This multicenter, prospective, double-blind study compared the safety and efficacy of clindamycin and ciprofloxacin versus ceftriaxone and doxycycline in the treatment of outpatients with mild to moderate pelvic inflammatory disease (PID) diagnosed by laparoscopy. Samples taken from the endocervix, endometrium, and abdominal cavity before treatment and from the endocervix after treatment were cultured for aerobes, anaerobes, Neisseria gonorrhoeae, and Chlamydia trachomatis. Of the 138 patients enrolled, 131 were evaluable for efficacy. The most prevalent bacteria were streptococci, staphylococci, and Escherichia coli (among aerobes) and Bacteroides species and peptostreptococci (among anaerobes). N. gonorrhoeae was present in 2% (3) of the 131 evaluable patients, and C. trachomatis was in 11% (15). The clinical cure rate was 97% (65 of 67) in the clindamycin and ciprofloxacin group and 95% (61 of 64) in the ceftriaxone and doxycycline group. Side effects were similar in both groups. In conclusion, the two regimens for the outpatient treatment of mild to moderate PID were similarly effective and safe.
Background:First Spanish trial of Ewing sarcoma (ES) including adults and children with the aim to test the efficacy of Gemcitabine and Docetaxel (G/D) in newly diagnosed high-risk (HR) patients.Methods:This was a prospective, multicentric, non-randomised, open study for patients ⩽40 years with newly diagnosed ES. HR patients (metastatic, axial-pelvic primaries or bone marrow micrometastasis) received 2 window cycles of G/D. Patients with an objective response (OR) to G/D received 12 monthly cycles of G/D after completion of mP6. The primary end point was the OR rate to the G/D window phase and the event-free survival (EFS) and overall survival (OS) for all patients. The study is registered at ClinicalTrials.gov (identifier: NCT00006734).Results:Forty-three patients were enroled, median age 17 years (range, 3–40). After a median follow-up of 43.4 months, the 5-year OS rate is 55.0% (95% CI, 41–74%) with an EFS of 50.0% (95% CI, 36–68%). The 5-year OS and EFS rates for standard risk (SR) patients was 76.0% (95% CI, 57–100%) and 71.0% (CI, 54–94%); for HR 36.0% (CI, 20–65%) and 29.0% (CI, 15–56%). Twelve of 17 (70.6%) high-risk (HR) patients showed an OR (7 PR and 5 SD) to G/D window therapy. The 5-year OS rate for patients ⩽18 years of age was 74.0% (CI, 56–97%) and 31.0% for >18 years (95% CI, 15–66%), P<0.001. Grade 4 adverse events during mP6 occurred in 28/39 of patients (72%) and did not correlate with age. Multivariate survival analyses with <18 vs ⩾18 and risk groups significant differences, P<0.00001. Using a Cox model for OS, both age and risk group were statistically significant (P=0.0011 and P=0.0065, respectively).Conclusions:Age at diagnosis is an independent prognostic factor superior to the presence of metastases with 18 years as the strongest cut-off. The mP6 regimen provided survival curves that plateau at 3 years and G/D produced significant responses in HR-ES that is worth further exploring.
Cyclic GMP, endothelin and prostaglandin E2 (PGE2) all have systemic vasoactive properties (with cyclic GMP acting as a second messenger of nitric oxide). Intrarenally they act as natriuretics and urinary levels reflect intrarenal production. Cyclic GMP and PGE2 also act as important inhibitors of platelet activation and thrombosis. The purpose of this study was to determine if urinary levels of cyclic GMP, endothelin, and PGE2 differ in preeclamptic as compared to normal pregnancies. Parameters were compared in 13 normotensive, nonpreeclamptic pregnancies, and 32 preeclamptic pregnancies. Preeclamptic women had significantly lower levels of urinary cyclic GMP (0.67 +/- 0.12 vs. 2.1 +/- 0.5 nmol/g creatinine), endothelin (0.88 +/- 0.09 vs. 3.75 +/- 1.4 ng/g creatinine), and PGE2 (26 +/- 4 vs. 9 ng/g creatinine) as compared to normals (p < 0.05). Intrarenal production of cyclic GMP, endothelin, and PGE2 are all disturbed in preeclampsia and may have implications in the sodium retention, hypertension, and intrarenal thrombosis and vasospasm of preeclamptic pregnancy.
All cases of cholera in pregnant women (84) admitted to Hospital Nacional Cayetano Heredia, Lima-Perú were reviewed from febraury 1 st to May 31 st , 1991. Most of the patients (90%) came from shanty towns sorrounding the hospital, their main complain was profuse watery diarrhea and vomiting.Vibrio cholerae 01 biotype El Tor serotype Inaba was identified as the causative agent. The 84 pregnant women represent less than 1% of all cholera patients attended at the hospital. Twenty patients requiered hospitalization because of sever dehydration; one developed acute renal failure. The proportion of pregnant women who requiered hospitalization was higher in those less than 20 years old (50%). Fetal loss ocurred mainly in young pregnant women (30%) and in 1 nd trimester patients (7%). The treatment was based in oral or intravenous fluid replacement and early administration of antimicrobial agents.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.