Results of ciprofloxacin therapy in urinary and respiratory tract infections

Ciprofloxacin was administered to 218 patients with various urinary and respiratory tracts infections, including 142 patients with urinary tract infections and 76 patients with respiratory tract infections. Bacteriological tests and routine laboratory tests were performed thrice (before, during and after therapy) in all patients. Ciprofloxacin was administered orally in daily dose of 500 mg for 10 days. Daily dose was increased to 1000 mg in 23 patients with severe respiratory tract infections. Satisfactory results (recovery or regression of the symptoms of exacerbated chronic disease) were achieved in 185 patients (84.9%) and no effect in 10 patients (4.6%). Significant improvement or transient improvement were noted in 23 patients (10.5%).     

Netilmicin in the treatment of bacterial respiratory tract infections

Netilmicin - a semisynthetic aminoglycoside - was administered to 33 patients with the acute or chronic lower respiratory tract or pulmonary infections in a daily dose of 5 mg/kg body weight for 10 days. A principle criterium of patients classification to netilmicin therapy were sensitive bacterial strains either in sputum or in BAL liquid. A significant clinical improvement was noted in 88% of the treated patients. However, elimination of pathogens from the sputum was achieved only in 52% of these patients. No improvement was observed in 4% of the treated patients. No adverse reactions were noted. Netilmicin proved safe and effective antibacterial agent in patients with respiratory infections.     

A few years of following up results of chronic respiratory infections with broncho-vaxom

Broncho-Vaxom was administered to 57 patients with chronic respiratory infections. A significant improvement was noted in 70% of the treated patients whereas mild improvement in 21%. Discussing the results of Broncho-Vaxom therapy, the author suggests so-called maintenance therapy with the same preparation to stabilize its effect.     

Possible presence of a capsule in Branhamella catarrhalis.

Clinical isolates of Branhamella catarrhalis from patients with respiratory infections were used in this study. Electron microscopic observation after treating Branhamella catarrhalis with immune serum and ruthenium red revealed the capsule. In the phagocytosis test, most organisms were not ingested by human polymorphonuclear neutrophils in the presence of normal rabbit serum (NRS), while organisms were primarily cell associated and apparently ingested in the presence of immunized rabbit serum (IRS). The capsule may be one of the virulence factors in this bacteria. This study demonstrates the possible presence of a capsule in Branhamella catarrhalis.     

Adult respiratory distress syndrome during pregnancy and immediately postpartum.

From 1976 to 1983, the adult respiratory distress syndrome occurred in 14 patients during pregnancy or within a month postpartum. There were 8 survivors, giving a 43% mortality. All but 2 patients had obstetric-related precipitating events--labor problems, infections, eclampsia-toxemia, and obstetric hemorrhages. During emergency cesarean sections, 3 patients had respiratory problems that may have caused their respiratory distress syndrome. The average duration of mechanical ventilatory support was 16 days. Six patients had barotrauma with 1 patient sustaining an irreversible anoxic central nervous system injury. Infections were documented in 8 patients, 6 of whom had obstetric foci. There is a lack of information regarding the adult respiratory distress syndrome in this patient group. Though uncommon, it can cause substantial mortality and morbidity.     

Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database

Objective To determine the extent to which antibiotics reduce the risk of serious complications after common respiratory tract infections.Design Retrospective cohort study.Setting UK primary care practices contributing to the general practice research database.Data source 3.36 million episodes of respiratory tract infection.Main outcome measures Risk of serious complications in treated and untreated patients in the month after diagnosis: mastoiditis after otitis media, quinsy after sore throat, and pneumonia after upper respiratory tract infection and chest infection. Number of patients needed to treat to prevent one complication.Results Serious complications were rare after upper respiratory tract infections, sore throat, and otitis media, and the number needed to treat was over 4000. The risk of pneumonia after chest infection was high, particularly in elderly people, and was substantially reduced by antibiotic use, with a number needed to treat of 39 for those aged ≥65 and 96-119 in younger age groups. Conclusion Antibiotics are not justified to reduce the risk of serious complications for upper respiratory tract infection, sore throat, or otitis media. Antibiotics substantially reduce the risk of pneumonia after chest infection, particularly in elderly people in whom the risk is highest.     

Rhinovirus genome variation during chronic upper and lower respiratory tract infections

Routine screening of lung transplant recipients and hospital patients for respiratory virus infections allowed to identify human rhinovirus (HRV) in the upper and lower respiratory tracts, including immunocompromised hosts chronically infected with the same strain over weeks or months. Phylogenetic analysis of 144 HRV-positive samples showed no apparent correlation between a given viral genotype or species and their ability to invade the lower respiratory tract or lead to protracted infection. By contrast, protracted infections were found almost exclusively in immunocompromised patients, thus suggesting that host factors rather than the virus genotype modulate disease outcome, in particular the immune response. Complete genome sequencing of five chronic cases to study rhinovirus genome adaptation showed that the calculated mutation frequency was in the range observed during acute human infections. Analysis of mutation hot spot regions between specimens collected at different times or in different body sites revealed that non-synonymous changes were mostly concentrated in the viral capsid genes VP1, VP2 and VP3, independent of the HRV type. In an immunosuppressed lung transplant recipient infected with the same HRV strain for more than two years, both classical and ultra-deep sequencing of samples collected at different time points in the upper and lower respiratory tracts showed that these virus populations were phylogenetically indistinguishable over the course of infection, except for the last month. Specific signatures were found in the last two lower respiratory tract populations, including changes in the 5'UTR polypyrimidine tract and the VP2 immunogenic site 2. These results highlight for the first time the ability of a given rhinovirus to evolve in the course of a natural infection in immunocompromised patients and complement data obtained from previous experimental inoculation studies in immunocompetent volunteers.     

酪酸梭菌活菌胶囊治疗慢性末端回肠炎疗效评价

目的观察和评价酪酸梭菌活菌胶囊(商品名:阿泰宁)治疗慢性末端回肠炎的临床疗效。方法采用随机对照研究方法,将入组患者随机分为酪酸梭菌联合甲硝唑组、酪酸梭菌组和甲硝唑组,进行治疗,疗程均为4周。治疗期间观察患者的症状、体征及肠镜下变化,治疗结束后评价药物的疗效。结果酪酸梭菌联合甲硝唑组和酪酸梭菌组总有效率分别为97.5%(39/40)和95%(19/20),且治疗中未见不良反应或副作用。酪酸梭菌联合甲硝唑组和酪酸梭菌组总有效率都高于单用甲硝唑组(P<0.01),酪酸梭菌联合甲硝唑组和酪酸梭菌组之间差异无统计学意义(P>0.05)。结论酪酸梭菌活菌胶囊是治疗慢性末端回肠炎的一种安全有效的微生态药品,其疗效优于单用甲硝唑。     

Prophylactic efficacy of reaferon in viral hepatitis A and acute respiratory infections in children

Reaferon, the analog of human alpha 2-interferon obtained by gene engineering techniques, was studied with a view to its use for the prevention of hepatitis A. The study involved children of preschool age in Tashkent. In a strictly controlled trial children aged 2-6 years received the preparation orally in a dose of 1 X 10(6) I. U. or the diluent alone used as placebo. The preparation was administered to 1,100 children and the placebo to 1,078 children. The preparation and placebo were administered twice a week for two months. On the whole, during that period hepatitis A morbidity in both test and control groups of children was the same (5.1% and 4.9% respectively), but among children of nursery age receiving Reaferon the incidence of hepatitis A and acute respiratory viral infections was lower than among those receiving the placebo, though this difference was statistically significant only for cases of acute respiratory infections.     

Community study of role of viral infections in exacerbations of asthma in 9-11 year old children.

OBJECTIVE--To study the association between upper and lower respiratory viral infections and acute exacerbations of asthma in schoolchildren in the community. DESIGN--Community based 13 month longitudinal study using diary card respiratory symptom and peak expiratory flow monitoring to allow early sampling for viruses. SUBJECTS--108 Children aged 9-11 years who had reported wheeze or cough, or both, in a questionnaire. SETTING--Southampton and surrounding community. MAIN OUTCOME MEASURES--Upper and lower respiratory viral infections detected by polymerase chain reaction or conventional methods, reported exacerbations of asthma, computer identified episodes of respiratory tract symptoms or peak flow reductions. RESULTS--Viruses were detected in 80% of reported episodes of reduced peak expiratory flow, 80% of reported episodes of wheeze, and in 85% of reported episodes of upper respiratory symptoms, cough, wheeze, and a fall in peak expiratory flow. The median duration of reported falls in peak expiratory flow was 14 days, and the median maximum fall in peak expiratory flow was 81 l/min. The most commonly identified virus type was rhinovirus. CONCLUSIONS--This study supports the hypothesis that upper respiratory viral infections are associated with 80-85% of asthma exacerbations in school age children.     

Reliability of the serological method of examination as a basis for diagnosis of associated respiratory virus infections.

The reliability of the results of serological examination in diagnostics of associated infections was studied on a model of artificially provoked vaccinal infections in humans and in laboratory animals. The effect of administered monopreparations on changes in the level of both homologous and heterologous antibodies was tested. The character of immunological changes following simultaneous administration of two or more respiratory viruses was analysed and the effect of these viruses in diseases of divers etiology was studied. According to the results of experiments on laboratory animals, repeated administration of any of the earlier used respiratory viruses stimulated the accumulation of only homologous antibodies while heterologous antibodies did not increase at all. The results revealed the possibility of simultaneous immunological reorganization of a child's organism in response to the influence of several different antigens from the group of respiratory viruses acting synchronously or in succession. Results of the analysis demonstrated the reliability of the employed serological methods of diagnosis of respiratory virus infections.     

百乐眠胶囊联合alpha-受体阻滞剂 治疗良性前列腺增生症引起的夜尿症

目的:观察百乐眠胶囊联合α-受体阻滞剂治疗良性前列腺增生症引起的夜尿症的疗效。方法:随机选取符合良性前列腺增生症诊断,采用α-受体阻滞剂单药治疗,夜尿仍大于等于2次的患者20例,在继续服用α-受体阻滞剂治疗的基础上,加用百乐眠胶囊,每日2次,每次4粒。加用百乐眠胶囊前和用药1个月后,分别采用国际前列腺症状评分表(International Prostate Symptom Score,IPSS),生活质量指数(quality of life index,QoL),膀胱过度活动症评分表(Overactive Bladder Symptom Score,OABSS)进行评估。结果:加用百乐眠胶囊1月后,IPSS评分表中夜尿评分从2.88降至2.41(P=0.03),OABSS评分表总分从6.31降至5.38(P=0.03),夜尿评分从2.63降至2.13(P=0.01),QoL评分无显著变化。结论:百乐眠胶囊联合α-受体阻滞剂治疗良性前列腺增生症引起的夜尿症有较好的疗效。     

Adenovirus infections in Manitoba

This review of adenovirus infections in Manitoba over a five-year period is introduced with a brief presentation on the structure-function relationships of the adenoviruses. Extensive research has resulted in the accumulation of a great deal of basic information, far surpassing our knowledge about the infections that these viruses produce in man. More research is needed on the epidemiological and clinical aspects of these diseases, including methods for prevention and treatment, and earlier methods of diagnosis.Features of 216 adenovirus respiratory infections diagnosed from 1963 to 1967 are reviewed and presented. All infections were diagnosed by showing a four-fold or greater increase. In addition, an adenovirus was isolated from many of the infections. These infections occurred every year in substantial numbers and they were seen during each month of the year, although they were more frequent and severe in the winter. Infants and younger persons were often affected. The most severe disease was a pneumonitis which occurred mainly in infants. Associated symptoms usually arose from the gastrointestinal tract, and were sufficiently common to indicate that one should suspect an adenovirus infection when respiratory and gastrointestinal symptoms occur together in a child.The possible role of adenoviruses in the etiology of other than respiratory diseases is discussed and the features of 96 possible non-respiratory infections are presented. Further work will be required to establish a definite etiologic role of the adenoviruses in most of these infections.     

Implantable encapsulated cytosine deaminase having 5-fluorocytosine-deaminating activity

A cell extract of Escherichia coli was found to contain a cytosine deaminase that can stoichiometrically deaminate 5-fluorocytosine to 5-fluorouracil. It was partially purified and aseptically encapsulated in semipermeable cellulose tubes. These capsules, each containing 0.20 U, were implanted under the skin of rats. After a month the capsules were taken out, and found to contain 0.025 ± 0.011 U per capsule (half-life of 10 ± 2 days) (mean ± S.D., n = 6).This fact provided us with an idea for a new approach to the chemotherapy of cancer with the combined use of 5-fluorocytosine administered orally and cytosine deaminase capsule implanted locally.     

Interferonogenic properties of prodigiozan and its effectiveness in treating acute respiratory diseases in children

The capacity of prodigiozan to stimulate interferon production in the cell culture of the human palatine tonsil lymphocytes was studied. The interferonogenic properties of prodigiozan administered in the form of aerosols to children were also investigated. The efficacy of the prodigiozan aerosols in treatment of children with viral respiratory diseases was estimated. It was shown that prodigiozan stimulated interferon production in the cell culture of the tonsil lymphocytes (the titers of 1 : 2--1 : 8) and induced formation of endogenic interferon in the host (in the tonsils and blood serum) 24 hours after the aerosol administration. 100 micrograms of prodigiozan administered in the form of aerosols in a single dose or in 2 doses at an interval of 1--2 days had a pronounced therapeutic effect 1--2 days after the administration. The use of prodigiozan in treatment of children with acute viral respiratory infections promoted a decrease in the frequency of complications, such as pneumonia and otitis. The data are indicative of the validity of prodigiozan in treatment of children with acute respiratory infections.     

Use of prodigiozan for preventing acute respiratory viral diseases in a children's collective]

The epidemiological efficacy of 0.02 per cent solution of prodigiosan, a bacterial polysaccharide was used for the treatment of children in an area with acute respiratory infections, such as influenza and parainfluenza. The drug was administered intranasally by means of a dosing sprayer in the amounts of 0.2 ml once in 4 days for 4 months. Among the children treated with prodigiosan the rate of the acute respiratory viral infections was 2 times lower and the average duration of the disease was 2.4 times lower as compared to the control group. After 4 months of the drug use the average value of the "skin autoflora" test was much lower than that in the control group which testified to an increase in the non-specific immunobiological reactivity of the children under the effect of prodigiosan.     

Reversal of sexual impotence in male patients with chronic obstructive pulmonary disease and hypoxemia with long term oxygen therapy

Erectile impotence is commonly encountered in male patients with respiratory failure and hypoxia. In this study, 42% of the patients experienced reversal of sexual impotence during long term oxygen therapy (LTOT). We examine the association between sexual impotence, gonadal axis hormones, hypoxia, and oxygen therapy. Nineteen sexually impotent male patients eligible for LTOT (pO₂ < 7.3 kPa during stable disease) and with sexual impotence received oxygen therapy for 1 month (n = 12) or 24 h (n = 7). pO₂, LH, FSH, testosterone, and SHBG (sex hormone binding globulin) were monitored. Five of 12 patients receiving oxygen for 1 month regained sexual potency. The responders showed a significant increase in arterial pO₂ and serum testosterone, and a decline in SHBG compared to non-responders. None of the patients receiving oxygen for 24 h experienced reversal of sexual impotence, despite a significant increase in pO₂. In these patients, serum testosterone did not increase significantly. Reversal of sexual impotence may be achieved in some patients with respiratory failure. The oxygen therapy must, however be administered for an adequate length of time.     

Untersuchungen über die Verteilung der ABO-Blutgruppen bei verschiedenen Erkrankungen im Säuglingsalter

Summary In the last ten years the ABO blood groups of our infants have been constantly ascertained and their distribution among some of the more prevalent diseases have been investigated. Other infants and healthy new-borns were used for comparison. The following results have been found:The blood group O is slightly more frequent in sick babies than in healthy new-borns. Among patients, who were under the age of 2 months at the time of admission, there were more with blood group O than among the older children. The blood group A tends to increase among the infants with anemia and with acute respiratory diseases, the blood group O tends to increase among those with staphylococcal infections and rachitis. With the latter the blood group B seems also to be found a little more frequently.Statistics show the increase of the blood group A in anemia in the 3. and 4. months of life and in acute respiratory diseases between the 3. and 12. month of life. The increase of the blood group O in staphylococcal infections is sure only among the youngest patients during their 1. month of life, it is obvious among the older patients, and there mainly among those of masculine sex. The increase of the blood groups O and B among infants with rachitis at the age of 3 to 12 months is almost certain. Premature babies show a sure decrease of the blood group O among both sexes, an increase of the blood group A among feminine, and of the blood group B among masculine patients.     

Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study.

OBJECTIVE: To assess the role of rhinoviruses in elderly people living in the community. DESIGN: Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, and specimens were collected for diagnostic serology and human rhinovirus polymerase chain reaction. SETTING: Leicestershire, England. SUBJECTS: 533 subjects aged 60 to 90. MAIN OUTCOME MEASURES: Symptoms, restriction of activity, medical consultations, and antibiotic use during 96 rhinovirus infections. Adjusted odds ratios for lower respiratory syndromes with respect to smoking and health status. RESULTS: A viral cause was established in 211 (43%) of 497 respiratory illnesses; rhinoviruses were identified in 121 (24%) and as single pathogens in 107. The median duration of the first or only rhinovirus infection in the 96 people with 107 rhinovirus infections was 16 days; 18 of the 96 patients were confined to bed and 25 were unable to cope with routine household activities. Overall, 60 patients with rhinovirus infections had lower respiratory tract syndromes; 41 patients consulted their doctor, 31 of them (76%) receiving antibiotics. One patient died. Logistic regression analysis showed that chronic medical conditions increased the estimated probability of lower respiratory rhinovirus illness by 40% (95% confidence interval 17% to 68%) and smoking by 47% (14% to 90%). There were almost six times as many symptomatic rhinovirus infections as influenza A and B infections. CONCLUSIONS: Rhinoviruses are an important cause of debility and lower respiratory illness among elderly people in the community. Chronic ill health and smoking increase the likelihood of lower respiratory complications from such infections. The overall burden of rhinovirus infections in elderly people may approach that of influenza.