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Acquired Bleeding Disorders Associated with Disease and Medications
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
William A. Rock, Sue D. Walker
A coumarin-like effect is seen in cephalosporins that display the molecular attachment N-methylthiotetrazole (MTT) or a similar substitution (Cefamandole, Cefbuperazone, Cefmenoxime, Cefmetazole, Cefonicid, Cefoperazone, Cefotetan, Cefpiramide, Moxalactam, Ceftriaxone, Cefazolin, and Cefazedone) (152). This substitution inhibits gamma-carboxylation of coagulation proteins, producing the coumarin-like effect. Clinically significant bleeding episodes may be seen most commonly in patients with underlying diseases such as sepsis, cancer, intraabdominal infections, or renal and/or hepatic failure. Bleeding may be serious or even fatal in these debilitated patients. Hypoprothrombinemia associated with MTT cephalosporins is rare in patients without complicating disease. Remember that these cephalosporins also may cause platelet dysfunction; use with caution in patients with thrombocytopenia or concomitant use of high-dose heparin, oral anticoagulants, aspirin, or other drugs that affect hemostasis.
Drug therapy for portal hypertension
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Other parenteral antibiotics such as ceftriaxone, cefonicid or amoxycillin associated with clavulanic acid, have shown a similar efficacy to cefotaxime in treating SBP, although the small number of patients evaluated precludes definite conclusions.
Lower Extremity Injury
Published in Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba, Acute Care Surgery and Trauma, 2016
Gustilo et al. [52] were first to recognize that fracture location, mechanism, grade, and operative management all influence the development of infection. In a doubleblind prospective trial, Dellinger et al. randomized 248 patients with open fractures to receive 1 or 5 days of cefonicid sodium therapy or 5 days of cefamandole nafate therapy as part of the initial treatment. Rates of fracture-associated infections in the three groups were 10 of 79 (13%), 10 of 85 (12%), and 11 of 84 (13%), respectively. The 95% confidence limit for the difference in infection rates between the 1-day group and the combined 5-day groups was 0%–8.3%. The actual difference was 0.2%. They concluded that a brief course of antibiotic administration was not inferior to a prolonged course of antibiotics for prevention of postoperative fracture site infections [45,46].
Outcomes of a fixed skeletonised mini mesh implant for pelvic organ prolapse repair with uterine preservation
Published in Journal of Obstetrics and Gynaecology, 2022
Omri Levor, Menahem Neuman, Jacob Bornstein
All the procedures included reinforced apical support using mini mesh implants, with preservation of the uterus and anti-incontinence surgery and colporrhaphy were performed when indicated. An hour before the surgery, the patients were given one g Monocef (Cefonicid, Beecham Healthcare) intravenously and their vaginal area was rinsed with iodine antiseptic vaginal wash, and the patients were put under general anaesthesia. Urinary bladder catheterisation and diagnostic cystoscopy were not routinely performed. The mini mesh implant used was Seratom PA MR MN (Serag Wiessner, Naila, Germany) made of partially absorbable materials, resulting in a lightweight mesh that loses 50% of its mass in six months. The mesh contains two pairs of ten-mm-wide arms for paravesical or pararectal and sacrospinous ligament (SSL) fixation. One pair of arms was fixed on the distal anterior or posterior part of the vagina and on either side of the proximal urethra or rectum, whereas the other pair was fixed to the SSL with SERAPRO® RSD-Ney (Serag Wiessner), a reusable-suturing device designed to facilitate suture placement through the SSL. It requires a relatively narrow transvaginal dissection towards SSL, thus, potentially reducing dissection-related complications, and the use of a small mesh implant lessens the invasiveness of the procedure. The mesh was inserted through an anterior vaginal wall incision to correct anterior or posterior compartment and apical prolapse. After the dissection was performed and the cystocele or enterocele was repaired, the skeletonised mini mesh implant provided enough support to the compartment prolapse.