Swiss medical weekly
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Swiss medical weekly · Dec 2000
Comparative Study[Evaluation of antibiotic prophylaxis in neutropenic patients with hematologic malignancies].
The benefits of oral prophylaxis for neutropenia have remained controversial up to now. We evaluated retrospectively the effect of antibiotic prophylaxis with ciprofloxacin and penicillin on the prevention of bacterial infections in 112 cases of prolonged neutropenia in adult patients treated for haematological malignancies. 41 patients received prophylaxis between December 1993 and November 1994 while 71 patients did not receive prophylaxis between December 1994 and November 1995. There were no significant differences between groups in age, sex, type or stage of haemopathy, type of chemotherapy and duration of neutropenia. ⋯ The prophylaxis did not reduce the overall incidence of bacteraemia, of clinically documented infections or of fever of unknown origin. This retrospective study confirms that oral prophylaxis with ciprofloxacin and penicillin decreases the incidence of infections and, in particular, of gram-negative bacteraemia, but does not modify the overall morbidity and mortality in our patients. In view of the risk of emergence of bacterial resistance, these data do not support the routine use of oral antibiotic prophylaxis in neutropenic patients with haematological malignancies.
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Swiss medical weekly · Nov 2000
Case Reports[Ant venoms: a rare cause of allergic reactions in Switzerland].
In Switzerland, unlike other countries, allergic reactions to ants are a rare phenomenon when compared to the well known allergies to bee and wasp venom. In this report we present a series of case reports and a review of the different types of allergy to ants. Due to increased travel and heterogeneity of the population, we have observed several patients with sensitisation or allergy to the venom of imported fire ants (Solenopsis), a species of ant found in the Americas. ⋯ In the light of our observations we assume cross-reactivity between the venoms of fire ants and mound-building wood ants, and it therefore seems appropriate to use fire ant diagnostics in determining sensitisation to mound-building wood ants. In patients with severe fire ant-venom allergy we recommend desensitisation by immunotherapy, whereas in patients presenting with minor allergic reactions, e.g. after bites by mound-building wood ants, we provide the patients with emergency medication. Since current knowledge of ant allergies in Europe is limited, further studies are warranted.
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Functional bowel disorders are collections of symptoms attributable to the mid or lower gastrointestinal tract. The two most common disorders, irritable bowel syndrome and functional dyspepsia, have common etiopathogenetic features, notably psychosocial disturbances, dysmotility and heightened sensitivity. The control mechanisms, pathophysiology, investigation and potential pharmacotherapies of these disorders are reviewed. Serotonergic and adrenergic agents are among the novel approaches that may have a significant impact on these disorders.
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Swiss medical weekly · Nov 2000
Case Reports[Neonatal alloimmune thrombocytopenia due to a rare anti-HPA-1b antibody].
Foetal and neonatal alloimmune thrombocytopenia is caused by transplacental transfer of antibodies directed against platelet antigens and affects approximately 1 in 1000-2500 neonates. Clinically relevant complications are the intracranial haemorrhages that occur in 10-20% of cases. 20 platelet antigen systems are currently known. ⋯ We report on a case of neonatal alloimmune thrombocytopenia due to an anti-HPA-1b antibody in the third pregnancy of a 31-year-old Caucasoid woman. The infant was treated with repeated maternal and random donor platelet transfusions and with a single dose of intravenous immunoglobulin.