Cost-effectiveness comparative study of ceftriaxone verus cefotaxime in the treatment of complicated urinary infections

Prospective, randomized, multicenter study in 267 patients with complicated urinary infection from 9 hospitals nationwide. Drug treatment was either Ceftriaxone 1 g once daily parenterally or Cefotaxime parenteral 1 g 8 hourly for a minimum of 7 days. Patients were clinically, analytically and microbiologically evaluated before and after treatment to assess the efficacy and tolerance of both drug products. To evaluate treatment cost, we used the price of both drugs and the material required for their administration (syringe and disposable needle). 119 patients were excluded from the cost-efficacy evaluation and 148 remained in the study (75 assigned to treatment with Ceftriaxone and 73 to Cefotaxime). Clinical efficacy of treatment was 93% and 87.6% for Ceftriaxone and Cefotaxime respectively (p > 0.05). Cost per patient was 27,347 pesetas for Ceftriaxone and 34,490 for Cefotaxime (p < 0.05).     

The effect of long-term Enduracin monotherapy on the clinical and biochemical status of patients with ischemic heart disease

13 patients aged 39 to 60 years with coronary atherosclerosis confirmed at selective coronary angiography combined with primary hyperlipidemia (phenotypes 2a and 2b) received enduracin in a dose 1500 mg/day. As a result of the treatment total cholesterol (TC) and LDL cholesterol lowered by 10.3 and 13.1%, respectively, whereas HDL cholesterol rose by 15.2%. Half of the patients demonstrated activation of hepatic transaminases, but discontinuation of the drug was not necessary. In 3 out of 4 patients after 2 years of enduracin treatment stabilization of atherosclerosis was observed. Thus, long-term enduracin is able to inhibit progression of atherosclerosis in coronary heart disease patients.     

Synthesis and elastase inhibitory activity of 6 alpha-chloro-2,2-dimethyl-3 alpha-(pivaloyloxy)methylpenam sulfone, 6 alpha-chloro-2,2-dimethyl-3-exo-methylenepenam sulfone, benzyl and methyl 6 alpha-substituted penicillanate sulfones

The triflates and pivalates of 3 alpha-hydroxymethyl-6-substituted-2,2-dimethylpenam sulfones 3, 5; methyl and benzyl 6-substituted penicillanates 6-9 and 3-exo-methylene-6-substituted-2,2-dimethylpenam sulfone 4 were synthesized. These novel compounds were evaluated as elastase inhibitors using porcine pancreatic elastase. The effects that structural modifications of substituents on C-3 and C-6 in the penam nucleus have on elastase activity were examined and several similarities and distinctions were identified when compared to the reported penicillin esters and amides elastase inhibitors.     

Nutrient utilization by sheep and performance and carcass characteristics of steers fed crab waste-straw silage

Exacerbations of asthma have been associated with exposure to ozone or particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10). We postulated in this study that the association of summertime air pollution (i.e. ozone and PM10) with acute respiratory symptoms, medication use and peak expiratory flow differs among patients grouped according to asthma severity. During the summer of 1995, effects of ambient air pollution on these parameters were studied in a panel of 60 nonsmoking patients with intermittent to severe persistent asthma. These patients were recruited from our Pulmonary Out-patient Clinic. Subgroup analysis was performed on the degree of hyperresponsiveness and lung steroid use before the start of the study, as indictors for the severity of asthma. Associations of the parameters studied with ozone, PM10, nitrogen dioxide (NO2), sulphur dioxide (SO2) and black smoke were evaluated using time series analysis. Several episodes with increased summertime air pollution occurred during the 96 day study period. Eight hour average ozone concentrations exceeded the World Health Organization (WHO) Air Quality Guidelines (120 microg x m(-3)) on 16 occasions. Daily mean levels of PM10 were moderately elevated (range 16-98 microg x m(-3)). Levels of the other measured pollutants were low. There was a consistent, positive association of the prevalence of shortness of breath (maximal relative risk (RRmax) 1.18) with ozone, PM10, black smoke and NO2. In addition, bronchodilator use was associated with both ozone and PM10 levels (RRmax 1.16). Stratification by airway hyperresponsiveness and steroid use did not affect the magnitude of the observed associations. No associations with peak expiratory flow measurements were found. We conclude that the severity of asthma is not an indicator for the sensitivity to air pollution.     

The effect of the Russian inhalant glucocorticosteroid budesonide on bronchial inflammation and hyperreactivity during the long-term treatment of bronchial asthma patients

11 patients with severe bronchial asthma entered a randomized trial of glucocorticosteroid budesonide of Russian produce. Of them 6 patients received inhalations of budesonide (800 micrograms/day for 6 months), 5 control patients did not receive the drug. As shown by investigations of external respiration and bronchoalveolar lavage with estimation of cytogram, metacholine provocative tests, fiber bronchoscopy, budesonide inhalations relieved clinical symptoms of asthma, bronchial hyperreactivity and inflammation.     

Bacillary generalized angiomatosis in HIV infection

A unique case of generalized bacillary angiomatosis (BA) in a patient who died of HIV infection is described. Apart from widely spread skin lesions there were also manifestations in the brain, lungs, heart, esophagus and intestine. Gram-negative bacteria were found in the histological sections. Oval and roundish bacteria with a predominantly perivascular location were found electron microscopically in the archives material.     

Modern methods of medical rehabilitation in traumatic detachment of retina

Condition was studied of collective specific immunity against diphtheria in vaccinated children who ranged from 2 to 15 years old, living in the industrial region of Pridneprovye, with special reference for the degree of the technogenous environmental pollution. To determine specific cellular sensibilization to diphtherial antigen. LAIT was used for the first time. The studies made showed that in a region under health-hazard conditions lower level of antitoxic antidiphtherial immunity occurs more frequently than in non-polluted areas (twice as much of the values), which fact suggests that technologeous pollution may have a suppressive effect on formation of postvaccinal immunity. Apart from measuring the level of specific antibodies for control of the formation of the immune responsiveness to be monitored you may use LAIT and measure levels of R-proteins.     

Continuous dynamic monitoring of pressure and flow patterns during assisted ventilation

On curettage, done in a 39 year old patient because of metorrhagia, a peanut-sized nodule was scraped away from the endometrium. Histologically it consisted of a jumble of irregularly shaped portions of normal appearing embryonal cartilage, of tortuous thick-walled vessels, of twisted bundles of nerves of ducts of respiratory and intestinal epithelium, and of sheets of hornifying skin. The haphazard disarray of tissues supported the notion that the lesion was not a remnant of a malformed embryo. Step-sections through the lesion revealed no traces of placental villi or decidua in the surrounding endometrium. The following were considered as possible origins of the teratoma: 1. displaced germinal cells, 2. retention of pluripotent müllerian epithelium, 3. overaged or blighted ovum. The latter seems most compatible with the histological findings.     

An improved technique for prolonged arterial catheterization in infants and children

Arterial catheterization for blood gas analysis and direct monitoring of blood pressure in infants and children can be attended by a variety of complications, which limit its use to short periods of time. An improved technique, consisting of elimination of stopcocks, the use of a continuous flushing system adapted for infants and children, and meticulous care of the system, was used in 57 children whose ages ranged from the neonatal period to 16 years. The mean duration of cannulation was 5.5 days (range, 1-31 days). All but one of the catheters were functional at the time of discontinuation. There were no thromboembolic phenomena, local or systemic infections or accidental bleeding. We feel that our approach to prolonged arterial cannulation can be an extremely valuable aid in the management of critically ill children.