Ultraviolet irradiation of the blood and hemosorption in the complex therapy of acute pancreatitis

Pancreonecrosis and hemorrhagic form of the acute pancreatitis was treated in 76 patients by "traditional" methods which were added by UV irradiation of autoblood (in 12 patients), hemosorption (in 17 patients), UV irradiation of blood followed by hemosorption within 15-20 min (in 46 patients). Positive changes of some homeostasis parameters after hemosorption following UVI of autoblood allow to consider their successive use in intensive therapy of patients with acute pancreatitis to be a perspective method.     

Ultraviolet blood irradiation therapy (Knott technic) in thrombophlebitis

1.

1. In eighteen consecutive instances patients with acute or chronic thrombophlebitis were given ultraviolet blood irradiation therapy (Knott technic).     

Ultraviolet irradiation of blood in surgery

The results of complex treatment of 81 patients with pyoinflammatory diseases with the use of blood ultraviolet irradiation are discussed. A marked clinical effect was noted, the terms of treatment reduced by 5-10 days, the outcomes improved, and the number of complications decreased. Irradiation of autologous blood by ultraviolet rays led to modulation of the indices of antimicrobial protection, increase of the intensity of the histochemical reaction to peroxidase up to 40-50%, and diminution of pH in the neutrophil phagosomes to 5.0. The ultrastructure and ability of thrombocytes to store serotonin were restored, and intensity of their metabolic processes increased, the membrane phospholipid composition changed, and juvenile platelet forms appeared.     

Ultraviolet irradiation of the blood

An analysis of the experience with using the method of ultraviolet irradiation of blood in 85 patients with different surgical diseases has shown the method to be simple, available and highly clinically effective.     

Ultraviolet irradiation of autotransfused blood in the treatment of postabortional sepsis

The use of ultraviolet irradiation of autotransfused blood in postabortional sepsis has markedly influenced the prognosis in this pathological condition. We believe because of the histories of instrumentation, septic fever, pelvic complications and even septicemia very few of these patients would be considered in conventional surgical practice as safe operative risks because of the well grounded fear of spreading infection both locally and into the blood stream. Needless to say, the prevention of the prolonged morbidity, usually found in the conventional handling of such patients, alone is well worth while.     

Ultraviolet irradiation of the blood in the complex treatment of suppurative-inflammatory diseases

The experience with the use of ultraviolet irradiation (UVI) of the blood in 98 patients with purulent-inflammatory disease is presented. UVI of the blood has considerably improved the results of treatment of the patients. The highest effectiveness of UVI of the blood is noted in treatment of chromosepsis. The treatment of psoriasis by the mentioned method appeared ineffective.     

Cefazolin as empiric therapy in hemodialysis-related infections: efficacy and blood concentrations

Concern about the increasing incidence of vancomycin-resistant organisms has tempered the enthusiasm for indiscriminate vancomycin use. Cefazolin has an antibacterial activity profile similar to vancomycin against most pathogens encountered in the hemodialysis (HD) population. We evaluated the clinical efficacy and serum concentrations that were achieved during empiric cefazolin use. Fifteen consecutive HD patients (five, conventional HD; five, high-efficiency HD; and five, high-flux HD) with suspected or documented infections warranting antibiotic intervention, including access-related, respiratory tract, urinary tract, or wound infections, were enrolled. Each patient received intravenous cefazolin (20 mg/kg actual body weight rounded to the nearest 500-mg increment [range, 1 to 2 g]) after each dialysis treatment for at least three doses. Cefazolin concentrations were obtained before and immediately after the next three consecutive dialysis treatments. Thirteen patients were evaluated for efficacy and all 15 were evaluated for toxicity and cefazolin blood concentrations. All patients showed at least a short-term (3-week) clinical resolution of infection with cefazolin treatment. No central nervous system toxicities were noted and no other adverse events were expressed by the patients during the course of cefazolin treatment. Predialysis cefazolin concentrations, as determined by high-performance liquid chromatography, were 70.2 +/- 42.7 (conventional HD), 45.6 +/- 18.9 (high-efficiency HD), and 41.6 +/- 23.9 mg/L (high-flux HD) over the three dialysis sessions. Cefazolin at doses of approximately 20 mg/kg administered post-HD appears to be a safe and effective empiric therapy and yields predialysis cefazolin concentrations of 2.5 times or greater than those considered to be the minimum inhibitory concentration breakpoint (16 mg/L) for susceptible organisms. These data support the broader use of cefazolin for empiric treatment in the HD population, allowing vancomycin to be reserved for confirmed resistant organisms.     

Efficacy of ultraviolet blood irradiation therapy in the control of staphylococcemias

There has been presented a report and analysis of sixteen cases of staphylococcemia given ultraviolet blood irradiation therapy as a method of controlling this type of acute pyogenic infection.The first seven staphylococcemic individuals treated by ultraviolet blood irradiation therapy failed to respond and died. Six of these seven received intensive sulfa drug therapy, whereas the seventh, whose Staphylococcemia arose from a bladder carcinoma and was complicated by atelectasis and empyema at the time of institution of ultraviolet blood irradiation therapy, received only blood irradiation and also died.The results of ultraviolet brood irradiation therapy in a second group of nine consecutive staphylococcemic individuals given blood irradiation was reported; all nine of these individuals recovered uneventfully; eight of the nine received no suIfa drugs whatsoever, and the ninth, forty-eight hours of sulfathiazole therapy one week before bIood culture became positive.In each of the sixteen cases reported one or more pure cuItures of pathogenic strains of either Staphylococcus aureus or StaphyIococcus albus were obtained from blood cuItures taken in tryptose phosphate broth.In fifteen of the sixteen cases there was present a profound toxemia at the time of institution of uItravioIet bIood irradiation therapy.Uterine diratation and curettage was performed in three individuaIs of Group Two, the recovery group, whiIe the blood culture in each of the three individuals was still positive. No untoward effects were observed to follow this radical procedure performed despite the presence of staphylococci in the bIood stream.     

Antibiotic therapy in acute infections of bone and joints in children

Effective antibiotic therapy forms the mainstay of the treatment of acute bone and joint infections in children. The causal organisms and bacterial sensitivities encountered in a prospective study are presented. Initial antibiotic therapy is discussed, while the need for immediate Gram staining to identify resistant organisms is stressed.