Σπονδυλοδισκίτιδα Από Βρουκέλλα

Abstract

The standard treatment of brucellar spondylitis with a combination of two antibiotics for 6-12 weeks is associated with high rates of treatment failure and relapse. The present study aimed to assess the safety and efficacy of a treatment strategy based on the prolonged administration of a triple combination of suitable antibiotics. Eighteen patients with brucellar spondylitis were treated with a combination of at least three suitable antibiotics (doxycycline, rifampin, plus intramuscular streptomycin or cotrimoxazole or ciprofloxacin) until the completion of at least 6 months of treatment, when clinical, radiological and serology re-evaluation was performed. If necessary, the treatment was continued with additional 6-month cycles, until resolution or significant improvement of clinical and radiological findings, or for a maximum of 18 months. At presentation, the median age was 66 years (range, 42-85 years) with male predominance. The median duration of therapy was 48 weeks (range 24-72 weeks). Treatment was discontinued early because of side-effects in only one patient. Surgical intervention was required for three patients. At the end of treatment all patients had a complete response. After completion of treatment, all patients were followed up with regular visits. During the follow-up period (duration 1-96 months, median 36.5 months), no relapses were observed. In conclusion, prolonged (at least 6 months) administration of a triple combination of suitable antibiotics appears to be an effective treatment for brucellar spondylitis.

The Greek Immigrant Family in the United States and Canada: The Transition from an “Institutional” to a “Relational” Form (1945–1970)

“…While these findings represent the majority view, several other studies have claimed that even during this period patriarchal and authoritarian hierarchy in the family still prevailed (Ioannou, 1983), and work outside the home simply meant a double load for the woman (Skodra, 1987). In addition, divorce, which was rare, was considered a dishonour to the family, with more negative consequences for the woman.…”

“…Second, relations between parents and children were still strained (Ioannou, 1983) but, in general, they could be characterized as much better than before with more open communication taking place. The father generally emerged as a shadowy, distant figure throughout childhood and adolescence because of his long hours of work.…”

“…In 1941, 26 per cent of immigrants were females; by 1971 the percentage had increased to 47.4. During the 1950s, the sex ratio had been affected by the entry of many young Greek girls to work as domestic servants in Montreal (Ioannou, 1983).…”