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Postoperative Infection in Urologic Surgery
1338
ONCOLOGY AND CHEMOTHERAPY
ONCOLOGY AND CHEMOTHERAPY
Postoperative Infection in Urologic Surgery
T. T. WARD, Infectious Diseases Section, Veterans Administration Medical Center, Portland, Oregon Urology, suppl. 5, 26: 6-10 (Nov.) 1985 The author reviewed the subject of infection in the urological patient. The problem of antibiotic-resistant strains of bacteria within the hospital setting is stressed. The use of third generation cephalosporins is favored because of the low toxicity and wide spectrum of activity. J. H. N. 1 table, 17 references
Antibiotic Prophylaxis and Urologic Surgery T. A. LOVE, Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota
Testosterone-Secreting Adrenal Adenoma Containing Crystalloids Characteristic of Leydig Cells J. VASILOFF, E.W. CHIDECKEL, C. B. BOYD AND L. J. FOSHAG, Departments of Medicine, Pathology and Surgery, West Virginia University School of Medicine, Morgantown, West Virginia Amer. J. Med., 79: 772-776 (Dec.) 1985 A 49-year-old woman presented with a virilizing adrenal tumor that showed typical Leydig cells and crystals of Reinke. Serum testosterone levels were elevated markedly with normal urinary 17-ketosteroids and serum dehydroepiandrosterone. Two similar cases were found in the literature. J. H. N. 1 figure, 1 table, 24 references
Urology, suppl. 5, 26: 2-5 (Nov.) 1985 The presence of indwelling catheters and necrotic tissue beds postoperatively greatly increases the risk of infection upon removal of the catheter or drain. This time in the postoperative urology patient is critical for the use of prophylactic antibiotics. A decisive 3 to 4-hour interval after incision also defines the effective timing for prophylactic antibiotic use. Proper use of antibiotics in this day of cost-conscious medicine is imperative. J. H. N. 24 references
Single-Dose Antibiotic Treatment for Uncomplicated Urinary Tract Infections: Less for Less? J. T. PHILBRICH AND J. P. BRACIKOWSKI, Division of General Medicine, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia Arch. Intern. Med., 145: 1672-1678 (Sept.) 1985 Recently, a large number of studies on the effectiveness of single dose antibiotic therapy for uncomplicated urinary tract infection have been reported. The advantages of such therapy include low cost, high compliance, convenience and decreased side effects. However, some reports question the validity of this treatment regimen. The authors reviewed 14 such studies from various centers and pooled the relevant information to determine the value of single dose therapy. Strict criteria were used for the selection of these reports. All of the studies were randomized and controlled, and were conducted in women with uncomplicated urinary tract infection. To eliminate statistical error owing to inadequate sample size in each study the data were pooled and re-evaluated. The results indicate that single dose sulfamethoxazoletrimethoprim (2 or 3 double strength tablets) was as effective as multiple dose therapy with the same antimicrobial agents. On the other hand, single dose amoxicillin (3 gm.) was less effective than the multidose therapy. Despite pooling the data from various similar studies the sample size was not considered to be adequate. Further studies on the effectiveness of single dose antibiotic therapy for uncomplicated urinary tract infection should be done with a statistically significant sample size. N. S. D. 5 tables, 32 references
Pelvic Exenteration
w.
F. LINDSEY, D. K. WOOD, H. A. BRIELE, J. A. GREAGER, M. J. WALKER, J. BORK AND T. K. DAS GUPTA, Division of Surgical Oncology, Department of Surgery, University of Illinois College of Medicine at Chicago, Cook County Hospital, the West Side Veterans Administration Hospital, and Hektoen Institute for Medical Research, Chicago, Illinois
J. Surg. Oneal., 30: 231-234 (Dec.) 1985 The authors report their experience with pelvic exenteration in 68 patients from 1969 to 1984. Of the patients 40 had total, 19 anterior and 9 posterior exenteration. Thirty-two patients had colorectal, 11 cervical, 7 bladder and 6 vulvar cancer. In 12 patients the cancers were in miscellaneous pelvic sites. There were 45 exenterations done with the intent to cure and 23 were performed for palliation in patients with bulky, necrotic tumors that had caused symptomatic fistulas, local sepsis, chronic bleeding or severe localized pain. The median survival time of patients who underwent curative exenteration was 27 months and the 5-year survival rate was 33 per cent. Most of the patient operated on for palliation died within 12 months. There were 30 major short-term complications within 30 days postoperatively, 12 of which required reoperation. Long-term complications occurred in 36 patients and 11 required reoperation. Overall, the postoperative (30-day) mortality rate was 4.4 per cent. P. M. H. 2 figures, 5 tables, 15 references
DNA/RNA Ratio in Bladder Cancer: A Factor Indicating the Recurrence Rate? G.
G. HADJISSOTIRIOU, D. K. GREEN, M.A. McINTYRE, T. B. HARGREAVE AND G. D. CHISHOLM, University Department
of Surgery /Urology, Department of Pathology, and MRC Clinical and Population Cytogenetics Unit, Western General Hospital, Edinburgh, Great Britain Brit. J. Urol., 57: 668-675 (Dec.) 1985 Flow cytometry measures the deoxyribonucleic (DNA) and ribonucleic (RNA) acid content of a large number of representative cells from bladder washout, and provides a profile of the DNA and RNA content. Flow cytometry was evaluated as a means to identify patients destined to have recurrence, and to
ONCOLOGY AND CHEMOTHERAPY
ONCOLOGY AND CHEMOTHERAPY
Postoperative Infection in Urologic Surgery
T. T. WARD, Infectious Diseases Section, Veterans Administration Medical Center, Portland, Oregon Urology, suppl. 5, 26: 6-10 (Nov.) 1985 The author reviewed the subject of infection in the urological patient. The problem of antibiotic-resistant strains of bacteria within the hospital setting is stressed. The use of third generation cephalosporins is favored because of the low toxicity and wide spectrum of activity. J. H. N. 1 table, 17 references
Antibiotic Prophylaxis and Urologic Surgery T. A. LOVE, Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota
Testosterone-Secreting Adrenal Adenoma Containing Crystalloids Characteristic of Leydig Cells J. VASILOFF, E.W. CHIDECKEL, C. B. BOYD AND L. J. FOSHAG, Departments of Medicine, Pathology and Surgery, West Virginia University School of Medicine, Morgantown, West Virginia Amer. J. Med., 79: 772-776 (Dec.) 1985 A 49-year-old woman presented with a virilizing adrenal tumor that showed typical Leydig cells and crystals of Reinke. Serum testosterone levels were elevated markedly with normal urinary 17-ketosteroids and serum dehydroepiandrosterone. Two similar cases were found in the literature. J. H. N. 1 figure, 1 table, 24 references
Urology, suppl. 5, 26: 2-5 (Nov.) 1985 The presence of indwelling catheters and necrotic tissue beds postoperatively greatly increases the risk of infection upon removal of the catheter or drain. This time in the postoperative urology patient is critical for the use of prophylactic antibiotics. A decisive 3 to 4-hour interval after incision also defines the effective timing for prophylactic antibiotic use. Proper use of antibiotics in this day of cost-conscious medicine is imperative. J. H. N. 24 references
Single-Dose Antibiotic Treatment for Uncomplicated Urinary Tract Infections: Less for Less? J. T. PHILBRICH AND J. P. BRACIKOWSKI, Division of General Medicine, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia Arch. Intern. Med., 145: 1672-1678 (Sept.) 1985 Recently, a large number of studies on the effectiveness of single dose antibiotic therapy for uncomplicated urinary tract infection have been reported. The advantages of such therapy include low cost, high compliance, convenience and decreased side effects. However, some reports question the validity of this treatment regimen. The authors reviewed 14 such studies from various centers and pooled the relevant information to determine the value of single dose therapy. Strict criteria were used for the selection of these reports. All of the studies were randomized and controlled, and were conducted in women with uncomplicated urinary tract infection. To eliminate statistical error owing to inadequate sample size in each study the data were pooled and re-evaluated. The results indicate that single dose sulfamethoxazoletrimethoprim (2 or 3 double strength tablets) was as effective as multiple dose therapy with the same antimicrobial agents. On the other hand, single dose amoxicillin (3 gm.) was less effective than the multidose therapy. Despite pooling the data from various similar studies the sample size was not considered to be adequate. Further studies on the effectiveness of single dose antibiotic therapy for uncomplicated urinary tract infection should be done with a statistically significant sample size. N. S. D. 5 tables, 32 references
Pelvic Exenteration
w.
F. LINDSEY, D. K. WOOD, H. A. BRIELE, J. A. GREAGER, M. J. WALKER, J. BORK AND T. K. DAS GUPTA, Division of Surgical Oncology, Department of Surgery, University of Illinois College of Medicine at Chicago, Cook County Hospital, the West Side Veterans Administration Hospital, and Hektoen Institute for Medical Research, Chicago, Illinois
J. Surg. Oneal., 30: 231-234 (Dec.) 1985 The authors report their experience with pelvic exenteration in 68 patients from 1969 to 1984. Of the patients 40 had total, 19 anterior and 9 posterior exenteration. Thirty-two patients had colorectal, 11 cervical, 7 bladder and 6 vulvar cancer. In 12 patients the cancers were in miscellaneous pelvic sites. There were 45 exenterations done with the intent to cure and 23 were performed for palliation in patients with bulky, necrotic tumors that had caused symptomatic fistulas, local sepsis, chronic bleeding or severe localized pain. The median survival time of patients who underwent curative exenteration was 27 months and the 5-year survival rate was 33 per cent. Most of the patient operated on for palliation died within 12 months. There were 30 major short-term complications within 30 days postoperatively, 12 of which required reoperation. Long-term complications occurred in 36 patients and 11 required reoperation. Overall, the postoperative (30-day) mortality rate was 4.4 per cent. P. M. H. 2 figures, 5 tables, 15 references
DNA/RNA Ratio in Bladder Cancer: A Factor Indicating the Recurrence Rate? G.
G. HADJISSOTIRIOU, D. K. GREEN, M.A. McINTYRE, T. B. HARGREAVE AND G. D. CHISHOLM, University Department
of Surgery /Urology, Department of Pathology, and MRC Clinical and Population Cytogenetics Unit, Western General Hospital, Edinburgh, Great Britain Brit. J. Urol., 57: 668-675 (Dec.) 1985 Flow cytometry measures the deoxyribonucleic (DNA) and ribonucleic (RNA) acid content of a large number of representative cells from bladder washout, and provides a profile of the DNA and RNA content. Flow cytometry was evaluated as a means to identify patients destined to have recurrence, and to