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PubMed1982

The value of the sputum gram's stain in community-acquired pneumonia.

Expectorated sputum Gram's stain was correlated with clinical presenting data, cultures, serological data, and response to antibiotic therapy in 89 patients admitted with community-acquired pneumonia. The finding of Gram-positive diplococci on Gram's stain correlated with brief antecedent illness, Streptococcus pneumoniae growing from cultures, and a rapid response to single-agent antibiotic therapy. Patients with no predominant pathogen on Gram's stain were clinically indistinguishable from those with Gram-positive diplococci except for a longer antecedent illness, lack of growth of pathogens from cultures, and more prolonged response to antibiotic therapy. Sputum cytological findings and transtracheal cultures were useful in patients with no Gram-positive diplococci on Gram's stain. The sputum Gram's stain is proposed as a sensitive and reliable indicator to guide therapy and predict outcome in adults with community-acquired pneumonia.

Acute Disease↗
PubMed1984

[Clinical aspects and diagnosis of pulmonary edema in pulmonary thromboembolism].

Thirty six patients that died with pulmonary thromboembolism (PTE) were retrospectively followed up, whose diagnosis had been made both by the classical instrumental investigations and by angiopulmography and scintigraphy of the lungs. The diagnosis pulmonary edema in PTE was made on the base of the clinical picture, in which the characteristic pink expectoration was absent. ECG was with signs of acute pulmonary heart. The X-ray of the lungs shows, most frequently, right and diffuse interstitial pulmonary edema.

Cardiac Catheterization↗
PubMedDate not supplied

[Acute fungal pneumopathy caused by Candida and Aspergillus (case report)].

A case is presented, of a patient with acute fungal pneumopathy. The evolution of the disease in this 63 years male was short and rapid, characterized by fever, dyspnea, thoracic pain, muco-purulent expectoration and intense coughing. In spite of the complex treatment applied the patient died with acute cardio-respiratory failure. The radiological examination revealed micro-nodular and nodular opacities extending predominantly in the left lung. Laboratory investigations included a microbiologic study for the Koch bacillus, which was negative. The post-mortem examination revealed multiple focuses with suppurative aspects on a diffuse background of hepatization. The microscopic examination evidenced the presence in the respective focuses of abundant colonies of Candida and Aspergillus, and a hematogenic invasion with Candida and allowed to determine a diagnosis of acute pneumopathy of fungal origin as a result of a double infection with Candida and Aspergillus strains.

Aspergillosis↗
PubMed1983

[Case of primary double lung cancer in the same lobe].

In a 70-year-old male complaining chiefly of cough and expectoration, an abnormal shadow was detected in the left upper lobe by chest X-ray. Therefore, he was admitted for further examination. A tumorous shadow, 5 X 4.5 X 2.5 cm was noted; it corresponded to S1 + 2b on the left side. Left upper lobectomy was performed. Histologic findings of the excised lung were giant cell cancer in the tumorous part, and squamous epithelial cancer at the cut end of the bronchus, i.e. the cut end of the left upper bronchi. This is a rare case with primary double cancer in the same lobe.

Aged↗
PubMed1983

Sfericase, a novel proteolytic enzyme.

Sfericase, a novel protease produced by a strain of Bacillus sphaericus, has endopeptidase activity. Sfericase inhibits various experimental acute inflammations and reduces viscosity of sputum obtained from subacute bronchitic rabbits by oral treatment. A low molecular fraction of serum obtained from animals given oral sfericase also has an anti-inflammatory effect. This result suggests that a secondarily produced substance might play a role in the manifestation of anti-inflammatory action. The toxicity of sfericase is as low as that of other anti-inflammatory enzymes. Sfericase is detected in serum of animals given massive oral dosage, but not at clinical dosage. Clinical studies have been carried out in more than 900 patients. In double-blind studies with serratiopeptidase, sfericase is as useful as the reference drug. Sfericase has been proven effective in some chronic inflammations, such as chronic sinusitis and difficult expectoration associated with bronchopulmonary diseases. Moreover, it has less side effects.

Animals↗
PubMed1984

[Respiratory pathology in occupational medicine: evaluation of 3 methods of data collection and research on risk factors].

Three methods of gathering data of respiratory symptoms (using a self questionnaire, a detailed interview and a shortened interview) were compared in 4.206 construction workers in different branches of their profession. There was non significant difference between the replies given, in either sex, to the self questionnaire and those given in the detailed interview by employees of the research bureau. The comparison between the long and the short interview, carried out on the painters, plumbers, carpenters and brick-layers did not show any difference for those questions asked in the same manner in the two documents. On the other hand the question relating to intrathoracic wheezing, which was more condensed in the shortened interview, did not have the same degree of affirmative replies. The replies concerning cough and expectoration obtained by the two methods enabled a comparison to be made between prevalance of chronic bronchitis in the different occupations. This pathology was most frequently seen amongst bricklayers and painters. Other factors (nationality, age, smoking habits) were also linked to chronic bronchitis. Taking all these factors into account has not weakened the link between chronic bronchitis and occupation.

Adult↗
PubMed1984

[Use of rapid microscopic sputum diagnosis in clinical practice].

A total of 222 unselected expectorated sputum samples obtained from patients with various diseases of the respiratory tract was examined microscopically following the method of Murray and Washington. Based on standardized criteria of evaluation of gram-stained smears direct microscopic examination is a simple and reliable method providing primary information, and can be recommended for bedside diagnostics.

Asthma↗
PubMed1984

Paragonimus heterotremus and other Paragonimus spp. in Thailand: pathogenesis, clinic and treatment.

Six species of Paragonimus have been reported in Thailand: P. siamensis in cat, bandicoot and rat; P. bangkokensis in mongoose; P. harinasutai in cat and dog (experiment); P. macrochis in bandicoot and rat; P. westermani in tiger and P. heterotremus in cat, dog and man. It is interesting to note that in 1965 two immature P. heterotremus worms were recovered for the first time in man, namely in subcutaneous swellings in a boy; in 1981 nine mature P. heterotremus worms were expectorated after praziquantel treatment. P. heterotremus has been postulated to be the main cause of human paragonimiasis in Thailand. The clinical manifestation of paragonimiasis heterotremus is similar to paragonimiasis westermani. In the 1960's and 1970's bithionol was used to treat paragonimiasis, the cure rate was only 50-60%, and side effects including urticaria, rash, abdominal pain, nausea, vomiting, diarrhoea and dizziness were common. In the past 4 years, niclofolan and praziquantel (2-cyclohexyl-carbonyl-1,2,3,6,7,11b-hexahydro - 4H - pyrazino [2,1-a]isoquinolin-4-one, EMBAY 8440, Biltricide) have been used. A single dose of 2 mg/kg body weight of niclofolan yielded 100% cure rate. Praziquantel at dosages of 3 X 25 mg/kg body weight daily for one day and two days gave 80% and 100% cure rates, respectively. The eggs disappeared in 2-3 weeks with improvement of symptoms and signs, but radiologically lesions took a few months or more to clear, depending on size and severity. Side effects in the niclofolan group were higher; in the praziquantel group side effects were minimal and no toxic effects were detected.

Anthelmintics↗
PubMed1984

Respiratory muscle training with the incentive spirometer resistive breathing device.

Utilizing the conceptual scheme of Kim, this study focused on the effect of inspiratory muscle training on the strength of the respiratory muscles, exercise performance, clinical manifestations, and activities of daily living. Unlike previous studies, inspiratory muscle training was performed by the use of an ISRBD that gave alinear inspiratory resistance of 50 cm H2O/L/sec at 1 L/sec flow. Subjects used an ISRBD twice a day for 15 minutes each day for 4 weeks. Strength of respiratory muscles as measured by PImax and sputum expectoration improved significantly (P less than 0.05) but there was no significant change in exercise performance (12-minute walk distance), other clinical signs and symptoms, or activities of daily living. Visual feedback given by the bellows of the ISRBD that inflated and deflated with inspiration and expiration apparently served as a positive reinforcer and motivator for most subjects. Daily logs of clinical signs and symptoms and activities of daily living, along with weekly telephone conferences with each subject, provided comprehensive data and may have contributed to the high compliance rate (98%) in this study.

Activities of Daily Living↗
PubMed1984

[Antibiotic sensitivity of Branhamella catarrhalis isolated from respiratory tract infections].

The efficacy of antibiotics including some newly developed penicillins and cephems on clinically isolated Branhamella catarrhalis was evaluated in vitro. Among 44 strains of B. catarrhalis which were isolated from expectorated sputum of patients with respiratory tract infections 36 strains were proved to produce beta-lactamase. MICs of penicillins for beta-lactamase positive strains ranged from less than or equal to 0.05 to 3.13 micrograms/ml, while those for beta-lactamase negative strains were all less than 0.05 microgram/ml. MICs of cephems, on the other hand, ranged more variably, especially among beta-lactamase positive strains. The most effective cephem we tested was LMOX which could inhibit all the strains of B. catarrhalis at the concentration of 0.05 microgram/ml or less. Aminoglycosides as well as macrolides also showed sufficiently low MIC values. We therefore concluded that the confirmation of beta-lactamase production by B. catarrhalis seems to be indispensable for the determination of an antibacterial activity of beta-lactam antibiotics.

Amoxicillin↗
PubMed1983

Cefoperazone pharmacokinetics and sputum levels after single/multiple i.m. injections in bronchopneumopathic patients and bone, pulmonary and prostatic tissue penetration.

Cefoperazone is a third-generation semisynthetic injectable cephalosporin. It has been reported that cefoperazone has beta-lactamase resistance and quite a broad antimicrobial spectrum against many Gram-positive and Gram-negative microorganisms and most anaerobes. In this study, the pharmacokinetics of cefoperazone were examined in a group of 10 patients suffering from acute exacerbations of chronic bronchitis, with purulent or mucopurulent expectorations. Cefoperazone was administered at the dose of 1 g i.m. every 12 hours. Serum and urinary parameters and the profile of bronchial mucus diffusion were assessed after the first administration and during the whole period of treatment which lasted for 7 days. In a second, third, and fourth group of volunteer patients who had to undergo surgical operations, bone, lung and prostatic penetration of cefoperazone was determined in correlation with serum levels.

Bone and Bones↗
PubMed1983

Pharmacokinetics and sputum levels of josamycin after single and multiple administrations in bronchopneumopathic patients.

Josamycin is a new macrolide antibiotic with low toxicity and effective therapeutic activity in many bacterial diseases, particularly bronchopulmonary infections. In the present study the pharmacokinetics of josamycin were investigated in a group of 10 patients suffering from acute exacerbation of chronic bronchitis, with purulent or mucopurulent expectoration. Patients were given one oral administration of 1 g of josamycin every 12 hours for seven days. Serum, urinary parameters and the profile of bronchial mucus diffusion were assessed after the first and the last administration.

Bronchi↗
PubMed1983

The influence of ketotifen and aminophylline on the central and peripheral airways.

In a double-blind study we compared the effect of 2 mg ketotifen (Zaditen) daily and 1050 mg aminophylline daily for 6 months in two groups of altogether 24 patients with bronchial asthma and a chronic obstruction of the airways. Lung function tests were done in regular intervals to investigate the effects of the drugs on the central airways resistance, thoracic gas volume, forced expiratory volume of the first second and inspiratory vital capacity--and the peripheral airways closing volume, flow of iso and the flow volume curve. Ketotifen reduced the obstruction of the central and of the peripheral airways. Aminophylline showed a less pronounced effect on the obstruction of the central airways and did not influence the peripheral airways. Number and severity of asthmatic attacks, cough, dyspnea and expectoration improved with both drugs. From our results we conclude that ketotifen reduces the obstruction of the central airways and also may exert a direct influence on the small airways. This drug therefore seems to possess special antiasthmatic effects. In contrast aminophylline acts as a rapidly effective bronchodilating agent with no detectable effects on the peripheral airways.

Adult↗
PubMed1978

Paraffin oil pneumonia. Analysis of saturated hydrocarbons in different human tissue.

Temperature-programmed gas chromatographic analysis on columns packed with Apiezon L as stationary phase is shown to be the best method for the qualitative and quantitative analysis of simple and complex hydrocarbon mixtures when compared with all the other applicable techniques (thin-layer chromatography, column chromatography, ultraviolet spectroscopy, infrared spectroscopy, nuclear magnetic resonance spectroscopy, mass spectrometry) described in this paper. Using the method in a patient with mineral oil pneumonia it could be demonstrated that he expectorated a maximum of 79.5 mg liquid paraffin daily and also transported equally complex saturated hydrocarbons in a concentration of 1.3 mg% in plasma and of 1.6 mg% in the cellular blood components. In an additional experiment the direct determination of liquid paraffin resorbed from the gastrointestinal tract was possible in a patient with a left chyle fistula in the neck. After a dose of 50 g liquid paraffin administered as a laxative, 246 ml chyle was collected within the following 14 h which yielded a total of 4.5 mg liquid paraffin. Its composition was identical with the administered laxative. Assuming a daily lymph volume of 1.51, the resorbed amount would correspond to a resorption rate of 0.5 (see article) liquid paraffin. The importance of these results as well as the diagnostic consequences arising from the described analytical technique are discussed in detail.

Adult↗
PubMed1982

A comparative randomized double-blind clinical trial of isoaminile citrate and chlophedianol hydrochloride as antitussive agents.

The efficacy and safety of a new centrally acting antitussive agent, isoaminile citrate, was compared with that of chlophedianol hydrochloride in a double-blind, randomized interpatient study. A total of 66 patients participated, two and four patients were lost to follow-up with isoaminile and chlophedianol, respectively. In the experimentally induced cough in 12 normal human subjects, isoaminile (40 mg) was as effective as chlophedianol (20 mg), but its duration of action was somewhat longer. One subject developed allergic skin rash with chlophedianol and was withdrawn from the study. In 60 patients with cough associated with chest diseases, isoaminile (40 mg, 3 x daily) was as effective as chlophedianol (20 mg, 3 x daily) in suppressing cough as judged from the 3-h and 24-h cough counts. The increase in PEFR at day 7 of treatment was somewhat more marked with chlophedianol as compared with isoaminile. None of the drugs interfered with the expectoration process. The side effects observed were few, mild in nature, and did not require a decrease in dose or withdrawal of treatment in any of the patients. Isoaminile citrate was concluded to be an effective and relatively safe antitussive agent. Isoaminile citrate, alpha(isopropyl)-alpha-(beta-dimethylaminoproyl) phenylacetonitrile citrate, is a centrally acting antitussive agent. In animal experiments this drug was as efficacious as codeine but was devoid of any respiratory depressant effect [Krause 1958, Kuroda et al. 1971]. This controlled double-randomized interpatient study was designed to test the comparative efficacy and safety of isoaminile and chlophedianol, another centrally acting antitussive, in humans.

Acetonitriles↗
PubMed1982

[Complementary studies in acute bronchopulmonary infections except tuberculosis].

Development of a strategy for the investigation of pulmonary infectious disease is aimed at identifying the organism responsible for the infection in order to prescribe the appropriate antibiotic therapy. Factors involved in the choice of a method are the underlying condition (healthy, high risk or immunodepressed subject), the type of infection (primary, secondary), the technical abilities of the medical and bacteriological team and finally the value of the different techniques of isolation. The latter must provide a specimen which is not contaminated by the oropharyngeal flora. Their reliability involves definition of a reference method which can be used to test the other techniques in comparison, and requires comparison of the bacteriological results obtained with clinical and radiological data as well as the results of the resultant therapeutic decision. Indirect methods of investigation (blood cultures, serological studies) are relatively unfruitful. Criteria of value of direct methods of investigation are defined and applied to each method (expectoration, transtracheal aspiration, bronchial fibroscopy, transparietal puncture). On the basis of data in the literature and their own results, the authors undertake an analytical then comparative (in a given patient) study of the different methods, and identify their indications.

Biopsy↗
PubMed1980

[Effect of prolonged peridural anesthesia on the indices of external respiration, lung gas exchange and central hemodynamics after partial lung resections].

The use of prolonged peridural anesthesia in the operation area and the zone of drainage openings during the postoperative period of patients after partial lung resections allows to avoid many complications. The restricting changes of external ventilation were found to decrease and the ablity of the patients to expectorate the sputum contributes to the liquidation of obstructive changes in tracheobronchial pathways, promotes earlier expansion of lungs and early normalization of indices of pulmonary gas exchange and central hemodynamics.

Adult↗