Gene/Protein Disease Symptom Drug Enzyme Compound
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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper presents the efficacy and cost of therapy with azithromycin for the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Two subgroups were investigated: out-patients and hospitalized patients--20 in each group (17 women and 23 men). Azithromycin 500 mg was administered sequentially once daily. A complete physical examination including temperature, respiratory rate, cough, production and characteristics of sputum so as general aspects of quality of life assessed by COPD exacerbation questionnaire was made in hospitalized patients on a daily base and in a day 10-14 after the end of therapy. Out-patients were assessed in day 1, 3-5 days after the start of study drug treatment and 10-14 days after the end of therapy. Pulmonary function tests were assessed three times during the whole study course. The results of the study suggest similar duration of therapy with azithromycin in both study subgroups, whereas in out-patients decrease and regression of symptoms were statistically significantly quicker with tendency approximately the same in both study subgroups. The cost of therapy with azithromycin was similar in both subgroups but the complete cost of COPD exacerbation treatment was significantly lower in out-patients in comparison to hospitalized patients group (473.71 PLN and 2587.87 respectively).
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PMID:[Evaluation of clinical effectiveness and direct costs of azithromycin treatment for exacerbation of chronic obstructive pulmonary disease in hospitalized patients and ambulatory care]. 1552 29

Community acquired pneumonia is the leading killer of children under the age of 5 years. In ER, a diagnosis of pneumonia may be made and the severity graded on basis of WHO's classification for pneumonia in children up to 5 years of age. It relies on age-specific respiratory rate, presence of lower chest indrawing and signs of severe illness. A diagnosis of pneumonia is made if a febrile child has history of cough and difficult or rapid breathing and a respiratory rate above age specific threshold; however, signs of airway obstruction should be ruled out. Severe pneumonia is diagnosed if with the above features lower chest wall retraction is present; nonetheless, all infants below 2 months and children with moderate to severe malnutrition with pneumonia are categorized as having severe pneumonia. A chest radiograph is indicated only if the diagnosis is in doubt; complications are suspected and there is severe/very severe or recurrent pneumonia. Non-severe pneumonia is treated at home with oral amoxicillin for 3-5 days. If there is no improvement in 48 h it is changed to amoxicillin-clavulanate. Azithromycin is added for atypical pneumonia. Indications for hospitalization include age <2 months, treatment failure on oral antibiotics, severe/very severe or recurrent pneumonia, shock, hypoxemia, severe malnutrition, immunocompromised state. Severe pneumonia is treated with injectable ampicillin; Cloxacillin is added if clinical/radiographic features suggest Staphylococcal infection. On review after 48 h, if improved, the child may be sent home on oral amoxicillin for 5 more days; if not, it is treated as very severe pneumonia. Very severe pneumonia is treated with injectable Ampicillin plus gentamicin. If improved after 48 h, oral amoxicillin and gentamicin are continued for 10 days. If not, respiratory support is enhanced, antibiotics are changed to intravenous ceftriaxone and amikacin and further work up is planned. Children with chronic diseases and recurrent pneumonia require specific antibiotics depending on the underlying cause.
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PMID:Acute community acquired pneumonia in emergency room. 2154 48

Although new chemotherapeutic drugs have been applied constantly, their efficacy for non-small cell lung cancer (NSCLC) is still not satisfactory. In recent years, epidemiological investigations have shown that lung cancer may be induced by chronic Chlamydia pneumoniae (Cpn) infection, since stable high titers of Cpn antibodies, especially IgA, are a hallmark of chronic infections. Azithromycin is commonly used for the treatment of Cpn infections; however, there are only few reports regarding the application of azithromycin (A) combined with paclitaxel and cisplatin (TP) for advanced NSCLC. Considering that patients with NSCLC have a higher rate of Cpn infection, we proposed to employ azithromycin for Cpn infection in chemotherapy for advanced NSCLC. The aim of this study was to explore the effects of azithromycin on chemotherapy for NSCLC. A total of 86 patients with stage III-IV NSCLC were randomly divided into TP and ATP groups; the characteristics of patients in the two groups showed no significant differences. The TP group was treated with paclitaxel and cisplatin, and the ATP group was treated with azithromycin combined with TP for at least 4 weeks, followed by evaluation and comparison of efficacy, side effects and patients' quality of life before and after chemotherapy between the two groups. Testing for Cpn infection revealed a significant difference in the case number before and after therapy in the ATP group (P < 0.01) compared with the TP group (P > 0.05), and a statistical difference was observed (P < 0.01) between the ATP and TP groups after treatment. The changes in quality of life of patients after two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only cognitive function after treatment. The changes in symptom scores of patients after the two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only shortness of breath and cough after treatment. Kaplan-Meier estimate was utilized to describe the survival function of patients in the two groups. The median survival time was 12.0 months for the TP group and 13.0 months for the ATP group. One-year survival rates of the TP and ATP groups were 45.0 and 75.0%, respectively, which were significantly different (P < 0.05). Our study of azithromycin+paclitaxe l+cisplatin on stage III-IV NSCLC patients achieved favorable results in terms of side effects and overall survival.
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PMID:Azithromycin enhances the favorable results of paclitaxel and cisplatin in patients with advanced non-small cell lung cancer. 2478 93

Mycoplasma pneumoniae is a common pathogen for respiratory infection in children, and vascular complication is one of the rarest extrapulmonary complications but with serious consequences. We report a twelve-year-old Chinese female presenting with fever, dry cough, and chest pain aggravated by respiration. She was diagnosed pneumonia due to Mycoplasma pneumoniae and treated with Azithromycin until unexpected tachypnea and swelling in the right lower limb happened. Then ultrasonic examination had revealed two separated thrombi in deep veins before pulmonary embolism was found. Finally she was cured by anticoagulation and immunosuppressive therapy. Though the mechanism of thrombosis after Mycoplasma pneumoniae infection remains unknown, the positive finding in anticardiolipin antibody as well as multi-site thromboses gives a strong hint to immune modulation. Thrombosis should be considered for those who have significantly increased C-reactive protein and positive anticardiolipin antibody after Mycoplasma pneumoniae infection. To our knowledge, this is the first report describing two unattached thrombi in deep veins associated with pulmonary embolism after Mycoplasma pneumonia infection.
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PMID:Two separated thrombi in deep veins associated with pulmonary embolism after Mycoplasma pneumoniae infection: a case in adolescent female. 2683 14

Bronchiectasis in pediatric age is a heterogeneous disease associated with significant morbidity.The most common medical conditions leading to bronchial damage are previous pneumonia and recurrent lower airway infections followed by underlying diseases such as immune-deficiencies, congenital airway defects, recurrent aspirations and mucociliary clearance disorders.The most frequent symptom is chronic wet cough. The introduction of high-resolution computed tomography (HRCT) has improved the time of diagnosis allowing earlier treatment.However, the term "bronchiectasis" in pediatric age should be used with caution, since some lesions highlighted with HRCT may improve or regress. The use of chest magnetic resonance imaging (MRI) as a radiation-free technique for the assessment and follow-up of lung abnormalities in non-Cystic Fibrosis chronic lung disease is promising.Non-Cystic Fibrosis Bronchiectasis management needs a multi-disciplinary team. Antibiotics and airway clearance techniques (ACT) represent the pillars of treatment even though guidelines in children are lacking. The Azithromycin thanks to its antinflammatory and direct antimicrobial effect could be a new strategy to prevent exacerbations.
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PMID:A pediatric disease to keep in mind: diagnostic tools and management of bronchiectasis in pediatric age. 2928 7