RESUMEN
Results of clinico-microbiological examinations of 147 patients with peritonitis were analyzed. Strict anaerobic technique was used. It was established that in most cases peritonitis represented a mixed anaerobic aerobic infection (59.2%). The coliform microorganisms were dominating among aerobic ones, bacteroids-among anaerobic ones. The microbic character of inflammation (from abacterial to mixed forms) is dependent on the level (localization) of the inflammation source, duration of the inflammatory process. Mixed aerobic-anaerobic peritonitis has characteristic clinical features and requires an adequate antibacterial therapy.
Asunto(s)
Infecciones por Bacteroides/complicaciones , Infecciones por Escherichia coli/complicaciones , Peritonitis/etiología , Adulto , Anciano , Humanos , Persona de Mediana Edad , Peritonitis/microbiologíaRESUMEN
An analysis of clinical observations shows the successful treatment of most patients with open pneumothorax to be possible under conditions of urgent suturing of the wound defect of the chest, drainage of the pleural cavity and antishock therapy. Thoracotomy is necessary for a small amount of the patients.
Asunto(s)
Pleura/lesiones , Neumotórax/cirugía , Heridas por Arma de Fuego/complicaciones , Drenaje/métodos , Humanos , Pleura/cirugía , Neumotórax/etiología , Choque Traumático/prevención & control , Técnicas de SuturaRESUMEN
Exact indications for urgent, early and late thoracotomy are given on the basis of a great clinical experience of the authors. Specific features of the operation, principles of the management of postoperative patients are described. The general postoperative lethality from chest injuries of the patients was 9.5%.
Asunto(s)
Traumatismos Torácicos/cirugía , Heridas Penetrantes/cirugía , Urgencias Médicas , Hemotórax/cirugía , Humanos , Neumotórax/cirugía , Cuidados Posoperatorios , Infección de la Herida Quirúrgica/prevención & control , Traumatismos Torácicos/complicaciones , Factores de Tiempo , Heridas Penetrantes/complicacionesRESUMEN
Skin tests with a complex of antigens have revealed anergy in the postoperative period in 17 out of 116 patients with acquired heart diseases. Postoperative purulent complications were observed in 13 out of them. They were effectively treated by repeated transfusions of concentrations of the donor compatible leukocytes.
Asunto(s)
Transfusión Sanguínea , Cardiopatías/cirugía , Transfusión de Leucocitos , Linfopenia/terapia , Infección de la Herida Quirúrgica/terapia , Cardiopatías/inmunología , Humanos , Tolerancia Inmunológica , Infección de la Herida Quirúrgica/etiologíaRESUMEN
Bacteriological examinations of 65 patients with abscesses of lungs and pleuritis have shown that non-sporulating anaerobic bacteria were isolated in 85% of purulent foci (without a concomitant aerobic microflora). Express-methods of diagnosis taking only 30-40 minutes give opportunities for early etiotropic therapy. Best results of treatment of anaerobic abscesses of lungs and pleuritis were obtained by a combination of sufficient drainage with the purposeful antianaerobic therapy.
Asunto(s)
Absceso Pulmonar/diagnóstico , Pleuresia/diagnóstico , Adulto , Anciano , Bacterias Anaerobias , Cloranfenicol/análogos & derivados , Cloranfenicol/uso terapéutico , Terapia Combinada , Femenino , Humanos , Lincomicina/uso terapéutico , Absceso Pulmonar/terapia , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Penicilinas/uso terapéutico , Pleuresia/terapiaAsunto(s)
Infección de la Herida Quirúrgica/diagnóstico , Adulto , Cromatografía de Gases/métodos , Infecciones por Clostridium/diagnóstico , Exudados y Transudados/análisis , Ácidos Grasos Volátiles/análisis , Femenino , Humanos , Infecciones Estafilocócicas/diagnóstico , Infecciones Estreptocócicas/diagnósticoRESUMEN
The article analyzes scientific problems for studying infection. Attention is paid to another role than that attributed by surgeons to staphylococci, gram-negative bacillus flora and anaerobes. A revision of the routinely used classification of surgical infections is shown to be necessary since their traditional division into purulent, putrifactive, anaerobic and specific ones is not up to the present state of science. It is noted that anaerobes take part in the appearance of 87% of postoperative complications and similar hospital infections.
Asunto(s)
Infecciones Bacterianas/epidemiología , Infección Hospitalaria/epidemiología , Infección de la Herida Quirúrgica/epidemiología , Bacterias Aerobias , Bacterias Anaerobias , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/etiología , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/etiología , Bacterias Gramnegativas , Humanos , Riesgo , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/etiologíaRESUMEN
An analysis of results of intracutaneous tests with a set of microbe allergens in 121 patients has shown that absence of a skin reaction to all the allergens under test demonstrates a disturbed immune response (incidence of infectious complications was 77%, both lethal outcomes included). The selective hypersensitivity to the injection of certain allergens was due to the carrier state. The normal reaction of slow type hypersensitivity was found in 101 patients (86,4%) and showed no disorders in immune reactivity which was confirmed by the postoperative course without complications. The test of the slow type hypersensitivity is considered to be highly informative and to allow prognosis of postoperative complications.
Asunto(s)
Antígenos Bacterianos , Infección de la Herida Quirúrgica/diagnóstico , Linfocitos B/inmunología , Humanos , Inmunidad Celular , Inmunoglobulinas/análisis , Recuento de Leucocitos , Pronóstico , Pruebas Cutáneas , Infección de la Herida Quirúrgica/inmunología , Linfocitos T/inmunologíaRESUMEN
On the basis of their experience with the treatment of such patients the authors describe modern principles of the treatment of penetrating wounds of the breast with special reference to indications for thoracotomy, treatment of lung contusion, posttraumatic empyema of the pleura.
Asunto(s)
Lesión Pulmonar , Heridas por Arma de Fuego/cirugía , Desbridamiento , Drenaje , Empiema/cirugía , Hemoneumotórax/cirugía , Hemotórax/cirugía , Humanos , Pleura/cirugía , Cirugía Torácica/métodos , Heridas por Arma de Fuego/complicacionesRESUMEN
The effect of lasting peripheral counterpulsation upon the haemodynamics and the main biochemical factors of the blood was studied in 14 dogs with intact hearts. In cases of significant tachycardia counterpulsation in a 1:2 regimen results in only a partial reduction of the resistance to the cardiac output. This does not always permit to prevent the formation of the phenomenon of an elevated myocardial contractility. The haemodynamic conditions are most optimal in a 1:1 regimen of counterpulsation. Slowing down of the cardiac rhythm was achieved by means of hypothermia.