Monitoring of vancomycin serum levels for the treatment of staphylococcal infections.

Vancomycin serum concentrations were determined for 1,737 patients treated with either 2 x 1 g of vancomycin or 4 x 500 mg daily (780 patients), according to current nomograms, or by continuous infusion (957 patients) with a loading dose (1 g) and a total of 2-6 g daily. Trough serum concentrations were determined after 36-48 h. Adequate serum levels for the treatment of a normal methicillin-resistant Staphylococcus aureus (MRSA) and a glycopeptide-intermediate S.

[Is tumour grade applicable to finasteride-treated prostate cancer?].

The treatment of prostate cancer by endocrine therapy induces histological changes of benign or malignant prostate glands. Treated cancers often have a more suspicious architecture, resulting in a higher Gleason score, while their nuclear grade (WHO) appears to be more reliable due to a reduction of the size of nuclei. Most authors appear to agree that cancers discovered by biopsy in patients treated with endocrine therapy should not be graded.

Great vessels transposition and aortic arch exclusion.

Aim: We describe our experience in endovascular repair of Thoracic Aortic Aneurysms and Dissections (TAAD) involving the aortic arch in high risk patients (HRP).

Methods: Twenty-nine patients presented with TAAD involving the aortic arch and were treated by endovascular exclusion. Pathologies were as follows: atherosclerotic aneurysms of the descending thoracic aorta in 15 cases, acute Stanford type A dissections in 6 cases, Stanford type B dissections in 7 cases (1 acute), and 1 false aneurysm of the ascending aorta.

The preoperative administration of ketoprofen improves analgesia after laparoscopic cholecystectomy in comparison with propacetamol or postoperative ketoprofen.

Background: Non-opioid analgesics, paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) are proposed for pain relief after laparoscopy. We compared perioperative propacetamol (P) and ketoprofen (K) to provide analgesia after laparoscopic cholecystectomy.

Methods: After ethical committee approval, we included 104 ASA I-II patients, without preoperative analgesic drugs, who were scheduled to undergo laparoscopic cholecystectomy.

Is MRI effective in detecting intraarticular abnormalities of the injured knee?

Background Data: Magnetic resonance imaging (MRI) is widely used for the diagnosis of intraarticular anomalies of the knee. Its reliability is controversial mainly in the pediatric population, and its results may vary from one center to the other. The purpose of this study was to assess the validity of MRI in detecting intraarticular abnormalities in patients who sustained an injury of their knee, by comparing its findings to those of arthroscopy.

False synergy between vancomycin and beta-lactams against glycopeptide-intermediate Staphylococcus aureus (GISA) caused by inappropriate testing methods.

The combination of vancomycin and beta-lactams is often considered synergistic and has been recommended for the treatment of glycopeptide-intermediate Staphylococcus aureus (GISA) infections. In this study, the combination of vancomycin or teicoplanin with different beta-lactams was tested. When using NaCl 4% w/v, for better expression of heterogeneous resistance to beta-lactams, with a longer (48-h) incubation period and a higher (10(7) CFU/mL) inoculum, the association of vancomycin with beta-lactams was antagonistic.

Nonpenetrating deep sclerectomy: a 6-year retrospective study.

Purpose: Nonpenetrating trabeculectomy, also called nonpenetrating deep sclerectomy (NPDS), is a filtering surgery where the internal wall of Schlemm's canal is excised, allowing subconjunctival filtration without actually entering the anterior chamber. This, technique was developed to minimize the complications of trabeculectomy. The authors investigated its safety and efficacy in a retrospective noncomparative study.

"Perthes-like" changes in a free riding untreated congenital dislocated hip.

The development of avascular necrosis of the femoral head (AVN) after the treatment of congenital dislocation of the hip (CDH) is a well-known complication, but the coexistence in an old child of untreated CDH and ischemic changes of the femoral head has not been reported. Many authors and several years of clinical observation have shown that Perthes-like changes do not occur unless the two sides of the joint are in contact. The purpose of this paper was to report a case of Perthes-like disease that occurred in an untreated CDH, and to discuss the possible pathogenesis.

Retrocaval passage of coronary bypass grafts to the inferior left ventricle wall.

Revascularization of the inferior side of the left ventricle is performed most often with aortocoronary free grafts. This article describes a technical improvement for anatomical fit and gain of length of these grafts by directing them to the right side of the heart after a passage behind the inferior vena cava.

Surveillance of resistant pathogens and rational use of antibiotics: general remarks.

Surveillance of resistant pathogens should lead to improved treatment of patients and to a rational use of antibiotics. The process for decision making between microbiology, general practice and health policy is still to be documented with careful studies.

Effects of two different crystalloid cardioplegic solutions assessed by myocardial pH, tissue lactate content and energy metabolism.

Objective: The influence of composition of crystalloid cardioplegia is imprecise in clinical practice. Therefore, we investigated changes in intramyocardial pH, tissue lactate content and energy metabolism during cardioplegic arrest with 2 different crystalloid cardioplegic solutions.

Methods: Twenty patients were randomly allocated to 2 groups: 10 patients had crystalloid cardioplegia buffered with bicarbonate (neutral pH of 7.

Autoimmune pemphigus. A distinct staining pattern with an anti-desmoglein antibody.

Background And Design: Diagnosis of autoimmune pemphigus is based on the immunodetection of IgG deposits in the epidermal intercellular spaces. Desmoglein is a desmosomal component that has been assumed to be the antigen of pemphigus foliaceus. We investigated the use of one monoclonal antibody (32-2B) to desmoglein 1 on paraffin sections.

Daunorubicin versus 5-fluoro-uracil in surgical treatment of primary open angle glaucoma: a prospective study.

In a prospective randomized study, we compare the results at 20 months of 5 Fluoro-Uracil and Daunorubicin filtering surgery in two groups of 25 patients with primary open-angle glaucoma. For the first group of 14 eyes, 10 injections of 5FU are done and only one subconjunctival preoperative injection of Daunorubicin in the second group of 13 eyes. 5FU group consists of 13 patients: 9 males, 4 females.

Comparison of different types of cardioplegia and reperfusion on myocardial metabolism and free radical activity.

Current techniques of myocardial protection during global ischemia include hypothermia, cardioplegic arrest and controlled reperfusion. To compare different types of cardioplegia and reperfusion techniques we measured the levels of adenine nucleotides and malondialdehyde (MDA, as free radical activity) in 33 patients undergoing heart surgery. The patients were randomized in three groups according to the characteristics of cardioplegia and reperfusion: cold blood cardioplegia with unmodified blood reperfusion (control group, 11 patients), crystalloid cardioplegia and reperfusion (Hôpital Lariboisière protocol, 11 patients) and crystalloid cardioplegia with allopurinol enriched blood reperfusion (Hôpital Broussais protocol, 11 patients).