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The treatment of a case of GAgP over a period of 6.7 years is presented in this case report. Initial periodontal therapy (week 1- 32) consisted of supragingival plaque control and three appointments of scaling and root planing. Based on the periodontal pathogens isolated (5 species), the patient also received metronidazole plus amoxicillin for one week, followed 10 weeks later by metronidazole plus amoxicillin/clavulanate for one week. The patient was put on regular supportive periodontal therapy (SPT) thereafter. Orthodontic treatment was performed after completion of the initial therapy for 96 weeks. Measurements of clinical attachment level, bleeding on probing and plaque index were obtained at every examination.
The aim of this study was to evaluate the applicability, safety and efficacy of an ambulatory treatment protocol in patients with uncomplicated acute diverticulitis.
The study group comprised 167 children aged from 7 to 10 years (100 males, 67 females) with CP from the OCS, who were subdivided into a preterm rupture of membranes (PROM) group (87 children) and an SPL group (80 children). The OCS sought follow-up information regarding the health and behaviour of surviving children at 7 years of age in the UK using a parent-report postal questionnaire. Families provided further information to define wider aspects of function and were offered a physiotherapy assessment.
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Neonatal mastitis is an uncommon infection. Twenty-one neonates with mastitis were treated at the Bnai Zion Medical Center and Hillel Yaffe Hospital during the years 1985-92. Half of them presented with mastitis, and the other half with breast abscess. The most common pathogen was Staphylococcus aureus, which was isolated in 85% of cases. Antibiotic therapy was the initial treatment in all cases except one, and included i.v. orbenin or augmentin. Puncture of six breast abscesses followed the initial antibiotic course, and another five abscesses were treated surgically by incision and drainage. About half the neonates (10 of 21) recovered after antibiotic treatment alone, indicating that aggressive antibiotic therapy is effective in about 50% of cases and, if started immediately upon diagnosis, no additional surgical treatment is necessary. When an abscess was formed, needle aspiration was as effective as incision and drainage.
Forty-eight patients with acute bronchitis and four with pneumonia were randomly assigned to receive five doses (500 mg on day 1, plus 250 mg/day on days 2-5) of azithromycin; 54 patients with acute bronchitis and four with pneumonia were assigned 30 doses (625 mg every eight hours for ten days) of amoxicillin/clavulanic acid (CA). The two regimens were equally effective, with clinical improvement or cure in 92% and 87% of patients respectively, bacteriological cure in 89% and 86%, with 91% and 89% of pathogens eliminated. Minor side effects occurred in 6% and 12% of patients in the two groups, respectively. No major abnormalities in laboratory safety parameters were seen in either group.
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Kenyatta University Health Services Clinic, Nairobi.
135 patients with infectious endocarditis (IE) were examined according to the routine scheme using modern methods of diagnosis and therapy control: transthoracic and transesophageal echo-CG, test for antibiotics sensitivity of the microflora, etc. Immediate results were assessed in all the patients, some of them were followed up for maximum 5 years.
The main indications for PEG insertions are the following: stroke/CVA/diffuse cerebral vascular disease, neurological conditions, e.g. head injury, motor neurone disease, Multiple Sclerosis etc. Peristomal infection can sometimes complicate PEG placement. Antibiotics, either prophylaxis or concurrent, can reduce the incidence of peristomal wound infection after PEG placement.
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A 63-year-old female patient was admitted to the department of neurology following an acute ischemic infarction of the right medial cerebral artery. She developed fever, respiratory failure, and hypotension and had to be transferred to the intensive care unit (ICU) for intubation and mechanical ventilation. Chest X-ray showed increased density of the complete right hemi-thorax, indicative of massive pleural effusion. Chest tube drainage produced 1.5 l of pus in 1 h. Cultures revealed growth of Enterococcus faecalis. The patient was treated with amoxicillin and clavulanic acid with good clinical response. Enterococci very rarely cause spontaneous pleural empyema. The natural resistance of enterococci to several types of antibiotics can lead to selection of enterococci as seen in other clinical studies and may lead to this unusual clinical consequence.
Currently in many centres the extended spectrum cephalosporins (e.g. cefotaxime and ceftriaxone) are being used empirically for patients with suspected bacterial meningitis. We present a case of meningitis in a penicillin allergic paediatric renal transplant patient from whose cerebrospinal fluid (CSF) Listeria monocytogenes was cultured, despite four days of cefotaxime therapy. The patient was successfully treated with meropenem but required neuro-endoscopic intervention for hydrocephalus.
Eleven (16%; 95% confidence interval 9% to 28%) children had an irregular course in the co-amoxiclav group and 10 (19%; 9% to 31%) in the placebo group (difference not significant). Age, dichotomised at 2 years, was the only significant prognostic factor for irregular course of the disease (odds ratio 5.9; 1.8 to 19.1). Among children aged below 2 years, 28% (4/14) in the co-amoxiclav group and 58% (7/12) in the placebo group had irregular courses. For children 2 years and older these percentages were 13% (7/52) and 7% (3/41).