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Only cases of chronic osteomyelitis of the mandible not associated with antiresorptive medications or radiotherapy to the maxillofacial region were included in the study. After confirmation of the diagnosis, initial clinical and radiologic findings, treatment approach, and outcome were evaluated for each patient. Fourteen male and 10 female patients (average age, 53.75 yr; range, 22 to 83 yr) were included.
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31 patients afflicted with primary hyperlipidemia who did not improve after 30 days on a diet were treated with 1800 mg/day of binifibrate. We measured the total cholesterol level and triglyceridemia, as well as blood viscosity and red cell deformability at day 0, 30, 60, 90 of treatment. We found a statistically significant decrease in cholesterol and triglyceride levels as well as blood viscosity, and an increment of red cell deformability which improved the circulatory dynamisms augmentin the tissular perfusion in these patients.
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The following aerobic opportunistic bacteria have been isolated in women with different inflammatory processes of the reproductive system: staphylococci--62%, enterobacteria--30%, streptococci--11%, pseudomonads--7%. Gram-positive cocci (staphylococci and streptococci, except for Streptococcus faecium) manifested the highest sensitivity to amoxycillin/clavulanic acid. Clinical isolates of enterobacteria were characterized by high percentage of strains sensitive to cyprofloxacine and cephalosporines of the third generation. The highest number of sensitive strains was registered in fluoroquinolon for Pseudomonas aeruginosa.
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The choice of antibiotics to be prescribed in otitis media may be guided by microbiological culture of the middle ear exudate obtained by tympanocentesis, or by direct examination and culture of purulent material obtained by myringotomy after rupture of the tympanic membrane. Otherwise, routine antibiotic prescription is based on the epidemiological frequencies of bacteria such as Streptococcus pneumoniae, Hoemophilus influenza or Strepcococcus A. In children who have infrequently received beta-lactam antibiotics, amoxicillin 50-75 mg/kg/day for 10 days may be the first choice. Children who suffer from recurrent episodes of acute otitis media may benefit from one of the three following prescriptions: amoxicillin + clavulanate (Augmentin), or an oral cephalosporin, or the erythromycin + sulfisoxazole combination (Pediazole). If recurrences are frequent and at short intervals, antibiotic prophylaxis may be effective, using penicillin V (Oracillin) 250,000 IU daily throughout the entire cold period.
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This small study did not provide evidence of a difference between 14 days of amoxycillin/clavulanate and 3 days of azithromycin. Larger studies will be needed to determine which, if any, antibiotic regimen should be used in treating subacute childhood rhinosinusitis.
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There was very little good quality evidence. Four studies were included, all of them investigating different interventions and therefore a meta-analysis was not possible.Only one study demonstrated a significant difference. Oral amoxicillin clavulanate was compared to placebo in 79 patients. The odds of having a discharge persisting eight days after starting treatment was 0.19 (95% CI 0.07 to 0.49) . The number needed to treat to achieve that benefit is 2.5. Participants in both arms of this study also received daily aural toilet. The results will therefore not be applicable to most settings including primary care. No significant benefit was shown in the two studies investigating steroids (oral prednisolone with oral amoxicillin clavulanate and topical dexamethasone with topical ciprofloxacin ear drops), or the one study comparing an antibiotic-steroid combination (Otosporin®) drops versus spray (Otomize®) (although more patients preferred the spray form).
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This manuscript reports an uncommon case of inferior third molar facial abscess with purulent secretion drainage through the left external acoustic meatus. The patient's left external acoustic meatus was filled with a purulent secretion observed on a CT scan. He underwent surgery to drain the facial abscess. Despite facial abscesses being routine occurrences, the literature does not contain many case reports of odontogenic facial abscesses with drainage via the external acoustic meatus. These situations occur in two possible ways: multiple fissures in the anterior wall of the cartilaginous portion of the external acoustic meatus; and congenital defects that are occasionally present in the anterior-superior aspect of the external acoustic meatus, known as the foramen of Huschke, which allow communication between the external acoustic meatus and mandibular fossa. These defects may also predispose the patient to the spread of the infection or tumour from the external auditory canal to the infratemporal fossa and vice versa. No otological sequelae were observed in this case. The authors conclude that the hypothesis of bone malformation cannot be excluded, and affirm that any facial abscess requires appropriate and immediate treatment for adequate resolution, by removing the causal factor and providing systemic support.
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A 25-year-old man presented with Touraine-Solente-Golé syndrome (primary pachydermoperiostosis), with an area of inflammatory dermatosis (12-month evolution) of the scalp at the cranial vertex. The patient presented with arthropathy, clubbing of the digits, diffuse periostosis, pachydermia of the hands and feet, and periosteal hyperostosis of the knee. Facial seborrhea and sebaceous gland hyperplasia were evident (Figure 1A and 1B and Figure 2A and 2B). Examination of the scalp revealed an erythematous pruritic plaque with erosions, crusts, and pustules, on which multiple tufts of 10 to 20 normal-looking hairs emerged from single follicular openings (Figure 3A). Slight pressure on the perifollicular areas resulted in the discharge of purulent material through the dilated follicular openings. Cervical and occipital lymph nodes were not enlarged, and the patient was in generally good health. Routine laboratory findings were normal. Immunologic studies, including a screening for antinuclear antibody, complement, and immunoglobulins, were normal. Both potassium hydroxide staining and fungal culture were negative. Bacteriologic culture of purulent material taken from the affected area was positive for Staphylococcus aureus. Videodermoscopy of the lesion showed rarefied interfollicular twisted red loops centered around actively affected follicles and white dots with absence of normal vascular pattern (Figure 3B). These dermoscopy patterns are markers for folliculitis decalvans, of which tufted hair folliculitis (THF) is a clinical variant. Histologic examination showed hair plugging, a dense perifollicular infiltrate of plasma cells, lymphocytes, neutrophils, and large areas of scarring and fibrosis, which would confirm suspected THE THF was diagnosed on the grounds of clinical, microbiologic, histologic, and videodermoscopy data. The patient was treated with amoxicillin 875 mg plus clavulanic acid 125 mg twice daily and topical nadifloxacin 1% twice daily for 20 days, achieving substantial clinical improvement. One month after antimicrobial therapy, a single area of cicatricial alopecia with a few hair tufts emerging from single orifices was observed, and no new lesions or symptoms had appeared.
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All infants and children with culture proven UTI from 2002 to 2008 were included. Urine culture was deemed positive with a pure growth >10(5) (single organism).