Swiss medical weekly
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426 patients who had undergone cholecystectomy took part in a retrospective study covering four years (1977-1980). 53 patients had gallbladder empyema. The complications in the 373 cholecystectomies without empyema were 4 wound infections (1.1%), 2 other infections, 10 postoperative hemorrhages (2.7%), 3 cases of retained stones (0.8%) and 7 other complications. Only 3 of the total of 6 infections required antibiotic therapy. ⋯ Treatment of acute cholecystitis is cholecystectomy within 24-48 h of onset of acute symptoms. The rate of infectious complications in patients with gallbladder empyema was 15.1%. Primary treatment for this disease is surgical removal of the infectious focus (cholecystectomy) and reduction of bacterial spread or treatment of peritonitis if already present.
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Five cases of Campylobacter fetus bacteremia are reported. This germ, found in blood cultures, induces high fever and is accompanied by either gastroenteritis with colitis or thrombophlebitis. Other, but much rarer septic sites are the meninges and endocardium. ⋯ This "microaerophil" germ does not survive in air which makes culturing difficult under ordinary conditions. On the other hand, Campylobacter jejuni induces gastrocolitis with spontaneous recovery. It is found in feces and thrives in contaminated water and milk.
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Swiss medical weekly · Feb 1983
[Diagnostic value of the determination of serum amylase and serum lipase in suspected acute onset of acute or chronic pancreatitis].
In a prospective study the value of serum amylase and serum lipase determination has been analyzed in 19 patients with an acute episode of acute or chronic pancreatitis and in 19 patients with acute abdomen not due to pancreatitis. The concentration of urinary amylase and the urinary output of amylase in the spot urine as well as after a two-hour collection period have also been examined. The normal values were determined in 21 healthy volunteers and the reproducibility of the various parameters was analyzed after 1 hour and 25 hours in these volunteers. ⋯ Except for the combination of serum amylase and serum lipase, none of the other tested combinations provides further diagnostic information. The examination of spot urine samples is not inferior to the 2-hour urine specimen. For the time being the combination of serum amylase and serum lipase determination is again recommended for diagnostic routine in patients with an acute episode of pancreatitis.
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Swiss medical weekly · Jan 1983
Review[Non-tuberculous Mycobacteria: epidemiologic importance and current pathogenicity].
The non-tuberculosis mycobacteria are reviewed, with emphasis on the epidemiological and pathogenic importance of these organisms when the prevalence of tuberculosis diminishes. The increasing proportion of weak reactions to human tuberculin observed between 1975 and 1981 among school children of the Canton of Geneva and the relatively high number of non-tuberculosis mycobacteria demonstrated in human material between 1979 and 1981 in this Canton suggest that these mycobacteria also play a role in this country.