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Register a new userResults of Continuous Irrigation With Antibiotics Method in Complex Therapy of Chronic Osteomyelitis
نتائج طريقة الإرواء المستمر بالصادات الحيوية في سياق العلاج المركب لذات العظم والنقي المزمنة
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Tishreen University ورقة بحثية
Publication date
2014
fields
Medicine
and research's language is
العربية
Authors
أحمد جوني( باحث )
Created by
Shamra Editor
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شملت الدراسة 84 مصاباً بذات العظم والنقي المزمنة (86 حالة) بأسباب مختلفة، وتوضع ودرجات مختلفة، وقد خضع جميع المرضى لعمل جراحي تمثل بتجريف واستئصال الأنسجة النخرية المنتنة، مع زرع نظام إرواء مستمر بالصادات وتمت متابعة الحالات لمدة سنة،وتم الحصول على نتائج إيجابية في 86% من الحالات، وكانت النتائج سلبية في 14% من الحالات. استطاعت طريقة الإرواء المستمر بالصادات الحيوية أن تؤمن وصولاً أكيداً للصادات الحيوية المختارة إلى بؤرة الإنتان بالتراكيز الكافية لقتل الجراثيم المسببة، مما سمح بالحصول على أفضل النتائج
Our study included (84) patients: 86 cases suffering from chronic osteomyelitis: various causes, location and degrees. All patients operated: after curettage of necrotic and infected tissues; system of continuous irrigation with antibiotics was inserted to the infected zone; all cases were followed up for 1 year. 86% of positive results were obtained and results were bad in 14% of cases> The high positive results (86%) confirm high effect of continuous irrigation with antibiotics as a good method for chronic osteomyelitis treatment, because this method allows delivery of suitable antibiotics in high concentration into the infected area, which is enough to kill microbes and allows to obtain best results.
Artificial intelligence review:
Research summary
تتناول الدراسة التي أجراها الدكتور أحمد جوني نتائج استخدام طريقة الإرواء المستمر بالصادات الحيوية في علاج ذات العظم والنقي المزمنة. شملت الدراسة 84 مريضًا يعانون من 86 حالة من ذات العظم والنقي المزمنة بأسباب ومواقع ودرجات مختلفة. خضع جميع المرضى لعملية جراحية تضمنت تجريف واستئصال الأنسجة النخرية وزرع نظام إرواء مستمر بالصادات الحيوية. تمت متابعة الحالات لمدة سنة، حيث أظهرت النتائج أن 86% من الحالات حققت نتائج إيجابية، بينما كانت النتائج سلبية في 14% من الحالات. أثبتت الدراسة فعالية طريقة الإرواء المستمر في إيصال الصادات الحيوية إلى بؤرة الإنتان بتراكيز كافية لقتل الجراثيم، مما سمح بالحصول على أفضل النتائج العلاجية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في مجال علاج ذات العظم والنقي المزمنة، حيث تقدم طريقة مبتكرة وفعالة في إيصال الصادات الحيوية مباشرة إلى بؤرة الإنتان. ومع ذلك، يمكن توجيه بعض النقد البناء للدراسة. أولاً، لم تذكر الدراسة تفاصيل كافية حول الآثار الجانبية المحتملة لطريقة الإرواء المستمر بالصادات الحيوية، مما يترك بعض التساؤلات حول سلامة هذه الطريقة على المدى الطويل. ثانياً، كان من الأفضل تضمين مجموعة مقارنة (مجموعة تحكم) لتقييم فعالية الطريقة بشكل أكثر دقة. وأخيراً، لم تتناول الدراسة بشكل كافٍ تأثير العوامل الاجتماعية والاقتصادية على نتائج العلاج، وهو جانب مهم يجب مراعاته في الدراسات المستقبلية.
Questions related to the research
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ما هي نسبة النجاح التي حققتها طريقة الإرواء المستمر بالصادات الحيوية في علاج ذات العظم والنقي المزمنة؟
حققت طريقة الإرواء المستمر بالصادات الحيوية نسبة نجاح بلغت 86% في علاج ذات العظم والنقي المزمنة.
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ما هي المدة الزمنية التي تمت خلالها متابعة المرضى في الدراسة؟
تمت متابعة المرضى لمدة سنة واحدة بعد إجراء العملية الجراحية وزرع نظام الإرواء المستمر بالصادات الحيوية.
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ما هي الأسباب الرئيسية لفشل العلاج في 14% من الحالات؟
لم تذكر الدراسة بشكل محدد الأسباب الرئيسية لفشل العلاج في 14% من الحالات، ولكن يمكن أن تكون مرتبطة بشدة الإنتان، مقاومة الجراثيم للصادات الحيوية، أو عوامل أخرى مثل التروية الدموية غير الكافية.
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ما هي الفئات العمرية التي شملتها الدراسة؟
شملت الدراسة فئات عمرية مختلفة، حيث كانت نسبة الإصابة عند الأطفال قليلة ولم تتجاوز 4.8%، بينما كانت النسبة الأكبر من الإصابات عند البالغين.
References used
Abril JC, Castillo F, Loewinsonh AF, Rivas C, Bernacer M. Chronic recurrent multifocal osteomyelitis after cute lymphoblastic leukaemia. Int Orthop 1994;18:126—8
Abril JC, Ramirez A. Successful treatment of chronic recurrent multifocal osteomyelitis with indomethacin: a preliminary report of five cases. J Pediatr Orthop 2007;27:587—91
Anderson SE, Heini P, Sauvain MJ, Geiger L, Johnston JO, Roggo A, et al. Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement. Skeletal Radiol 2003;32:328—36
Azouz EM, Jurik AG, Bernard C. Sternoclavicular hyperostosis in children: a report of eight cases. AJR 1998;171:461—6
Backmeyer C, Lionnet F, Gibeault M, Damsin JP. Chronic multifocal osteomyelitis due to Clostridium difficile in an adolescent with sickle cell anemia. Pediatr Infect Dis J 2008;27:951—2
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system was accomplished according to designed plan. The irrigation period was 12 days
(mean) with mean hospitalization period 12 days. Irrigation fluid was considered regarding
to culture and susceptibility results in addition to antibiotic qualities .Results were
collected depending on joint functional activitiy return regarding to capacity,bearing and
stability(after a month-3 months- year),as well as natural laboratory and vlinical features
return .we used the criteria healing (irrigation handout). The joint functional activity
returned after a month in (70% mean) ,after 3 months in (77% mean), after a year in (89%
mean).while the clinical infection signs fell back after a week in (85% mean) ,after a
month in (92% mean), after 3 months in ( 97%). The laboratory signs fell back after a
month in (91% mean), after 3 months in (97% mean). A comparing was achieved between
these results and irrigation period ,hospitalization period by using CHI² test . The use of
continuous irrigation system in treatment of bacterial arthritis once it is diagnosed (in
regard to designed plan, irrigation fluid qualities and the host condition) improves the joint
functional activity and reduces hospitalization period so that ,it lessens economic load and
accelerates the return professional activity.
Self-medication with antibiotics is a worldwide problem and led to several problems such as antimicrobial resistance. A descriptive cross-sectional questionnaire-based study was conducted in Latakia city. Among 259 participants, 204(78.8%) reported a
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from each segment of normal macroscopically colonic mucosae from patients who have
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ronic watery diarrhea of unknown etiology.
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have endoscopically normal colon .
Materials and Methods:We prospectively enrolled 84 patients reviewed in
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collagenous colitis in these patients.
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