Emergence of multiple antibiotic resistance during the therapy of Klebsiella pneumoniae meningitis.

A patient is described in whom multiple antibiotic resistance developed during the course of therapy of Klebsiella pneumoniae meningitis. Sequential resistance developed to chloramphenicol, gentamicin and eventually amikacin. As previously reported, the use of the chloramphenicol alone in the therapy of gram-negative bacillary meningitis can result in rapid emergence of resistance and treatment failure.

Cardiopulmonary resuscitation in a university hospital. An analysis of survival and cost.

A cost analysis and study were done of patient survival after inhospital cardiopulmonary resuscitation during one year at a university hospital. The immediate survival rate in 128 patients was 52 percent. Survival to discharge and six-month survival rates were 19 percent and 15.

Aminoglycoside use monitored by clinical pharmaceutical services.

A pharmacy-infectious diseases program designed to promote the rational use of, and decrease the adverse reactions attributed to, amikacin and tobramycin is described. Requests for amikacin and tobramycin were screened initially by a pharmacist and later reviewed by an infectious disease physician. When the appropriateness of amikacin or tobramycin use was questionable, the drug was released pending review of the order by the chief of infectious diseases.

Sequential study of C 1 q-binding substances and of anti-DNA antibodies in (NZB X NZW)F1 mice: evidence for an acute phase of the lupus disease in 2-month-old mice.

Longitudinal studies of C 1 q and DNA-binding substances were performed in sera from 38 (NZB X NZW)F1 female mice between days 39 and 150 of life. Results suggest a two-phase evolution of circulating immune complexes and anti-DNA antibodies in young (NZB X NZW)F1 mice and show the existence of an acute phase of the disease during the second month of life of these mice.

[Retro-peritoneal tumors. Report of 21 cases (author's transl)].

The authors report their experience about 21 cases of retroperitoneal tumors. They emphasise their often late revelation, the frequent malignity and the involvement of the surroundings organs. They insist on the interest of the opacification of urinary tract and angiography and the value of echo-ranging and total body scanner to evaluate the characteristics of these tumors and theirs extensions.

Urinary tract infection/vaginitis protocol. Use in a walk-in clinic.

A process, outcome and salary-cost analysis was made of the use of a urinary tract infection/vaginitis protocol. Three nurse practitioners, in a university-based, walk-in clinic, cared for 128 women presenting with complaints of dysuria or vaginal discharge, or both. There were no significant differences among the nurse practitioners in data collection, diagnostic accuracy or patient outcome.

Bacillus cereus pneumonia. Survival in a patient with cavitary disease treated with gentamicin.

Cavitary pneumonitis due to Bacillus cereus occurred in a patient with acute lymphoblastic leukemia. Pneumonia due to this organism is uncommon and recovery has not been previously reported. The present report is the first description of cavitary pneumonia due to B.

[Primary and idiopathic hyperaldosteronism. Course 1 year after operation. Apropos of 28 cases].

The course of mean arterial pressure was compared in two series concerning 18 primary or tumoral hyperaldosteronism and 8 idiopathic ones. Identification of the nature of the hyperaldosteronism should not yet motivate a decision on principle, surgical in case of tumor, medical in an idiopathic case. In the latter case cooperation and tolerance of medical treatment, severity of hypertension also come into consideration.

The use of heparin in the treatment of idiopathic rapidly progressive glomerulonephritis.

14 cases of idiopathic rapidly progressive glomerulonephritis (I. R. P.

Genesis and pathogenicity of anti-DNA antibodies.

The formation of anti-DNA antibodies appears to be under a genetic control similar to that regulating the immune response to complex antigenic compounds. The ability to develop a high immune response to DNA seems to be predominantly dependent on the nature of the B-cell population whereas a major role of the T-cell suppressor population is not evident in this response. The immune response to DNA does not necessarily need the presence of thymus-derived lymphocytes, but in some cases T-cells may exert a helper effect.

Dihydroergotamine: an effective treatment for postural hypotension due to antihypertensive drugs (ganglion-blocking agents excepted).

In this study the effect of DHE on postural hypotension induced by major antihypertensive drugs was evaluated in 40 patients. 30 patients were treated with methyldopa, five with guanoxan sulphate and five with bethanidine sulphate. To obtain a more accurate picture of the effectiveness of DHE and to test the reproducibility of its effect, each patient was observed during five separate, successive periods: in the first period the antihypertensive agent was given alone; in the second period it was given along with placebo; in the third period it was given with DHE; in the fourth period the antihypertensive agent was given alone again; and in the fifth period it was again given with DHE.

Are chlamydial infections the most prevalent venereal disease?

We studied two population groups (more than 1,600 patients) to determine the prevalence and clinical associations of genital tract infections with chlamydiae and herpesviruses. Base-line isolation rates for asymptomatic women having routine pelvic examinations were much lower than rates for symptomatic women. In both groups, chlamydiae were more prevalent than herpesviruses.

[Lupus nephropathy. Treatment with the indomethacin-hydroxychloroquine combination and comparison with corticoids].

The authors report their comparative experience of the treatment of proliferative lupus glomerulonephritis using prednisone (16 patients) or the indomethacin-hydroxychloroquine association (12 patients). Prednisone in high dosage was associated in this series with 9 deaths and in 6 patients, with renal failure or an extra-renal complication. By contrast, the indomethacin-hydroxychloroquine association proved to be highly effective, without side-effect.