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

Chronic respiratory infection with Pseudomonas aeruginosa is a leading clinical problem among patients with cystic fibrosis. Because antimicrobial agents are usually ineffective in eradicating these infections, additional therapeutic or prophylactic measures should be considered. In this study, an experimental guinea pig model of chronic Pseudomonas aeruginosa bronchopneumonia was utilized to determine whether active immunization with lipopolysaccharide (LPS) P. aeruginosa antigen may favorably influence the course of this infection. Experimental pneumonia was established by tracheobronchial instillation of suspensions of microscopic agar beads, which were impregnated with viable P. aeruginosa. After 4 wk of infection, the geometric mean (reciprocal) passive hemagglutinating Pseudomonas antibody titer was 185+/-1.3, and lungs contained 16.8+/-4 x 10(3) colony-forming units Pseudomonas/ml of lung homogenate. Pseudomonas immunization, given prior to a 4-wk infection, resulted in significantly higher passive hemagglutinating titers (474+/-1.4; P < 0.05), lower numbers of viable Pseudomonas in lung tissues (2.4+/-0.6 x 10(3); P < 0.01), and reduced histopathology in lungs. In contrast, providing Pseudomonas immunization to animals 2 wk after pulmonary infection was established, offered no apparent benefit. Likewise, no protection was afforded by prophylactic immunization with a non-Pseudomonas LPS antigen (Escherichia coli J5 vaccine). Using a Raji cell assay, modified to detect circulating immune complexes in vaccinated and infected guinea pig sera, there was no evidence that active immunization increased the frequency of circulating immune complexes in infected guinea pigs. It is concluded that prophylactic immunization with Pseudomonas LPS antigen may confer protection from subsequent Pseudomonas bronchopneumonia, but that immunization during established infection is not beneficial.
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PMID:Active immunization with lipopolysaccharide Pseudomonas antigen for chronic Pseudomonas bronchopneumonia in guinea pigs. 679 29

The effects of a home care program with 102 courses (2336 patient-days) of intravenous antibiotic therapy were evaluated. Home care nurses changed the intravenous cannula site every 3 days. The initial hospital stay averaged 11.8 days and the duration of home therapy averaged 22.9 days. The diseases treated included osteomyelitis, septic arthritis, endocarditis, cystic fibrosis and pneumonia, staphylococcal bacteremia, blastomycosis, actinomycosis and other soft tissue infections. All classes of commonly used antibiotics, including penicillins, cephalosporins, aminoglycosides and amphotericin B, were administered, alone or in combination. There were no side effects that necessitated discontinuation of home treatment or readmission to hospital. The average cost per patient-day was $58, compared with an estimated $193 for in-hospital therapy; in addition, 2336 hospital bed-days were made available. Most patients were able to resume many or all of their daily activities while receiving intravenous antibiotic therapy.
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PMID:Self-administration of intravenous antibiotics: an efficient, cost-effective home care program. 680 5

The dosing frequency of aminoglycoside antibiotics may alter efficacy and toxicity independent of total daily dose. Once-daily tobramycin dosing was compared with continuous infusion in three models of efficacy. Acute pneumonia due to Pseudomonas aeruginosa in guinea pigs responded better to once-daily dosing, and chronic pneumonia in rats and endocarditis in rabbits responded equally to both regimens. Dogs given gentamicin, tobramycin, or netilmicin once daily, with maximum serum concentrations of greater than 100 mg/liter, had less nephrotoxicity than dogs given continuous infusions. Tobramycin was given once daily or continuously to 52 patients with cystic fibrosis who in 10 days had no change in creatinine clearance or hearing despite maximum serum tobramycin concentrations of 40 mg/liter. Intermittent dosing of aminoglycosides, causing infrequent large maximum serum concentrations, may be less toxic and equally efficacious as frequent dosing.
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PMID:Once-daily vs. continuous aminoglycoside dosing: efficacy and toxicity in animal and clinical studies of gentamicin, netilmicin, and tobramycin. 686 Apr 16

Activities of elastase- and trypsin-like proteinases from granulocytes as well as content of their acid-stable inhibitors were studied in 80 samples of the bronchial secretory products obtained from 34 children from 4 to 15 years old suffering from various forms of bronchopulmonary pathology/primary chronic pneumonia, Cartagener's syndrom, mucoviscidosis, pulmonary malformations. Normal bronchial secretory products were characterized by high content of the acid-stable inhibitors as well as by absence of the granulocytic proteinases activity. Development of inflammatory impairments in bronchi was accompanied by 2-3-fold decrease in content of the inhibitors with simultaneous increase in the enzymatic activity. The data obtained suggest that the relationship between activity of granulocytic proteinases and content of acid-stable inhibitors in bronchial secretory products might be considered as an important index of inflammatory processes in bronchi. De novo synthesis of acid-stable inhibitors in lungs appears to be decreased in the course of development of inflammation.
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PMID:[Activity of granulocyte proteinases and level of acid-stable proteinase inhibitors in the bronchial secretions of children with bronchopathies of different etiology]. 700 5

Carbenicillin and ticarcillin are penicillins which were initially developed as agents to treat serious Pseudomonas infections in the seriously ill hospitalized patient. These drugs have made a major contribution to improved survival in the neutropenic patients with Pseudomonas infection, the burn patient and to the care of the patient with cystic fibrosis. Areas of use for the compounds have enlarged to include aspiration pneumonitis in hospitalized patients, intra-abdominal and pelvic sepsis, and infections due to Proteus and Enterobacter species. Careful attention to the pharmacology of the agents is necessary to achieve clinical and bacteriologic success and to avoid the toxic side-effects such as bleeding and hypokalemia associated with the use of these agents. A decade of use has shown that the agents have remained effective agents in institutions in which their use has not been abused. It is too early to clearly position azlocillin, mezlocillin, and piperacillin. In the next few years the role of these potent compounds will be established. As noted in this review, these three agents have been used with success to treat all of the aforementioned infections. With these drugs it is also essential that the physician closely correlate in vitro data and the human pharmacology of the drugs if he or she wishes to achieve the most effective response from the agents.
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PMID:Carbenicillin and ticarcillin. 703 41

The use of combinations of trimethoprim (TMP) and sulfamethoxazole (SMZ) for the treatment of chest infections is described. A number of studies have shown that TMP-SMZ is effective treatment for exacerbations of chronic bronchitis. The long-term use of TMP-SMZ as chemoprophylaxis of chronic bronchitis is also described. Conventional doses of TMP-SMZ (320 mg of TMP and 1600 mg of SMZ) have proved most effective in the prevention of chronic bronchitis; the drug combination is nontoxic and does not lead to the emergence of any resistant organisms. The use of TMP-SMZ for the treatment of pneumonia has been previously described. TMP-SMZ has also been found effective for long-term use in the treatment of cystic fibrosis.
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PMID:The use of trimethoprim-sulfamethoxazole in the treatment of chest infections. 705 Dec 45

The first known case of a 20-year-old cystic fibrosis patient in Switzerland, ending at 40 weeks' gestation in delivery by cesarean section performed under peridural anesthesia is presented. Obstetric care of the patient was complicated by pneumonia during the 31st week of pregnancy. The epidemiology, pathogenesis and clinical symptoms of cystic fibrosis, the problems anticipated during pregnancy, delivery and childbed in patients with cystic fibrosis, and the questions surrounding therapeutic abortion and contraceptive counseling are discussed.
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PMID:[Pregnancy and delivery in a woman with mucoviscidosis]. 707 9

Pharmacokinetic and clinical evaluations of cefsulodin (CFS) were made and the following results were obtained. 1. Pharmacokinetic study Three hundred fifty grams of CFS (20 mg/kg) was administered by 30 minutes intravenous drip infusion to 7 years old child (17.5 kg in weight). Serum concentrations of CFS at the end of the infusion and 1,1.5,2.5,6.5 hours thereafter were 46.0,44.9,23.0,11.9 mcg/ml and 0.6 mcg/ml respectively. Urinary recovery rate until 6 hours from the start of infusion was 66.2%. 2. Clinical study CFS was administered to the case of bronchitis with cystic fibrosis of the pancreas and bronchiectasia (treatment was made 2 times), and each 1 case of pyelonephritis with renal calculus and measles pneumonia with infantile spasm. All infections were caused by P. aeruginosa and administration and dosage of CFS was 47 to 86 mg/kg/day, 2 to 4 times daily by intravenous injection or intravenous drip infusion for 5 to 11 days. Result was good in 3 infections (2 cases) and fair in 1 case, i.e. measles pneumonia. Effectiveness rate was 75.0%. Side effect as well as abnormal change of laboratory findings were not observed. Thus, CFS is considered to be the useful drug for the treatment of pediatric infection caused by P. aeruginosa.
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PMID:[Clinical studies of cefsulodin in the pediatric field]. 716 66

The effects of concentration of PHA-P and time in culture on cells from patients with systemic, polyarticular and pauciarticular juvenile arthritis have been studied. Responses to suboptimal concentrations are depressed at 3 days, particularly of systemic and polyarticular patients, but normal by 5 days and probably prolonged at 7 days. The responses approach normal with 5 micrograms/ml PHA-P. This delay also occurs in cells from children with cystic fibrosis and acute pneumonia and so is not disease specific. Kinetic studies show a slower recruitment of cells. The delay is corrected by 1 microgram/ml indomethacin. After 7 days, cultures from patients with juvenile arthritis have fewer E, heat-stable E, and EAC rosetting cells than do cultures from normal children or children with cystic fibrosis.
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PMID:In vitro responses of lymphocytes in juvenile arthritis: effects of time and concentration of PHA-P. 731 Jul 72

Few data on exercise training in hospitalized patients are available, but because exercise may help and it unlikely to harm, some sort of early and maximal mobilization should be attempted. Breathing exercises as practiced currently have little apparent effect beyond the temporary benefit of inducing a slow, deep breathing pattern. New breathing exercises, based on data from physiology laboratories, should be formulated and evaluated. Postural drainage and percussion represent the physiotherapist's mainstay in dealing with exacerbations of chronic obstructive disease. In some patients, these maneuvers increase production of sputum and produce improvements in pulmonary function that, although not large, are significant. Other patients show no acute benefit. Current belief holds that patients with large sputum volumes, notably those with cystic fibrosis and bronchiectasis, are the most likely to be helped by postural drainage and percussion; but definitions vary as to what is a large sputum volume. Two studies have assessed the effect of postural drainage and percussion on the clinical course of patients with pneumonia and patients with exacerbations of chronic bronchitis, and both produced negative results.
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PMID:Physiotherapy in hospitalized medical patients. 745 44


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