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Biomedical subjects

P Sfikakis

Publications and source records attributed to P Sfikakis.

At least 37 records · Page 2Linked to original sources
PubMed1989

Pefloxacin versus ceftazidime in the treatment of a variety of gram-negative-bacterial infections.

In a prospective open randomized trial, pefloxacin was given to 53 patients and ceftazidime was given to 50 patients suffering from bronchopneumonia (n = 29), deep soft tissue infection (n = 19), urinary tract infection (n = 28), chronic osteomyelitis in exacerbation (n = 15), chronic otitis media in exacerbation (n = 3), malignant external otitis (n = 3), abdominal abscess (n = 2), septic arthritis (n = 1), acute cholangitis (n = 1), bacterial endocarditis (n = 1), and subacute sinusitis (n = 1). Underlying aggravating factors coexisted in 45 and 41 patients in the pefloxacin and ceftazidime groups, respectively, with 32 and 33 infections characterized as nosocomial and severe in each group, respectively. Pefloxacin was given at a dose of 400 mg intravenously (i.v.) (n = 16) or per os (n = 23) every 8 or 12 h, as well as i.v. followed by per os (n = 14), for 7 to 180 days; and ceftazidime was given at 2 g i.v. every 8 h (n = 45) or 1 g intramuscularly every 8 h (n = 5) for 7 to 56 days. Pseudomonas aeruginosa and various members of the family Enterobacteriaceae predominated in culture specimens. Clinical cure was observed in 38 and 39 patients given pefloxacin and ceftazidime, respectively; 10 and 7 patients were improved; and in 5 and 4 patients treatment failed. Pathogen eradication was observed in 42 and 39 patients, respectively; persistence was observed in 8 and ll patients, respectively, followed by the emergence of resistance in five and four P. aeruginosa strains, respectively (P = not significant). With the exception of photosensitivity rash in seven patients given pefloxacin, all side effects observed in eight and three patients in the pefloxacin and ceftazidime groups, respectively (P < 0.01), were not important and were self-limited. It is concluded that pefloxacin is as effective as ceftazidime in moderate to severe gram-negative-bacterial infections, with similar trends toward development of resistance during therapy.

Administration, Oral↗
PubMed1988

The treatment of gynaecological and intra-abdominal infections: a comparative study of cefotetan versus netilmicin plus clindamycin.

In a prospective randomised study 60 patients with gynaecological or intra-abdominal infections were given either 2g iv every 12 hours of cefotetan or a combination of netilmicin (150mg iv every 12 hours) and clindamycin (600mg iv every 8 hours). The clinical condition of nearly half the patients (26 of 60) was characterized as serious and surgical manipulation and drainage were performed in 57 of the 60 patients. The clinical response was similar in both groups with 21 of 29 patients in the cefotetan group and 29 of 33 patients in the netilmicin plus clindamycin group. Side effects were few and mild in nature with no significant differences between the two groups. This work is continuing but the results to date suggest that cefotetan monotherapy is a safe and effective alternative to a combination of netilmicin and clindamycin in the treatment of gynaecological and intra-abdominal infections.

Abdomen↗
PubMed1986

Evaluation of imipenem/cilastatin against nosocomial infections and multiresistant pathogens.

Thirty-five patients suffering from soft tissue infections (12), upper UTIs (6), bronchopneumonia (6), septicaemia (2), chronic osteomyelitis (2), intra-abdominal abscess (2), liver abscess (1), lung abscess (1), acute cholangitis (1), thoracic empyema (1) and chronic prostatitis (1) were given imipenem/cilastatin for 6-21 days. In 22 patients several aggravating factors coexisted, while infection in 16 patients was polymicrobial. The following pathogens were implicated: Pseudomonas aeruginosa (21), Escherichia coli (15), Enterobacter cloacae (6), Proteus spp. (3), Klebsiella pneumoniae(3), Citrobacter freundii (1), Salmonella enteritidis (1), Acinetobacter spp. (4), Haemophilus influenzae (2), Bacteroides fragilis (1) and Peptococcus saccharolyticus (1) with MICs to imipenem ranging between 0.5 and 8 mg/l. A successful clinical response was observed in 91.4% of the patients, while pathogens were eradicated in 75.9%, persisted in 24.2% and recurred, in 9.1% of patients, with development of resistance to imipenem in two Ps. aeruginosa strains. Against 150 multiresistant strains of Ps. aeruginosa, 40% of which were resistant to amikacin, 86.4% and 88.9% were found sensitive to ceftazidime and imipenem respectively. It is concluded that imipenem provides the possibility of treating successfully multiresistant and polymicrobial infections with a single antimicrobial.

Adult↗
PubMedDate not supplied

Levels of the circulating cell adhesion molecule E-selectin and disease progression in HIV infection.

The levels of soluble form of E-Selectin (sEs), or endothelial-leukocyte adhesion molecule-1, were measured in 96 sera derived from 72 HIV-infected patients at different stages of the disease, 60 healthy blood donors, and 50 HIV-negative patients with infections, using a quantitative ELISA. Levels of sEs in HIV-infected individuals without AIDS, according to the 1993 classification system of the Centers for Disease Control, were higher than normal (mean +/- SEM 48 +/- 4 versus 35 +/- 3 ng/ml, p = 0.003). Patients with established AIDS, who were afebrile and had no evidence of acute concurrent infection, had even higher sEs serum levels (70 +/- 9 ng/ml, p = 0.009, compared to those without AIDS). A significant increase in clinical category disease progression was present. Individual concentrations of sEs correlated directly with levels of soluble intercellular adhesion molecule-1 (p < 0.00001) and IL-2 receptor (p = 0.001), but not with CD4+ T-cell counts. Zidovudine treatment was not associated with changes in sEs serum levels. Elevated sEs levels were also found in HIV-seronegative patients with other bacterial and protozoal infections. Since sEs is a biologically active molecule, further studies should investigate the pathogenetic significance of circulating sEs in HIV-related disease progression, and assess the prognostic value of sEs determination for these patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Metabolic effects of honey (alone or combined with other foods) in type II diabetics.

The metabolic effects of honey - alone or combined with other foods - were investigated in type II diabetics using 2 protocols: A) 33 g honey and 50 g bread (same amounts of carbohydrate) were given on alternate days to 12 patients. Blood levels of glucose, insulin and triglycerides were determined in venous samples before and every 30 min after meal ingestion (for a total of 3h). Areas under glucose curves were equal, although honey - compared to bread - resulted in higher blood sugar concentrations at 30 min (p less than 0.01) and lower at 90 min (p less than 0.05). B) Another 19 type II diabetics consumed on separate days 3 different meals: H (30 g honey), HA (30 g honey, 100 g almonds), HB (30 g honey, 125 g cheese, 10 g bread, 10 g butter). HA and HB contained the same amount of fat, but were different in fiber. No significant differences in the areas under glucose curves were observed. However, meal H produced earlier hyperglycemia than HA and HB (30 min: p less than 0.01). Insulin levels were higher after HB compared to H (p less than 0.05). Meals HA and HB were followed by higher triglyceride levels than H (p less than 0.05). It is concluded that: 1) honey and bread produce similar degrees of hyperglycemia in type II diabetics. 2) Fat-rich foods added to honey do not alter the total hyperglycemic effect but result in higher triglyceride and insulin serum concentrations.

Adult↗