Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The two main antibiotics that make up the group of lincosamides are lincomycin and its more recent derivative clindamycin; the latter, more active drug is gaining preference over the former. These antibiotics are active primarily against Gram positive cocci (i.e. staphylococci, pneumococci and group A and unclassifiable streptococci) and against most anaerobes (including Bacteroides fragilis). This action originates in binding to the 50S ribosomal fraction. Lincosamides may be given per os, intramuscularly or intravenously. After an oral dose of clindamycin, 90% of the drug is absorbed, and the peak serum level is reached within the first hour. Drug absorption is not modified by meals. Regardless of the route of administration, the serum half life of clindamycin is 2 to 3.8 hours in healthy individuals. Longer half lives are observed in patients with severe renal or hepatic failure, requiring that lower dosages be given by widening the intervals between doses. Diffusion of lincosamides into tissues is of clinical significance except for the central nervous system, especially the cerebrospinal fluid. On the whole, lincosamides are well tolerated. Pseudomembranous colitis is a potential hazard. The main indications of clindamycin are infections due to anaerobes, especially intestinal and vaginal infections. As clindamycin has virtually no effect against Gram negative aerobic pathogens, in most instances another antibiotic, usually an aminoglycoside, is given simultaneously. Other less common indications are some instances of aspiration pneumonia, septicemias due to B. fragilis, and actinomycoses. Because of the risk of pseudomembranous colitis, prophylactic use of clindamycin to prevent postoperative infections following colorectal surgery seems unadvisable.
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PMID:[Lincosamides]. 351 77

We report here our first experience with the use of a total artificial heart in a human being. The heart was developed at the University of Utah, and the patient was a 61-year-old man with chronic congestive heart failure due to primary cardiomyopathy, who also had chronic obstructive pulmonary disease. Except for dysfunction of the prosthetic mitral valve, which required replacement of the left-heart prosthesis on the 13th postoperative day, the artificial heart functioned well for the entire postoperative course of 112 days. The mean blood pressure was 84 +/- 8 mm Hg, and cardiac output was generally maintained at 6.7 +/- 0.8 liters per minute for the right heart and 7.5 +/- 0.8 for the left, resulting in postoperative diuresis and relief of congestive failure. The postoperative course was complicated by recurrent pulmonary insufficiency, several episodes of acute renal failure, episodes of fever of unidentified cause (necessitating multiple courses of antibiotics), hemorrhagic complications of anticoagulation, and one generalized seizure of uncertain cause. On the 92nd postoperative day, the patient had diarrhea and vomiting, leading to aspiration pneumonia and sepsis. Death occurred on the 112th day, preceded by progressive renal failure and refractory hypotension, despite maintenance of cardiac output. Autopsy revealed extensive pseudomembranous colitis, acute tubular necrosis, peritoneal and pleural effusion, centrilobular emphysema, and chronic bronchitis with fibrosis and bronchiectasis. The artificial heart system was intact and uninvolved by thrombosis or infectious processes. This experience should encourage further clinical trials with the artificial heart, but we emphasize that the procedure is still highly experimental. Further experience, development, and discussion will be required before more general application of the device can be recommended.
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PMID:Clinical use of the total artificial heart. 1476 80

Anaerobic bacteria have been shown to play a role in infection of all types in humans. Certain infections are notable for the prominent role played by anaerobes; included are brain abscess, chronic sinusitis and otitis media, oral and dental infections, neck space infections, bite infections, lung abscess, aspiration pneumonia, empyema, intra-abdominal infections of all types (notably peritonitis, intra-abdominal abscess, and liver abscess), abdominal surgical wound infections, female genital tract infections of all types, various superficial and deep soft tissue infections, and osteomyelitis. In recent years, two new anaerobic infections have been appreciated-infant botulism and pseudomembranous colitis due to Clostridium difficile. Considerable progress has been made recently in delineating factors predisposing to anaerobic infections, virulence factors in anaerobes, and host defense mechanisms vs. these organisms. Taxonomic schemes for anaerobes have been improved and simplified considerably, as have techniques for growing and identifying anaerobic bacteria. Rapid procedures are coming into the picture. Finally, much has been learned about therapy of these infections. Although there has been some problem of increased resistance of anaerobes to antimicrobial agents, several promising new drugs are now available to offset this.
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PMID:The role of anaerobes in human infections. 694 63