cilastatin--imipenem-drug-combination and Multiple-Organ-Failure

Experimental and clinical studies demonstrated that probiotics containing lactobacilli significantly improve the outcome of acute pancreatitis. In a prospective, randomized, double-blinded study the role of "Synbiotic 2000", a new synbiotic composition with high colony forming unit (CFU) was evaluated in the treatment of severe acute pancreatitis.. Patients with severe acute pancreatitis were randomized into two groups. Nasojejunal feeding was commenced within 24 hours after admission in both groups and continued for at least seven days. The first group of patients received four different lactobacilli preparations with 1010 CFU, respectively, and prebiotics containing four bioactive fibers (inulin, beta-glucan, resistant starch and pectin) in addition. Patients in the second (control) group received only prebiotics.. 62 patients with severe acute pancreatitis completed the study. Altogether 8 patients died. Lower incidence of multiorgan failure (MOF), septic complications and mortality were detected in the first group compared to the control, but the differences were not significant statistically. The total incidence of systemic inflammatory response syndrome (SIRS) and MOF were significantly different between the two groups (8 vs. 14; p < 0.05). Furthermore, the number patients recovering with complications were significantly less in the first group receiving modern synbiotic therapy compared to the control (p < 0.05). Finally, lower rate of late (over 48 hours) organ failure was detected in the first versus the control group (3.0% vs. 17.2%).. The results suggest that early nasojejunal feeding with synbiotics may prevent organ dysfunctions in the late phase of severe acute pancreatitis. In addition, the data also indicate that the infection of pancreatic necrosis may be associated with early phase organ failure.

Topics: Adult; Aged; Bacterial Infections; Cilastatin; Cilastatin, Imipenem Drug Combination; Combined Modality Therapy; Dietary Fiber; Dietary Supplements; Double-Blind Method; Drug Combinations; Enteral Nutrition; Female; Humans; Imipenem; Male; Middle Aged; Multiple Organ Failure; Pancreatitis, Acute Necrotizing; Probiotics; Prospective Studies; Survival Rate; Systemic Inflammatory Response Syndrome; Treatment Outcome

Small bowel obstruction is common in emergency departments. However, the exact cause of intestinal pseudo-obstruction (IPO) is often misdiagnosed. IPO is considered a severe manifestation of systemic lupus erythematosus (SLE). However, IPO is rare as the initial manifestation of SLE. This paper reports a female patient who presented with IPO as the initial manifestation and was ultimately diagnosed with SLE. The 31-year-old female was definitively diagnosed with SLE after IPO symptoms for 1 month. She then presented multiple organ dysfunction syndrome (MODS) leading to a poor prognosis. Patients with unexplained SBO symptoms should be aware of systemic diseases. Early diagnosis and prompt medical treatment are crucial to avoid unnecessary surgery and obtain satisfactory outcomes.

Topics: Adult; Cilastatin, Imipenem Drug Combination; Delayed Diagnosis; Emergency Service, Hospital; Female; Humans; Immunoglobulins; Immunosuppressive Agents; Intestinal Pseudo-Obstruction; Intestine, Small; Lupus Erythematosus, Systemic; Methylprednisolone; Multiple Organ Failure; Prognosis; Radiography, Abdominal; Tomography, X-Ray Computed

Topics: Adult; Anti-Bacterial Agents; Cilastatin; Cilastatin, Imipenem Drug Combination; Dose-Response Relationship, Drug; Drug Combinations; Drug Monitoring; Hemofiltration; Humans; Imipenem; Kidney Transplantation; Male; Multiple Organ Failure; Sepsis; Serum Albumin; Teicoplanin