Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
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The aim of 36 months follow up study was to assess the safety and efficacy of Filgrastim (Neupogen) for preventing neutropenia and bacterial infection during combination therapy of chronic HCV infection with pegilated interferon alfa and ribavirin. Study enrolled 64 patients with chronic active hepatitis C, aged 20-65. Among them 49 were male and 15 female). Among 64 patients: 5 patients had HCV genotype 1a, 24 patients HCV genotype 1b, 17 patients HCV genotype 2a/2c and 18 patients HCV genotype 3a. Treatment regimen for chronic hepatitis C patients was as follows: Pegylated interferon alfa 2a (Pegasys) 180 micro kg or alfa 2b (PegIntron) 1,5 micro g/kg. and ribavirin (RBV). RBV daily dose was adjusted by body weight- 1000/1200 mg. Treatment duration was 48 weeks for HCV genotype 1 patient and 24 weeks for HCV non 1 genotype accordingly. The patients were divided into two groups: 29 patients (1st group) besides combination antiviral therapy (pegilated interferon alfa plus ribavirin) systematically received Filgrastim and other 35 patients (2nd group) - same antiviral therapy without administration of Filgrastim. Selection of patients was performed by computerized randomization method. HCV antibodies were detected by ELISA and RIBA. HCV RNA by Real time PCR. HCV genotype- by Inno-Lipa. Among 2nd group 35 patients (without Filgrastim administration) during antiviral therapy 8 patients (22.8%) developed different bacterial infections.(3 patients- urinary tract infection, 2 patients- pneumonia, 1 patient- bronchitis, 1 patients - sinusitis and 1 patient-gingivitis/stomatitis). 7 patients required interferon dose modification (dose reduction) and in 5 patients treatment stopped due to severe neutropenia. Among 1st group patients (with filgrastim administration) only one patient developed bacterial infection (urinary tract infection). None of patients, due to neutropenia, required neither stoppage of therapy, nor interferon dose reduction. The quality of life of 1st group patients was better in comparison of 2nd group patients. Filgrastim was safe and effective for prevention neutropenia and bacterial infections in Hepatitis C patients with Peg-INF/RBV combination antiviral therapy. Filgrastim was well tolerated by patients. It gives possibility to maintain interferon dose during treatment period and significantly improves the patient's quality of live.
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PMID:Safety and efficacy of systematic administration of Filgrastim to prevent neutropenia and infections in patient with hepatitis C. 1989 21

Pneumonia remains the leading cause of death in nursing home residents. The accumulation of dental plaque and colonization of oral surfaces and dentures with respiratory pathogens serves as a reservoir for recurrent lower respiratory tract infections. Control of gingivitis and dental plaques has been effective in reducing the rate of pneumonia but the provision of dental care for institutionalized elderly is inadequate, with treatment often sought only when patients experience pain or denture problems. Direct mechanical cleaning is thwarted by the lack of adequate training of nursing staff and residents' uncooperativeness. Chlorhexidine-based interventions are advocated as alternative methods for managing the oral health of frail older people; however, efficacy is yet to be demonstrated in randomized controlled trials. Development and maintenance of an oral hygiene program is a critical step in the prevention of pneumonia. While resources may be limited in long-term-care facilities, incorporating oral care in daily routine practice helps to reduce systemic diseases and to promote overall quality of life in nursing home residents.
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PMID:Association between pneumonia and oral care in nursing home residents. 2153 35

Oral care is essential to maintain oral health and prevent complications such as tooth loss, gingivitis and periodontitis. Poor oral hygiene in dependent, hospitalised patients could lead to serious complications such as chest infection, pneumonia, poor nutritional intake and increased length of hospital stay. Patients who have had a stroke may have physical and cognitive problems that make them dependent on others for their personal care, including oral care. It is essential that nurses and carers understand why maintaining oral hygiene is important following stroke and the consequences of poor oral care.
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PMID:Maintaining oral health after stroke. 2293 Sep 59

Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.
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PMID:Severe dapsone hypersensitivity syndrome in a child. 2380 93

Patients with hyperimmunoglobulin E syndrome (HIES) and chronic granulomatous disease (CGD) have prominently increased immunoglobulin (Ig) E levels. We present a 9-year-old boy with medical history revealing recurrent pneumonia, suppurative lymphadenitis, diarrhea, and otitis. The patient was hospitalized with severe pneumonia. The examination showed tachypnea, crackles at the right and left base of the lung, freckles on his face, red-hair, gingivitis, a high arched palate, and retained primary dentition. Serum IgE level was markedly increased. Nevertheless, patient did not have STAT3 or DOCK8 mutation, characteristic of HIES. Neutrophil function test with dihydrorhodamine (DHR) showed X linked-CGD pattern and molecular analysis of DNAshowed a splice site mutation (c.338-1G > A) in CYBB gene. Herein, we present a case of CGD with selective IgA deficiency. Laboratory findings and elevated IgE mimic the features seen in HIES. Thus, CGD must be considered as a differential diagnosis in patients with elevated Ig E.
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PMID:Chronic granulomatous disease with markedly elevated IgE levels mimicking hyperimmunoglobulin E syndrome. 2382 47

Feline calicivirus (FCV) is a common cause of mild to severe upper respiratory tract disease (URTD) in cats. FCV strain 21223 was isolated from a kitten with severe pneumonia in a disease outbreak with unusually high mortality (35 %) that occurred in a Missouri feline colony in 1995-1996. Phylogenetic analysis of the genome sequence of strain 21223 indicated the emergence of a new FCV strain. Analysis of the full-length genome sequence of a closely related (99.5 % nucleotide identity) strain, 3786, obtained from an asymptomatic animal in the same colony four months later, showed the presence of seven amino acid substitutions, with six of them located in the VP1 capsid sequence encoded by ORF2. Comparative analysis of the E-region sequences (426-521 aa ORF2) presumably involved in virus-host cell receptor interactions did not identify amino acid substitutions unique to the virulent strain. We determined the complete genome sequences of four virus isolates that were collected in regional catteries in the months following the outbreak that were associated with different manifestations of the disease (URTD, chronic stomatitis, and gingivitis). We show that genetically distinct FCV strains were cocirculating in the area, and no apparent correlation could be made between overall sequence and observed disease.
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PMID:Genetic characterization of feline calicivirus strains associated with varying disease manifestations during an outbreak season in Missouri (1995-1996). 2421 71

Chlorhexidine gluconate is used to prevent the accumulation of dental plaque and gingivitis, infection of the surgical site, and ventilator-associated pneumonia in maxillofacial surgery, but it is not clear whether the metabolites of chlorhexidine are detectable in the patient's saliva at clinically relevant concentrations. Forty-three patients who had orofacial operations were randomised to use a 0.2% chlorhexidine gluconate (n=23), or an octenidine-based, chlorhexidine-free (n=20), mouthwash once preoperatively and three times daily for five postoperative days. After the first, 8.7 (23.3) mg/L chlorhexidine (0.7%-2.5% of the total amount used) was measured in saliva. The concentration increased to 15.2 (6.2) mg/L after the second rinse (first postoperative day), and peaked at 29.4 (11.2) mg/L on the fourth postoperative day. It remained detectable for up to 12hours after the last one, but was not detectable in serum or urine at any time. The potentially carcinogenic metabolite p-chloroaniline was detectable in saliva at higher concentrations in the chlorhexidine group (0.55mg/L) than the octenidine group (0.21mg/L), and p-chloronitrobenzene was detected in both groups in only minimal concentrations (0.001-0.21mg/L). Chlorhexidine gluconate mouthwashes do increase the concentration of p-chloroaniline, but a single use seems to be safe. Whether prolonged exposure over many years may have carcinogenic potential is still not clear. Based on the hitherto unknown kinetics of p-chloroaniline in saliva, the recent recommendation of the Federal Drug Administration (FDA) in the USA to limit the use of a chlorhexidine gluconate mouthwash to a maximum of six months seems to be justified.
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PMID:Measurements of chlorhexidine, p-chloroaniline, and p-chloronitrobenzene in saliva after mouth wash before and after operation with 0.2% chlorhexidine digluconate in maxillofacial surgery: a randomised controlled trial. 2778 77

Infectious pathogens from the oral cavity cause oral diseases such as caries, gingivitis, periodontitis, endodontic infections, and alveolar osteitis, and often are also concomitant to systemic diseases, including cardiovascular disorders, stroke, preterm birth, diabetes, and pneumonia, among others. The relationship(s) between oral infections and systemic diseases are still unclear. Using the bacterial cell surface antigen I/II from S. mutans and cardiovascular diseases as a model, this study analyzes peptide commonalities that might underlie autoimmune crossreactions between the bacterial antigen and human proteins associated with cardiovascular disorders. The study outlines a vast peptide sharing that calls attention on autoimmune crossreactivity as a possible mechanism by which S. mutans infection might contribute to induce cardiovascular diseases, and, more in general, offers a new approach to investigate the still elusive molecular links between focal oral infections and human systemic diseases.
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PMID:Streptococcus mutans antigen I/II and autoimmunity in cardiovascular diseases. 2828 7

Myiasis; is defined as the infestation of dead or living tissues of humans and animals by the diptera larvae. It is prevalent all over the world, especially in tropical and subtropical countries with low socioeconomic status. Myiasis of humans has been associated with low socioeconomic status, alcoholism, mental or neurological diseases, poor personal hygiene, patients with varicose veins, diabetes, malnutrition, advanced stage cancer, pediculosis, immunosuppression, sexually transmitted disease, gingivitis and other oral cavity lesions. Myiasis is most commonly seen as skin invasion in the human body, but can be observed in many areas such as eye, ear, nose, throat, urogenital, intestinal, cerebral and tracheopulmonary. Tracheo pulmonary myiasis is a very rare condition. This report presents a case of pneumonia-associated sepsis in a patient with a tracheostomy accompanied by third-stage larval Sarcophagidae. A 51-year-old male patient developed hypoxic brain injury after myocardial infarction 10 months ago before his admission to the hospital. Tracheostomy and percutaneous endoscopic gastrostomy were performed. Shortness of breath and fever were present for five days. The patient has been admitted to the emergency service with the reason for the deterioration of the general situation. The patient was unconscious. Purulent secretion in the tracheostomy area and bilateral crepitation rales in the lung bases were detected. Leukocyte level was normal with C reactive protein (CRP) 14 mg/dl. Nodular infiltration was detected bilaterally in the middle and lower zones, more prominently in the right thoracic computerized tomography. Seftriaxon, moxifloxacin and fluid therapy were initiated in the patient who was admitted with pneumonia-related sepsis diagnosis. The tracheostomy cannula has changed. On the fourth day of admission, Sarcophagidae third stage larvae were detected in deep tracheal aspiration. Treatment of piperacillin/tazobactam and teicoplanin was started by discontinuing the current antibiotherapy of the patient who had no clinical response and elevated CRP level, 18 mg/dl. The patient was discharged on the 25th day of hospitalization with improved clinical and laboratory responses. Complete healing was observed in the control performed by the home care unit. Bed-dependent, lack of self-care, and poor tracheostomy hygiene were risk factors for this patient. In this case, fluid therapy and antibiotic treatment for sepsis was given but no treatment for myiasis. Larva has been considered to have prepared a base for pneumonia due to the foreign body effect and secretion accumulation. Untreated injuries, especially those with impaired oxygenation, leave the eggs of adult flies and provide a suitable environment for larval development. Therefore, should be given importance to combat with flies and regular tracheostomy care in bedside and tracheostomized patients.
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PMID:[Case of pneumonia associated sepsis accompaning pulmonary myiasis]. 3052 29

Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review.
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PMID:Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis. 3229 79


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