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

Paired nasopharyngeal aspirate (NPA) and nasopharyngeal swab (NPS) specimens obtained from each of 32 hospitalized infants with X-ray-confirmed pneumonia (91%) or bronchiolitis were tested for respiratory syncytial virus (RSV) infection by virus culture, the indirect immunofluorescent-antibody (IFA) technique, enzyme-linked immunosorbent assay (ELISA; Ortho Diagnostic Systems, Inc.), and spot hybridization with a human genomic probe to quantitate cellular DNA. RSV was isolated in cell cultures from 72% (23 of 32) of patients by using NPA specimens compared with 47% (15 of 32) by using NPS specimens. With tissue culture positivity as the reference test, the sensitivities of the ELISA on NPA and NPS specimens were found to be 69% (16 of 23) and 61% (14 of 23), respectively, with a specificity and a positive predictive value from both sites of 100%. The sensitivities of the IFA technique compared with the cell culture on NPA and NPS specimens were 61% (14 of 23) and 52% (12 of 23) with specificities of 89 and 78% and positive predictive values of 96 and 92%, respectively. Despite the recovery of significantly more cells (as shown by detection of more cellular DNA by using NPA specimens), virus was detected by the IFA technique or ELISA at similar frequencies in paired specimens. However, virus was recovered more often from NPA than NPS specimens by cell culture, and ELISA optical density readings and the number of RSV-positive fluorescing cells were greater for NPA specimens. NPA specimen collection was less traumatic for the patient, was an easier procedure for the physician to perform, and provided a superior laboratory specimen for RSV diagnosis than the NPS technique.
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PMID:Comparison of nasopharyngeal aspirate and nasopharyngeal swab specimens for respiratory syncytial virus diagnosis by cell culture, indirect immunofluorescence assay, and enzyme-linked immunosorbent assay. 329 83

Five cases of meningitis due to Haemophilus influenzae type b are reported. In four, the same pathogen was recovered from blood. In every case, meningitis developed despite administration of macrolides for ENT infections (4 cases) or pneumonia (1 case). These five observations are conclusive evidence that macrolides failed to prevent meningeal diffusion of Haemophilus influenzae presumptively responsible for the initial focal infection. In vitro activity of macrolides against Haemophilus influenzae is poor. For the treatment of ENT infections in pediatric patients aged 2 months to 5 years, the age group most susceptible to infection by Haemophilus influenzae, we recommend amoxicillin which is more active and bactericidal. An adequate dosage should be used (50 to 100 mg/kg/24 h) divided into four oral doses given at six hour intervals. This therapeutic attitude may need to be revised if the prevalence of beta-lactamase-producing H. influenzae strains (5 to 10% as of now) were to increase. In this case, use of an amoxicillin-clavulanic acid combination under the same conditions as outlined above may prove satisfactory. Correct administration of judiciously chosen antibiotics in ENT infections in infants and children is the most effective means of preventing meningitis due to H. influenzae.
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PMID:[Haemophilus influenzae infections in infants and macrolides. Importance of the choice of an effective antibiotic and compliance with its administration schedule]. 389 73

A new oral prodrug cephalosporin, cefcanel daloxate, was compared with cefaclor, another oral cephalosporin, in the treatment of acute purulent maxillary sinusitis. Three hundred fifty-four patients with purulent sinus secretion were recruited and randomized at thirteen European ENT clinics for the double blind study. The patients were treated with either cefcanel 300 mg tablets twice daily or cefaclor 250 mg capsules three times daily for ten days. Apart from the sinus puncture and secretion aspiration, the existence of sinus pain and purulent nasal secretion were inclusion criteria. Between days 12 and 15, reaspiration of the sinus was performed and signs and symptoms noted. The latter were checked again at the final visit between days 25 and 30. Samples of blood and urine were obtained for safety evaluation at inclusion, during and after treatment. The bacteriological culture of the purulent sinus secretion in 58.4% of patients revealed Haemophilus influenzae (37.9%) as the most prevalent pathogen followed by Streptococcus pneumonia (19.7%), while Streptococcus pyogenes, Branhamella catarrhalis, and Staphylococcus aureus amounted each to 6-7% only. The overall clinical outcome was defined as cure/improvement in 83.3% of the patients in the cefcanel group and 89.3% in the cefaclor group, respectively. No statistically significant differences with regard to efficacy were found between the two treatment groups. Adverse events, mostly related to gastrointestinal reactions, were reported by 36 patients (15.7%) in the cefcanel group and by 16 (13.4%) in the cefaclor group. Both cefcanel 300 mg twice daily and cefaclor 250 mg three times daily were highly effective with only minimal adverse events in the treatment of acute purulent maxillary sinusitis.
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PMID:[Cephalosporin treatment of maxillary sinusitis]. 766 79

The dynamics in schoolchildren's health status varies in time, as the incidence of some chronic diseases decreases and that of the others increases. As a result, the health status of schoolchildren has deteriorated due to a reduction in the number of healthy children and an increase in the number of chronic patients in the past 30 years. Nervous, immune (allergic), and blood diseases have become frequent. Chronic ENT diseases have been encountered more infrequently due to the noticeable reduction in the incidence rates of tonsillitis and otitis. The positive trend is that schoolchildren have no rheumatism, infective allergic myocarditis, chronic pneumonia and diffuse glomerulonephritis and that the prevalence of locomotor disorders, renal and metabolic (obesity) diseases is low. During school time, the health status of children slightly improves due to the lower incidence rates of chronic diseases and the higher proportion of healthy children, but it has remained still worse than it was 30 years ago. The formation of chronic diseases has been found to occur in health group II children, who have morphological and functional changes, in 50% of cases from the first to the sixth forms and in 20% of cases from the seventh to the tenth forms. The present-day children are characterized by a combination of abnormalities and functional disturbances. This all require active and timely prophylactic measures to block chronization at the premorbid stage. Lifestyle (to keep the hygienic school regime, to do exercises and to go in for sports), sociohygienic conditions and genetic factors have profound effects on the health status.
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PMID:[The health status dynamics of schoolchildren and the importance of biomedical factors in its development]. 768 98

37 subjects were admitted to hospital after the accident which caused their exposure to liquid ammonia which produced respiratory lesions in 29 of them. The severity of the respiratory damage depended on oxygen insufficiency (stenosing laryngeal or tracheal bronchitis, pneumonia) and intoxication. Multimodality treatment resulted in cure of 24 patients, 3 patients improved, 2 patients died. The authors think it proper to place such victims into general hospitals where multiprofile care can be rendered including that of ENT specialist whose care proved necessary for the majority of the above patients. Subjects exposed to ammonia can be transported to distant hospitals as the symptoms worsen gradually.
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PMID:[Critical and emergency medical care in ammonia intoxication of upper respiratory tract]. 778 56

During the last decade a large number of novel antimicrobial agents has been developed and marketed. For the practitioner, three groups of oral substances are important, namely cephalosporins, fluoroquinolones and macrolides. The new oral cephalosporins have an improved beta-lactamase stability. Their serum half-life of 2 to 4 h is more than twice as long as that of older substances; however, their oral bioavailability is lower than that of older cephalosporins. They have an excellent activity against gram-negative bacteria, but no or only little activity against staphylococci. They are especially indicated in ENT and UT infections. The fluoroquinolones have an excellent bioavailability and are therefore ideal as oral drugs. Their microbiological spectrum is best against gram negative microorganisms. Pneumococci are not very susceptible to quinolones, with the exception of sparfloxacin. There is an increasing emergency of resistance due to a broad use of these substances. Main indications are UT infections, febrile enterocolitis, and bone and joint infections. New macrolides give less side effects and improved pharmacokinetics. Clarithromycin and azithromycin have high tissue concentrations. The main indications are upper respiratory tract infections and the community-acquired pneumonia. Newer indications for clarithromycin and azithromycin are non-tuberculous mycobacteriosis and in special cases toxoplasmosis in AIDS patients. Despite the different advantages of the new oral antibiotics, older substances such as aminopenicillins and cotrimoxazole are still important agents in the outpatient treatment.
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PMID:[Current antibiotics for clinical practice]. 896 13

Human immunodeficiency virus (HIV) infection is one of the most widespread diseases in the world. By the end of 1995, 800,000 HIV infected persons were suspected in Thailand, although the reported number of symptomatic HIV patients was only 13,267 and the number of cases of acquired immunodeficiency syndrome (AIDS) was 31,439. Approximately 5.2% of AIDS patients are cases of paediatric AIDS, contracted mostly by perinatal transmission and with a 25% vertical transmission rate. In a study of paediatric AIDS patients in the Children's Hospital, Thailand, from 1992 to 1995, the five most common clinical manifestations were hepatosplenomegaly (82.85%), persistent pneumonia (64.4%), oral candidiasis (59.6%), chronic diarrhoea (58.4%) and failure to thrive (51.2%). In addition to oral candidiasis, other ENT (ear nose-throat) presentations were lymphadenopathy (41.6%), repeated upper respiratory tract infection (39.5%), otitis media (18.4%), parotitis (5.2%) and sinusitis (0.8%).
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PMID:AIDS in ENT in children. 972 25

Acute infectious disease presentations among many at-risk patient groups (eg, uninsured, homeless, and recent immigrants) are frequently seen in emergency departments. Therefore EDs may be useful sentinel sites for infectious disease surveillance. This article describes the background, development, and implementation of EMERGE ncy ID NET, an interdisciplinary, multicenter, ED-based network for research of emerging infectious diseases. EMERGE ncy ID NET was established in cooperation with the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) as part of the CDC's strategy to expand and complement existing disease detection and control activities. The network is based at 11 university-affiliated, urban hospital EDs with a combined annual patient visit census of more than 900,000. Data are collected during ED evaluation of patients with specific clinical syndromes, and are electronically stored, transferred, and analyzed at a central receiving site. Current projects include investigation of bloody diarrhea and the prevalence of Shiga toxin-producing Escherichia coli, animal exposures and rabies postexposure prophylaxis practices, seizures and prevalence of neurocysticercosis, nosocomial ED Mycobacterium tuberculosis transmission, and hospital isolation bed use for adults admitted for pneumonia or suspected tuberculosis. EMERGE ncy ID NET also was developed to be a mechanism for rapidly responding to new diseases or epidemics. Future plans include study of antimicrobial use, meningitis, and encephalitis, and consideration of other public health concerns such as injury and national and international network expansion.
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PMID:EMERGEncy ID NET: an emergency department-based emerging infections sentinel network. The EMERGEncy ID NET Study Group. 983 68

(1) Moxifloxacin is the fourth fluoroquinolone to be licensed in France with indications covering ENT and respiratory tract infections. (2) In community-acquired pneumonia, acute bacterial sinusitis and acute exacerbations of chronic bronchitis, moxifloxacin seems no more effective than other fluoroquinolones available in France (with which it has not been compared) or the other antibiotics with which it has been compared. (3) Moxifloxacin has the usual adverse effects of fluoroquinolones, but carries a greater risk of QT prolongation than ciprofloxacin, levofloxacin and ofloxacin.
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PMID:Moxifloxacin: new preparation. A me-too with more cardiac risks. 1246 94

(1) Macrolides are an alternative to beta-lactam agents for treating uncomplicated community-acquired pneumonia, acute exacerbations of chronic bronchitis, sinusitis and throat infections. The choice of macrolides is based mainly on the risk of interactions, which is lowest with spiramycin. (2) Telithromycin is a macrolide antibiotic derived from erythromycin. It was first marketed in France in 2002, for the above indications. (3) Telithromycin is no more effective than the antibiotics with which it has been compared, namely amoxicillin and clarithromycin in non life-threatening pneumonia; amoxicillin-clavulanate and cefuroxime axetil in acute exacerbations of chronic bronchitis and acute sinusitis; and clarithromycin and phenoxymethylpenicillin (penicillin V) in pharyngotonsillitis. (4) In clinical trials, telithromycin was not more effective than comparator antibiotics on infections thought to be due to pneumococcal strains resistant to penicillin and/or erythromycin. Cases of erythromycin cross-resistance have been observed. (5) The adverse effects of telithromycin are the same as those of other macrolides, mainly gastrointestinal disturbances, headache, dizziness, and hepatotoxicity. Telithromycin also carries a risk of torsades de pointes, and seems to cause more visual problems than other macrolides. (6) Telithromycin inhibits cytochrome P450 isoenzymes, so there is a high risk of drug interactions. (7) In practice, spiramycin remains the standard option when a macrolide is indicated for the treatment of common ENT and pulmonary infections.
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PMID:Telithromycin: new preparation. A needless addition to the other macrolides. 1260 73


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