Queries 5

September 21, 2009 · Posted in Uncategorized · Comments Off 

Surgical Infectious Disease. Management Of Surgical Infections


MANAGEMENT OF SURGICAL INFECTIONS

21. What is the drug of choice for the treatment of an abscess?

Show answer
A knife. Surgically drain the abscess. Abscesses have no circulation of blood within them to deliver an antibiotic. The antibiotic, even if injected directly into the abscess, would be worthless because the abscess contains a soup of dead microorganisms and white blood cells (WBCs). Even if the organisms were barely alive, they would not be reproducing and incorporating the antibiotic. The drug most likely would not work at all at the pH and pKa conditions of the abscess environment.

Liver Transplantation. Controversies


CONTROVERSIES

12. Should liver transplants be performed in individuals with alcoholic liver disease?

Show answer
Transplant centers have strict criteria that alcohol-induced liver transplant recipients must undergo extensive psychological testing and abstain from alcohol before being placed on the waiting list. The recidivism rate (i.e., transplant patients who start drinking again) remains low. Financially, the cost is comparable, if not lower, than continued medical management of end-stage liver disease. We currently do provide care for other self-inflicted medical problems, such as cigarette smokers. The public must realize that people are not being pulled off bar stools and taken to the hospital for their transplant.


Tracheoesophageal Malformations


85 TRACHEOESOPHAGEAL MALFORMATIONS
Denis D. Bensard M.D., David A. Partrick M.D.

1. What are tracheoesophageal fistula (TEF) and esophageal atresia (EA)?

Show answer
The trachea and esophagus appear as a ventral diverticulum arising from the primitive foregut during the third week of gestation. The trachea and esophagus undergo separation by the ingrowth of ectodermal ridges during the fourth week of gestation. Failure of separation results in anomalous connection of the trachea to the esophagus (i.e., TEF) with or without incomplete formation of the esophagus (i.e., EA).