrhea were cured. All cases of anogenital gonorrhea caused by beta-lactamase producing Neisseria gonorrheae (11 patients), gonococci with high-level, plasmid-mediated tetracycline resistance (11 patients), or gonococci with chromosomally mediated penicillin resistance (22 patients) were cured. The IC90 for enoxacin of N. gonorrhoeae isolated in this study was 0.06 microgram/ml. Enoxacin appears to be a well tolerated, efficacious alternative to currently recommended therapy for patients with uncomplicated, anogenital gonorrhea including cases potentially caused by antibiotic resistant N. gonorrhoeae.

Adult↗
PubMedDate not supplied

Enoxacin in the therapy of anal and pharyngeal gonococcal infections.

In this randomized double-blind study, 51 patients with uncomplicated anal or pharyngeal Neisseria gonorrhoeae infection were evaluated to determine the efficacy and safety of 200- or 400-mg of enoxacin twice a day for two days. Enoxacin cured all anal infections and 12 out of 13 pharyngeal infections. All 82 isolates of N. gonorrhoeae tested were inhibited by 1 microgram of enoxacin/ml.

Administration, Oral↗
PubMed2005

Optimizing therapy in patients with pancolitis.

Pancolitis affects approximately 20% to 40% of the total ulcerative colitis population and remains a therapeutic challenge for clinicians. Practitioners must focus on pancolitis when evaluating a patient for ulcerative colitis, because pancolitis is associated with more severe and fulminant disease and a higher rate of colorectal cancer and colectomy. It is imperative for clinicians to be knowledgeable in the clinical course, medications, and appropriate manner to induce and maintain clinical remission to prevent serious sequelae of the disease. The purpose of this article is to provide a review of the treatment of pancolitis for general gastroenterologists, because medical management decisions have life-long effects for this subgroup of patients.

Adult↗
PubMed2006

Endoscopic treatment of chronic radiation proctopathy.

PURPOSE OF REVIEW: Chronic radiation proctopathy is a complication of pelvic radiation therapy. The acute phase of radiation injury to the rectum occurs during or up to 3 months following radiation. Acute radiation injury can continue into a chronic phase or chronic radiation proctopathy may develop after a latent period of several months or years. Symptoms associated with the condition include diarrhea, rectal pain, bleeding, tenesmus, and stricture formation. Of the various symptoms, only bleeding from radiation-induced telangiectasias is amenable to endoscopic therapy. This paper summarizes the findings of experts in the field on endoscopic treatment of bleeding from chronic radiation proctopathy. RECENT FINDINGS: Medical management is generally ineffective in controlling bleeding from chronic radiation proctopathy. Surgical intervention has a high incidence of morbidity. Promising advances have been made in endoscopic therapy, including formalin, neodymium/yttrium aluminum garnet, argon and potassium titanyl phosphate laser treatments, as well as argon plasma coagulation. Argon plasma coagulation presents an effective, efficient, inexpensive and reasonably safe noncontact method for destruction of radiation telangiectasias. SUMMARY: Based on currently available data and trends, argon plasma coagulation is the favored treatment for bleeding from chronic radiation proctopathy.

Argon↗
PubMed2006

Treatment of haemorrhagic radiation-induced proctopathy using small volume topical formalin instillation.

BACKGROUND: Between 2 and 5% of patients undergoing pelvic radiotherapy develop chronic radiation proctopathy, occurring as a result of damage to the rectal mucosa during the treatment. Rectal bleeding of varying severity can occur as a consequence. There have been no formal trials of treatment for haemorrhagic radiation proctopathy and a variety of methods are currently used. AIM: In a retrospective study of 20 patients treated at a single centre, we assessed the efficacy of small volume topical formalin instillation to control bleeding from radiation proctopathy. METHOD: Patients were treated by a single operator using 20 mL of a 5% solution of formalin instilled into the rectum via a flexible sigmoidoscope for 3 min. Patients were followed up for an average of 22.7 months (range: 2-69). RESULTS: A single session of formalin treatment was effective in 13 of 20 (65%) patients and a further four (20%) patients responded to a second treatment. No complications of the treatment was identified. CONCLUSION: Small volume formalin instillation therapy appears to be safe and effective in the context of haemorrhagic radiation proctopathy. The technique is simple, inexpensive, quick and requires no sedation. We suggest that it should be considered as a first line for patients presenting with this distressing condition.

Administration, Topical↗
PubMed1990

Perianal streptococcal cellulitis with penile involvement.

Perianal streptococcal cellulitis is described occurring in a 5-year-old boy. The condition also involved the penis and presented as a possible case of sexual abuse. The correct diagnosis was established by culturing beta-haemolytic streptococci group A from the penile and perianal skin.

Cellulitis↗
PubMed2004

Ocular refractive changes in patients receiving hyperbaric oxygen administered by oronasal mask or hood.

PURPOSE: The aim of this study was to quantify ocular refractive changes after a standard hyperbaric oxygen (HBO) treatment protocol and to characterize the time period of recovery. PATIENTS AND METHODS: Hyperbaric oxygen therapy was given for 90 min daily at a pressure of 240 kPa for 21 days. Oxygen was administered to 20 patients using an oronasal mask and to 12 patients using a hood. Follow-up examinations were carried out 2-4 days after treatment, and thereafter regularly for up to 10 weeks in both groups. Refraction was assessed automatically and by the monocular subjective refraction method. A subgroup of nine of the 20 patients to whom oxygen was administered by an oronasal mask underwent a separate eye examination, which included crystalline lens opacity measurements and LOCS III gradings. RESULTS: In the patients given oxygen by mask, there was a significant myopic shift in the mean spherical equivalent, which was largest 2-4 days after treatment. The shift was - 0.55 +/- 0.40 D in the right eye and - 0.53 +/- 0.42 D in the left eye. In the patients given oxygen by hood, the largest shift was observed after 12-16 days, and was - 1.06 +/- 0.52 D in the right eye and - 1.10 +/- 0.57 D in the left eye. The refractive changes returned to baseline 6 weeks and 10 weeks after HBO treatment, respectively. No significant changes in crystalline lens transparency were revealed. CONCLUSIONS: The myopic shift after HBO therapy recovers within 10 weeks and may be more pronounced when patients are given oxygen using a hood compared with using an oronasal mask.

Cystitis↗
PubMed2004

Argon plasma coagulation as first-line treatment for chronic radiation proctopathy.

BACKGROUND AND AIM: Chronic radiation proctopathy is a troublesome complication of radiotherapy to the pelvis, for which current treatment modalities are unsatisfactory. The present prospective study was designed to determine the usefulness and safety of argon plasma coagulation in the management of chronic radiation proctopathy. METHODS: Twenty-five consecutive patients (M:F 24:1, mean age: 69 years) with radiation proctopathy were prospectively included. All patients received argon plasma coagulation by a standard protocol. Response to treatment was assessed by symptom response, bleeding severity score, hematological parameters and transfusion requirements over a median 14-month follow up. RESULTS: Patients received a median of one treatment session with argon plasma coagulation. There was significant improvement in rectal bleeding in all patients, with complete cessation of bleeding in 21 (81%) of the patients. The median bleeding severity score fell from 3 to 0 (P < 0.0005). The mean hemoglobin level rose from 10.05 +/- 2.21 g/dL before treatment to 12.44 +/- 1.09 g/dL at 6 months following treatment (P < 0.002). There was also improvement in other symptoms such as urgency and diarrhea. Over the period of follow up, there was no recurrence of anemia and no complications were noted. CONCLUSION: These results suggest that argon plasma coagulation is a safe and effective modality in the treatment of chronic radiation proctopathy.

Aged↗
PubMed1975

The in-vitro action of lymphocytes on autologous colon epithelial cells in ulcerative colitis.

The action in culture of peripheral blood lymphocytes on autologous large-intestinal epithelial cells was studied in 13 patients with severe mucosal ulcerative colitis. Two different methods were used to measure lymphocyte activity. These showed that autologous-lymphocyte-induced release of isotopic label and detachment in monolayer culture of large-intestinal epithelial cells was increased in acute ulcerative colitis when compared with findings in the same studies in six normal subjects. Subsequently in four of the six patients who responded to cortisone it was shown that lymphocyte activity against epithelial cells returned to the normal range. Further control studies showed little lymphocyte activity against autologous skin and ileum, suggesting that autologous-lymphocyte-induced damage of large-intestinal epithelial cells is a tissue-specific reaction in patients with acute ulcerative colitis. The absence of reactivity in other colonic inflammatory diseases also suggested that such increased in vitro lymphocyte activity is disease-specific for ulcerative colitis.

Adolescent↗
PubMed1980

Concealed rectal prolapse.

In a series of 97 patients with rectal prolapse 36 were unaware that the prolapse was occurring. Failure to recognize the prolapse may cause delay in diagnosis and inappropriate treatment. In most instances the prolapse was considered to be primary and responded well to surgical repair; however, in a few patients the prolapse seemed to follow prolonged straining, and in these surgical repair is not so successful.

Adolescent↗