Treatment of experimental Pneumocystis carinii pneumonia with analogs of pentamidine

Seven analogs of pentamidine were tested for their activity against an immunosuppressed rat model of Pneumocystis carinii pneumonia. Structural alterations of the pentamidine molecule included variations of the alkyl chain linking the two p-amidino phenoxy moieties and relocation of the amidine groups from the para to the meta position on the phenoxy rings. All analogs of pentamidine were active against P. carinii pneumonia when compared to a saline-treated control group. One derivative, 1, 4-di(4'-amidinophenoxy)butane, proved to be statistically more active than the parent drug.     

Treatment and prophylaxis for Pneumocystis carinii pneumonia

Without treatment, Pneumocystis carinii pneumonitis is almost always fatal in the immunocompromised host. Here, Walter Hughes discusses proven and potential treatments, and methods of chemoprophylaxis in high-risk patients. Two drugs, pentamidine isethionate and trimethoprimsulfamethoxazole, are equally effective therapeutically - permitting the recovery of approximately 75% of patients - but the latter drug combination is preferred because of its lower toxicity and fewer adverse effects. The pneumonitis can be prevented by prophylactic administration of trimethoprim-sulfamethoxazole. Other drugs with proven efficacy or under study include Fansidar, dapsone, trimetrexate and difluoromethylornithine.     

Chelation in metal intoxication XVIII: Combined effects of thiamine and calcium disodium versenate on lead toxicity

Calcium disodium ethylenediaminetetraacetate (Ca-Na2EDTA; Versenate) was more effective than thiamine (vitamin B1) in enhancing the urinary excretion of lead, reducing tissue lead and restoring lead induced biochemical alterations in rats. However, the combination of CaNa2EDTA and vitamin B1 enhanced the beneficial effect of CaNa2EDTA in lead intoxication and was particularly effective in reducing the brain concentration of lead.     

Treatment of experimental Pneumocystis carinii pneumonia with 1,3-di(4-imidazolino-2-methoxyphenoxy)propane lactate.

An analogue of pentamidine, 1,3-di(4-imidazolino-2-methoxyphenoxy)propane (DMP) lactate, was tested against rat Pneumocystis carinii pneumonia (PCP). The drug was found to be highly active in the treatment of rat PCP at a dose of 1.75 mg/kg (parent molecule) when administered by intravenous (i.v.) injection (daily for 2 wk). The compound was also active against PCP when given orally, however, significantly higher doses of DMP were necessary when compared to the i.v. dosing regimen. Prophylactic doses (i.v.) of the drug also proved highly effective in preventing PCP.     

Fatal pneumonia with terminal emaciation in nude mice caused by pneumonia virus of mice

Athymic nude mice used as sentinel animals in a mouse holding room died of pneumonia 17 to 32 weeks after being placed in the room. Lesions in the pulmonary parenchyma consisted of monocytic exudate, epithelial cell necrosis, hemorrhage, fibrin deposition and interstitial fibrosis. Septal edema, septal cell necrosis and septal capillary stasis were common, but there was limited sloughing of bronchial lining epithelium. Indirect fluorescence microscopy (IFA) of lung sections using pneumonia virus of mice (PVM) antibody was positive. The pneumonia and IFA results were reproduced in euthymic mice inoculated experimentally with lung suspension from naturally infected mice or with tissue culture fluid from cultures infected with American Type Culture Collection PVM. The lungs of a naturally infected nude mouse were studied by transmission electron microscopy. Virus growth was found on Type II alveolar epithelium and on poorly differentiated replacement alveolar epithelium. Virus particles appeared as long exophytic filaments containing one to six linearly arranged nucleocapsids. Inclusion bodies and intracellular virus structures were not observed.     

肺腺癌发生阻塞性肺炎的临床分析

目的研究阻塞性肺炎与肺腺癌发病的关系以及对预后的影响。方法对2003年12月至2013年1月于大连医科大学附属二院确诊的436例肺腺癌患者病历进行回顾,根据患者临床特征进行分组,并进行统计学分析。结果晚期肺腺癌患者更易出现阻塞性肺炎（χ2=5．662,P=0．017）;中心型肺腺癌较周围型更易出现阻塞性肺炎（χ2=4．432,P=0．035）;在肺腺癌中,性别、年龄、吸烟史以及体重下降与否与阻塞性肺炎的发生经比较差异无统计学意义（P〉0．05）。结论阻塞性肺炎的发生与晚期肺腺癌以及中心型肺腺癌有关,重视筛查对肺腺癌的诊断和预后有重要意义。     

大剂量氨溴索联合头孢哌酮钠对卡氏肺孢子菌肺炎(PcP)的临床疗效分析

目的:探讨大剂量氨溴索联合头孢哌酮钠对卡氐肺孢子菌肺炎的临床疗效。方法:选取我院收治的肺孢子菌肺炎患者68例,按照随机数字表法分组,对照组34例予以小剂量新诺明治疗;研究组34例在对照组基础上予以大剂量氨溴索联合头孢哌酮钠治疗,记录并比较两组临床症状、动脉血气分析、血清细胞因子水平、临床疗效及并发症的发生情况。结果:照组临床总有效率(70.59%)显著低于研究组(91.18%),差异具有统计学意义(P0.05);与对照组比,研究组临床症状缓解时间较短,治疗后PaO_2、PaO_2/FiO_2、SaO_2较高,血清IL-10、IFN-γ、IL-8、IL-23水平较低,差异均具有统计学意义(P0.05);两组患者均无恶性不良反应发生,存在轻微的恶心,呕吐等胃肠道反应,两组间不良反映的发生率对比无显著性差异(P0.05)。结论:大剂量氨溴索联合头孢哌酮钠对卡氐肺孢子菌肺炎疗效好,安全性高。     

非免疫抑制患者医院获得性肺炎及呼吸机相关肺炎病原菌组成及耐药性分析

目的分析非免疫抑制患者医院获得性肺炎及呼吸机相关肺炎临床特征、病原菌组成及耐药性,指导临床诊断及合理使用抗菌素。方法回顾性分析46例前瞻性观察诊断的非免疫抑制患者医院获得性肺炎及呼吸机相关肺炎临床及微生物学资料。结果平均起病时间为人院后（14．3±13．2）d,最常见基础疾病依次为脑血管意外（16／46）,慢性肺部疾病（13／46）和糖尿病（5／46）。培养阳性率58．7％,最常见细菌依次为鲍曼不动杆菌（8／27）、铜绿假单胞菌（6／27）、阴沟肠杆菌（3／29）及金黄色葡萄球菌（3／29）。80．4％患者入院72h内使用过抗生素,初始经验性治疗最常使用的抗菌素依次为头孢菌素（29／46）、碳青霉烯类（9／46）、糖肽类（5／46）。8株鲍曼不动杆菌对头孢哌酮／舒巴坦中介MIC〉32mg／L,对其他抗生素耐药;2株铜绿假单胞菌对美罗培南高度耐药MIC=128mg／L。结论非免疫抑制患者医院获得性肺炎及呼吸机相关肺炎多发生在有脑血管疾病及慢性肺疾病老年患者,我院非免疫抑制患者医院获得性肺炎及呼吸机相关肺炎最常见的病原菌多药耐药鲍曼不动杆菌,铜绿假单胞菌对碳青霉烯类耐药率较高。应优化医院获得性肺炎及呼吸机相关肺炎初始抗生素使用。     

Case of Legionella pneumonia complicated with pulmonary thromboembolism

We report a patient with community acquired Legionella pneumonia, complicated with pulmonary embolism. The patient was cured by levofloxacin and anticoagulant therapy. We performed laboratorial control and we excluded the thrombophilia and antiphospholipid syndrome. Our case report draws attention to the possible association between Legionella infection and pulmonary embolism.