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At least 721 records · Page 40Linked to original sources
PubMed1986

[Ceftriaxone in the therapy of infections of the lower respiratory tract: comparison with cefotaxime].

20 patients suffering from severe lower respiratory tract infections were included in the study. 10 patients were given ceftriaxone (1-2 g/day) and the other 10 cefotaxime (2-4 g/day) for a week. The results of microbiological findings and both local and systemic tolerance were found to be similar for both drugs. This indicates that 7-14 g of ceftriaxone and 14-28 g of cefotaxime are equivalent quantities in the treatment of severe respiratory tract infections.

Acute Disease↗
PubMed1999

Upper respiratory tract infection, heterologous immunisation and meningococcal disease.

To test the hypothesis that an episode of upper respiratory tract infection or heterologous immunisation is a predisposing factor for the occurrence of meningococcal disease, data from 377 cases of meningococcal disease and their household contacts (n = 1124) were analysed by conditional logistic regression analysis with stratification for household. The odds ratio for a recent upper respiratory tract infection for patients versus household contacts, adjusted for age and the presence of an underlying predisposing disease, was 2.8 and that for recent heterologous immunisation 1.0. These results support previous observations regarding the association between a preceding upper respiratory tract infection and the occurrence of meningococcal disease; however, no association was found between preceding heterologous immunisation and meningococcal disease. Therefore, increased alertness after heterologous immunisation does not seem warranted.

Adolescent↗
PubMed2006

[Resistance of infectious agents involved in low respiratory tract infections in France].

This review concerning the major lower respiratory tract pathogens in France has for aim to describe the epidemiology of resistance to beta-lactams, macrolides, ketolides, and fluoroquinolones especially in Streptococcus pneumoniae and Haemophilus influenzae. It should also provide new insights on the mechanisms of acquired resistance and the level of resistance conferred, highlighting the related ecological impact. In the context of this XVth consensus conference, this review should contribute to the elaboration of guidelines for the treatment of lower respiratory tract infections in adults.

Anti-Bacterial Agents↗
PubMed2003

Antimicrobial resistance in Haemophilus influenzae and Moraxella catarrhalis respiratory tract isolates: results of the Canadian Respiratory Organism Susceptibility Study, 1997 to 2002.

A total of 7,566 unique patient isolates of Haemophilus influenzae and 2,314 unique patient isolates of Moraxella catarrhalis were collected between October 1997 and June 2002 from 25 medical centers in 9 of the 10 Canadian provinces. Among the 7,566 H. influenzae isolates, 22.5% produced beta-lactamase, while 92.4% of the 2,314 M. catarrhalis isolates produced beta-lactamase. The incidence of beta-lactamase-producing H. influenzae isolates decreased significantly over the 5-year study period, from 24.2% in 1997-1998 to 18.6% in 2001-2002 (P < 0.01). The incidence of beta-lactamase-producing M. catarrhalis isolates did not change over the study period. The overall rates of resistance to amoxicillin and amoxicillin-clavulanate for H. influenzae were 19.3 and 0.1%, respectively. The rank order of cephalosporin activity based on the MICs at which 90% of isolates were inhibited (MIC(90)s) was cefotaxime > cefixime > cefuroxime > cefprozil > cefaclor. On the basis of the MICs, azithromycin was more active than clarithromycin (14-OH clarithromycin was not tested); however, on the basis of the NCCLS breakpoints, resistance rates were 2.1 and 1.6%, respectively. Rates of resistance to other agents were as follows: doxycycline, 1.5%; trimethoprim-sulfamethoxazole, 14.2%; and chloramphenicol, 0.2%. All fluoroquinolones tested, including the investigational fluoroquinolones BMS284756 (garenoxacin) and ABT-492, displayed potent activities against H. influenzae, with MIC(90)s of < or = 0.03 microg/ml. The MIC(90)s of the investigational ketolides telithromycin and ABT-773 were 2 and 4 microg/ml, respectively, and the MIC(90) of the investigational glycylcycline GAR-936 (tigecycline) was 4 microg/ml. Among the M. catarrhalis isolates tested, the resistance rates derived by using the NCCLS breakpoint criteria for H. influenzae were <1% for all antibiotics tested except trimethoprim-sulfamethoxazole (1.5%). In summary, the incidence of beta-lactamase-positive H. influenzae strains in Canada is decreasing (18.6% in 2001-2002), while the incidence of beta-lactamase-positive M. catarrhalis strains has remained constant (90.0% in 2001-2002).

Adolescent↗
PubMedDate not supplied

[Analysis of plasma fibrinogen in evaluating the effectiveness and prognosis of polyradiomodifying therapy of malignant tumors of the upper respiratory tract].

Patients with malignant tumors of the upper respiratory tract showed higher concentrations of fibrinogen in plasma the level of which was correlated with the stage of disease. Measurements of the protein in the course of radiation therapy demonstrated that two months after effective treatment fibrinogen concentrations decreased to normal values and remained at that level throughout the remission time. If radiation therapy was ineffective, fibrinogen concentrations remained high during 2 to 4 months after exposure. Metastases and recurrent tumors caused a drastic increase in the fibrinogen content, the change occasionally occurring prior to clinical manifestations. In view of this, plasma fibrinogen can be recommended as an additional measure that can be used to evaluate therapy effectiveness, to prognose the course of disease and to identify metastases in patients with malignant tumors of the upper respiratory tract.

Brachytherapy↗
PubMed1999

The penetration of ceftibuten into the respiratory tract.

STUDY OBJECTIVE: To determine the penetration of ceftibuten into various respiratory tissues and fluids. DESIGN: Single-dose, open-label, pharmacokinetic study. SETTING: Veterans Administration Medical Center. PATIENTS: Twelve hospitalized men aged 34 to 75 years with a variety of noninfectious pulmonary symptoms/diseases. INTERVENTIONS: Patients received a single oral dose of ceftibuten, 200 mg, prior to undergoing diagnostic fiberoptic bronchoscopy. Plasma samples for the determination of ceftibuten concentrations were collected pretreatment and up to 12 h postdosing. Nasal secretions, tracheal secretions, BAL fluid, and lung tissue from a biopsy were obtained at bronchoscopy from 2 to 7 h postdosing. MEASUREMENTS AND RESULTS: Mean pharmacokinetic parameters for ceftibuten in plasma were the following: maximum observed plasma concentration (Cmax), 8.77 microg/mL; time to reach Cmax, 2.2 h; area under the plasma concentration-time curve extraploated to infinity, 49.21 microg/h/mL; and terminal elimination half-life, 3.17 h. These parameters were similar to those obtained in studies using healthy volunteers. Mean penetration of ceftibuten into nasal, tracheal, and bronchial secretions was 47%, 50%, and 30%, respectively. Mean penetration into BAL fluid was 81%, whereas penetration into lung tissue was 39%. No patient experienced any adverse effects related to ceftibuten. CONCLUSIONS: Ceftibuten penetrates well into various tissues and fluids of the upper and lower respiratory tracts. The results support the activity of ceftibuten in the treatment of upper and lower respiratory tract infections.

Adult↗
PubMed2006

Thrombocytosis in pediatric patients is associated with severe lower respiratory tract inflammation.

BACKGROUND: Secondary thrombocytosis is associated with a variety of clinical conditions. The aim of this study was to determine the incidence and to analyze the clinical significance and prognostic value of thrombocytosis in lower respiratory tract infection. METHODS: A total of 102 pediatric patients were hospitalized with lower respiratory tract infection during a period of 30 months. RESULTS: Forty nine (48%) of those patients had platelet counts >500 x 10(9)/L. The median age of the thrombocytotic patients was 31 months as opposed to 61 months for the non-thrombocytotic ones. The patients with thrombocytosis had more serious illness. This is indicated by three factors: more severe clinical condition on admission, presence of respiratory distress and longer hospitalization. Sedimentation rate >70 mm/h was observed in 44.4% patients of the thrombocytotic group compared to only 27.7% of the non-thrombocytotic ones. Almost all patients with pleural effusion were thrombocytotic. The children with very high platelet counts >650 x 10(9)/L presented with respiratory distress on admission and required longer hospitalization time. No other significant clinical or laboratory differences were demonstrated between these patients and the remainder of the thrombocytotic patients. CONCLUSIONS: Thrombocytosis is a common finding among patients with lower respiratory tract infection. Thrombocytotic patients have a more severe clinical condition. Importantly, thrombocytosis occurs almost exclusively in patients with pleural effusion. The platelet count may be a useful clinical marker associated with the severity of the lower respiratory tract infection.

Blood Platelets↗
PubMedDate not supplied

[In vitro activity of cefetamet compared with other antimicrobial agents against bacteria isolated from respiratory tract infections].

UNLABELLED: Cefetamet pivoxil is a new beta lactamase orally stable administered cephalosporin. Antimicrobial resistance among respiratory pathogens has become an important problem for both the physician and the microbiologist and the patterns of resistance vary greatly depending on geographic location, often requiring in vitro susceptibility testing of isolates. PURPOSE: The in vitro activity of cefetamet, the microbiologically active metabolite of the prodrug cefetamet pivoxil, was compared with other 11 drugs against 376 bacterial strains recently isolated from patients with respiratory tract infections. METHODS: The comparative activity in vitro of cefetamet and other 11 antimicrobial agents was measured against 376 bacterial strains isolated from patients with respiratory tract infections, during a six month period. Through the determination of minimum inhibitory concentration by the microdilution technique, patterns of antimicrobial resistance were reported. RESULTS: Cefetamet showed high in vitro activity against all the bacterial tested, possessing a spectrum of activity similar to that other recently developed oral cephalosporins. The good activity of cefetamet against beta-lactamase producing isolates, like Moraxella catarrhalis, can be due to its beta-lactamase stability. At a concentration of 1.0 microgram/mL, cefetamet inhibited 97% of all the tested bacteria. CONCLUSION: The MIC90 of the cumulative susceptibility results of the 12 antimicrobics tested in the 376 strains studied, confirm the excellent activity of cefetamet against the common respiratory tract pathogens.

Anti-Bacterial Agents↗
PubMed1995

Granular cell tumours of the lower respiratory tract.

Granular cell tumours rarely involve the lower respiratory tract. We report eight cases surgically resected at our institution. There were four females and four males, aged between 18 to 56 years (mean 40). One tumour associated with a peripheral lung adenocarcinoma was asymptomatic. The other lesions presented with obstructive pneumonitis (3 cases), haemoptysis (2), dyspnea (1) or cough (1). These tumours were tracheal (1) or bronchial (6) and one case was located in the lung parenchyma. Four cases were multicentric with associated lesions located in a bronchus (2), the oesophagus (1) or a mediastinal lymph node (1). All tumours, with the largest diameter ranging from 0.5-4.5 cm, were histologically invasive. The tumours were positive for S-100 protein, neuron specific enolase, KP1 (CD68) and vimentin. No tumour expressed desmin, keratin or p53 oncoprotein. Our study demonstrates that, in spite of marked anatomical and clinical polymorphism, the rare granular cell tumours of the lower respiratory tract have a constant histological appearance. Our observations confirm that large tumours (> 8-10 mm) usually extend beyond the tracheo-bronchial cartilages and, therefore, only surgical treatment may avoid recurrence.

Adolescent↗
PubMed1988

Determining the basic characteristics of aerosols suitable for studies of deposition in the respiratory tract.

Studies of aerosol particle deposition in the respiratory tract requires experimental inhalation of artificial model aerosols. The paper formulates some of the most important requirements for the properties of such aerosols. Several suitable fractions were prepared as part of a research project dealing with the use of microporous polymers for diagnostic purposes. 5 fractions of the polymer designated G-gel 60 with the particle size as stated by the manufacturer, ranging from 3 to 7 micron were evaluated using a 16-channel particle dispersity analyzer HIAC/ROYCO MT 3210 with the sensor 1200 and operated by a microprocessor, the equipment being coupled to an APPLE IIe computer. G-gel 60 particles introduced into the aerosol were characterized by the parameters CMAD, MMAD and sg both numerically and graphically. The measurement procedure was found to be very sensitive with respect to all fractions in evaluating the subtile differences between different lot numbers of the aerosol. G-gel 60 fractions characterized both numerically and graphically were compared with the known aerosols from paraffin oil and atmospheric air. The equipment MT 3210 enables prompt determination of the percentages of aerosol particles distribution by size class. The authors conclude that the procedure, both in its numerical and graphical versions, is particularly suitable for the diagnosis of aerosol particles deposition in the respiratory tract, offering a new application for HIAC/ROYCO in the field of medicine. In evaluating atmospheric aerosol in exhaled air, the number of particles was found to be below that in inhaled air, the difference being dependent on the choice of investigation methods. Percentual distribution of deposited particles following one minute ventilation proved to be at its maximum, as regards atmospheric aerosol, in the 0.30-0.50 micron range. The deposition curve was similar to already published curves, being characterized by an S-shaped pattern with maximum deposition in the greater size classes. An analysis of inhaled, exhaled and deposited aerosol suggested that deposited aerosol is more polydisperse and has particles of greater sizes than inhaled aerosol. Investigation of the effect of apnoe on deposition indicated that deposition increased as a function of apnoeic pause.

Aerosols↗
PubMed2005

Significance of positive Stenotrophomonas maltophilia culture in acute respiratory tract infection.

Stenotrophomonas maltophilia is a common coloniser of the respiratory tract of patients with chronic lung disease, and, in the absence of pneumonia or bacteraemia, is often ignored by physicians at the Royal Perth Hospital (Perth, Australia). Experience at the Royal Perth Hospital was reviewed to determine whether ignoring S. maltophilia in this setting has any apparent effect on clinical outcome. All patients who presented with an acute respiratory illness and yielded a positive culture for S. maltophilia between 1995 and 2002 were retrospectively reviewed. All subjects had to yield a positive respiratory isolate of S. maltophilia and undergo chest radiography within 24 h of the isolate being obtained. Ninety-two episodes were identified in 89 individuals; 64 showed no evidence of consolidation. Of the study group, 51 (80.0%) received no anti-S. maltophilia antibiotic therapy and 21 (32.8%) had a nosocomially acquired isolate. The overall mortality rate was 20.3%. There was no impact of anti-S. maltophilia therapy on outcome. The only independent predictor of mortality was serum albumin level. As there was no measurable impact of antibiotic therapy, in the absence of consolidation, a positive respiratory tract isolate of Stenotrophomonas maltophilia probably represents colonisation of a severely impaired host rather than invasive disease.

Acute Disease↗