Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy and tolerance of the new oral cephalosporin cefaclor was tested in 61 patients treated for a variety of moderate to severe ENT infections which were not expected to undergo a spontaneous remission without antibacterial therapy. The most frequently isolated pathogens were streptococci and Staphylococcus aureus. The dosage consisted of 500 mg cefaclor three times daily, and the treatment lasted between 4 and 43 days (average 14 days). In 35 cases, some of whom had already been treated unsuccussfully with another antibiotic, the results were very good. In 22 patients locally applied medicaments or surgery contributed to the good result. In four patients an unequivocal evaluation was not possible or therapy was not successful. The frequently noted rapid response to treatment with cefaclor was impressive. No relapses were recorded. In pharmacokinetic studies a cefaclor concentration of 2.8 mcg/g was obtained in the tonsils 90 minutes after oral administration of 1000 mg. Clinical examinations in 61 patients and a complete range of laboratory tests in 47 patients did not reveal any case of allergic reaction. One patient only complained of nausea and diarrhoea. In two patients temporary low grade thrombopenia and thrombocytosis respectively were observed. In several patients a slight transitory rise in transaminases was seen. Cefaclor thus proved to be an effective and well-tolerated antibiotic. Its indications in the treatment of ENT infections are discussed.
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PMID:[Experience with cefaclor in the treatment of ear, nose and throat infections. Indications for cefaclor therapy (author's transl)]. 55 Oct 89

In the adult, the irritable bowel syndrome is characterized by intestinal transit disorders associated or not with chronic abdominal pain. Two different forms can be seen: in one, pain and constipation are predominant, while in the other, pain and diarrhea alternate. The second form is encountered with predilection in the child. Various terms can be used to name the syndrome including colitis, non specific or benign colitis, irritable bowel syndrome in the child, infantile diarrhea, and others, all of which attests to our ignorance of the pathophysiology of this disorder. This syndrome is by far the most frequent cause of chronic or recurrent diarrhea in the child. Before the age of 3 or 4 years, the principal syndrome is diarrhea, which usually appears before the age of 6 months. Onset is generally brutal, as in acute enteritis or an extradigestive infection (ENT...) but persists, or else, more often, the syndrome appears insidiously over several days. The child has soft or liquid stools of fetid odor in most cases, very rarely sourish, inhomogeneous and in which intact aliments can be found. Stools are often associated with mucous discharge, rarely with blood, and do not contain any pus. Stools are not fatty but occasionally they are sticky and adhere to the pot. During the day, stools change from well formed in the morning to soft in the evening. Their frequency varies from one day to another as well as during a given 24 hour period, ranging from one or two to 10 per day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Irritable bowel syndrome in children]. 221 Jan 87

In spite of the development of upper digestive tract fiberoptic endoscopy (FE) within the last 10 years, early detection of esophageal carcinoma (EC) is rare except in certain high-risk groups such as patients with head and neck cancers. The aim of this study was to assess the value of a meticulous histoendoscopic examination with vital toluidine blue (TB) staining in all alcohol and tobacco abusers undergoing FE for any reason except dysphagia. In 18 months, 100 patients (90 men, 10 women) who were over 40 years old and who consumed more than 80 g of alcohol and 20 g of tobacco per day underwent FE. No patient had a history of head and neck or esophageal cancer. FE was decided in 48 patients for epigastric pain, in 28 for esophageal varices, in 8 for weight loss, in 8 for anemia, in 7 for peptic disease, and in 1 for diarrhea. Staining with TB was carried out at the end of the examination and two routine biopsies were obtained 5 cm above the lower esophageal sphincter. Specimens were obtained from each abnormal area (TB + or TB -). Clinical ENT examination was recommended for all patients. Two esophageal carcinomas (1 microinvasive, 1 in situ) and 15 cases of dysplasia were detected. Dysplasia was classified as severe in 1 case, moderate in 9 cases, and mild in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic detection of dysplasia and subclinical cancer of the esophagus. Results of a prospective study using toluidine blue vital staining in 100 patients with alcoholism and smoking]. 231 48

Cefixime, the first oral third generation cephalosporin, was administered to 2,832 patients in the USA, UK, FRG and France. 478/1063 patients were treated for urinary tract infections (upper or lower UTI) with 200 mg cefixime bid; clinical cure was obtained in 92 and 96 per cent of upper and lower UTI respectively, and bacteriological cure in 97.5 and 89 per cent of the cases; among 142 patients with a 1 month follow-up, no relapse or reinfection was observed in 78 per cent of cases. Of 521 patients treated for lower respiratory tract infection, 355 received 200 mg cefixime bid and 166 received a single daily dose of 400 mg. Clinical cure was obtained in 88 per cent and 93 per cent patients with pneumonia or bronchitis respectively, with bacteriological cure in 93.2 and 93.8 per cent. Among ENT infections, the most interesting study was in the treatment of sinusitis and otitis. Good clinical results were shown in nearly 95 per cent of cases, with bacteriological cure in more than 90 per cent. The safety studies demonstrated a global 6.6 per cent incidence of undesirable effect. These manifestations were mild and reversible, consisting of abdominal discomfort and minor diarrhea in most cases. The overall effectiveness of cefixime appears to be similar to that of established compounds as far as susceptible pathogens are concerned. However, in clinical trials, cefixime seemed to be effective on isolated bacteria unresponsive to conventional antibiotics.
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PMID:[Efficacy and tolerability of cefixime in international and French studies]. 253 May 48

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

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
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PMID:HIV infection in children--impact upon ENT doctors. 1466 74

In addition to the SARS coronavirus (treated separately elsewhere in this volume), the complete genome sequences of six species in the coronavirus genus of the coronavirus family [avian infectious bronchitis virus-Beaudette strain (IBV-Beaudette), bovine coronavirus-ENT strain (BCoV-ENT), human coronavirus-229E strain (HCoV-229E), murine hepatitis virus-A59 strain (MHV-A59), porcine transmissible gastroenteritis-Purdue 115 strain (TGEV-Purdue 115), and porcine epidemic diarrhea virus-CV777 strain (PEDV-CV777)] have now been reported. Their lengths range from 27,317 nt for HCoV-229E to 31,357 nt for the murine hepatitis virus-A59, establishing the coronavirus genome as the largest known among RNA viruses. The basic organization of the coronavirus genome is shared with other members of the Nidovirus order (the torovirus genus, also in the family Coronaviridae, and members of the family Arteriviridae) in that the nonstructural proteins involved in proteolytic processing, genome replication, and subgenomic mRNA synthesis (transcription) (an estimated 14-16 end products for coronaviruses) are encoded within the 5'-proximal two-thirds of the genome on gene 1 and the (mostly) structural proteins are encoded within the 3'-proximal one-third of the genome (8-9 genes for coronaviruses). Genes for the major structural proteins in all coronaviruses occur in the 5' to 3' order as S, E, M, and N. The precise strategy used by coronaviruses for genome replication is not yet known, but many features have been established. This chapter focuses on some of the known features and presents some current questions regarding genome replication strategy, the cis-acting elements necessary for genome replication [as inferred from defective interfering (DI) RNA molecules], the minimum sequence requirements for autonomous replication of an RNA replicon, and the importance of gene order in genome replication.
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PMID:Coronavirus genome structure and replication. 1560 7

Coronaviruses (CoVs) possess large RNA genomes and exist as quasispecies, which increases the possibility of adaptive mutations and interspecies transmission. Recently, CoVs were recognized as important pathogens in captive wild ruminants. This is the first report of the isolation and detailed genetic, biologic, and antigenic characterization of a bovine-like CoV from a giraffe (Giraffa camelopardalis) in a wild-animal park in the United States. CoV particles were detected by immune electron microscopy in fecal samples from three giraffes with mild-to-severe diarrhea. From one of the three giraffe samples, a CoV (GiCoV-OH3) was isolated and successfully adapted to serial passage in human rectal tumor 18 cell cultures. Hemagglutination assays, receptor-destroying enzyme activity, hemagglutination inhibition, and fluorescence focus neutralization tests revealed close biological and antigenic relationships between the GiCoV-OH3 isolate and selected respiratory and enteric bovine CoV (BCoV) strains. When orally inoculated into a BCoV-seronegative gnotobiotic calf, GiCoV-OH3 caused severe diarrhea and virus shedding within 2 to 3 days. Sequence comparisons and phylogenetic analyses were performed to assess its genetic relatedness to other CoVs. Molecular characterization confirmed that the new isolate belongs to group 2a of the mammalian CoVs and revealed closer genetic relatedness between GiCoV-OH3 and the enteric BCoVs BCoV-ENT and BCoV-DB2, whereas BCoV-Mebus was more distantly related. Detailed sequence analysis of the GiCoV-OH3 spike gene demonstrated the presence of a deletion in the variable region of the S1 subunit (from amino acid 543 to amino acid 547), which is a region associated with pathogenicity and tissue tropism for other CoVs. The point mutations identified in the structural proteins (by comparing GiCoV-OH3, BCoV-ENT, BCoV-DB2, and BCoV-Mebus) were most conserved among GiCoV-OH3, BCoV-ENT, and BCoV-DB2, whereas most of the point mutations in the nonstructural proteins were unique to GiCoV-OH3. Our results confirm the existence of a bovine-like CoV transmissible to cattle from wild ruminants, namely, giraffes, but with certain genetic properties different from those of BCoVs.
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PMID:Biologic, antigenic, and full-length genomic characterization of a bovine-like coronavirus isolated from a giraffe. 1734 85

Coronaviral infection of New World camelids was first identified in 1998 in llamas and alpacas with severe diarrhea. In order to understand this infection, one of the coronavirus isolates was sequenced and analyzed. It has a genome of 31,076 nt including the poly A tail at the 3' end. This virus designated as ACoV-00-1381 (ACoV) encodes all 10 open reading frames (ORFs) characteristic of Group 2 bovine coronavirus (BCoV). Phylogenetic analysis showed that the ACoV genome is clustered closely (>99.5% identity) with two BCoV strains, ENT and LUN, and was also closely related to other BCoV strains (Mebus, Quebec, DB2), a human corona virus (strain 043) (>96%), and porcine hemagglutinating encephalomyelitis virus (>93% identity). A total of 145 point mutations and one nucleotide deletion were found relative to the BCoV ENT. Most of the ORFs were highly conserved; however, the predicted spike protein (S) has 9 and 12 amino acid differences from BCoV LUN and ENT, respectively, and shows a higher relative number of changes than the other proteins. Phylogenetic analysis suggests that ACoV shares the same ancestor as BCoV ENT and LUN.
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PMID:Analysis of the genome sequence of an alpaca coronavirus. 1745 44

Bovine coronavirus (BCoV) causes severe diarrhea in newborn calves, is associated with winter dysentery in adult cattle and respiratory infections in calves and feedlot cattle. The BCoV S protein plays a fundamental role in viral attachment and entry into the host cell, and is cleaved into two subunits termed S1 (amino terminal) and S2 (carboxy terminal). The present study describes a strategy for the sequencing of the BCoV S1 gene directly from fecal diarrheic specimens that were previously identified as BCoV positive by RT-PCR assay for N gene detection. A consensus sequence of 2681 nucleotides was obtained through direct sequencing of seven overlapping PCR fragments of the S gene. The samples did not undergo cell culture passage prior to PCR amplification and sequencing. The structural analysis was based on the genomic differences between Brazilian strains and other known BCoV from different geographical regions. The phylogenetic analysis of the entire S1 gene showed that the BCoV Brazilian strains were more distant from the Mebus strain (97.8% identity for nucleotides and 96.8% identity for amino acids) and more similar to the BCoV-ENT strain (98.7% for nucleotides and 98.7% for amino acids). Based on the phylogenetic analysis of the hypervariable region of the S1 subunit, these strains clustered with the American (BCoV-ENT, 182NS) and Canadian (BCQ20, BCQ2070, BCQ9, BCQ571, BCQ1523) calf diarrhea and the Canadian winter dysentery (BCQ7373, BCQ2590) strains, but clustered on a separate branch of the Korean and respiratory BCoV strains. The BCoV strains of the present study were not clustered in the same branch of previously published Brazilian strains (AY606193, AY606194). These data agree with the genealogical construction and suggest that at least two different BCoV strains are circulating in Brazil.
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PMID:Molecular analysis of the bovine coronavirus S1 gene by direct sequencing of diarrheic fecal specimens. 1839 49


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