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The European journal of surgery. Supplement. : = Acta chirurgica. Supplement最新文献

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Duration of antibiotic treatment in surgical infections of the abdomen. Undesired effects of antibiotics and future studies. 腹部手术感染的抗生素治疗时间。抗生素的不良影响和未来的研究。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
E P Dellinger
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. Undesired effects of antibiotics and future studies.","authors":"E P Dellinger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Effects of antibiotic administration other than bacterial killing are common and include drug interactions, toxic, and allergic reactions. Effective antibiotics do release endotoxin from enteric bacteria, but the clinical significance of this effect is uncertain, and present knowledge does not support alteration of clinical practice based on this information. The duration of antibiotic administration that is necessary for prophylactic purposes is short, probably 12 hours or less in all cases. The duration of administration that is necessary for treatment of established infections is not known in most cases. It is likely that current clinical practice errs on the side of continuing antibiotics longer than necessary. Prospective studies to find out the necessary duration of antibiotic treatment are needed. The design and interpretation of these studies will be difficult. Studies of a decision rule for stopping antibiotics are probably preferable to studies of arbitrary duration.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"29-31; discussion 31-2"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. The future: randomised prospective studies. 腹部手术感染的抗生素治疗时间。未来:随机前瞻性研究。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
J S Solomkin
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. The future: randomised prospective studies.","authors":"J S Solomkin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The important questions are: what is the most efficient, least costly, and least hazardous way of providing antimicrobial therapy to postoperative patients? These questions, and the answers, are integral to the practice of medicine. I discuss a few pitfalls associated with antibiotic studies and suggest potential solutions. I urge doctors interested in these problems to focus on establishing the hospital systems needed to provide continuous feedback, rather than sporadic information driven by collegial requests.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"33-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SIRS, MODS and tertiary peritonitis. SIRS, MODS和第三期腹膜炎。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
P H Reemst, H van Goor, R J Goris
{"title":"SIRS, MODS and tertiary peritonitis.","authors":"P H Reemst,&nbsp;H van Goor,&nbsp;R J Goris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Some patients with peritonitis develop a septic response without a detectable infective focus. It is suggested that an immunological dysfunction is responsible for this so called tertiary peritonitis. The role of the gastrointestinal tract in the development of multiple organ dysfunction syndrome (MODS) is discussed. In patients with tertiary peritonitis treatment should be directed towards restoration of the immunological balance, which is probably more important than the elimination of microorganisms with antibiotics.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"47-8; discussion 49"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. At what point is infection cured but inflammation persists? 腹部手术感染的抗生素治疗时间。什么时候感染被治愈，但炎症仍在继续?
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
A V Pollock
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. At what point is infection cured but inflammation persists?","authors":"A V Pollock","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>While infection is a consequence of invasion of microorganisms, sepsis is a phenomenon of the host. Systemic inflammatory response syndrome (SIRS), \"severe sepsis\", and \"septic shock\" may occur without infection, or persist, and lead to multiple organ dysfunction syndrome (MODS) after infection has been eradicated with antibiotics and surgery. The mechanisms responsible for these phenomena are increasingly being elucidated, but we cannot yet define when infective sepsis merges into non-infective sepsis. What do we know is they are just as lethal as each other.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"13-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19873090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of Antibiotic Treatment in Surgical Infections of the Abdomen. Discussion forum for attaining consensus. 腹部手术感染的抗生素治疗时间。达成共识的论坛。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
{"title":"Duration of Antibiotic Treatment in Surgical Infections of the Abdomen. Discussion forum for attaining consensus.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"1-75"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20042020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. Penetrating abdominal trauma. 腹部手术感染的抗生素治疗时间。穿透性腹部创伤。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
A Hirshberg, K L Mattox
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. Penetrating abdominal trauma.","authors":"A Hirshberg,&nbsp;K L Mattox","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Infection is a major cause of morbidity and mortality following penetrating abdominal trauma. Antibiotics are routinely used although their effectiveness has never been evaluated in a placebo-controlled randomised trial, and they have never been shown to reduce the incidence of post injury intra-abdominal, as opposed to wound, infections. The available evidence indicates that a single preoperative dose of an appropriate antibiotic is adequate prophylaxis for penetrating abdominal injuries. Postoperative antibiotics should be reserved for \"late\" (> 12 hours) operations for enteric perforations. The optimal duration of treatment under these circumstances is not well established. Fever and leucocytosis are poor indicators of the need for continued postoperative administration in the severely traumatised patient.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"56-7; discussion 57-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. Blunt abdominal trauma. 腹部手术感染的抗生素治疗时间。钝性腹部创伤。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
G A Melcher, T P Rüedi
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. Blunt abdominal trauma.","authors":"G A Melcher,&nbsp;T P Rüedi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Blunt abdominal trauma is associated with a low risk of injury to the microorganism-containing hollow viscera. Therefore, routine pre-operative administration of antibiotics is not necessary. Antibiotics are given intraoperatively, if laparotomy discloses transmural injury of a hollow organ and peritoneal contamination. If intervention is early (< 12 hours) and there is no evidence of purulent exudate in the abdominal cavity, the antibiotic should be considered prophylactic and not exceed one dose. Neglected injuries should be treated with antibiotics for a maximum of 5 days.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"59-60"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. Minimal antibiotic therapy: technology assessment instead of clinical trials. 腹部手术感染的抗生素治疗时间。最小限度的抗生素治疗:技术评估代替临床试验。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
A Lechleuthner, H Troidl, R Lefering
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. Minimal antibiotic therapy: technology assessment instead of clinical trials.","authors":"A Lechleuthner,&nbsp;H Troidl,&nbsp;R Lefering","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In modern medicine which already uses maximal resources, additional improvements involve huge extra efforts. With increasing complexity of diseases, specific treatments have only a limited influence on the \"whole process\". In complex clinical situations (including sepsis and SIRS) the available methodology to identify groups of patients who may benefit from a specific treatment are weak. This is why prospective randomised \"megatrials\" may be needed to detect small differences in outcome. We suggest that careful prospective assessment of cohorts of well stratified patients, subjected to a specific and standardised treatment, may replace prospective controlled trials.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"36-7; discussion 37-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duration of antibiotic treatment in surgical infections of the abdomen. Antibiotics and the gut. 腹部手术感染的抗生素治疗时间。抗生素和肠道。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
R Saadia, J Lipman
{"title":"Duration of antibiotic treatment in surgical infections of the abdomen. Antibiotics and the gut.","authors":"R Saadia,&nbsp;J Lipman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The inflammatory response of the body to a variety of insults is indistinguishable from that to infection. Antibiotics are neither innocuous nor are they a substitute for correct surgical management. In this paper we stress the side effects of antibiotics particularly affecting the gut and, by means of patient stratification, propose a goal oriented approach to antibiotic use, in conjunction with basic surgical strategies, for the management of intra-abdominal infection.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transition from contamination to infection: implications in colonic surgery. 从污染到感染的转变:结肠手术的意义。
The European journal of surgery. Supplement. : = Acta chirurgica. Supplement Pub Date : 1996-01-01
P O Nyström
{"title":"Transition from contamination to infection: implications in colonic surgery.","authors":"P O Nyström","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>After reviewing the processes leading from contamination to infection and its clinical implications I conclude that outcome after emergency colonic surgery in general is the result of three factors: elimination of the surgical problem; extent of preoperative physiological derangement; and the patient's immediate response to intensive care and surgery. Antibiotic treatment is important but secondary. For most patients with minor contamination and infection, including appendicitis and trauma, the duration of antibiotic administration following emergency surgery has been established to be one or at most four doses. Patients in the intensive care units need individualised treatment. There is a minor group treated outside intensive care units but with substantial infection where the duration should be re-evaluated in new trials, preferably by comparing short and long duration in randomised fashion.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 576","pages":"42-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19872952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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