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PubMedDate not supplied

[Effectiveness of treatment with rifampicin and isoniazid in association with ethambutol or prothionamide in patients with recently detected pulmonary tuberculosis].

In newly discovered patients with cavitary forms of pulmonary tuberculosis treatment with rifampicin, in association with other drugs, leads to recovery (negativation) in 69,6 percent of the patients in 3 months, in 92 per cent after 6 months and in 94,6 percent after 9 months of treatment. Closure of cavities is found in 23,4 percent, 64,5 percent and 76,6 percent of all patients at the corresponding time intervals. Comparisons of the various regimens of chemotherapy which include rifampicin showed that the maximal efficiency was obtained with rifampicin, ioniazid and a third drug (either etambutol or protionamide). The time intervals for the disappearence of bacilli and for the closure of cavities depend to a great extent on the degree of development of the pathological process, on the type of the lesions and the intensity of bacilli elimination at the start of the treatment. The use of rifampicin in new patients, in association with other drugs, leads to a rapid negativation, a shortening of the time necessary for the closure of cavities, especially in patients in whom the disappearence of the bacilli from the sputum occurs in the first three months.

Adult↗

PubMed1988

[The use of sentinel animals for the evaluation of the control of vectors of sleeping sickness: preliminary reports at a Congolese site].

A large-scale control trial against Glossina palpalis palpalis was carried out in the Congo using a new trapping technique. In the same way a test related to the experimental utilization of sentinel animals was performed, concurrently to the classical epidemiological and entomological evaluation. 564 domestic animals (pigs, sheep, goats) were examined parasitologically (wet blood films, Woo/HCT) and serologically (Testryps CATT) in six villages. When a drastic reduction of tsetse populations was achieved (i.e. zero point of apparent density) a parasitological negativation was first noted after one year and a complete serological negativation was observed after two years. If only a relative decrease in the vector's apparent densities occurred, it was related with a lower of sero-parasitological prevalence rate. The use of a serological test which was able to detect Trypanosoma congolense antibodies as the Testryp CATT, is a particularly useful technique for estimating the animal transmission level. These first results give some arguments that a parasitological and serological continuous of sentinel animals as pigs and sheep is a useful mean for evaluating the efficiency of a control campaign against sleeping sickness vectors.

Animals↗

PubMedDate not supplied

[Treatment of typhoid fever with chloramphenicol or ampicillin combined with oxyphenbutazone].

Ninety-four patients with typhoid fever were treated, at random, with three therapeutic regimens: chloramphenicol alone, chloramphenicol plus oxyphenbutazone, and ampicillin plus oxyphenbutazone. The results are evaluated analyzing the body temperature graph and by serial blood had bone marrow cultures taken at intervals until they became negative. Bacteriologic diagnosis was confirmed by blood culture (39.3%) and/or bone marrow culture (77%). The mean duration of fever was 3.3 days for the group treated with chloramphenicol-oxyphenbutazone, 4.3 for those with chloramphenicol alone and 5 days for the group ampicillin-oxyphenbutazone; at the same time, blood cultures became negative at 4.4, 5.5 and 4.4 days respectively. Negativization of bone marrow cultures was not influenced by the addition of oxyphenbutazone. It is concluded that the influence of oxyphenbutazone in shortening the febrile period or in the negativization of blood cultures is not significant. It is considered that oxyphenbutazone is not an important therapeutic tool in this group of diseases.

Administration, Oral↗

PubMed1981

[Diarrhea in young calves. 4. Redox potential of the gastrointestinal tract of clinically healthy calves, and calves with spontaneous diarrhea, experimental Escherichia coli infection, and cyclophosphamide treatment].

The redox potential (ROP) dropped strongly in a calf, from two hours after birth to 48 hours of age. The drop in the colon was more strongly pronounced than that in the small intestine. -The Eh values recorded throughout the small intestine of clinically intact calves, aged between four and ten days, were more negative than those in the stomach. The most negative ROP values, which differed with significance from those of all proximal gastro-intestinal sections, were recorded from the caecum. -Intracolonic negativation of ROP in calves, during the first hours of life, must be attributed to progressing germ population. The same relationship is borne out clearly by a pronounced rise in anaerobic germ count accompanied by significant ROP negativation in the colon. -Growing age was accompanied by drastic change in ROP values throughout the gastro-intestinal tract. Calves aged between six and nine weeks were compared to animals aged between four and ten days. ROP values in stomach, proximal and distal jejunum as well as in the ileum of the former group were negative with significance, whereas ROP values in the caecum and colon of the same group were more positive. -Animals with diarrhoea exhibited significant ROP deviations only in the ileum. They were more negative, as compared to clinically intact calves aged between four and ten days. Pathophysiological intestinal disorders which could be measured via ROP were found to play no role at all in the genesis and course of diarrhoea of calf. -No pronounced gastro-intestinal ROP deviations were exhibited by calves with experimentally induced Escherichia coli infection and manifest coli dysentery nor by animals which received cyclophosphamide treatment.

Animals↗

PubMed1980

Factors influencing the effects of the initial phase of tuberculosis chemotherapy.

Two groups of patients suffering from extensive pulmonary tuberculosis treated with daily or twice-weekly regimens of isoniazid (INH) plus rifampicin (RMP) plus ethambutol (EMB) were formed by random selection. The effectiveness of treatment was expressed by the slope of regression line calculated for each patient in terms of quantitative time dependent decrease of mycobacteria isolated by culture per 1 ml of sputum. Chemically serum concentrations of drugs in five time intervals following simultaneous administration were established. It was shown that the rate of decrease of mycobacteria did not significantly vary in the compared groups. Negativity was reached in 48 day on the average. The mean regression line with double standard deviation allocated patients with rapid, normal or slow sputum conversion. Rapid convertors were the youngest, excreted largest amounts of mycobacteria before the start of treatment, and their x-ray showed predominantly changes of exudative character. Slow convertors excreted least amounts of mycobacteria. In the group of slow convetors with daily regimen was significantly higher number of rapid INH inactivators compared with groups of rapid and normal convertors. Analysis of multiple correlation and variance of the ratio of mycobacterial decrease rate and of the parameters of the biological availability of drugs as expressed by the area under the curve of drug serum levels reveal the rate of mycobacterial decrease to be dependent always on the drug out of the combination. In daily regimen the decrease rate was controlled by INH, in the intermittent regimen by RMP. The speed of negativization could therefore be increased in daily regimen by increased doses of INH, chiefly in rapid INH inactivators. The most important share of RMP in the mycobacterial decrease rate during intermittent administration can be judged from dependence of biological availability on the dose of RMP. Under the experimental circumstances of this study the pharmacological means for speeding up negativization were best utilized. Further shortening of time necessary for obtaining negativity would be practicable only when residual factors are involved presumably existing beyond the region of pathogen and drug relationship.

Adult↗

PubMed1995

[Congenital Chagas disease in the city of Santa Fé. Diagnosis and treatment].

We studied 6123 pregnant women and their 341 newborn (NB), from Santa Fe city, by the following serological tests for chagasic infection: Direct Agglutination with and without 2-mercaptoethanol, Indirect Hemagglutination and Indirect Immunofluorescence test, and by identification of parasites by Fresh drops, Strout and/or by Xenodiagnosis. The prevalence of seropositivity found in pregnant women was of 14.62% with a 73% of migratory history. The parasitological studies yielded 9/341 incidence of transplacentary infection. Clinical examinations were made in the infected newborn (NB). They were treated with Benznidazol or Nifurtimox, and post-treatment evolution was evaluated. We registered connatal infection in twin-brothers. Brothers/sisters (siblings) of infected NB were also studied. Some of them were seropositive and the others seronegative. Results here obtained show that this way of transmission is important, and should be considered even in low endemicity areas. The parasitological assays proved to be decisive for the NB infection diagnosis (Table 1). The serological assays enabled us to follow the non-infected NB up to their negativization. A 6 month follow-up is recommended. It is impossible to define only one clinical outline because both symptomatic and asymptomatic infected NB may be found with gestational age at term and pre-term and when born with a weight above or below 2000 g. We obtained parasitological and serological negativization in all cases. The chagasic pregnant woman does not necessarily transmit the infection to all her descendents. Only 2.64% are infected. It is possible to systematize the diagnosis without extra resources beyond the usual ones.

Animals↗

PubMedDate not supplied

[Acute catatonia and neuroleptic malignant syndrome. A case of infantile psychosis].

Similar clinical and biological features in lethal catatonia (LC) and neuroleptic malignant syndrome (NMS) suggest a relationship between both affections and common physiopathologic mechanisms. Pharmacological effects of several drugs--dopaminergic agonists, benzodiazepines, carbamazepine--suggest an impairment of several systems of neurotransmitters. We report the case of a young woman with infantile psychosis who developed catatonic syndrome worsened by neuroleptic treatment, arising the problem of the chronology of both affections. The evolution with treatment may partially explain the physiopathology. A 18-year old woman with an history of infantile psychosis, experienced insomnia, anorexia, paradoxical agitation developed after affective traumatism (mother's hospitalization). Chlorazepate (150 mg) remained inefficient and hospitalization was necessary. The patient was dumb, prostate in bed. She presented negativism, rigidity of the four limbs, catalepsia and hyperpyrexia (38.5 degrees C). Hepatic transaminases were increased (SGOT: 71 UI/l; N < 30). After cumulated dose of levomepromazine (100 mg) profuse sudation, thermic and cardiovascular instability, alteration of consciousness, major rigidity of limbs appeared. (Blood) hepatic transaminases and muscular enzymes increased. Bacteriological samples, cerebrospinal fluid analysis, CT-scan and EEG were normal. Within 48 hours after rehydratation and bromocriptine (30 mg per day) alteration of consciousness and autonomic disorders decreased but hyperpyrexia (38 degrees C) persisted. Biological parameters were normalized 10 days later. Negativism and psychomotor inertia remained. Lorazepam (3 mg per day) failed to be clinically beneficial. On carbamazepine (600 mg per day) she started speaking and moving spontaneously. Catalepsia disappeared but rigidity and anorexia persisted. Electroconvulsivotherapy (ECT) was necessary. After 2 shocks she started standing up, walking, taking food and speaking fluently.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1994

Treatment of experimental endocarditis caused by penicillin-resistant Streptococcus sanguis with different doses of teicoplanin.

Streptococcus viridans continues to be the most frequent causal agent of infective endocarditis. Treatment has become more complicated due to the increase in resistance to penicillin and cephalosporins. In order to study the possible efficacy of teicoplanin at low and high doses, this antibiotic was investigated in rabbits as a monotherapy and in association with gentamicin. The effects were compared with a control group and a group given classical penicillin-gentamicin treatment. Infective endocarditis was induced in 120 rabbits with a clinical isolate of Streptococcus sanguis. Treatment was started 48 h after infection, and lasted 5 days. Animals were divided into 6 groups of 20 rabbits each: G1, untreated controls; G2, penicillin+gentamicin; G3 low-dose teicoplanin; G4, low-dose teicoplanin+gentamicin; G5, high-dose teicoplanin; and G6, high-dose teicoplanin+gentamicin. Response to therapy was evaluated with mortality curves, negativization of blood cultures, concentration of S. sanguis in aortic vegetations and rate of sterilization of vegetations. Vegetation weight was significantly lower in treated groups than in controls; lower weights were found in G4, the only treatment that sterilized 65% of vegetations. Death occurred only in the control group (10% mortality). Negativization of blood cultures was greatest and most rapid in G4, followed by G6. Concentrations of S. sanguis in aortic vegetations were significantly lower in all treated groups compared with controls, with the lowest being in groups G4 and G6. Combined treatment with teicoplanin+gentamicin may be highly efficacious in patients with endocarditis caused by penicillin-resistant Streptococcus sanguis. High-dose teicoplanin+gentamicin does not seem to be more efficacious than low-dose teicoplanin+gentamicin.

Animals↗

PubMed1993

[Treatment with vancomycin of experimental endocarditis caused by Streptococcus sanguis II resistant to penicillin].

BACKGROUND: Streptococcus viridans continues to be the most frequent causal agent of infective endocarditis. Treatment has become more complicated due to the increase in resistance to penicillin and cephalosporins. In order to study the possible efficacy of vancomycin, this antibiotic was investigated in rabbits as a monotherapy and in association with gentamicin. The effects were compared with a control group and a group given classical penicillin-gentamicin treatment. MATERIAL AND METHODS: Minimum inhibitory concentration, minimum bactericidal concentration, lethality curves and synergism were determined against Streptococcus sanguis II. Infective endocarditis was induced in 80 rabbits, which were infected via catheter. Treatment was started 48 hours after infection, and lasted 5 days. The animals were divided into 4 groups of 20 rabbits each: 1, untreated controls; 2, penicillin-gentamicin; 3, vancomycin; 4, vancomycin-gentamicin. Response to therapy was evaluated with mortality curves, negativization of blood cultures, concentration of Streptococcus sanguis II in aortic vegetations, rate of sterilization of vegetations, body weight and serum bactericidal capacity. RESULTS: Vegetations weight was significantly lower in treated groups than in controls; lower weights were found in groups 2 and 4. The lowest vegetation weight was recorded in group 4, the only treatment that sterilized 75% of vegetations. Death occurred only in the control group (10%). Negativization of blood cultures was greatest and most rapid in group 4. Serum bactericidal capacity was greater after the two combined treatments, and highest in group 4. CONCLUSIONS: Combined treatment with vancomycin-gentamicin may be highly efficacious in patients with endocarditis caused by penicillin-resistant Streptococcus viridans.

Animals↗

PubMed1995

[Pre S1 antigen in different forms of hepatitis B virus infection].

Pre S1 antigen was measured using an ELISA technique in patients with different forms of hepatitis B virus infection. It was detected in 10 of 19 patients with acute hepatitis B (53%), 12 of 15 chronic hepatitis B virus carriers (80%), 9 of 11 patients with chronic hepatitis B (82%) and 3 of 4 patients with hepatoma and positive markers of hepatitis B virus infection. Pre S1 remained positive beyond 150 days in two patients with acute hepatitis that evolved to chronicity. Among subjects with chronic hepatitis B that received interferon, pre S1 antigen negativized only in the patient that had a complete response. Pre S1 detection is an index of hepatitis B virus replication and its persistence determines chronicity. Its negativization after antiviral therapy should have a predictive value.

Acute Disease↗

PubMedDate not supplied

[An analysis of syphilis morbidity depending on the time of the incubation period and the negative serological reaction].

The article analyses findings from cases syphilis treated at the clinic of the chair of dermatovenereology of the Ukrainian State Medical University in Kiev. It is shown that lengths of negativation of seroreaction during the course of treatment as well as in the course of negativation of seroreaction while treating syphilis patients depend on duration of the incubation period.

Adult↗

PubMed1997

[Complete response to IFN in a case of typical HBV cirrhosis].

A rare case of "wild-type" HBV cirrhosis (CHIL A/HBeAG+/HBV-DNA+) with complete response to IFN treatment after 3 successive series based on different types of IFN is reported. In this patient, HBeAg and HBV-DNA negativization after the second treatment with r-alpha-2b-IFN was observed and after the third treatment with lymphoblastoid-IFN HBcAb,-IgM negativization simultaneously with ALT persistent normalization. Over one year after the interruption of the last treatment, HBV clearance with HBsAg elimination and HBsAb, seroconversion was observed. The effectiveness of IFN was histologically confirmed with decrease of the piecemeal necrosis in the liver and presence of light fibrosis whereas the results of 3 previous histological evaluations showed: 1) CPH (1985); 2) CAH lightly active with initial signs of cirrhotic evolution (1988); 3) CAH with presence of nodular cirrhosis in the liver (1991). In particularly selected cases the possibility of a favourable response to the series of IFN treatment is stresses even in more advanced chronic "wild" HBV forms in which there is not evidence of mutants in the viral population.

Antiviral Agents↗

PubMedDate not supplied

[Yield of xenodiagnosis and PCR in the evaluation of specific chemotherapy of Chagas' disease in children].

Amplification by the polymerase chain reaction (PCR) of Trypanosoma cruzi kinetoplastic DNA was used to enhance sensitivity in the detection of the parasite in blood, with the ultimate goal of improving the parasitological diagnosis of Chagas' disease in 0-10 year-old infected children. Twenty eight children were evaluated by using xenodiagnosis (XD) and PCR. Whereas XD detected 75.0% of the cases PCR was positive in 96.8%. The usefulness of the PCR was further investigated in the 28 children who have received specific treatment with nifurtimox. Negativation of XD after three and six months post treatment was observed in all the cases, but only 21.4% and 35.8% negativation of the PCR after three and six months post treatment respectively. These observations suggest that PCR is the most sensitive and quick technique available for direct detection of T. cruzi in chagasic children and that it can be a very useful tool for the follow-up of infected subjects after specific chemotherapeutical treatment.

Chagas Disease↗

PubMed1999

Contribution of psychosis and depression to behavioral disturbances in geropsychiatric inpatients with dementia.

BACKGROUND: Specific behavioral disturbances in dementia may be associated with underlying disorders such as the presence of psychosis and depression. The objective of this study was to examine the association of depression and psychosis with behavioral disturbances in geropsychiatric inpatients with dementia. METHODS: All admissions between October 1993 and May 1995 were reviewed to identify those patients admitted to the Houston Veterans Affairs Geropsychiatry Unit with a diagnosis of dementia; 208 patients were included in the study. Hierarchical regression models were constructed to explore the contribution of depressive and psychotic symptoms, and depression and psychosis diagnoses to Cohen-Mansfield Agitation Inventory (CMAI) scores. RESULTS: Both depression and psychotic symptoms were significantly and positively correlated with behavioral disturbances. Psychotic symptoms were associated with aggressive behavioral symptoms, and depressive symptoms were associated with constant requests for help, complaining, and negativism. Dementia severity accounted for significant variance in CMAI scores and was positively associated with behavioral disturbance; though disorder symptoms accounted for more behavioral disturbance variance than did depressive symptoms. CONCLUSIONS: Both depressive and psychotic symptoms were associated with overall behavioral disturbances in patients with dementia. Psychotic symptoms and depressive symptoms were associated with different types of behavioral disturbances. Our findings support the contention that underlying depression or psychosis may partially account for different behavioral disturbances and that not all behavioral disturbances should be globally labeled "agitation." Future studies should address symptom-specific treatment of behaviorally disturbed patients.

Aged↗

PubMed1989

A description of agitation in a nursing home.

Agitation is a significant problem for elderly persons, their families, and their caregivers. This study describes the agitated behaviors of 408 nursing home residents. Nurses who were familiar with the residents used a 7-point scale to rate how often each resident manifested 29 agitated behaviors. Each resident was rated independently by three nurses, one from each of the three nursing shifts. Results showed that agitated behaviors occurred most often during the day shift (i.e., when residents were most active), and least often during the night shift. The most frequently exhibited agitated behaviors were general restlessness, pacing, repetitious sentences, requests for attention, complaining, negativism, and cursing. Most agitated behaviors correlated significantly across shifts, suggesting that such behaviors occur and reoccur throughout the 24-hour day. Factor analysis yielded three syndromes of agitation: aggressive behavior, physically nonaggressive behavior, and verbally agitated behavior. These results provide a foundation for further studies of agitation in elderly persons.

Aged↗

PubMed1988

Role of psychologic and social variables in TMJ pain dysfunction syndrome (PDS) symptoms.

The aim of this study was to measure the relative importance of a number of psychologic and social variables in explaining the severity of symptoms of functional disturbances of the stomatognathic system. 261 non-care seeking patients with respect to pain and dysfunction of the stomatognathic system were examined. The total sample consisted of two subgroups: Group 1 (n = 130) with a complete natural dentition and Group 2 (n = 131) wearing complete maxillary and mandibular dentures. Symptoms of functional disturbances of the stomatognathic system were assessed using two questionnaires. One was derived from the Anamnestic Dysfunction Index and the other was an extended questionnaire which included accessory symptoms frequently mentioned in the literature. The patients also completed the Hopkins Symptom Checklist, the Dutch Personality Inventory, and a Dutch form of the Minnesota Multiphasic Personality Inventory. In both patient subgroups symptoms of functional disturbances of the stomatognathic system were significantly correlated with patient's sex and a complex of highly intercorrelated psychologic variables: psychoneurotic- and somatic symptoms, neuroticism, negativism, and somatization.

Adult↗

PubMed2000

Predeployment personality traits and exposure to trauma as predictors of posttraumatic stress symptoms: a prospective study of former peacekeepers.

OBJECTIVE: The authors' goal was to study the contribution of predeployment personality traits and exposure to traumatic events during deployment to the development of symptoms of posttraumatic stress disorder (PTSD) in individuals involved in military peacekeeping activities. METHOD: Five hundred seventy-two male veterans who participated in the United Nations Protection Force mission in the former Yugoslavia completed a short form of the Dutch MMPI before deployment. Following deployment, they participated in a survey of all Dutch military veterans who had been deployed in the years 1990-1995 and completed the Self-Rating Inventory for PTSD. RESULTS: Exposure to traumatic events during deployment had the highest unique contribution to the prediction of PTSD symptom severity, followed by the personality traits of negativism and psychopathology, followed by age. CONCLUSIONS: Both pretrauma vulnerabilities and exposure to traumatic events were found to be important factors in the etiology of posttraumatic stress symptoms. The current study replicates in a non-American sample of peacekeepers findings obtained among American Vietnam veterans. Particularly, there is accumulating evidence for an etiological role of the personality trait of psychoneuroticism in the development of posttraumatic stress symptoms.

Adolescent↗

PubMed1983

[Psychotherapy of schizophrenia].

Schizophrenic existence is the experience of an awful negativism, which comes from the depth of the Unconscious and appears at the surface of the conscience as the destruction of all positive symbols of life. Interpretations of psychodynamic mechanisms, of transference and countertransference, of dreams and fantasies must be rooted in the dominant therapeutic endeavour of creating with the remaining potentialities of the patient new positive symbols of the schizophrenic existence. The author's experience in the 30 years of his dealing with schizophrenic patients is here summarized.

Fantasy↗