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[A case of immotile-dyskinetic cilia syndrome responding to clenbuterol hydrochloride and azithromycin].

In this case, a 30-year-old man had been treated for chronic sinusitis and bronchiectasis since 2000, and presented at our outpatient clinic in May 2001 with chief complaints of massive yellow sputum expectoration and dyspnea. After he was admitted by our hospital, Pseudomonas aeruginosa bacteria were isolated at the rate of 10(8)/ml from his sputum culture. In electron-microscopic observation, the cilia of the bronchial epithelium were found to lack dynein arms. Semen examination revealed decreased sperm motility. Thus, the following diagnosis was made: diffuse bronchiectasis associated with the immotile-dyskinetic cilia syndrome, complicated with a P. aeruginosa infection. After the airway infection was ameliorated, 40 mg/day of clenbuterol hydrochloride was administered in combination with 250 mg of azithromycin, which was given twice a week, and which led to a markedly decreased frequency of exacerbation of airway infection. Moreover, chest CT scanning and respiratory function testing also indicated improvements. It was hypothesized that the decreased cilia motility due to P. aeruginosa-produced pyocyanin would be ameliorated with a b2 stimulant, and the inhibitory effect of a macrolide on the P. aeruginosa biofilm and production of pyocyanin would also be involved in the improvement of this case.

Adult↗

Immunological studies on bronchial secretion. I. Antigenic relationship between bronchial secretion and serum: bronchial secretion constituents detected in human sera.

Rabbit anti-human bronchial secretion serum yielded, by double gel-diffusion, 5 precipitation bands with the homologous antigen. This anti-bronchial secretion serum reacting with 150 human sera (86 from patients with asthma, 17 from patients with tuberculosis, 25 from patients with other diseases and 22 normal sera) showed 1 to 3 precipitation bands in 136 sera, 4 precipitation bands in 13 sera and 5 precipitation lines in 1 serum. Precipitation bands with identity reactions were obtained when the anti-sputum sera reacted simultaneously with human sera and bronchial secretion. Identity reactions were also obtained when the anti-bronchial secretion serum absorbed with normal human sera reacted with bronchial secretion and human sera from six patients and one normal individual. The number of precipitation bands in some sera was not the same after 1 or 2 years. Based on these immunological data, the physiological concept of expectoration, according to which part of the bronchial secretion may be absorbed, was discussed.

Animals↗

Prevalence of acquired MDR-TB and HIV co-infection.

BACKGROUND: Mounting prevalence of primary and acquired multidrug-resistant tuberculosis in India is a sorry reminder of all round failure in our fight against tuberculosis and also of the necessity for new effective strategies. OBJECTIVES: (1) To assess the prevalence and pattern of drug resistant pulmonary tuberculosis among treated patients or on those on treatment without adequate response and (2) to evaluate HIV seropositivity among MDR-TB patients. METHODS: Pulmonary TB patients, who had at least six months of unsuccessful anti-tuberculous treatment were selected for the study. Their sputum specimens were examined for M. tuberculosis culture and drug sensitivity pattern and serological examinations for HIV infection were carried out. RESULTS: Sputum specimens of 618 patients' (61.8%) of a total of 1000 examined had shown culturable M. tuberculosis. Four hundred ninty-five patients (49.5%) were found to expectorate tubercle bacilli resistant to one or more anti TB drugs. MDR-TB was detected in 339 patients (33.9%). HIV seropositivity among MDR-TB was 4.42%. Significantly, 245 patients (24.5%) had tubercle bacilli resistant to one or more reserve drugs too (ethionamide, kanamycin and/or ofloxacin). CONCLUSIONS: Prevalence of MDR-TB was high in the study population. It is essentially an acquired condition. Its association with HIV disease was at present on the lower side, an observation contrary to published western literature. Higher rates of resistance for reserve drugs (ethionamide, kanamycin and/or ofloxacin) in patients who never had these drugs in their earlier treatment schedules suggest the possibility of emerging spontaneous drug resistant mutants.

AIDS-Related Opportunistic Infections↗

[Analysis of flavonoids in the flowers and leaves of Monarda didyma L].

Monarda didyma L. is a herbaceous perennial with the square stems and opposite leaves characteristic of herbs in the Labiate family. Monarda didyma L. is often used as a domestic medicine, being particularly useful in the treatment of digestive disorders. The leaves and flowering stems are antihelmintic, carminative, diuretic, expectorant, febrifuge, rubefacient and stimulant. Monarda didyma L. has twenty-six compounds in the essential oil, of which thymol, with smaller amounts of para-cymene, d-limonene, carvacrol, linalool, and hydrothymoquinone. A new method was used for the determining of the amount of separate flavonols by high-performance liquid chromatography. The flavonoids (rutin, hyperoside, quercitrin, luteolin, quercetin) were found in leaves and flowers of beebalm. The quantity of flavonoids was higher in flowers than in leaves of Monarda didyma L.

Chromatography, High Pressure Liquid↗

[Pharmacologic studies on processed snakegall].

The results showed that the processed snakegall could obviously relieve cough induced by the irritation of ammonia water in mice. It could also increase the secretion of respiratory tract and promote expectoration.

Animals↗

Mucin-producing elements and inflammatory cells.

Airway goblet cells and submucosal glands form the major sources of human respiratory mucins. In the adult, mucus-secreting glands occupy about one-third of the inner airway wall wherever there is supportive cartilage (i.e. from the larynx to small bronchi). In hypersecretory conditions such as chronic bronchitis, asthma and cystic fibrosis, glands are considered to be the major source of tracheobronchial mucus, especially that which is expectorated abnormally as sputum. In contrast, goblet cells are regularly found throughout the tracheobronchial tree. Normally sparse or absent in bronchioles (i.e. small airways of less than 1 mm diameter), goblet cells appear and increase in number in airway hypersecretory conditions: their secretions likely contribute to airflow obstruction and early closure of bronchioles, especially during expiration. The increase in gland mass has been considered to be the histological correlate of mucus-hypersecretion in conditions such as chronic bronchitis. However, there appears to be a better association of sputum production with scores of airway wall inflammation than with gland size per se. Thus, while the absolute mass of mucus-secreting tissue is important, it is likely that the release of inflammatory cell secretions (e.g. neutrophil elastase, mast cell chymotryptase), mediators of inflammation (e.g. interleukin 4, 13) and products of the metabolism of arachidonic acid (such as 15-HETE) contribute more than previously realized to the hypersecretion of mucus in chronic bronchitis. New data discussed herein provide supportive evidence for this hypothesis and identify a newly reported link between plasma cells and mucus-hypersecretion by submucosal glands. These considerations demonstrate the complexity of targets that need to be considered for the treatment of mucus hypersecretion.

Animals↗

[Treatment for multidrug-resistant tuberculosis in Japan].

INTRODUCTION: Multidrug-resistant (MDR) tuberculosis is now refractory against standard chemotherapy for tuberculosis. The curability of medical treatments for it has been up to 50-75%. In Japan several hundreds new MDR tuberculosis cases are supposed to occur every year. This review is the outline of Japanese preliminary guideline of treatment for MDR tuberculosis. DRUG SUSCEPTIBILITY TEST: One of the most important points to manage MDR tuberculosis is the drug usages according to drug susceptibility. Recently some susceptibility tests with liquid media were introduced in our country, but Japanese new standard test of Ogawa method (using absolute concentration with proportion method) is still important from point of true evaluation of susceptibility. MEDICAL CHEMOTHERAPY: In MDR tuberculosis one-half of two-third cases are cured by suitable resume of anti-tuberculosis chemotherapy. If patients would prove to be suffered from MDR tuberculosis, chemotherapy resume must be changed from standard resume to special one, that are made from effective and stronger four or five (at least three) anti-tuberculosis drugs including new quinolons. Those drugs should be changed at the same time, not one by one. Although CPM and Tb1 cannot be available in Japan, but sometimes we have to try administrations of those drugs, beta-lactam antibiotics, interferon. The duration of treatment will be 18-24 months usually. If decreasing of tuberculosis bacilli in sputa is failed under new effective resume through four months treatment, surgical treatment may be indicated. SURGICAL TREATMENT: (1) In Fukujuji Hospital, Japan Anti-Tuberculosis Association, surgical treatments for seventy four cases of MDR tuberculosis were undergone from 1983 to 2001 March. 85 surgical interventions for them were performed in 71 pulmonary resections (pneumonectomy in 20, lobectomy in 44, segmentectomy in 7) for 64 cases, 8 thoracoplasties alone for 8 cases, 5 cavernostomies for 5 cases, 1 phrenic nerve avulsion for 1. The result of pulmonary resections was as follows; early negative conversion rate of tuberculosis expectorations was 97.2%, reexpectoration rate of sputa tuberculosis bacilli was 13.8%, final success rate of pulmonary resections was 91.7%. The factors significantly correlated to reexpectoration of tuberculosis bacilli were preoperative positive bacilli in sputa, few sensitive drugs, other cavitary lesions remained, postoperative prolonged bronchopleural fistula. The result of thoracoplasty alone revealed 75% success rate. In postoperative complications of 85 interventions, there was no operative death, prolonged bronchopleural fistula in 17.6%, respiratory failure in 8.7%, pyothorax in 5.9%. (2) Recently results of surgical treatment for MDR tuberculosis were reported in several literatures. Those success rates were almost same 85-95% as our result. They seemed to be very excellent for refractory cases against vigorous medical treatments. So any surgical treatment for MDR tuberculosis should be indicated more constructively in its earlier course. (3) Indication of surgical treatment is as follows; Main target lesions that should be removed are cavitary ones in pulmonary or pleural foci. And any capsulated localized tuberculosis foci more than 2 cm in diameter is better to be resected because of the possibility of later cavitation. Surgically it is the best that all tuberculosis foci are within a resected lobe, effective drugs remained as many as possible and no cardiopulmonary risks. But even if patient's state are over those criteria, resections of more extended pulmonary foci including in opposite sides can be tried within tolerable cardiopulmonary function. OTHER COMMENTS: Treatment for HIV-positive MDR tuberculosis and protection for nosocomial transmission of MDR tuberculosis are discussed briefly in this article. Preventive therapy for newly infected persons with MDR tuberculosis is controversial. At this time just in MDR tuberculosis cases no preventive therapy, careful following up, and drastic treatment with remained effective drugs after developping of disease will be recommended.

Humans↗

[Substantiation of preclinical manifestations of bronchopulmonary diseases in workers exposed to organic dust].

144 workers of two Ukrainian fodder plants have been examined. Respiratory troubles presenting as cough, expectoration, shortness of breath have come to be the case from not only exposure to high concentrations of endotoxins but from low-level exposures as well. The prevalence of the toxic organic dust syndrome, musocal irritation syndrome, bronchial hyper-reactivity and obstructive changes in the ventilation function of the lungs have been found out to be associated with endotoxin levels in the air of the work environment of the production floor-area. Regarded as valid screenring procedures to early identify those persons predisposed to obstructive changes in the function of external respiration are pharmacological loading tests. Sanitary-and-hygienic and treatment-and-prophylactic measures are proposed to prevent development of occupational diseases in workers exposed to organic dust.

Air Pollutants, Occupational↗

[Seasonal changes in the hemolytic effects of the head of Bellis perennis L].

The drug Bellidis flos is used in therapy as a diuretic and an expectorant agent. Its principal constituents are saponins. The paper examined the haemolytic activity of the drug obtained by the collection of the capitula of Bellis perennis L. in a one month interval (from March to October) in the course of three years. The determination of haemolytic activity was carried out following the method of Pharmacopoea Bohemoslovaca IV. It has been found that the haemolytic activity of the drug changes in dependence on the time of collection of capitula during the year; it is lowest in March, then it increases, reaching the maximum in summer months (June, July, August), and then it decreases again.

Asteraceae↗

Pulmonary manifestations in brucellosis: a report on seven cases from Bikaner (north-west India).

OBJECTIVES: Pulmonary manifestations of Brucellosis are rare. We came across seven patients with predominant symptomatology of pulmonary involvement amongst 98 patients of active brucellosis seen in last four years. MATERIAL AND METHODS: The study is related to patients of brucellosis whose principal presenting features were related to respiratory symptom (cough, expectoration, pain in chest and breathlessness) along with fever and other constitutional symptoms. It included seven patients amongst 98 patients of active brucellosis seen during June 1996 to Feb. 2000 at PBM Hospital Bikaner. Diagnosis was confirmed by demonstration of the raised brucella agglutination titre of 1:320 or more in the serum. All patients were treated with rifampicin 900 mg daily and doxycyclin 100 mg twice daily for six week. The treatment was extended for another four weeks in two patients because of persistence of skiagram abnormalities. RESULT: Three patients had abnormality in skiagram chest in the form of pleural effusion, multiple paranchymal opacities and pneumonia. The skiagram chest was normal in remaining four patients. The response of treatment started with 10-15 days and all the patients became symptom-free at the end of six weeks except one patient. Skiagram chest at this time was normal in patients of pleural effusion but there was persistence of haziness and few opacities in other two patients. Follow up skiagram chest at the end of six months and twelve months was normal in all patients except calcified opacity in one patient. There was no evidence of relapse in any patient at the end of one year follow up. Liver function tests remained within normal range and no drug toxicity was observed. CONCLUSION: Pulmonary manifestations of brucellosis are rare. Treatment with rifampicin and doxycylin showed marked clinical and radiological improvement. All patients were completely disease-free at the end of one year follow up.

Adolescent↗

[The role of mycoses in intrabdominal infections]

In the last few years, there has been a continuous, marked increase in serious mycotic infections, with a high incidence of morbidity and mortality especially among patients undergoing surgery in Intensive Therapy Units. Many risk factors are associated with the development of mycotic infections, amongst which the following may be highlighted: immunosuppression, protracted antibiotic treatment, long NPT, serious trauma, central venous catheterization and, in critical patients, a high APACHE II score. Mycotic peritonitis, an increasingly rare complication found in patients undergoing peritoneal dialysis, seems to be linked to gastric or duodenal perforations treated late (> 24 h) or to secondary, chiefly post-operative peritonitis, in the case of anastomotic dehiscences or fistules, and more generally in surgical patients in unstable conditions, i.e. those with severe acute pancreatitis and cirrhotic imbalances. In the absence of clear clinical signs of mycotic infection, diagnosis is based on the positivity of the culture test carried out in all explorable sites (expectorate, urine, blood, drainage, ascites, intrabdominal sampling), while positivity of haemoculture alone is a real dilemma for the clinician as it may be the result of transitory fungemia or a widespread infection. As yet, there is no reliable diagnostic test, though histopathology, the general signs of sepsis and positive culture in normally sterile sites are used to provide clear indications. Until recently, most patients with intrabdominal infections were not treated with general antimycotics, both because of the relatively low probability of developing a systemic infection and the feared toxicity of amphotericine B. Nowadays, this wait-and-see approach has been discarded, such that high-risk patients are recommended early empirical antimycotic treatment or even prophylaxis. The choice of antimycotic agent, dosage and duration of therapy depends on the aetiologic agent isolated, on the source of infection, renal functionality and associated pathologies. In conclusion, while the incidence of serious mycotic infection has sharply increased, an appropriate therapeutic strategy has not yet been definitively identified, due both to the lack of numerically significant clinical studies and especially the extreme variability and complexity of patients to be treated.

Journal Article↗

[Comparative analysis of the effectiveness and costs of azithromycin and cefoperazone treatment of patients during COPD exacerbation].

UNLABELLED: The effectiveness and costs of azithromycin and cefoperazone treatment of COPD exacerbation have been analysed in this study. Forty patients at the mean age of 65.9 (+/- 11.5) years were enrolled. The subjects were randomly selected and treated either with cefoperazone 2 x 1.0 g i.v. daily (group I = 20 persons) or with azithromycin 1 x 0.5 g (group II = 20 persons), in sequential method. Body temperature, cough intensity, quality and quantity of expectorated sputum, number of breaths per minute and adverse events were recorded daily. The values of pulmonary function tests and leucocytosis were assessed three times during the study. Statistically significant differences between both groups have been found with respect to the mean time of staying in hospital (9.1 days--group I vs 6.1 days--group II), mean total duration of antibiotic therapy (10.1 days--group I vs. 6.6 days--group II) and duration of intravenous antibiotic therapy only [7.5 days (group I) vs 2.9 days (group II)] (p < 0.05). Taking into account the duration of hospitalization, it was shown that the mean total costs of treatment of COPD exacerbation with azithromycin was significantly lower than that of treatment with cefoperazone (2375.9 PLN and 1663.7 PLN, respectively) (p < 0.05). CONCLUSIONS: The effectiveness of treatment with azithromycin in patients with COPD exacerbation was evident. The total costs of treatment of COPD exacerbation with azithromycin is lower than with cefoperazone. Both azithromycin and cefoperazone are safe in the treatment of exacerbation of COPD.

Acute Disease↗

NTP Toxicology and Carcinogenesis Studies of Iodinated Glycerol (Organidin(R).) (CAS No. 5634-39-9) in F344/N Rats and B6C3F1 Mice (Gavage Studies).

Toxicology and carcinogenesis studies of iodinated glycerol (Organidin(R)., a complex mixture prepared by the reaction of iodine with glycerol and found to contain 33% 3-iodo-1,2-propanediol as the major component) were conducted because of human exposure to iodinated glycerol as an expectorant and its possible relationship to the formation of alkyl iodides, e.g., methyl iodide, a suspected animal carcinogen. These studies were conducted by giving iodinated glycerol in water by gavage (5 days per week) to groups of F344/N rats and B6C3F1 mice for 16 days, 13 weeks, or 2 years. Genetic toxicology studies were conducted with iodinated glycerol in Salmonella typhimurium, mouse L5178Y lymphoma cells, Chinese hamster ovary (CHO) cells, and B6C3F1 mice (in vivo bone marrow micronucleus test). Also, 3-iodo-1,2-propanediol was tested in S. typhimurium and B6C3F1 mice (in vivo micronucleus assay). Sixteen-Day and Thirteen-Week Studies: Sixteen-day studies were conducted by giving iodinated glycerol at doses up to 1,000 mg/kg to rats and up to 500 mg/kg to mice. All female rats and 4/5 male mice in the highest dose group died before the end of the studies; there were no dose-related effects on body weights of male or female rats or male mice at the end of the studies. The forestomach of 2/5 female mice that received 500 mg/kg was thickened and granular. Thirteen-week studies were conducted by administering iodinated glycerol at doses up to 500 mg/kg to rats and mice. During these studies, 3/10 female rats and 1/10 female mice that received 500 mg/kg died. Final mean body weights of rats and mice that received 500 mg/kg were 4% lower than those of vehicle controls for males and 6%-7% lower for females. Kidney tubular cell lesions, including cortical necrosis, regeneration, and calcification, were observed at increased incidences in the highest dose group of female rats. Lymphoid hyperplasia of the stomach was observed in dosed male and female rats. Kidney tubular cell regeneration was also observed in dosed female mice. Inflammation or abscesses of mild-to-moderate severity and hyperplasia, acanthosis, and/or hyperkeratosis of mild-to-moderate severity were observed in the forestomach of the highest dosed group of female mice. Body Weight and Survival in the Two-Year Studies: Two-year studies were conducted by administering 0, 125, or 250 mg/kg iodinated glycerol in deionized water by gavage, 5 days per week for 103 weeks, to groups of 50 male F344/N rats and 50 male B6C3F1 mice. Groups of 50 female F344/N rats and 50 female B6C3F1 mice were administered iodinated glycerol on the same schedule at lower doses of 0, 62, or 125 mg/kg because of the increased severity of kidney and stomach lesions in the 13-week studies. Mean body weights of high dose male rats were 5%-10% lower than those of vehicle controls from week 43 to week 68 and 10%-13% lower from week 72 to the end of the studies. Mean body weights of low dose male rats and high dose female rats were 4%-9% lower than those of vehicle controls from week 88 to the end of the studies. The survival of the high dose group of male rats was considerably lower than that of the vehicle controls after week 86. No other significant differences in survival were observed between any groups of rats of either sex (male: vehicle control, 28/50; low dose, 20/50, high dose, 2/50; female: 31/50; 30/50; 27/50). Mean body weights of dosed and vehicle control male mice were similar. Mean body weights of high dose female mice were 6%-8% lower than those of vehicle controls from week 40 to week 64 and were 9%-13% lower thereafter. No significant differences in survival were observed between any groups of mice of either sex (male: 36/50; 40/50; 32/50; female: 40/50; 33/50; 38/50). Nonneoplastic and Neoplastic Effects in the Two-Year Studies: The incidence of mononuclear cell leukemia were increased in dosed male rats (vehicle control, 14/50; low dose, 29/50; high dose, 24/50). Follicular cell carcinomas of the thyroid gland in male rats occurred at an increased incidence in low dose male rats (0/49; s of the thyroid gland in male rats occurred at an increased incidence in low dose male rats (0/49; 5/49; 1/49). Reduced survival of high dose male rats may have been responsible for the decreased tumor incidence in this group relative to that in the low dose group. Follicular cell carcinomas were observed in one low dose and one high dose female rat. Follicular cell carcinomas of the thyroid gland have been observed in 3/293 water gavage vehicle control male F344/N rats and in 10/1,904 untreated control male F344/N rats. Adenomas of the nasal cavity were observed in two high dose male rats. Adenomas of the nasal cavity have not been observed in 300 water gavage vehicle control male F344/N rats or in 1,936 untreated control male F344/N rats. Squamous metaplasia and focal atrophy of the salivary glands were observed at increased incidences in dosed rats (squamous metaplasia--male: 0/48; 47/50; 48/49; female:1/49; 48/50; 49/50; focal atrophy--male: 1/48; 10/50; 30/49; female: 0/49; 4/50; 11/50). In dosed female mice, adenomas of the anterior pituitary gland were increased (10/47; 15/45; 24/46). The incidences of adenomas of the harderian gland in dosed female mice were increased (6/50; 8/40; 13/50). A carcinoma of the harderian gland was observed in another high dose female mouse. Dilatation of the thyroid gland follicle and follicular cell hyperplasia were observed at increased incidences in dosed mice (dilatation--male: 0/48; 28/50; 32/50; female: 4/48; 11/48; 10/48; hyperplasia--male: 3/48; 46/50; 34/50; female: 2/48; 25/48; 35/48). The incidences of follicular cell adenomas were 3/48, 6/50, and 0/50 for males and 2/48, 3/48, and 4/48 for females. Hyperkeratosis and acanthosis of the forestomach were observed at increased incidences in high dose male mice (hyperkeratosis: 0/49; 0/49; 5/50; acanthosis: 0/49; 1/49; 5/50). Squamous cell papillomas were observed in female mice (1/49; 2/50; 5/49). The historical incidence of forestomach squamous cell neoplasms is 4/339 (1.2&percnt;) in water gavage vehicle control female B6C3F1 mice and is 18/1,994 (0.9&percnt;) in untreated control female B6C3F1 mice. Squamous cell neoplasms were not observed in male mice. Genetic Toxicology: Treatment of the base-substitution mutant S. typhimurium strains TA100 and TA1535 with iodinated glycerol in a preincubational protocol with and without S9 resulted in a dose-related increase in the number of revertant colonies; no increase in revertants was observed with the frame-shift mutant strains TA98 or TA1537. 3-Iodo-1,2-propanediol was also mutagenic in TA100 with or without S9; it was not mutagenic in TA98. Iodinated glycerol increased the number of trifluorothymidine-resistant cells in mouse lymphoma L5178Y/TK&plusmn; assay in the absence of exogenous metabolic activation; it was not tested with activation. Iodinated glycerol induced sister chromatid exchanges (SCEs) and chromosomal aberrations in CHO cells without S9; with S9, the frequency of SCEs was increased more than without S9 but no chromosomal aberrations were induced. No increase in micronucleated polychromatic erythrocytes was observed in the bone marrow of B6C3F1 mice after injection with either iodinated glycerol or 3-iodo-1,2-propanediol. Conclusions: Under the conditions of these 2-year gavage studies, there was some evidence of carcinogenic activity for male F344/N rats administered iodinated glycerol, as indicated by increased incidences of mononuclear cell leukemia and follicular cell carcinomas of the thyroid gland. Adenomas of the nasal cavity in two high dose male rats may have been related to the administration of iodinated glycerol. There was no evidence of carcinogenic activity for female F344/N rats administered 62 or 125 mg/kg iodinated glycerol by gavage for 103 weeks. There was no evidence of carcinogenic activity for male B6C3F1 mice administered 125 or 250 mg/kg iodinated glycerol by gavage for 103 weeks. There was some evidence of carcinogenic activity for female B6C3F1 mice administered iodinated glycerol, as indicated by increased incidences of adenomas of the anterior pituitary gland and neoplasms of the harderian gland. Squamous cell papillomas of the forestomach may have been related to the administration of iodinated glycerol. Significant nonneoplastic lesions considered related to exposure of iodinated glycerol were squamous metaplasia and focal atrophy of the salivary gland in male and female rats. Dilatation of the thyroid gland follicle and follicular cell hyperplasia were observed in male and female mice. Synonyms or Trade Names: Organidin&reg;.; iodopropylidene glycerol

Journal Article↗

[The prevalence of respiratory symptomes and immediate hypersensitivity reactions in a population exposed to flour and cereal dust in five flour mills in Morocco].

OBJECTIVE: To evaluate the prevalence of respiratory symptoms, ventilatory function disorder and immediate hypersensitivity reactions in a population exposed to flour and cereal dusts in five flour mills in Morocco. METHODS: The study of 373 exposed and 301 non-exposed subjects consisted of an analysis of working conditions and a medical survey. RESULTS AND CONCLUSION: The prevalence of clinical respiratory symptoms was 64.1% among exposed subjects and 41.2% among non-exposed subjects. Cough, expectoration, rhinitis, conjunctivitis, dermatitis, asthma and chronic bronchitis were more frequent among mill-workers. Spirometry was abnormal in 31.6% of those exposed: anomalies were found in both flow and volume. Among exposed subjects with a ventilatory disorder, 77.9% had only small airways syndrome or a light deficit. Smoking was the cause of excess morbidity. Skin prick tests were positive for at least one allergen in 65.4% of exposed compared to 27.2% non-exposed subjects. The prevalence of positive skin tests to occupational allergens alone was higher among those exposed (42.4%) than among the non-exposed (9.9%). The implementation of adequate medical and technical prevention may reduce this risk.

Adult↗

[Findings of bile duct ultrasonography in 100 patients with AIDS in black Africa].

A systematic study of bile ducts by abdominal echotomography on 100 African patients affected by AIDS disease has showed 11 bile ducts abnormalities (7 alithiasic cholecystitis and 6 inflammatory cholangitis, associated in 2 cases). The patients studies showed several associated infections, particularly a pulmonary tuberculosis and/or extra-pulmonary. The etiology of bile ducts attack has not been formally specified: lack of Cryptosporidium at the stools parasitologic exam, but presence of several opportunistic germs, or no, in the several samples (blood, cerebrospinal fluid, stools, expectoration).

Acquired Immunodeficiency Syndrome↗

[Pulmonary mycobacterioses--frequency of occurrence, clinical spectrum and predisposing factors].

Various types of non-tuberculous mycobacteria can be the aetiologic factors of chronic lung infections especially in patients with underlying chronic lung diseases. The aim of this study is to present the cases of pulmonary mycobacterioses observed in Institute of Tuberculosis and Lung Diseases in the years 1995-2001. There were 23 patients, 12 men and 11 women in the age between 35-77 years, mean 56 years. 16 out of 23 patients had underlying respiratory problems, mainly healed tuberculosis (7) and COPD (6). Two additional patients suffered from other diseases with potential immunosuppression (leukopenia). In 5 patients no disease other than mycobacteriosis was found, but they were chronic smokers. In 19 cases cough and expectoration of purulent sputum lasting from several months to several years was observed. In 5 patients onset of disease was acute or subacute with high fever. Eight patients had haemoptysis. In chest X-ray pathological lesions including (18 cases) lung cirrhosis (10) and cavities (15) were found. In 4 cases disseminated bronchiectases with small nodules were the main radiologic feature. Mycobacteriosis was caused by M. kansasii in 11 cases, by M. intracellularae in 6, by M. xenopi in 5 and by M. scrofulaceum in 1 case.

Adult↗

Etiology of pulmonary infections in predominantly HIV-infected adults with suspected tuberculosis, Botswana.

SETTING: In countries with high HIV rates, diagnosis of lower respiratory disease etiology is both challenging and clinically important. OBJECTIVE: To determine the etiology of lower respiratory tract disease among persons with suspected tuberculosis (TB) and abnormal chest X-rays in a setting with very high HIV seroprevalence. DESIGN: Cross-sectional prevalence data from a prospective cohort of predominantly hospitalized adults with suspected TB in Botswana, January-December 1997. RESULTS: Of 229 patients, 86% were HIV-positive and 71% had a pathogen identified. TB was confirmed in 52%, 17% had acute mycoplasma pneumonia, 3% had Pneumocystis carinii, 27% grew a bacterial pathogen from sputum and 8% from blood. Ninety-four per cent of TB diagnoses were made through expectorated sputum and only 5% of TB cases were diagnosed by sputum induction alone. Polymerase chain reaction (PCR) for Mycobacterium tuberculosis had positive and negative predictive values of 94% and 59%, respectively. Male sex, cough < 2 weeks, and tuberculin skin test > or = 5 mm were independently associated with culture-positive TB among persons with negative acid-fast bacilli smears. Co-infection with two or more pathogens occurred in 25%. CONCLUSIONS: Mycoplasma pneumoniae infection was quite common despite clinical suspicion of TB, and sputum induction and PCR did not significantly improve our ability to diagnose TB, although clinical presentation had some predictive value.

Adult↗

[Respiratory symptoms and pulmonary function in the Italian primary aluminum industry].

The paper reports the results of a longitudinal study of 1478 workers in the primary aluminium industry in Italy (aluminium reduction with the pre-baked anode process) covering the prevalence and incidence of chronic obstructive lung disease, chronic bronchitis and bronchial asthma, and analysis of lung function deterioration over time (annual decline in FEV1) in relation to occupational exposure and individual non-occupational features. The incidence of respiratory symptoms of chronic cough and expectoration was significantly higher among electrolytic shop workers, in whom the annual decline in FEV1 was also significantly greater. In this group the incidence and prevalence of asthmatic manifestations was particularly high compared to casting and workshop workers. Asthmatic symptoms showed a short latency period related to exposure in potrooms and seems to be characterized by a marked deterioration in lung function over time even after withdrawal from exposure.

Adult↗