One hundred patients with infections mostly outside of the urinary tract were studied in a prospective, open manner to ascertain the effectiveness and safety of ciprofloxacin in a variety of clinical situations. There were 41 instances of bacteremia, including 38 with Salmonella typhi, and 21 respiratory, 17 skin and skin structure, 11 bone or joint, 6 gastrointestinal, and 4 urinary tract infections. The patients were given 500 mg of ciprofloxacin orally every 12 h for 2 to 107 days (mean, 15.1 days). Microorganisms isolated disclosed susceptibilities comparable to those reported previously, with a MIC for 90% of the strains of 0.25 ,ug/ml. For Streptococcus pneumoniae the MIC for 90% of the strains was 0.03 ,ug/ml, and it was higher for Pseudomonas aeruginosa (0.5 ,ug/ml), although still in the therapeutic range, Levels in blood were lower than those reported in other series, and no accumulation of the drug during treatment was detected. In 88 instances there was resolution of the infectious process, in 7 there was improvement, in 3 there was a failure to respond, and in 2 the clinical response was indeterminate. Bacteriological eradication was documented in 87 infections. Despite extensive clinical and laboratory examinations before, during, and after therapy, no major abnormalities related to therapy were seen; only one patient required discontinuation of ciprofloxacin due to gastrointestinal intolerance. Ciprofloxacin is an effective and safe therapeutic alternative in many tissue infections caused by susceptible microorganisms.Ciprofloxacin (Bay o 9867) is a new quinoline carboxylic acid derivative with greater antibacterial activity than earlier related compounds, such as nalidixic, oxolinic or pipemidic acids, or norfloxacin (12). This agent is active against both gram-positive and gram-negative bacteria, with MICs generally in the range of 0.005 to 2.0 ,ug/ml (1, 3). Against anaerobic organisms mixed results have been reported, with MICs for Bacteroides spp. ranging from 0.8 to 16 ,ug/ml (2; S.

Introduction Anti-RNP autoantibodies occur either in Mixed Connective Tissue Disease (MCTD) (with a frequently favorable prognosis), or in systemic lupus (SLE) cases with aggressive major organ disease. It is uncertain how to assess for the risk of severe disease in anti-RNP+ patients. Methods Following IRB-approved protocols, clinical data and blood was collected from patients with known or suspected anti-RNP autoimmunity and normal controls in a cohort study. Samples were screened for parameters of immune activation. Groups were compared based on clinical diagnoses, disease classification criteria, disease activity, and specific end-organ clinical manifestations. Results 97% of patients satisfying Alarcon-Segovia MCTD criteria also met SLICC SLE criteria, while 47% of the anti-RNP+ SLE patients also met MCTD criteria. Among SLICC SLE patients, MCTD criteria were associated with reduced rates of renal disease (Odds Ratio 4.3, 95% confidence interval 1.3–14.0), increased rates of Raynaud’s Phenomenon (OR 3.5, 95% c.i. 1.3–9.5), and increased serum BCMA, TACI, and TNFa levels. Circulating immune markers and markers of Type I Interferon activation were not effective at distinguishing clinical subgroups. Conclusions Among anti-RNP patients, the question of MCTD versus SLE is not either/or: most MCTD patients also have lupus. MCTD classification criteria (but not a broad set of immune markers) distinguish a subset of SLE patients at reduced risk for renal disease.

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. In the oral cavity, clinical manifestations are considered atypical lesions. The aim of this study was to report an unusual granular ulcer secondary oral TB that does not heal, chronic, had irregular appearance with deep depression of 2 cm in diameter, and was located in buccal mucosa of the premolar area–the left mandibular arch, of a 42-year-old woman. The patient was subjected to surgical excision of ulcer in its entirety and accordingly a periodontal plastic surgery in the area of the lesion was performed positioning an autograft subepithelial connective tissue. We obtained optimal results in improving oral health, function, and patient’s comfort, in postoperative controls at 15, 30, and 60 days, respectively.