Fluconazole 50 mg daily for 14-28 days was effective in the treatment of patients with AIDS and AIDS-related complex with severe oropharyngeal and oesophageal candidiasis. Of 24 patients entered, 17 (81%), including seven with oesophageal candidiasis, were clinically cured and two (9.5%) improved at the end of treatment. Following clinical cure, 14 patients were entered into the double-blind phase of the study, where fluconazole (150 mg) or placebo capsules were given once weekly. Treatment was double blind. Fluconazole 150 mg once weekly was found to be effective in maintaining patients both clinically and mycologically free of oropharyngeal candidiasis.

AIDS-Related Complex↗

PubMed1990

Botulism.

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Botulism↗

PubMed1990

Acute gastroenteritis in infants under 6 months old.

Sixty two babies under the age of 6 months who were admitted with gastroenteritis completed a study of gradual refeeding compared with abrupt refeeding after a period of rehydration. There was no difference in the incidence of recurrence of diarrhoea due to lactose intolerance, effect on weight, or duration of hospital stay. Twenty six babies (42%) had recurrence of diarrhoea after refeeding, all of whom settled with the introduction of a lactose free soya based formula. Well nourished babies under 6 months of age with mild to moderately severe gastroenteritis can be fed immediately with full strength milk feeds after rehydration. The introduction of a lactose free soya based preparation may provide an alternative to repeated attempts at regrading with cows' milk feeds in those patients with lactose intolerance.

Acute Disease↗

PubMed1990

Successful late treatment of venous air embolism with hyperbaric oxygen.

A case of haemodialysis-associated venous air embolism is described. The patient commenced hyperbaric oxygen therapy 21 hours after the event when, despite appearing decerebrate, he made a complete recovery. This case underlines the importance of all clinicians being aware of those centres with facilities for hyperbaric therapy and the need to refer all patients with cerebral air embolism even following a prolonged delay.

Embolism, Air↗

PubMed1988

Antibiotics carried in general practitioners' emergency bags.

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Anti-Bacterial Agents↗

PubMed1988

Death despite malaria prophylaxis.

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Animals↗

PubMed1988

Does isolation of patients with infections induce mental illness?

Forty-one patients admitted into single-bedded isolation cubicles in an infectious diseases unit were assessed for evidence of mental disturbance. By use of the Crown-Crisp Experimental Index as a measure of mental state, the scores for somatic anxiety, free floating anxiety, and the total score were found to be significantly raised on admission, falling towards those found in a control general practice population by the time of discharge from hospital. Higher scores were associated with a past history of mental illness. There was, however, no statistical correlation between the psychological indices and consumption of alcohol, smoking, or patient's sex. Clinically apparent behavioural disturbance, mainly anxiety and agitation, was seen in 12 patients. Overall, patients expressed a preference for single rooms and did not find the isolation rituals disconcerting. The findings indicate that anxiety in patients with acute infections is more related to their illness and referral to hospital than to their imposed isolation. Only those patients with a past psychiatric history are likely to benefit from transfer to an open ward during convalescence.

Adaptation, Psychological↗

PubMed1988

A double-masked, placebo-controlled trial of acyclovir cream in immunocompetent patients with herpes zoster.

Sixty-four patients with herpes zoster were entered into a randomised double-masked, placebo-controlled trial of 5% acyclovir cream applied five times daily for 5 days. Of these patients, 56 were included in the final analysis (26 acyclovir, 30 placebo). Significant and objective differences in either progression of the rash, severity of acute pain or incidence of post-herpetic neuralgia were not observed. Although significantly more rashes involuted in the acyclovir group, this isolated finding cannot be explained. Twenty-two patients (12 acyclovir, 10 placebo) experienced erythema or desquamation or both during treatment with the cream. The similar incidence of skin reactions in both groups suggests that they were related to the cream base rather than the acyclovir.

Acyclovir↗

PubMed1986

Infection of cardiac mural thrombus associated with left ventricular aneurysm.

Infection is a rare complication of cardiac mural thrombus and may prove difficult to diagnose and treat. We describe a patient with infected thrombus associated with a left ventricular aneurysm, involving Salmonella typhimurium. Cross-sectional echocardiography proved helpful in establishing the diagnosis.

Echocardiography↗

PubMedDate not supplied

Efficacy and effects on pulmonary function tests of weekly 600 mg aerosol pentamidine as prophylaxis against Pneumocystis carinii pneumonia.

A prospective study was designed to evaluate the efficacy and effects on pulmonary function tests of weekly 600 mg aerosolised pentamidine as prophylaxis against Pneumocystis carinii pneumonia (PCP) amongst two groups of patients infected with the human immunodeficiency virus. Group 1 (primary prophylaxis) consisted of patients with either diseases indicative of AIDS other than PCP or whose absolute CD4 positive lymphocyte count was below 200/mm3, and Group 2 (secondary prophylaxis) comprised patients with previous proven episodes of PCP. Fifty-five patients (30-Group 1, 25-Group 2) were studied over a period of 36 months, and no patients reached a study end point of either relapse or death due to PCP after a mean duration of treatment of 14.9 months (range 9-36 months). There were no significant differences between the pulmonary function tests (forced expiratory volume in the first second, forced vital capacity and carbon monoxide diffusion capacity) performed at the start and end of the study on both groups of surviving patients. Ten patients (18%) reported coughing and eight patients (15%) were documented to have bronchoconstriction, which was found to be preventable by prior administration of disodiumcromoglycate. The results showed that weekly 600 mg aerosolised pentamidine is effective and well tolerated for primary and secondary prophylaxis against PCP without additional adverse effects. Further prospective randomized trials are needed to determine whether doses higher than the current recommended 300 mg monthly dosage of aerosolised pentamidine provide more efficacy before such an alternative prophylactic treatment is generally adopted for patients who cannot tolerate other systemic agents.

Administration, Inhalation↗