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PubMed1990

[Pneumocystis carinii pneumonia in HIV infections. Committee of the 1st Consensus Conference of anti-infectious therapy organized in May 1990 in Paris by the Société de Pathologie Infectieuse de Langue Française].

At the end of the first consensus conference on anti-infectious therapy organized by the French Language Society of Infectious Pathology in May 1990 and devoted to pneumocystosis in patients with human immunodeficiency virus (HIV) infection, the consensus committee produced this paper which answers the following 4 questions: what are the indications, technical requirements, sensitivity and benefits of induced expectoration in the diagnosis of Pneumocystis carinii pneumonia? what are the initial and secondary severity factors; in which cases is transfer to an intensive care unit indicated; in which manner can treatment be modified? what is the position occupied by corticosteroid therapy in the management of pneumocystosis? when is prophylaxis of pneumocystosis indicated; what prophylactic methods are used and how to choose among them?

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Validity limits of data on secretory IgA].

Secretory IgA (sIgA) in saliva, and sometimes in expectoration, have been titrated in various groups of persons, both in pediatric age and in adults, by means of radial immunodiffusion technic. The aim was to find differences among sIgA levels in the course of respiratory tract infections, both acute and chronic, in consequence of treatment with Erythromycin (in children and in adults) in consequence of surgical intervention (in adults). Adjunctive aim was to establish if it was possible to recognize hereditary of the character that remark the predisposition to produce high sIgA quantities. The very high variability of the data collected in the various occasions and situations allowed serious doubts about the possibility of use of the parameter sIgA in saliva for the evaluations that were assumed as aim of the research. The said high variability was confirmed in a single surely healthy boy, in which sIgA were performed on saliva specimens collected for ten consecutive days, morning and evening, always at the same time (8 a.m. and p.m.). In the attempt to clarify the reason of such a variability, the intervention of psychical solicitation and emotional conditions were ipotized to modify production, mobilization and secretion of IgA generally considered and sIgA particularly.

Acute Disease↗
PubMed1990

[The study on salivary clearance in children. 3. The volume of saliva in the mouth before and after swallowing].

Several kinds of substances such as acids and bacterial toxins diffuse from dental plaque into the salivary film which moves slowly between the plaque on the teeth and oral mucosa. The volume of saliva retained in the mouth before and after swallowing seem to be very important with respect to clearance of such substances from plaque. In 30 subjects, five-year-old children of each gender, the volume of saliva in the mouth after swallowing (X) could be computed by measuring the potassium concentration in unstimulated saliva and in the expectorate after a five-second rinse with 3 ml of water immediately following a swallow. The volume of saliva normally swallowed was calculated from the unstimulated salivary flow rate and the normal swallowing frequency. The volume of saliva before swallowing (Y) was calculated as the total of (X) plus the volume normally swallowed. The unstimulated salivary flow-rate was 0.22 +/- 0.14 ml/min, the mean values of (X) and (Y) were 0.38 +/- 0.11 ml and 0.50 +/- 0.15 ml, respectively, and there were no significant differences in these values based on gender. These values were about half the values of those parameters in adults (Lagerlöf and Dawes, 1985), and insertion in the computer program (Dawes, 1983) of these values suggested that sugar clearance in the five-year-old children would be slightly faster than in adults.

Child, Preschool↗
PubMed1990

[Pharmacosurveillance of antipyretics. Evaluation of the risk-benefit ratio of a combination of paracetamol and sobrerol. Monitoring of 3501 ambulatory patients].

3501 outpatients with fever due to respiratory disorders or eruptive diseases or to other causes were included in a post-marketing surveillance study aimed at extending knowledge of antipyretics and particularly of the paracetamol-sobrerol combination. The antipyretic activity of the drug under test was comparable to that of the reference molecules. Paracetamol-sobrerol combination exerted an extremely valid therapeutic action on cough and difficult expectoration, parameters which usually are associated with the phlogosis and congestion typical for airway infections. As already observed in literature, patients receiving salicylates complained of side effects while patients treated with pyrazolics complained of side effects involving nervous system and cardiovascular apparatus. Side effect incidence in patients treated with the paracetamol-sobrerol combination (3.7%) was significantly lower than that observed in subjects treated with paracetamol (6.1% - P less than 0.01), salicylics (25.1% - P less than 0.001), pyrazolics (12.6% - P less than 0.001), propionics (20.3%, P less than 0.001) or other antipyretics (17.9% - P less than 0.001). These findings demonstrate that the paracetamol-sobrerol combination is a valid therapeutic tool and is particularly suitable in febrile airway pathology. In addition, the low incidence of side effects due to the lower doses of paracetamol, makes this product well tolerated also by at risk subjects such as children and old patients.

Acetaminophen↗
PubMed1990

[Combination of oral bacterial vaccines and antibiotics in acute recurrent respiratory infections].

The authors treated 34 patients with acute bronchopulmonary disease or flare-ups of chronic ones with equal doses of ambroxol and ceftriaxone considering the homogeneity of the morbid processes. Patients were divided into two groups of 17 subjects each: group A was given a polyvalent oral bacterial vaccine, group B a placebo. Relevant differences were found between the experimental and control groups concerning cough (score: A = 108, B = 119), duration of expectoration (A = 5.3 days, B = 6.4 days), duration of antibiotic therapy (A = 8.0 days, B = 8.8 days), and length of hospitalization (A = 10.9 days, B = 12.0 days). Differences were slight as far as duration of fever, characteristics of cough and objective findings on the chest were concerned.

Acute Disease↗
PubMed1990

[Teratoma of the lung: report of 3 cases].

In this paper, 20 cases of teratoma of the lung (3 cases were presented and 17 reviewed) were analyzed. There were 13 males and 7 females, the age ranging from 16-47 years. The primary symptoms were: cough (19 cases, 95%), blood sputum or hemoptysis (16 cases, 80%), chest pain (12 cases, 60%), fever (7 cases, 35%) and expectoration of hair (4 cases, 20%) etc. The histogenesis, diagnosis and treatment of the disease were discussed.

Adult↗
PubMed1990

The history, chemistry and pharmacokinetics of Sanguinaria extract.

Sanguinaria extract is a mixture of benzophenanthridine alkaloids derived from Sanguinaria canadensis L. (bloodroot). This mixture of alkaloids has a long history of use in tinctures and expectorants in pharmaceutical products. The purity of Sanguinaria extract is well defined. The chemistry and biochemistry of these alkaloids, including the dynamic equilibrium between acid and base forms, and pharmacokinetics of Sanguinaria extract shall be presented when this extract is incorporated into a dentifrice or oral rinse formulation.

Alkaloids↗
PubMed1990

Double-blind randomized study of prolonged higher-dose oral amoxycillin in purulent bronchiectasis.

Thirty-eight patients with bronchiectasis and daily expectoration of purulent sputum despite conventional antibiotic courses were randomly allocated to receive a sachet of amoxycillin (3 g) or matched placebo twice daily for 32 weeks in a double-blind study. Nine patients (four amoxycillin, five placebo) were withdrawn from the study treatment; the response of the two patients (both on amoxycillin) withdrawn within the first six weeks was not assessed. The pretreatment characteristics of the two groups were similar. Independent assessment of overall response based on patients' diary cards showed that a higher proportion improved in the amoxycillin group (11 of 17) than in the placebo group (four of 19; p = 0.02). Patients in the amoxycillin group spent significantly less time confined to bed and away from work during treatment. The frequency of exacerbations during the study treatment phase was similar in the two groups but they were less severe than before study treatment in the amoxycillin group. There was a greater reduction in purulent sputum volume between exacerbations during the study treatment in the amoxycillin group to 20 per cent of pretreatment volume than in the placebo group (88 per cent of pretreatment volume, p = 0.008), although the concentrations of Haemophilus spp. in sputum between exacerbations was similar in the two groups. Adverse effects experienced were minor except in one patient (amoxycillin) withdrawn after developing a rash and in six patients (three amoxycillin, three placebo) who had diarrhoea lasting more than one week necessitating withdrawal of two patients (one amoxycillin, one placebo) from study treatment. Sputum and stool cultures collected regularly during the study showed no important changes in the bacterial flora in either group. Prolonged higher-dose antibiotic therapy in these patients with severe purulent bronchiectasis significantly reduced the host (patient) inflammatory response to colonizing microorganisms and reduced morbidity.

Adult↗
PubMed1990

[Broncholithiasis in a case of silicotuberculosis].

Broncholithiasis is usually a late complication of tuberculous lymphadenopathy. Clinical symptoms are not suggestive of the condition in most cases, except for lithoptysis which occurs in 5 to 34% of the patients. Owing to the currently low frequency of tuberculosis, broncholithiasis is a rare and sometimes surprising diagnosis, as in the case reported here. In this 65-year old silicotic man, broncholithiasis was manifested by blood-stained expectoration. Fibroscopy established the diagnosis by showing 2 broncholiths, about 1 cm wide, which were endoscopically extracted. The second peculiarity of this case is that broncholithiasis was associated with active tuberculosis.

Aged↗
PubMed1990

[Methicillin-resistant Staphylococcus aureus (MRSA) infection--significance of MRSA in respiratory tract infection].

We have examined background factors in MRSA infection in cases in which S. aureus had been isolated from sputa. The incidence of isolation of S. aureus was high and still increasing in expectorated sputa, and causative organisms in the cases of pneumonia and autopsied lungs. A significant correlation was observed between high incidence of isolation of S. aureus and abuse of third-generation cephems. MRSA isolation rates of inpatients was higher than that of outpatients. Among the inpatients such cases with severe underlying diseases and prolonged admission showed the highest incidence of isolation of MRSA. There seemed to be a correlation between distribution of patients with S. aureus and that of rooms with S. aureus in the air. This suggests nosocomial infection. Although MRSA was frequently isolated from sputa, most cases showed no signs of infection, and this suggested that they had been transient colonization. Such antimicrobial agents as rifampicin, teicoplanin, vancomycin reveal excellent antibacterial activity against MRSA and minocycline, ofloxacin were moderately effective. The physician must be informed of the significance of MRSA, because their understanding of MRSA still remains insufficient.

Anti-Bacterial Agents↗
PubMed1990

[Preoperative assessment for the risk of postoperative pulmonary complications in patients with esophageal cancer].

Retrospective study was carried out to assess pulmonary complications in 50 patients with esophageal cancer who underwent esophagectomy over the last 5 years. Spirometrical parameters such as V25 and V50/V25, which reflect small air way closure of the lung, were studied preoperatively and compared with the incidence of postoperative expectoration disorders such as atelectasis and/or pneumonia. All patients developed the pulmonary complications after the operation in following conditions: 1) V25 less than 0.3 l/sec and V50/V25 greater than 4 in patients without thoracotomy; 2) V25 less than 1.0 1/sec and V50/V25 greater than 3 in patients with thoracotomy; 3) V25 less than 1.0 l/sec and V50/V25 less than 3 with closed pattern of the V-V curve in patients with thoracotomy. Although the causes of postoperative pulmonary complications are multifactorial, the preoperative values of V25 and V50/V25 are considered to be useful indices to decide the optimal operative procedure and predict the postoperative pulmonary complications.

Adult↗
PubMed1990

[Results of re-thoracotomy for the management of early postoperative complications after bronchoplastic operations].

We reviewed cases of re-thoracotomy performed for early complications after bronchoplastic procedures. One hundred and sixteen bronchoplasties were performed in our department over 20 years. The diseases for which bronchoplasty was undertaken were lung cancer in 102 patients (87.9%), tuberculous stenosis of the bronchus in eight, esophageal cancer in three, and trauma in three. The most frequent postoperative complication was difficulty of expectoration and atelectasis, which generally improved with conservative treatment. Re-thoracotomy was performed for early postoperative intrathoracic complications on 11 patients. The reasons for re-thoracotomy were bronchial anastomotic dehiscence in five cases, obstruction of bronchial anastomosis in two, atelectasis in two, and occlusion of anastomosis of pulmonary arterial angioplasty in two cases. All except two underwent re-thoracotomy within two weeks of the first operations. The operative procedures performed were completion pneumonectomy in six cases, re-bronchoplasty in three, suture of anastomotic dehiscence in two, patch closure of pericardial defect with aspiration of secretions in the atelectatic lobe in one, and partial decortication with suture closure of the alveolar fistula in one. Pedicled omental wrapping was applied to two patients with re-bronchoplasty and one with completion pneumonectomy. Post-operative complications after re-thoracotomy were anastomotic insufficiency in two cases, bronchopleural fistula in two, and pneumonia in one. Two patients underwent a third thoracotomy. There was no anastomotic dehiscence or bronchopleural fistula in the patients with pedicled omental wrapping. One patient died due to bronchopleural fistula within 30 days of re-thoracotomy. Six patients died of recurrence or pneumonia from 39 days to one year after re-thoracotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchi↗
PubMed1990

[Elimination of secretions in CF patients under amiloride inhalation].

Inhaled amiloride reduces active absorption of sodium of respiratory epithelium in CF patients and so, transiently, diminishes loss of water. 10 CF patients, 8 to 28 years of age, were examined on two days. First day, they inhaled in a randomised order isotonic saline and a solution of amiloride hydrochloride (0.3 mg/ml) one after another, each inhalation taking twenty minutes. Second day, inhalations were performed in an inverse order. To intensify the effect of inhalation, the inhalation procedure was combined with "autogenic drainage", a special kind of physiotherapy. Main criterion for evaluation was the amount of expectorated sputum. Mean increase of sputum during amiloride inhalation in comparison to saline was +50.4%. Patients and physiotherapist observed a liquefaction of secretion and a decrease of coughing by amiloride and a support of physiotherapy. These results suggest a beneficial clinical effect of regular amiloride inhalation in CF patients.

Absorption↗
PubMedDate not supplied

Recovery of pituitary-adrenal axis after withdrawal or reduction of systemic corticosteroids in patients with bronchial asthma.

In 36 patients with bronchial asthma a new inhalable corticosteroid (Fluocortin-butyl-ester) was administered to reduce systemic steroids and especially to study the recovery of pituitary-adrenal function. On the basis of the present results, it can be said that patients with the least degree of emphysema and obstruction and with good coughing dynamics and productive expectoration are most suitable for therapy with inhalable corticosteroids. If the systemic steroid reduction is adequate, the recovery phase of the pituitary-adrenocortical system begins after about 5 months and the response to ACTH appraoches normal values after about 8-9 months. About 4 mg prednisolone-equivalent per day can be assumed to be the systemically effective limiting dose. The reducibility as a percentage of the initial dose-regardless of its absolute value- and the maintenance dose achieved also appear to be of equal importance for the recovery of the functional reserve of the pituitary-adrenocortical system. No relationship to the duration of the disease and the initial steroid dose could be demonstrated. The clinical picture of the corticosteroid withdrawal syndrome is dependent on endogenous cortisol synthesis. The symptoms disappear spontaneously with increasing synthesis.

Adrenal Cortex Hormones↗
PubMed1990

[Endobronchial tuberculosis simulating cancer].

Endobronchial tuberculosis may simulate a bronchial neoplasm. It is the data from a bronchial biopsy carried out along with the X-ray and endoscopy examination followed by the bacteriology of the expectorating sputum which enables a diagnosis to be made. This form of diagnosis is known but is rare. The clinical outcome is very good after specific treatment, although the radiological signs and above all the endoscopic findings improve more slowly.

Adult↗
PubMed1990

[Effectiveness of using semiconductor laser in the complex treatment of patients with obstructive forms of chronic nonspecific lung diseases].

Laser puncture (LJ) using semiconductor gallium-arsenide apparatus Uzor (wave-length 890 nm) was made in 30 patients with chronic obstructive diseases of the lungs. The results were compared to the response in acupuncture. The study covered pulmonary volumes pattern, changes in bronchial permeability and partial oxygen pressure in capillary blood. A berotek pharmacological test evaluated LP effect on bronchial adrenoreceptors function. LP was found to promote the benefit of the standard treatment, to improve bronchial permeability, enhance oxygenation of arterial blood, reduce dyspnea and cough, to stimulate expectoration, normalize sleep and appetite. Lower doses or discontinuation of sympathomimetics became feasible.

Acupuncture Therapy↗
PubMed1990

[Human pulmonary ascariasis in Anhui Province: an epidemiological survey].

924 subjects, 542 males and 382 females working in grainstoring, or herb-storing, from different parts of Anhui Province were examined for the possible existence of pulmonary acariasis. 49 cases(5.3%), 31 males and 18 females, were found positive for mites in their sputum. 83.7% of the sufferers aged 16-45. 22 out of the 22 out of the 49 sufferers developed a marked eosinophilia ranging from 4% to 48% and a count of 320-5,050/mm3, whereas X-ray films revealed varied degrees of widening lung hilum shadow with increased and disordered lung markings. In some cases, the chest-film showed a lot of scattered nodular shadows 1-5 mm in diameter in the lung lobes. The symptoms presented were cough, expectoration, depression in the chest, restlessness, low fever, asthma, hemoptysis, etc. 10 species of mites were found in the sputum of the 49 sufferers, i.e. Acarus siro, Tyrophagus putreseltiae, Aleuroglyphus ovatus, Caloglyphus berlesei, C. myoophagus, Dermatophagoides farinae, D. pteronyssinus, Euroglyphus maynei, Tarsonemus granarius, Cheyletus eruditus.

Adolescent↗