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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clavulanic acid is a potent inhibitor of bacterial beta-lactamases, and ticarcillin is a potent antipseudomonal penicillin. The combination of ticarcillin disodium and clavulanate potassium provides an excellent spectrum of activity against the majority of bacterial pathogens responsible for serious infections in both normal and abnormal hosts. Eighteen courses of therapy were administered to 16 patients; 35 percent of the patients were in poor or critical condition, and all but one had severe underlying disease. Thirteen separate episodes of pneumonia were treated, of which nine were in patients with cystic fibrosis, and 11 involved Pseudomonas aeruginosa. Of the 13 cases of pneumonia, 11 showed clinical cure or improvement, whereas only three showed bacteriologic cure. Of the four nonpulmonary cases, three showed clinical improvement or cure, and one showed a bacteriologic cure. In two patients, phlebitis developed at the site of intravenous infusion. The combination of ticarcillin and clavulanic acid is safe and effective therapy for pneumonia in anatomically compromised hosts.
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PMID:Ticarcillin plus clavulanic acid in the treatment of pneumonia and other serious infections. 407 99

Ultrastructurally atypical bronchial cilia are studied and semiquantitatively analysed in 24 children suffering from recurrent respiratory tract infections with or without bronchiectasis. In patients with Kartagener's syndrome normal-looking and shortened dynein arms are present at some axonemal microtubular doublets. This finding suggests that the polymerization or assemblage of dynein molecules on microtubules only is defective but not totally lacking. Bilateral, local and partial absence of dynein arms is demonstrated in some of the patients with acquired unilateral bronchiectases. These patients also reveal anomalies of the "9 + 2" microtubular axonemal pattern. It is suggested that these abnormalities of the tubulin-dynein system are local and acquired defects that may impair bronchial mucociliary clearance. None of the patients with pneumonia and asthma or with cystic fibrosis studied show any anomalies of the dynein arms. However aberrant axonemal microtubular patterns and other ciliopathies such as naked axonemes and megacilia are present at times in these patients. We postulate that these atypical cilia are secondary acquired abnormalities. Only some patients with bacterial or viral pneumonia demonstrate a partial lack of dynein arms in bronchial cilia. Other ciliopathies such as megacilia, naked and intracytoplasmic axonemes and apical blebs are more frequent and more common in these patients. We suppose they manifest a secondary and rather aspecific pathogenic influence upon the bronchial ciliary substructure.
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PMID:Atypical bronchial cilia in children with recurrent respiratory tract infections. A comparative ultrastructural study. 623 18

Ceftriaxone is an investigational cephalosporin with a half-life of five to eight hours. In an uncontrolled study, we evaluated its efficacy and safety in 30 pediatric and 12 young adult patients with serious bacterial infections. This agent was administered to children at a dosage of 50 to 75 mg/kg/day intravenously in two divided doses. Those with CNS infections received 100 mg/kg/day. In adults, the dosage was 1 g either once or twice daily. The diseases we treated included pneumonia (17), sepsis (eight), ventriculoperitoneal shunt infections (three), osteomyelitis (three), brain abscess (two), peritonitis (two), and miscellaneous (seven). Clinical cures were achieved in all cases, although one child with cystic fibrosis and Pseudomonas pneumonia had persistent colonization in his sputum. No serious side effects were observed. Although not the agent of choice for many of these pathogens, ceftriaxone appears to represent an important alternative to therapy.
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PMID:Ceftriaxone for the treatment of serious infections. 631 5

Ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. Of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. In this study, 57.7% had infections due to Escherichia coli (24.7%), Klebsiella sp. (14.5%) and Pseudomonas sp. (18.5%). Two children with cystic fibrosis and Pseudomonas pneumonia and an adult with Legionella pneumonia responded well to ceftazidime treatment. Seventy patients had fever before treatment and most of them became apyrexial in less than 2 to 3 days. Ceftazidime was given either intramuscularly (42 patients) or intravenously (48 patients), in a dose of 1 g tds in 71 patients or 2 g tds in severe infections in 11 patients, or reduced to suit the renal function (7 patients) or in paediatric doses (2 children). Blood ceftazidime levels were measured in eight patients with normal renal function. The average level one hour post dosing was 45.2 mg/l and the average trough level was 8.1 mg/l. Six patients were suffering from variable degrees of renal insufficiency (serum creatinine 149 to 668 mmol/l). Their average blood level 1 h post-dosing was 68.8 mg/l. In a patient with meningitis, the CSF level was 2.4 mg/l 2 h after a 1 g dose. These levels are several times the ceftazidime MIC values for most clinical bacterial isolates. Ceftazidime is a valuable and safe alternative to aminoglycoside therapy.
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PMID:Ceftazidime: a new approach in the treatment of moderate and severe infections. 635 15

An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital. Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp. or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia. The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis. In this group, ceftazidime was given as 1-2 g tid intravenously. In three patients, gentamicin was used concurrently and in four metronidazole was added. 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia. No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.
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PMID:An open study of the use of ceftazidime in Gram-negative infections. 635 50

X-ray findings in chronic bronchopulmonary diseases in children are presented on the basis of observations made during the last 20 years. Six groups of diseases can be differentiated according to signs and clinical course: Pneumonias with delayed healing, chronic relapsing infiltrations, mucoviscidosis, chronic pleuropneumonia with abscess formation, chronic interstitial processes and chronic infiltrations with bronchiectasis. The typical phenomena and possibilities of differential diagnosis are discussed.
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PMID:[Roentgenologic findings in chronic bronchopulmonary diseases in children]. 637 38

Pseudomonas aeruginosa has emerged as an important pathogen during the past two decades. It causes between 10% and 20% of infections in most hospitals. Pseudomonas infection is especially prevalent among patients with burn wounds, cystic fibrosis, acute leukemia, organ transplants, and intravenous-drug addiction. P. aeruginosa is a common nosocomial contaminant, and epidemics have been traced to many items in the hospital environment. Patients who are hospitalized for extended periods are frequently colonized by this organism and are at increased risk of developing infection. The most serious infections include malignant external otitis, endophthalmitis, endocarditis, meningitis, pneumonia, and septicemia. The likelihood of recovery from pseudomonas infection is related to the severity of the patient's underlying disease process. The introduction of the antipseudomonal aminoglycosides and penicillins has improved substantially the prognosis of these infections. Ticarcillin and carbenicillin have been especially beneficial in neutropenic patients; however, prompt institution of therapy is mandatory for optimal benefit. Many new drugs with antipseudomonal activity, including penicillins, cephalosporins, and other beta-lactams, have been introduced in recent years and offer the potential for new approaches to therapy for these infections.
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PMID:Infections caused by Pseudomonas aeruginosa. 640 75

A model of chronic pulmonary infection was used for studying cellular events in a sequential manner. In this model, agarose beads containing Pseudomonas aeruginosa were instilled endotracheally into cats. Nine cats were inoculated with agarose beads containing P. aeruginosa, and four others were inoculated with sterile beads. With a fiberoptic bronchoscope, bronchial washings were obtained biweekly for up to 30 weeks. The quantitative pulmonary inflammatory cell response and alveolar macrophage morphology of the animals exposed to P. aeruginosa were compared with those for the animals exposed to a chronic irritant (agarose beads). Bronchial washings of all animals before inoculation showed that 70 to 90% of the cells were macrophages. After inoculation with P. aeruginosa, a persistent inflammatory response was observed (60 to 70% granulocytes). In the sterile-bead-inoculated group, the response was less prominent (30 to 40% granulocytes). As early as 2 weeks after inoculation, alveolar macrophages from infected animals were larger and had cytoplasmic features that differed from those of controls. Electron microscope examination showed prominent surface alterations in alveolar macrophages from the infected cats. These alterations persisted from 2 to 12 weeks after infection. In animals inoculated with sterile beads, alveolar macrophages exhibited less extensive surface changes that had resolved by week 8. Histologically, chronic bronchiolitis and pneumonia were more severe in the infected animals than in controls. This model of chronic inflammation and macrophage stimulation, which is similar to the chronic pneumonia of cystic fibrosis, may be a useful approach to answer questions on the role of macrophage activation in chronic lung disease.
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PMID:Pulmonary cellular response to chronic irritation and chronic Pseudomonas aeruginosa pneumonia in cats. 643 97

The growth and survival mechanisms used by Pseudomonas aeruginosa in human infections are similar to those used by the organism in aquatic systems. P. aeruginosa attaches to inert solid or tissue surfaces and grows predominantly in biofilms that release mobile swarmer cells into the surrounding fluid phase. These natural and pathogenic biofilms are covered by an exopolysaccharide matrix (glycocalyx) that serves as a barrier against hostile environmental factors, such as host defense mechanisms and antibiotics. Glycocalyx-enclosed biofilms of P. aeruginosa or other bacteria have been identified in experimental or clinical infections arising from contaminated prostheses and in chronic refractory infections, such as endocarditis, osteomyelitis, and P. aeruginosa pneumonia associated with cystic fibrosis. Conventional in vitro antibiotic susceptibility tests are directed against unprotected, mobile, swarmer cells. Antibiotics used to treat sequestered infections should be tested against populations of pathogens in intact biofilms to determine the ability of the antibiotics to penetrate the glycocalyces and to kill the component bacteria.
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PMID:The etiology and persistence of cryptic bacterial infections: a hypothesis. 644 63

Radiographs of 50 patients age 17 or more with documented cystic fibrosis were reviewed. Peripheral nodular and nonvascular linear densities were common early abnormalities. Specific findings of bronchiectasis were found in 90% of all cases. Hyperinflation was seen in 76% of cases, especially in the lower lobes; atelectasis and all other abnormalities were more common in the upper (and middle) lobes. Cystic air spaces developed in 24% of cases. The severity of abnormalities (including hyperinflation, atelectasis, and bronchial changes) increased in 30 of the 39 patients with follow up for a year or more. Eight of the 15 patients who died came to autopsy. The lungs showed acute and chronic inflammation of airways, including peripheral bronchioles, with adjacent parenchymal inflammation of airways peripheral bronchioles, with adjacent parenchymal infiltrates and fibrosis. The surrounding alveoli were aerated and enhanced the visibility of the thick-walled airways, except in regions of lobar atelectasis, scarring, or active pneumonia. Large and small airway shadows can be described more precisely than by the terms "honeycombing," "interstitial" or "bronchovascular markings".
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PMID:Pulmonary cystic fibrosis in the adult: early and late radiologic findings with pathologic correlations. 678 26


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