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J Elo

Publications and source records attributed to J Elo.

At least 19 recordsLinked to original sources

Comparison of the bronchodilating efficacies of a novel salbutamol metered dose powder inhaler and a pressurised metered dose aerosol with a spacer.

In a two-day, randomised, double-blind, double-dummy, cross-over multicenter study, the bronchodilating effect of 100 micrograms of salbutamol (CAS 18559-94-9) inhaled from a new metered dose powder inhaler (MDPI; Taifun) was compared with that of an identical dose of salbutamol inhaled from a conventional pressurised metered dose inhaler connected to a spacer (pMDI + S). Thirty-six non-smoking, adult asthmatic outpatients with a baseline forced expiratory volume in 1 s (FEV1) between 35 and 70% of the predicted value participated in the study. After inhalation of the study medication pulmonary function, FEV1 and airway resistance (R(aw)), blood pressure (BP), and heart rate (HR) were measured up to 6 h. Area under the FEV1 vs. time curve (AUCFEV1) was used as the primary efficacy parameter, and the 90% confidence intervals (CI) were used to judge clinical equivalence. Other efficacy parameters were used in supportive analyses as secondary parameters. Both treatments produced a clear improvement in pulmonary function. The mean +/- SD AUCFEV1 were 893 +/- 281 and 889 +/- 2761.min after MDPI and pMDI + S, respectively. The 90% CI for the relative efficacy of the MDPI is from 98 to 103% of that of the pMDI + S. Also the other efficacy parameters gave similar results without significant differences: the mean +/- SD values of percent increase in FEV1 were 47.2 +/- 19.3 and 44.7 +/- 20.8, the maximum absolute value of FEV1 were 2.87 +/- 0.77 and 2.86 +/- 0.77, the maximum percent decrease in R(aw) 53.2 +/- 20.5 and 55.0 +/- 19.1, and the minimum absolute value of R(aw) 0.27 +/- 0.11 and 0.30 +/- 0.12 kPa.s.l-1 for the MDPI and pMDI + S, respectively. The salbutamol doses had no significant effect on BP or HR, and were equally well tolerated. Furthermore, 57.5% of the patients preferred the MDPI, 35% the pMDI + S, and 7.5% considered that there was no difference between the devices. In conclusion, this study demonstrates that the new MDPI is as effective and safe a device as a conventional pMDI connected to a spacer in administering inhaled salbutamol for asthmatic patients. Further, most patients considered the MDPI easier to handle, and preferred it over the pMDI + S.

Adult↗

Terbutaline controlled-release tablets and ipratropium aerosol in nocturnal asthma.

The effect of oral terbutaline (controlled-release [CR] tablets) was compared with that of inhaled ipratropium bromide (aerosol) in 21 patients with nocturnal asthma. In a randomized, double-blind, crossover study, the patients were treated with terbutaline CR 10 mg twice daily, ipratropium 40 micrograms four times daily, and the two drugs in combination. Each treatment was given for 3 weeks. Before the start of the study, the patients participated in a 1-week run-in period. The mean nocturnal decline in peak expiratory flow rate (PEFR) was 29% in the run-in period and was reduced to 22% in the terbutaline CR period, 27% in the ipratropium period, and 23% in the period with the combination of the two drugs. The mean night PEFR was significantly (P < 0.05) higher in the period with terbutaline CR, as compared with the period with ipratropium. The mean morning PEFR was also highest in the terbutaline CR period. The mean evening PEFR was significantly (P < 0.05) higher during treatment with terbutaline CR alone and with the combination, as compared with treatment with ipratropium alone. Treatment with terbutaline CR alone or the combination was preferred by as many patients as was treatment with ipratropium alone. When present, adverse reactions were judged to be mild or moderate. Treatment with terbutaline CR alone and the combination significantly improved the evening and night PEFR, as compared with treatment with ipratropium alone.

Adult↗

Properties of Escherichia coli isolates from urinary tract infections in boys.

Fifty-five isolates of Escherichia coli from urine of boys younger than three years of age with urinary tract infection (UTI) were compared with strains from girls of the same age range who had UTI. The frequency of P fimbriae, hemolysin, and type 1C fimbriae, previously described as associated with pyelonephritis (PN) in girls, was also high (76%, 60%, and 31%, respectively) in UTI-associated strains from boys. However, in contrast to isolates from girls, strains from lower UTI in boys did not differ from PN-associated strains regarding these three characteristics. In contrast, aerobactin production was significantly associated with PN compared with lower UTI in both sexes. Serotypes O4 and O6 were overrepresented among all UTI-associated strains from boys and PN-associated strains from girls. This overrepresentation was largely accounted for by three clones, one of which was a new clone identified among the UTI-associated strains from boys.

Age Factors↗

Association of P and other fimbriae with clinical pyelonephritis in children.

196 episodes of urinary tract infection in children were analysed. 74 were classified as pyelonephritic (PN), 61 as cystitis (C), and 61 as asymptomatic bacteriuria (ABU) on the basis of three clinical signs (elevated temperature, erythrocyte sedimentation rate, and/or white blood cell count). The frequency of P-fimbriae was found high in PN (77%), and significantly lower in C (23%), ABU (20%) and among fecal strains (16%). The common, type 1 fimbriae were also more frequent in PN (92%) than in the other groups (84-76%), whereas other, so-called X-fimbriae, were relatively rare in all the patient groups (15-6%). P-fimbriation was not significantly associated with the presence or absence of reflux or obstructive anomalies. By contrast, the frequency of P-fimbriation increased with increasing severity of the clinical symptoms of pyelonephritis (95% in episodes of elevated temperature, erythrocyte sedimentation rate and white blood cell count).

Bacteriuria↗

P-fimbriated clones among uropathogenic Escherichia coli strains.

A total of 237 Escherichia coli strains isolated from the urine of patients with various forms of urinary tract infection or from feces of healthy children were analyzed for O group, possession of K1 capsule, type 1 fimbriae, P fimbriae, X adhesin, and production of hemolysin. Some of the strains were also analyzed for K and H antigens, outer membrane protein pattern, and plasmid content. P fimbriation, hemolysin production, and certain O groups were found to be significantly correlated with pyelonephritogenicity. Possession of type 1 fimbriae or of K1 capsule or plasmid content did not significantly correlate with virulence. Outer membrane protein patterns in 139 strains of the more common O groups were analyzed. Only one to three patterns, which varied between serotypes, were usually found within any one O group. Distinctive groups (clones) were found when the strains were grouped according to complete serotype, fimbriation, hemolysin production, and outer membrane protein pattern; also, the mean number of plasmids was typical of the strains in a given clone. Seven clones associated with pyelonephritis were found; together they accounted for 57% of the O serotypable strains from the pyelonephritis patients. The seven clones were P fimbriated but differed in their serotypes as follows: O1:K1:H7, O4:K12:H1, O4:K12:H5, O6:K2:H1, O16:K1:H6, or O18ac:K5:H7. All O1:K1:H7 strains observed fell into two clones according to the presence or absence of type 1 fimbriae and hemolysin production. One clone associated with cystitis was also found; this consisted of O6:K13:H1 strains lacking P fimbriae. Not a single representative of these eight clones was found among the fecal strains from the healthy children. They are proposed to represent virulent clones with special ability to cause human urinary tract infection.

Agglutination Tests↗

Character of urinary tract infections and pyelonephritic renal scarring after antireflux surgery.

We followed 40 girls who had undergone antireflux surgery (the Politano-Leadbetter technique) at the mean age of 5.2 years until they reached a mean age of 9.5 years. Each girl was matched with a control. The pairs were matched for age at the onset of urinary tract infections and time of operation or selection, number as well as grade (1 to 3) of severity of the preoperative episodes and grade (II to IV) of reflux. Followup time for each member of the pair was identical. Postoperatively, the incidence of pyelonephritic urinary tract infection episodes (grade 3) was significantly less (p less than 0.01) among the operated than the nonoperated cases (9 versus 29), while the number of symptomatic lower urinary tract infections (grade 2) was virtually the same (14 versus 19) in both groups. The operated cases had more asymptomatic bacteriuria (26 versus 12 episodes) so that the total numbers of episodes of bacteriuria (grades 1 through 3) were similar in both groups. Antireflux surgery did not prevent the progression of pyelonephritic renal scarring, which continued equally in operated and nonoperated cases.

Child↗

The role of pili in the adhesion of Escherichia coli to human urinary tract epithelial cells.

Pili or fimbriae were purified by a new technique involving solubilization from the bacterial outer membrane by deoxycholate and separation from flagella by 6M urea. This technique was employed to clarify the role of pili for the adherence of urinary tract pathogenic E. coli; a virulence factor in urinary tract infection. The isolated pili formed single bands in SDS gels and were pure by serologic criteria. They retained the binding properties of the whole piliated bacteria, since they bound to uroepithelial cells and agglutinated erythrocytes. Antibodies to purified pili blocked adhesion. The adhesion and hemagglutination reactions by the strains used for pilus purification were mannose-resistant but globotetraos-sensitive, i.e. the strains recognized globoseries glycolipid receptors in the target cells. The occurrence of this property in a freshly collected material of strains was tested using erythrocytes of blood groups P1, P2k and p.

Cross Reactions↗

Effect of beta 2-adrenergic stimulation on serum lipids.

The effect of a beta 2-adrenoceptor agonist, salbutamol, on serum lipids was studied over a 3-month period. Thirteen patients with bronchial asthma were treated with 2 mg salbutamol three times daily (one patient with 4 mg three times daily). The concentrations of serum total cholesterol and LDL-cholesterol were slightly but not statistically significantly higher after 3 months with salbutamol than before the medication. The serum HDL-cholesterol and triglyceride concentrations remained constant during the therapy. Serum free fatty acid levels decreased slightly but not significantly during the therapy. Treatment with salbutamol did not elevate plasma free fatty acid levels, which may have arrhythmic effects. The results indicate that beta 2-adrenergic stimulation has no effect on basal serum lipid levels.

Adrenergic beta-Agonists↗

[Age distribution of urinary tract infections (UTIs) and their severity grade in children (author's transl)].

Urinary tract infections in 339 children (77 boys and 262 girls) have been followed up. An excretory urography and a urethrocystography were done for all the children. The frequency of functional and anatomical abnormalities is given. The severity grade of UTI was determined according to the classification of Elo and Stenström. Almost all episodes of UTI among boys occurred during the first three years of life and were mostly severe. After the 3rd year of life the occurrence of UTI among the boys was sporadic. Among the girls the severe episodes dominates during the first three years of life, but after that the episodes tended to become milder in character becoming mostly asymptomatic. The peak of asymptomatic episodes among girls was at 10 years of age. After that age the number of episodes dropped abruptly. The classification used, based on the erythrocyte sedimentation rate (ESR) and on white blood cell count (WBC), has shown to be useful and makes it possible to differentiate between renal (pyelonephritic) episodes and the lower tract episodes.

Age Factors↗

Tobramycin-clindamycin versus cephalothin-cephalexin in the treatment of appendicular peritonitis.

Forty-seven children, ages 1 to 14 years, with appendicular peritonitis were randomly divided into two groups: 27 were treated with the combination tobramycin-clindamycin and 20 with cephalothin followed by cephalexin. The overall rate of complications was 32%. Patients who had had their symptoms for less than 48 hours before being admitted to hospital had significantly fewer complications than those whose symptoms had lasted longer. Patients treated with tobramycin-clindamycin had significantly fewer wound infections. As clindamycin is effective against anaerobes this observation supports the view that anaerobes play an important role in the infectious complications in peritonitis. In this series, 12 species of aerobes and eight species of anaerobes were cultured from peritoneal fluid. In eight patients only one species was isolated; in the remaining 39 patients 29 different combinations of bacteria were encountered. Early diagnosis and administration of antibiotics preoperatively or during surgery, including clindamycin, metronidazol or tinidazol is recommended in the treatment of children with appendicular peritonitis.

Adolescent↗