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Biomedical subjects

E Loza

Publications and source records attributed to E Loza.

At least 55 records · Page 3Linked to original sources

[Evaluation of the treatment with oral ciprofloxacin: experience with 24 patients].

We have evaluated the clinical effectiveness and possible side effects of oral ciprofloxacin therapy in 24 patients (11 females and 13 males). Two episodes from overall 25 infections were excluded of clinical and microbiological evaluation but were assessed regarding possible side effects. In most patients, the clinical condition was stable at the beginning of therapy. Only 3 patients had nonfatal diseases. Seventeen episodes were urinary tract infections (four of them with concomitant bacteremia), four chronic osteomyelitis, and two severe soft tissue infections; 21 episodes were monomicrobial, and two polymicrobial. The isolated organisms were mostly aerobic gram negative bacilli or facultative anaerobes: E. coli (9), Pseudomonas aeruginosa (5), Proteus mirabilis (5), Serratia marcescens (1), Klebsiella pneumoniae (1), Pseudomonas stutzeri (1), and Acinetobacter calcoaceticus (1). There were only two gram positive isolates: Staphylococcus aureus (1) and Staphylococcus epidermidis (1). The overall clinical response rate was 91%. Gastrointestinal tolerance was excellent. Colonization by Candida or Enterococcus developed in 3 cases (13%), and only one of them developed superinfection. Four patients developed several nervous system abnormalities, two increased transaminase activity and one drug exanthema. Ciprofloxacin appears as an effective drug for the monotherapy of several bacterial infections, including severe enterobacteriaceae and Pseudomonas infections.

Administration, Oral↗

Small bowel bypass prevents the trophic action of cholecystokinin on the rat pancreas.

The effect of a chronic administration of cholecystokinin (CCK) on the rat pancreas has been studied in rats subjected to a 90% jejunoileal bypass or an intestinal transection (controls). Jejunoileal bypass, when compared to transection, did not modify the size of the pancreas but decreased its enzyme content, especially for amylase, and reduced the number of zymogen granules. These structural and biochemical changes were maintained when bypassed animals were treated three times daily and for six days with cholecystokinin (20 Ivy Dog Units (IDU)/kg). In contrast, CCK treatment in transected animals induced growth of the pancreas due to cellular hypertrophy and hyperplasia; pancreatic enzyme content, especially for chymotrypsin, and the population of zymogen granules in acinar cells were also enhanced. It is concluded that jejunoileal bypass prevents the trophic action of chronic CCK on the pancreas.

Animals↗

Serratia bacteremia.

During a 6-yr period, 146 patients at our institution had Serratia bacteremia (3.8% of the total number of episodes of bacteremia), with an incidence of 1.24/1000 admitted patients. We chose a random group of 50 cases for clinical analysis in the present study. The disease was community-acquired in 8% of the cases and nosocomially-acquired in the remaining 92%. The bacteremia was unimicrobial in 84% and part of a polymicrobial bacteremia in 16% of the episodes. The most frequently isolated species of the Serratia genus was S. marcescens. Portals of entry, in decreasing order of frequency, were: urinary, unknown, respiratory, and surgical wound infections. Clinically, the most frequent finding was fever (100%). Shock occurred in 28% of the patients, and none of our cases showed evidence of disseminated intravascular coagulation. We found 62% of Serratia isolates resistant to gentamicin. Overall mortality was 38% and factors associated with a poor prognosis were: severity of the underlying disease, critical clinical situation at onset of bacteremia, presence in the intensive care unit (I.C.U.), occurrence of shock or polymicrobial bacteremia, portal of entry in the respiratory tract, and inadequate treatment.

Adolescent↗

Influence of repeated administration of bombesin on rat pancreatic secretion.

To study the effects of chronic bombesin on pancreatic growth and secretion, rats were injected subcutaneously, 3 times daily for 4 days with either saline or bombesin (10 micrograms/kg). Bombesin significantly increased the pancreatic weight and content in protein and RNA but not in DNA. The ratios of the three former parameters to DNA increased, suggesting cellular hypertrophy. The pancreatic content in enzymes was also elevated, especially for chymotrypsin and to a lesser degree for amylase. However, the volume of pancreatic secretion and the output of enzymes in response to CCK under a continuous infusion of secretin remained unchanged. The in vitro secretory response to caerulein and bombesin was reduced for amylase and lipase. It is concluded that chronic bombesin exerts a trophic action on the rat pancreas but decreases the sensitivity of each cell to hormonal stimulation.

Animals↗

Enterobacter bacteremia. An analysis of 50 episodes.

During a six-year period, 147 patients had Enterobacter bacteremia (3.8% of the episodes of bacteremia), with an incidence of 1.25 per 1,000 admitted patients. We chose a random group of 50 cases for analysis. The disease was community acquired in 24% of the cases and nosocomially acquired in the remaining 76%. The bacteremia was unimicrobial in 70% and part of a polymicrobial bacteremia in 30%. The species most commonly causing bacteremia was Enterobacter cloacae. Portals of entry, in decreasing order of frequency, were unknown, surgical wound, respiratory tract, and urinary tract. The most common clinical finding was fever (92%). Shock occurred in 30% of the patients, and only two patients had evidence of disseminated intravascular coagulation. Of the Enterobacter isolates, 12% were resistant to gentamicin. Overall mortality was 42%; factors associated with a poor prognosis were inadequacy of antimicrobial chemotherapy, septic shock, type of underlying disease, clinical condition, and requirement of intensive care.

Adolescent↗

Leptotrichia buccalis bacteremia in neutropenic children.

Two new cases of Leptotrichia buccalis bacteremia in seriously ill patients were described. The anaerobic, gram-negative microorganism L. buccalis was isolated from blood cultures of two children with severe leukopenia. Anaerobic organisms should be taken into account when a standard protective antibiotic chemotherapy is considered in the immunosuppressed host.

Adolescent↗

Temocillin. In vitro activity compared with other antibiotics.

Temocillin is a recently developed penicillin with a methoxy group in the 6-alpha position. The in vitro activity of temocillin was studied using 932 recent clinical isolates of aerobic and anaerobic Gram-negative bacilli and Gram-positive cocci, and its activity was compared with that of other beta-lactam antibiotics. Temocillin was active against the Enterobacteriaceae, with narrow ranges of MICs and MIC90 values (less than or equal to 8 mg/L) for all isolates except Serratia marcescens and Enterobacter species. Moreover, the compound was active against 46 multiresistant Enterobacteriaceae strains. The drug was also strongly active against Haemophilus influenzae, with beta-lactamase-producing strains being as susceptible as non-beta-lactamase-producing strains. Temocillin showed no useful activity against Pseudomonas aeruginosa, Acinetobacter or Gram-positive cocci, and had only discrete activity against the Bacteroides fragilis group. In general, temocillin displayed the same spectrum of activity against Enterobacteriaceae as third generation cephalosporins, but with a substantially lower intrinsic activity.

Enterobacteriaceae↗

International collaborative study on standardization of bacterial sensitivity to fosfomycin.

An international collaborative study was undertaken involving 6 working groups to correlate the zone sizes obtained with 50 micrograms fosfomycin + 25 micrograms glucose-6-micrograms glucose-6-phosphate (G6P) and 50 micrograms fosfomycin + 50 micrograms G6P/disc with the MICs in the presence of 25 mg G6P/litre. The recommendations of the ICS for the MIC and disc diffusion methods were followed and Oxoid Mueller-Hinton agar was used. The regression lines obtained with the method of least squares show that the best correlation coefficient (r = 0.8227) corresponds to the disc with 50 micrograms fosfomycin + 50 micrograms G6P. Considering both the pharmacokinetics of fosfomycin after intravenous administration of 2 or 4 g and the distribution of sensitive bacterial populations, two breakpoints were established at MIC values of 16 and 64 mg/l corresponding to zone sizes and 18 and 22 mm, respectively.

Anti-Bacterial Agents↗

Evaluation of ceftazidime in the treatment of severe bacterial infection.

We investigated the clinical efficiency and safety of ceftazidime for treatment of 33 episodes of infection in 30 patients (17 males and 13 females), whose ages ranged from 9 to 92 years (mean 52.5). Fourteen patients had ultimately fatal disease and the remaining 16 had non-fatal diseases. The clinical condition of patients at the beginning of treatment was critical or poor in 16 cases. Episodes of infection treated were: 24 urinary tract infections (eight of them with concomitant bacteraemia), seven wound infections (one with concomitant bacteraemia and three with osteomyelitis), and two episodes of pneumonia. Twenty-nine episodes of infection were monomicrobial and the four remaining ones were polymicrobial. Significant organisms isolated were all aerobic or facultatively anaerobic Gram-negative rods and were responsible for the following episodes of infection: Escherichia coli (14), Pseudomonas aeruginosa (12), Pseudomonas cepacia (1), Proteus mirabilis (5), Serratia marcescens (2), Klebsiella (2), Enterobacter aerogenes (1) and Haemophilus influenzae (1). Total dosage of ceftazidime ranged from 28 to 240 g (mean 82.4 g), and mean duration of therapy was 17 days (range 8 to 44 days). The overall rate of clinical response to ceftazidime was 91%. Local and general tolerance to the drug was excellent. Enterococcal and/or candida colonization occurred in 12 episodes (36%) and superinfections by the same micro-organisms occurred in three episodes. Ceftazidime seems to be an effective and safe single agent for therapy of many bacterial infections, including those caused by Ps. aeruginosa.

Adolescent↗

Comparison of ceftazidime concentrations in bile and serum.

Biliary excretion of ceftazidime, a new broad-spectrum cephalosporin, was studied in two groups of patients after administration of a 2-g dose intravenously. Group A included 10 patients in whom ceftazidime levels in bile were measured during cholecystectomy. Group B included 10 patients with indwelling biliary tubes in whom ceftazidime levels in bile and serum were simultaneously measured at 0.5, 1, 2, 4, 6, and 8 h after administration of the drug. Although ceftazidime levels were variable, they exceeded the minimal inhibitory concentrations of most biliary tract pathogens in both groups.

Adult↗

Evaluation of lamoxactam in the treatment of severe bacterial infections.

We investigated the clinical efficiency and safety of lamoxactam for treatment of 28 episodes of infection in 26 adult patients (15 males and 11 females) whose ages ranged from 17 to 83 years (mean 48.7). 4 patients had 'ultimately fatal diseases' and the remaining 22 had 'nonfatal diseases'. The clinical condition at the beginning of treatment was 'critical' or 'poor' in 15 cases. Episodes of infection treated were: 14 intraabdominal, 9 bacteremia, 5 nephro-urinary, 3 osteomyelitis, and a miscellaneous group including pneumonia, soft tissue, parameningeal focus and infected V-P shunt. A total of 34 microorganisms were responsible for 25 episodes of infection. 15 and 10 episodes were mono- and polymicrobial, respectively. Isolated microorganisms included 13 aerobic facultative gram-negative bacillus, 5 facultative gram-positive cocci, and 16 anaerobes. Total dosage of lamoxactam administered by patient ranged from 24 to 234 g (mean 57.6 g), and mean duration of therapy was 15.2 days (range 8-42 days). The overall rate of clinical response to lamoxactam was excellent, amounting to 84% of episodes and 91% of patients. Local and general tolerance was good, and lamoxactam had to be discontinued only once during therapy due to an episode of neutropenia. Enterococcal colonization (5 of 26 patients, 19%) and superinfections (3 of 26 cases, 11.5%) were undesirably frequent in our patients. Lamoxactam seems to be an effective and safe single-agent therapy for many bacterial infections. The possibility of enterococcal colonization and superinfections should be monitored, specially in patients with urinary or intraabdominal infections.

Abdomen↗

Gas-liquid chromatography in routine processing of blood cultures for detecting anaerobic bacteraemia.

Gas-liquid chromatography was performed on 233 positive blood cultures and findings were compared with culture results. Obligate anaerobic bacteria were recovered from 78 out of 79 blood cultures containing butyric or iso-valeric acids, or both; from 28 out of 69 blood cultures containing succinic acid; and from only one out of 41 blood cultures containing succinic but not butyric or iso-valeric acid. Good correlations (88%) were found for the recovery of anaerobic bacteria and the detection of butyric and/or iso-valeric acids. Detecting volatile fatty acids by gas-liquid chromatography performed on blood cultures at the first signs of growth can therefore provide an early and reliable indication of the presence of anaerobic bacteria.

Anaerobiosis↗