[Pertussis: study of 200 cases in childhood].
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Biomedical subjects
Publications and source records attributed to G Frigerio.
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An unusual case of cholestatic toxic hepatitis observed during the treatment of rheumatoid arthritis with gold salts (colloidal sulphide) is reported. The primarily histological diagnosis was supported by the absence of hepatotoxic drugs and the ruling out of other forms of liver disease. Furthermore, the histological picture fitted that described in the few cases in the international literature.
A double-blind controlled trial was carried out to compare the effects of chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), and placebo on cholesterol and triglyceride levels in patients with endogenous hypertriglyceridemias. The dose of both bile acids was four 150-mg capsules day. Total serum cholesterol levels did not show appreciable changes with any of the treatments. HDL cholesterol was significantly increased after CDCA but not after UDCA or placebo. CDCA feeding was associated with a significant decrease in serum triglyceride levels, whereas the other treatments failed to show an effect. It is concluded that UDCA does not affect serum lipid levels, whereas CDCA lowers serum triglycerides and may be useful in the treatment of endogenous hypertriglyceridemia.
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To document the efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ) in treating bacterial exacerbations of chronic bronchitis, and to evaluate the efficacy of thiamphenicol (TAP), 29 patients with chronic bronchial disease were treated for two separate bacterial exacerbations, once with 0.48 g of TMP and 2.4 g SMZ daily, and once with 1.5 g of TAP daily, for 14 days. Patients were evaluated weekly and different measurements, including graded clinical observations, ventilatory tests, sputum measurements, quantitative bacterial counts and blood studies were performed. Side effects were closely monitored. Of the 29 patients entered, 20 finished the trial and hence 40 exacerbations were evaluated. All graded clinical observations were improved by the antimicrobials, whereas no marked change in the ventilatory tests was seen. Of the sputum measurements the daily volume, purulence, numbers of neutrophils and bronchial epithelial cells decreased, as did the numbers of Haemophilus influenzae and pneumococci. Of the blood studies the red blood cell count fell by more than 20% of the pretreatment value in 2 patients on TAP and 2 on TMP-SMZ. Using the same criterion, the hemoglobin level fell in 4 patients on TAP and in the hemoglobin level fell in 4 patients on TAP and in 2 patients on TAP-SMZ, while the hematocrit fell in 4 patients on TAP and in 1 on TMP-SMZ. However, all these changes were completely reversible. Minor gastrointestinal side effects were observed in 11 patients receiving TAP, compared to 3 patients on TMP-SMZ. 1 patient on the latter drug experienced a rash at the end of therapy. From the viewpoint of overall clinical assessment, 16 patients improved and 4 remained unchanged during therapy with TAP. The corresponding figures for TMP-SMZ were 17 patients improved, 2 the same and 1 worse at the end of therapy. The average relapse time after TAP was 184 days and after TMP-SMZ 180 days. In conclusion, 80% or more of exacerbations were improved by the two drugs. For all the variables measured, no significant differences were statistically detectable between the two antimicrobials, whether given in the sequence TAP first and TMP-SMZ second, or vice versa.
The effect of ursodesoxycholic acid (UDCA) on dyspeptic symptoms and pain in cholelithiasis and biliary dyskinesia has been investigated in a double blind trial. The results obtained in 661 patients investigated after 7 and 14 days of treatment show a significantly superior effect of UDCA compared with placebo.
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A double-blind cross-over trial was carried out to evaluate the antitussive activity of viminol p-hydroxybenzoate; the comparison was done with three preparations: a placebo and the drug at two doses, 70 and 140 mg respectively. The responses were scored hourly up to 4 hours after the administration of single doses in the morning to subjects with persistent cough. The highest dose of viminol showed a definite antitussive activity, whereas the lowest did not differ from the placebo. The antitussive effect appears clinically useful for the treatment of cough, but further studies are indicated to define optimal dosage schedules.
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