WorldWideScience

Sample records for expectorants

  1. Neonatal goiter caused by expectorant usage.

    Science.gov (United States)

    Bostanci, I; Sarioģlu, A; Ergin, H; Akşit, A; Cinbiş, M; Akalin, N

    2001-01-01

    A female newborn was admitted with the symptoms of mild respiratory distress, protruding tongue, hypotonicity, cutis marmorata, sclerema, myxedema, abdominal distension, and feeding problems on the first day of life. She had a huge neck mass, a large anterior and posterior fontanel, and hoarse cry. She had no umbilical hernia or jaundice. A history of maternal potassium iodine (expectorant) usage without doctor's advice was obtained; the mother had not attended a clinic throughout the pregnancy. On ultrasonographic examination, the thyroid right lobe was 53 x 31 mm and the left lobe was 34 x 31 mm. The results of thyroid hormone tests on the first day were as follows: T3 20 ng/dl (normal: 32-216 ng/dl), T4 0.9 microg/dl (11.8-22.6 microg/dl), TSH 120 mIU/l (2.5-13.3 mIU/l). This patient is presented to emphasize the role of hypothyroidism in drug-induced neonatal goiter and to discuss the possibility of a life-threatening effect of congenital goiter, i.e. respiratory tract obstruction.

  2. 21 CFR 341.78 - Labeling of expectorant drug products.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Labeling of expectorant drug products. 341.78 Section 341.78 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE COLD, COUGH, ALLERGY, BRONCHODILATOR, AND ANTIASTHMATIC DRUG PRODUCTS FOR...

  3. Studies on the expectorant, antitussive and antiasthmatic properties ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-12-01

    Dec 1, 2009 ... 1College of Marine Life Sciences, Ocean University of China, Qingdao 266003, China. 2Scientific and Technological College of Chemistry and Biology, Yantai University, Yantai 264005, China. Accepted 30 April, 2009. The aim of this study was to analyze the expectorant, antitussive and antiasthmatic ...

  4. Thoracic lymphangiectasis presenting with chyloptysis and bronchial cast expectoration

    Energy Technology Data Exchange (ETDEWEB)

    Orliaguet, O. [Pneumology Center Henri Bazire, St. Julien de Ratz, BP 129, 38504 Voiron Cedex (France); Beauclair, P. [General Hospital St. Marcellin (France); Gavazzi, G. [Department of Internal Medicine, Centre Hospitalier Universitaire Grenoble (France); Winckel, P. [Clinique du Mail, Grenoble (France); Laporte, F. [Department of Biochemistry, Centre Hospitalier Universitaire Grenoble (France); Coulomb, M.; Ferretti, G.R. [Department of Radiology, Centre Hospitalier Universitaire Grenoble (France)

    2002-07-01

    A 70-year-old man with recurrent undiagnosed episodes of bronchial cast expectoration and pulmonary infiltrates on chest radiography for 15 years is described. The diagnosis of chyloptysis was established by chemical analysis of the bronchial aspiration. We emphasize the radiological findings of this rare observation. The CT-associated lymphangiography showed mediastinal lymphangiectasis with retrograde opacification of mediastinal and hilar lymph nodes as well as submucosal lymphatic vessels protruding into the lumen of the tracheo-bronchial tree without evidence of thoracic duct obstruction as well as a ''crazy-paving appearance.'' Congenital incompetence of the valves of the lymphatic vessels originating from the thoracic duct is held to be the cause. Chyloptysis and pulmonary lymphatic disorder should be sought in cases of bronchial cast expectoration. (orig.)

  5. A new method for evaluating mucolytic expectorant activity and its application. I. Methodology.

    Science.gov (United States)

    Kasé, Y; Seo, H; Oyama, Y; Sakata, M; Tomoda, K; Takahama, K; Hitoshi, T; Okano, Y; Miyata, T

    1982-01-01

    A new method for evaluating in vivo effect of mucolytic expectorants was devised. In this report, however, the focus is placed on methodology but not on pharmacology. Rabbits with subacute bronchitis were prepared by long-term exposure to minute amounts of SO2 gas. The sputum was quantitatively collected from the animal through a tracheal cannula at suitable time intervals according to the Perry and Boyd's method. As a preliminary study, changes in volume, viscosity and amounts of freeze-dried substance of sputa were examined after intraduodenal administration of water instead of mucolytic expectorants, the effects of which will be described in the subsequent paper, but no significant changes occurred with this test.

  6. Investigating the quality of expectorated sputum for tuberculosis diagnosis in Bolivia.

    Science.gov (United States)

    Hernández, P; Punchak, M; Camacho, M; Hepple, P; McNerney, R

    2015-09-01

    A low-power microscope-based cytological system to assess the quality of expectorated sputum provided for tuberculosis (TB) diagnosis was piloted in Bolivia. A total of 3688 samples were subjected to visual and cytological examination in nine laboratories: of these, 591 (16%) were misclassified by visual examination and 294 (8%) were found to be degraded. The degree of discordance varied between locations, and laboratories received a higher number of degraded specimens from isolated health clinics. Cytological assessment of sputum was found to be feasible and identified areas for improvement in the Bolivian diagnostic system for TB.

  7. Cannabinoids and metabolites in expectorated oral fluid after 8 days of controlled around-the-clock oral THC administration

    OpenAIRE

    Milman, Garry; Barnes, Allan J.; Schwope, David M.; Schwilke, Eugene W.; Goodwin, Robert S.; Kelly, Deana L.; Gorelick, David A.; Huestis, Marilyn A.

    2011-01-01

    Oral fluid (OF) is an increasingly accepted matrix for drug testing programs, but questions remain about its usefulness for monitoring cannabinoids. Expectorated OF specimens (n=360) were obtained from 10 adult daily cannabis smokers before, during, and after 37 20-mg oral Δ9-tetrahydrocannabinol (THC) doses over 9 days to characterize cannabinoid disposition in this matrix. Specimens were extracted and analyzed by gas chromatography– mass spectrometry with electron-impact ionization for THC,...

  8. Suppressive effects of the expectorant drug ambroxol hydrochloride on quartz-induced lung inflammation in F344 rats

    OpenAIRE

    Kanie, Shohei; Yokohira, Masanao; Yamakawa, Keiko; Nakano-Narusawa, Yuko; Yoshida, Shota; Hashimoto, Nozomi; IMAIDA, KATSUMI

    2016-01-01

    Surfactant proteins (SPs) are essential to respiratory structure and function. The expectorant drug ambroxol hydrochloride is clinically prescribed to stimulate pulmonary surfactant and airway serous secretion. Therefore, ambroxol hydrochloride may affect SP production and pulmonary inflammation. Lung toxicity of fine particles of various materials has been examined previously in our in vivo bioassay using the intratracheal (i.t.) instillation approach. In the present study, we evaluated modu...

  9. [Results of international multicentre non-interventional clinical study of the effectiveness and safety of ascoril expectorant for the treatment of cough in Kazakhstan and Uzbekistan].

    Science.gov (United States)

    Nurgozhin, T S; Guliaev, A E; Ermekbaeva, B A; Zhaugasheva, S K; Abuova, G T; An, É A

    2013-01-01

    This paper reports results of international multicentre non-interventional clinical study of the effectiveness and safety of ascoril expectorant for the treatment of cough in Kazakhstan and Uzbekistan. The study included 16312 patients examined in different cities during 2011-2012. It showed that ascoril expectorant (Glenmark) at a standard dose is an effective agent for the treatment of cough in children above 3 years and adults aged up to 78 years with ARVI and acute bronchitis, exacerbation of these conditions or grade I-II chronic obstructire pulmonary disease. Most patients reported good therapeutic effect within 1 day after intake. Ascoril expectorant caused no adverse reactions and was well tolerated by the patients. 91% of the attending physicians describe the drug as highly effective.

  10. [Clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery].

    Science.gov (United States)

    Zhou, Zhou; Han, Xiaotong; Ning, Fengling; Wen, Hui; Fan, Maiying; Yuan, Xia; Luo, Jieying; Zhang, Yi

    2017-03-01

    To investigate the clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery. A retrospective case control study was conducted. Seventy-six patients with pulmonary infection after abdominal surgery admitted to the First Affiliated Hospital of Hunan Normal University from September 2015 to September 2016 were enrolled. According to whether accept the pulmonary rehabilitation therapy or not, the patients were divided into two groups. In the control group (n = 35), the conventional expectoration method was adopted. The patients in pulmonary rehabilitation group (n = 41) received both methods of the control group and pulmonary rehabilitation treatment, including respiratory exercise (effective cough, lip reduction breathing), respiratory exercise device (respiratory exerciser tri-ball), and vibrated expectoration. The 24-hour sputum volume, degree of comfort, inflammatory and pulmonary function parameters, and recovery situation were recorded in the two groups. (1) There were no significant differences in the parameters of inflammation and pulmonary function before treatment between the two groups. After treatment, the white blood cell (WBC) and C-reactive protein (CRP) in both groups were significantly decreased, and the forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were significantly increased. The above changes in pulmonary rehabilitation group were more significant than those of the control group [WBC (×109/L): 11.12±2.88 vs. 13.42±2.62 at 3 days, 8.22±1.48 vs. 9.27±1.92 at 5 days; CRP (mg/L): 13.47±4.77 vs. 16.03±4.94 at 3 days, 9.69±1.56 vs. 11.77±1.41 at 5 days; FEV1 (L): 2.48±0.14 vs. 2.29±0.16 at 3 days, FEV1/FVC: 0.78±0.04 vs. 0.75±0.04 at 3 days; all P rehabilitation group were significantly higher than that of the control group (mL: 30.51±4.15 vs. 18.30±3.64 at 1 day, 31.08±3.22 vs. 20.37±3

  11. Using Chest Vibration Nursing Intervention to Improve Expectoration of Airway Secretions and Prevent Lung Collapse in Ventilated ICU Patients: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Yu-Chih Chen

    2009-06-01

    Conclusion: The results suggest that chest vibration may contribute to expectoration and thus improve lung collapse among ventilated patients in an ICU. Chest vibration nursing intervention is a safe and effective alternative pulmonary clearance method and can be used on patients who are on ventilators in ICUs.

  12. A new method for evaluating mucolytic expectorant activity and its application. II. Application to two proteolytic enzymes, serratiopeptidase and seaprose.

    Science.gov (United States)

    Kasé, Y; Seo, H; Oyama, Y; Sakata, M; Tomoda, K; Takahama, K; Hitoshi, T; Okano, Y; Miyata, T

    1982-01-01

    Using our new method described in a preceding paper, in vivo effects of two proteolytic enzymes such as serratiopeptidase (SER) and seaprose (SAP) on sputa collected from bronchitis rabbits were examined. SER (20 mg/kg) and SAP (30 mg/kg) significantly reduced the viscosity of sputum (P less than 0.05) at the 1-3-h periods and the 4-6-h periods, respectively, after intraduodenal administration. 50 mg/kg of SER also significantly decreased not only viscosity (P less than 0.001) but also amount of freeze-dried substance (P less than 0.05) of sputum at the 1-3-h periods, but SAP did not affect the amount of dried substance. Both enzymes significantly increased the volume of sputum, probably as the result of liquefaction. Thus, mucolytic expectorant activity of both enzymes can be demonstrated first by the reduction in viscosity and next of the increase in volume of sputa. However, the decrease in amount of freeze-dried substance is not always in accord with the reduction viscosity.

  13. Cannabinoids and metabolites in expectorated oral fluid after 8 days of controlled around-the-clock oral THC administration.

    Science.gov (United States)

    Milman, Garry; Barnes, Allan J; Schwope, David M; Schwilke, Eugene W; Goodwin, Robert S; Kelly, Deana L; Gorelick, David A; Huestis, Marilyn A

    2011-08-01

    Oral fluid (OF) is an increasingly accepted matrix for drug testing programs, but questions remain about its usefulness for monitoring cannabinoids. Expectorated OF specimens (n = 360) were obtained from 10 adult daily cannabis smokers before, during, and after 37 20-mg oral Δ(9)-tetrahydrocannabinol (THC) doses over 9 days to characterize cannabinoid disposition in this matrix. Specimens were extracted and analyzed by gas chromatography-mass spectrometry with electron-impact ionization for THC, 11-hydroxy-THC, cannabidiol, and cannabinol, and negative chemical ionization for 11-nor-9-carboxy-THC (THCCOOH). Linear ranges for THC, 11-hydroxy-THC, and cannabidiol were 0.25-50 ng/mL; cannabinol 1-50 ng/mL; and THCCOOH 5-500 pg/mL. THCCOOH was the most prevalent analyte in 344 specimens (96.9%), with concentrations up to 1,390.3 pg/mL. 11-hydroxy-THC, cannabidiol, and cannabinol were detected in 1, 1, and 3 specimens, respectively. THC was detected in only 13.8% of specimens. The highest THC concentrations were obtained at admission (median 1.4 ng/mL, range 0.3-113.6) from previously self-administered smoked cannabis. A total of 2.5 and 3.7% of specimens were THC-positive at the recommended Substance Abuse and Mental Health Services Administration (2 ng/mL) and Driving Under the Influence of Drugs, Alcohol and Medicines (DRUID) (1 ng/mL) confirmation cutoffs, respectively. THC is currently the only analyte for monitoring cannabis exposure in OF; however, these data indicate chronic therapeutic oral THC administration and illicit oral THC use are unlikely to be identified with current guidelines. Measurement of THCCOOH may improve the detection and interpretation of OF cannabinoid tests and minimize the possibility of OF contamination from passive inhalation of cannabis smoke.

  14. Suppressive effects of the expectorant drug ambroxol hydrochloride on quartz-induced lung inflammation in F344 rats.

    Science.gov (United States)

    Kanie, Shohei; Yokohira, Masanao; Yamakawa, Keiko; Nakano-Narusawa, Yuko; Yoshida, Shota; Hashimoto, Nozomi; Imaida, Katsumi

    2017-04-01

    Surfactant proteins (SPs) are essential to respiratory structure and function. The expectorant drug ambroxol hydrochloride is clinically prescribed to stimulate pulmonary surfactant and airway serous secretion. Therefore, ambroxol hydrochloride may affect SP production and pulmonary inflammation. Lung toxicity of fine particles of various materials has been examined previously in our in vivo bioassay using the intratracheal (i.t.) instillation approach. In the present study, we evaluated modulatory effects of ambroxol hydrochloride on quartz-induced lung inflammation in F344 rats. Male 6-week-old F344 rats were exposed by i.t. instillation to 2 mg of quartz particles suspended in 0.2 mL of saline. Ambroxol hydrochloride was administered at 0, 12, and 120 ppm in rat basal diet for 28 days, and then formalin-fixed paraffin-embedded lung, liver, and kidney samples were prepared. No changes in general condition, body and organ weights, or food consumption upon exposure to quartz were noted. The mean ambroxol intake in rats of the 12 ppm group was comparable to the human conventional dose. Histopathology of lung lesions was evaluated, and the degree of inflammation was scored. At 120 ppm, ambroxol hydrochloride significantly decreased individual lung inflammation scores for pulmonary edema and lymph follicle proliferation around the bronchiole, as well as the total inflammation score, in quartz-treated rats. Expression of SP-C in the type II alveolar cells and macrophages was greater in inflammatory lesions than in non-inflamed areas. Ambroxol treatment did not affect expression of SP-B and SP-C. In conclusion, we demonstrated that ambroxol hydrochloride relieves quartz-induced lung inflammation.

  15. Extractions of oil from Descurainia sophia seed using supercritical CO2, chemical compositions by GC-MS and evaluation of the anti-tussive, expectorant and anti-asthmatic activities.

    Science.gov (United States)

    Gong, Jian-Hong; Zhang, Yan-Li; He, Jin-Li; Zheng, Xiao-Ke; Feng, Wei-Sheng; Wang, Xiao-Lan; Kuang, Hai-Xue; Li, Chun-Ge; Cao, Yan-Gang

    2015-07-22

    Descurainia sophia is widely distributed in China and is one of the most troublesome annual weeds. It has diverse medicinal usage. D. sophia has abundant oil, making it an important oil plant in China. The main goal of this study was to obtain the maximum yield of the oil by an optimal selection of supercritical fluid extraction parameters. According to the central composite design and response surface methodology for supercritical fluid extraction method, a quadratic polynomial model was used to predict the yield of D. sophia seed oil. A series of runs was performed to assess the optimal extraction conditions. The results indicated that the extraction pressure had the greatest impact on oil yield within the range of the operating conditions studied. A total of approximately 67 compounds were separated in D. sophia seed oil by GC-MS, of which 51 compounds represented 98.21% of the total oils, for the first time. This study was also aimed at evaluating the anti-asthmatic, anti-tussive and expectorant activities in vivo of D. sophia seed oil which supplied for further research on bioactive constituents and pharmacological mechanisms.

  16. Extractions of Oil from Descurainia sophia Seed Using Supercritical CO2, Chemical Compositions by GC-MS and Evaluation of the Anti-Tussive, Expectorant and Anti-Asthmatic Activities

    Directory of Open Access Journals (Sweden)

    Jian-Hong Gong

    2015-07-01

    Full Text Available Descurainia sophia is widely distributed in China and is one of the most troublesome annual weeds. It has diverse medicinal usage. D. sophia has abundant oil, making it an important oil plant in China. The main goal of this study was to obtain the maximum yield of the oil by an optimal selection of supercritical fluid extraction parameters. According to the central composite design and response surface methodology for supercritical fluid extraction method, a quadratic polynomial model was used to predict the yield of D. sophia seed oil. A series of runs was performed to assess the optimal extraction conditions. The results indicated that the extraction pressure had the greatest impact on oil yield within the range of the operating conditions studied. A total of approximately 67 compounds were separated in D. sophia seed oil by GC-MS, of which 51 compounds represented 98.21% of the total oils, for the first time. This study was also aimed at evaluating the anti-asthmatic, anti-tussive and expectorant activities in vivo of D. sophia seed oil which supplied for further research on bioactive constituents and pharmacological mechanisms.

  17. Studies on the expectorant, antitussive and antiasthmatic properties ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-12-01

    Dec 1, 2009 ... There has been extensive interest in the search for new ... sponges and ascidians and considerable interest current- ... choline and other chemicals were at analytical grade and were pur- chased from chemical company in Yantai. Animals. Kunming mice (18-22g) and guinea pigs (200-250 g) were ...

  18. An Expectorated "Stent": An Unexpected Complication of EBUS-TBNA.

    Science.gov (United States)

    Zamora, Felix D; Moughrabieh, Anas; Gibson, Heidi; Podgaetz, Eitan; Dincer, H Erhan

    2017-07-01

    Endobronchial ultrasound-guided transbronchial needle aspiration has a low complication rate and is a cost-effective procedure for mediastinal staging and diagnosis when compared with the more invasive mediastinoscopy. There are increasing case reports of unexpected complications including equipment failures with and without significant medical consequences. Knowledge of complications, including those that are rare, is essential for the physician performing this minimally invasive procedure. We report a case of a retained foreign body from the unexpected separation of a distal spring/coil mechanism from the Olympus ViziShot Aspiration needle following early needle deployment within the working channel of the bronchoscope.

  19. [Assisted cough--physiotherapy to improve expectoration of mucus].

    Science.gov (United States)

    Schmidt, I

    2008-03-01

    Pulmonary complications are the most common causes of mortality in patients with severe inspiratory and/or expiratory muscle weakness. An inspiratory tidal volume below 1500 ml and a peak cough flow below 160 L/min result in mucus retention and increase the risk of pneumonia. An intact cough function is pivotal for airway clearance during acute and chronic airway infections with increased mucus production as well as for protection against endotracheal aspirations. Effective cough requires that all of its phases work or are effectively supported. Non-invasive assistance of inspiration can be provided by manual hyperinflation, air stacking, glossopharyngeal breathing or mechanical insufflation. Safe and effective methods of expiration assistance include manual thorax and abdominal compression, manual self-assistance as well as mechanical insufflation-exsufflation. The use of these non-invasive inspiratory and expiratory muscle aids can decrease the risk of pulmonary complications in patients with severe ventilatory muscle weakness.

  20. Characterization of Streptococcus milleri group isolates from expectorated sputum of adult patients with cystic fibrosis.

    Science.gov (United States)

    Grinwis, Margot E; Sibley, Christopher D; Parkins, Michael D; Eshaghurshan, Christina S; Rabin, Harvey R; Surette, Michael G

    2010-02-01

    With the recent insights into the Streptococcus milleri group (SMG) as pulmonary pathogens in patients with cystic fibrosis (CF), we sought to characterize 128 isolates from the sputum of adults with CF, along with 45 isolates from patients with invasive diseases for comparison. The tests performed included Lancefield grouping; tests for hemolysis; tests for the production of hyaluronidase, chondroitin sulfatase, DNase, proteases, and hydrogen peroxide; and PCR for the detection of the intermedilysin gene (ily). We also generated biochemical profiles with the Rapid ID Strep 32 API system and tested cell-free supernatants for the presence of the signal molecule autoinducer-2 (AI-2) using a Vibrio harveyi bioassay with a subset of CF strains. The S. intermedius isolates from both strain collections were similar, while the S. constellatus and S. anginosus isolates yielded several biotypes that differed in prevalence between the two strain collections. Beta-hemolytic, Lancefield group C S. constellatus comprised 74.4% of the S. constellatus isolates from patients with CF but only 13.3% of the corresponding isolates from patients with invasive infections. This was the only S. constellatus biotype associated with pulmonary exacerbations. Hyaluronidase-positive S. anginosus was detected only among the isolates from patients with CF. Strain-to-strain variability in AI-2 expression was evident, with the mean values being the highest for S. anginosus, followed by S. constellatus and then S. intermedius. Cluster analysis and 16S rRNA sequencing revealed that the species of SMG could be accurately determined with a minimum of three phenotypic tests: tests for the Lancefield group, hyaluronidase production, and chondroitin sulfatase production. Furthermore, isolates from patients with invasive infections clustered with isolates from the sputum of patients with CF, suggesting that the respiratory tract isolates were equally pathogenic.

  1. Rapid Urine LAM Testing Improves Diagnosis of Expectorated Smear-Negative Pulmonary Tuberculosis in an HIV-endemic Region.

    Science.gov (United States)

    Drain, Paul K; Gounder, Lilishia; Sahid, Faieza; Moosa, Mahomed-Yunus S

    2016-02-11

    We sought to determine if urine lipoarabinomannan (LAM) would improve diagnosis of pulmonary TB. We enrolled consecutive adults presenting with ≥2 TB-related symptoms, obtained one induced sputum sample for smear microscopy (AFB) and mycobacterial culture, and performed urine LAM testing (Determine(TM) TB LAM, Alere). We used culture-confirmed pulmonary TB as the gold standard, and compared accuracy with area under receiver operating characteristic curves (AUROC). Among 90 participants, 82 of 88 tested (93%) were HIV-infected with a median CD4 168/mm(3) (IQR 89-256/mm(3)). Diagnostic sensitivities of urine LAM and sputum AFB were 42.1% (95% CI 29.1-55.9%) and 21.1% (95% CI 11.4-33.9%), and increased to 52.6% (95% CI 39.0-66.0%) when combined. Sensitivity of LAM increased significantly among participants with a lower Karnofsky Performance score, anemia, hypoalbuminemia, and higher C-reactive protein. Combining LAM with AFB had an AUROC = 0.68 (95% CI 0.59-0.77), significantly better than AFB alone (AUROC=0.58; 95% CI 0.51-0.64). The combination of LAM and AFB was significantly better than AFB alone among patients with Karnofsky Performance score ≤90, hemoglobin ≤10 g/dL, albumin ≤25 g/L, C-reactive protein ≥25 mg/L, or CD4 LAM testing may be most beneficial among patients with functional impairment, elevated inflammatory markers, or greater immunosuppression.

  2. Extractions of Oil from Descurainia sophia Seed Using Supercritical CO2, Chemical Compositions by GC-MS and Evaluation of the Anti-Tussive, Expectorant and Anti-Asthmatic Activities

    OpenAIRE

    Gong, Jian-Hong; Zhang, Yan-Li; He, Jin-Li; Zheng, Xiao-Ke; Feng, Wei-Sheng; Wang, Xiao-Lan; Kuang, Hai-Xue; Li, Chun-Ge; Cao, Yan-Gang

    2015-01-01

    Descurainia sophia is widely distributed in China and is one of the most troublesome annual weeds. It has diverse medicinal usage. D. sophia has abundant oil, making it an important oil plant in China. The main goal of this study was to obtain the maximum yield of the oil by an optimal selection of supercritical fluid extraction parameters. According to the central composite design and response surface methodology for supercritical fluid extraction method, a quadratic polynomial model was use...

  3. Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

    NARCIS (Netherlands)

    C.M. van Winden; A. Visser (Adriaan); P.J. Sterk (Peter); S. Beckers; J.C. de Jongste (Johan); W.C.J. Hop (Wim)

    1998-01-01

    textabstractRecently, the flutter was introduced as a new device to improve sputum expectoration. Preliminary data suggested a significant improvement in expectoration and lung function during flutter treatment in patients with cystic fibrosis (CF). The aim of the

  4. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

    National Research Council Canada - National Science Library

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    .... To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD...

  5. COUGH PHYTOTHERAPY IN EARLY CHILDHOOD

    Directory of Open Access Journals (Sweden)

    I. V. Davydova

    2012-01-01

    Full Text Available Treatment of acute respiratory infections remains one of the most pressing problems in children. Mucolytic and expectorant therapy aimed at facilitating the expectoration of sputum and improvement of the drainage function of bronchi, is an integral part of this treatment. Expectorant herbal medicine occupies a special niche in the treatment of acute respiratory viral infections. This paper presents literature data on the efficacy and safety of herbal expectorants in children, as well as the results of a comparative analysis of single- and multicomponent herbal medications.  

  6. Drug: D04329 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04329 Mixture, Drug Foeniculated ammonia spirit (JP16); Foeniculated ammonia spirit...ts 223 Expectorants 2232 Ammonium salts D04329 Foeniculated ammonia spirit (JP16)...orants R05FB02 Cough suppressants and expectorants D04329 Foeniculated ammonia spirit (JP16) PubChem: 17398055 ...

  7. Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

    NARCIS (Netherlands)

    van Winden, C. M.; Visser, A.; Hop, W.; Sterk, P. J.; Beckers, S.; de Jongste, J. C.

    1998-01-01

    Recently, the flutter was introduced as a new device to improve sputum expectoration. Preliminary data suggested a significant improvement in expectoration and lung function during flutter treatment in patients with cystic fibrosis (CF). The aim of the present study was to compare the effects of the

  8. Nutritional Value and Utilization of Amaranthus ( Amaranthus spp ...

    African Journals Online (AJOL)

    diabetic, antipyretic, anti-snake venom, antileprotic, anti-gonorrheal, expectorant, to relieve breathing in acute bronchitis. It also has anti-inflammatory properties, immunomodulatory activity, anti-androgenic activity and anthelmintic properties.

  9. Drug: D09065 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available [BR:br08304] Formulas Diaphoretic formulas Diaphoretic dformulas pungent in flavo...r and cool in property D09065 *Kyoseihatekigan Formulas for dampness Cough suppressant and expectorant formulas D09065 *Kyoseihatekigan PubChem: 96025746 ...

  10. Drug: D01036 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available R RESPIRATORY SYSTEM R05 COUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DA Opium alkal...oids and derivatives R05DA07 Noscapine D01036 Noscapine

  11. Drug: D07848 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available R RESPIRATORY SYSTEM R05 COUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DA Opium alkalo...ids and derivatives R05DA11 Dimemorfan D07848 Dimemorfan

  12. Drug: D08579 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available R RESPIRATORY SYSTEM R05 COUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DA Opium alkalo...ids and derivatives R05DA10 Thebacon D08579 Thebacon hyd

  13. Drug: D02101 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available cotics 81 Alkaloidal narcotics 811 Opium alkaloids 8115 Codeines D02101 Codeine phosphate hydrate (JP16); Co... EXPECTORANTS R05DA Opium alkaloids and derivatives R05DA04 Codeine D02101 Codeine phosphate hydrate (JP16);

  14. Pertussis

    Science.gov (United States)

    ... mixtures, expectorants, and suppressants are most often not helpful. These medicines should NOT be used. Outlook (Prognosis) ... childhood immunizations, protects children against pertussis infection. DTaP vaccine can be safely given to infants. Five DTaP ...

  15. Drug: D06703 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Chinese Medicine in Japan [BR:br08304] Crude Drugs Drugs for dampness Cough suppr...essants and expectorants D06703 *Platycodon root; Powdered platycodon root; Platycodon root Drugs for pus discharge Drugs

  16. Drug: D08417 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 3] R RESPIRATORY SYSTEM R05 COUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DB Other cou...gh suppressants R05DB18 Prenoxdiazine D08417 Prenoxdiazi

  17. Drug: D07850 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 3] R RESPIRATORY SYSTEM R05 COUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DB Other cou...gh suppressants R05DB28 Dimethoxanate D07850 Dimethoxana

  18. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 9990 ...

    African Journals Online (AJOL)

    Prof Kakande

    August. East and Central African ... abdomino-thoracic surgery, and many other conditions which reduce or inhibit patient ability to expectorate or cough. .... Obviously, if the reflex was blunted by general anaesthesia, the advantage of cough ...

  19. Drug: D08697 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D08697 Mixture, Drug Platycodon fluidextract - glycyrrhiza extract - plantago herb ...extract - peony root extract - dihydrocodeine phosphate mixt; Opisezol codeine (TN) Platycodon fluidextract ... Antitussives and expectorants 2249 Others D08697 Platycodon fluidextract - glycyrrhiza extract - plantago h

  20. Drug: D04336 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04336 Mixture, Drug Cherry bark extract - codeine phosphate hydrate mixt; Brocin c...iratory organ agents 224 Antitussives and expectorants 2249 Others D04336 Cherry bark extract...odeine (TN) Cherry bark extract [DR:D04335], Codeine phosphate [DR:D02101] Therapeutic category: 2249 ATC co...tics D04336 Cherry bark extract - codeine phosphate hydrate mixt PubChem: 17398059 ... ...ONS R05FA Opium derivatives and expectorants R05FA01 Opium derivatives and mucoly

  1. [Acute plastic bronchitis--case report].

    Science.gov (United States)

    Cavrić, Gordana; Naumovski-Mihalić, Slavica; Kardum-Skelin, Ika; Dzebro, Sonja; Jelić-Puskarić, Biljana; Sustercić, Dunja; Skurla, Bruno; Mestrović, Ivica Premuzić; Filipec-Kanizaj, Tajana; Prkacin, Ingrid; Bartolek, Dubravka; Jurić, Klara; Mosler, Domagoj

    2011-09-01

    Plastic bronchitis is a rare disorder characterized by formation and sometimes dramatic expectoration of bronchial casts. It may occur at any age, but most published cases refer to pediatric population. We report a case of an 81-year-old man hospitalized at intensive care unit, who presented with the appearance of plastic bronchitis type I. He had profuse expectoration of several pieces, a few cm long and up to 1 cm wide, of wormlike reddish-brownish "tissue". Histologically, it was a slimy purulent secretion with abundant fibrin and blood and with cytopathic effect of herpes virus. The pathogenesis of plastic bronchitis is not clear.

  2. ПРИМЕНЕНИЕ МУКОАКТИВНЫХ ЛЕКАРСТВЕННЫХ СРЕДСТВ В ПРАКТИКЕ ТЕРАПЕВТА

    Directory of Open Access Journals (Sweden)

    Ф. Т. Малыхин

    2013-01-01

    Full Text Available Russia is among the countries where using of mucolytic drugs in clinical practice is widespread. In chronic bronchitis, chronic obstructive pulmonary disease, acute respiratory syndrome with prolonged cough, pneumonia, tuberculosis and many other pathologies using of expectorants and mucoregulating drugs is common. Among the synthetic mucolytics benzyalamine bromhexine has been introduced for a long time in practice; and then its derivative — ambroxol hydrochloride which has better pharmacokinetics and pharmacodynamics. Using of ambroxol (Ambrobene in patients with cough, accompanied by difficult expectoration, is useful as it promotes the implementation of the protective cough reflex, providing evacuation of viscous mucus or foreign particles from the respiratory tract.

  3. Drug: D03888 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D03888 Drug Domiodol (USAN) C5H9IO3 243.9596 244.0276 D03888.gif Mucolytic ATC code...ND COLD PREPARATIONS R05C EXPECTORANTS, EXCL. COMBINATIONS WITH COUGH SUPPRESSANTS R05CB Mucolytics R05CB08 Domiodol D03888 Domiodo

  4. Terminalia mjuna (Roxb.ex DC) Wight & Am. of COl11bretaceae is a ...

    Indian Academy of Sciences (India)

    ... white and borne 011 branched inflorescences. Fruit is ovoid lrvith 5-7 angles or 'wings. Bark is astringent, sweet, acrid, cooling, aphrodisiac, demulcent, cardiotonic, antidysenteric, urinary astringent, expectorant, alexiteric and tollie. It is useful ill ulcers, urethrorrhea, leucorrhoea, diabetes, anaemia, cardiopathy, cirrhosis ...

  5. Sputum induction as a simple diagnostic tool?

    African Journals Online (AJOL)

    Objectives. To assess the value of sputum induction (SI) as a diagnostic tool for patients with suspected pulmonary tuberculosis (PTB) who are unable to expectorate or who have a negative sputum smear, Design, Study of an inpatient cohort undergoing SL Setting, Mseleni Hospital, a rural district hospital in northern ...

  6. Drug: D06679 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D06679 Crude, Drug Gambir (JP16); Powdered gambir (JP16); Gamibir (TN) (+)-Catechin...JP16) Traditional Chinese Medicine in Japan [BR:br08304] Crude Drugs Drugs for dampness Cough suppressants a...nd expectorants D06679 Gambir; Powdered gambir; Gamibir Drugs for external use Drugs for external use D06679

  7. Sireeratawong et al., Afr J Tradit Complement Altern Med. (2013) 10 ...

    African Journals Online (AJOL)

    AJTCAM

    Roxb. is an indigenous plant in Southeast Asia and Thailand. It is a plant in the family Combretaceae and commonly known as “Sa Maw Phi Phek” in Thai name (Smitinand, 2001). T. bellerica has been extensively used in Thai traditional medicine for laxative, carminative, astringent, expectorant and tonic (Department of.

  8. [The use of plastic prosteses in laryngeal and tracheal stenoses (author's transl)].

    Science.gov (United States)

    Révész, G; Mihók, G

    1975-02-01

    A "T" shaped polyvinylpyrrolidine tube was used to resolve cicatricial stenosis of the larynx and trachea. The plastic prosthesis is softened by heat. According to clinical experience the prosthesis insures unhindered respiration, free expectoration, speech and deglution. A number of successes are demonstrated.

  9. Drug: D01610 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D01610 Drug Potassium guaiacolsulfonate (JP16); Sulfogaiacol (INN) C7H7O2. SO3K 241...5CA Expectorants R05CA09 Guaiacolsulfonate D01610 Potassium guaiacolsulfonate (JP16); Sulfogaiacol (INN) CAS: 1321-14-8 PubChem: 7848673 ...

  10. Annona squamosa L. (English: Custard apple; Hindi: Sharifa or ...

    Indian Academy of Sciences (India)

    Fruits are green, globose with well-marked areoles. The pulp is sweet in the ripe fruit which is haematinic, expectorant and tonic and used to treat anaemia. Seeds are many, brownish-black and hard. Leaves and seeds are used as insecticide and used in destroying lice in the hair. The roots are a powerful purgative.

  11. Drug: D09818 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D09818 Drug Oxeladin tannate (JAN) ATC code: R05DB09 Anatomical Therapeutic Chemica...ANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DB Other cough suppressants R05DB09 Oxeladin D09818 Oxeladin tannate (JAN) PubChem: 124490558 ...

  12. Drug: D08310 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D08310 Drug Oxeladin (INN) C20H33NO3 335.246 335.4809 D08310.gif Antitussive ATC co... AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DB Other cough suppressants R05DB09 Oxeladin... D08310 Oxeladin (INN) CAS: 468-61-1 PubChem: 96024997 Li

  13. [Therapeutic efficacy and general tolerability of 4-carbomethoxythiazolidine chlorohydrate in patients with exacerbated chronic bronchitis].

    Science.gov (United States)

    Scillieri, E

    1990-01-01

    4-carbomethoxythiazolidine HCl has been administered to 24 patients (aged between 64 and 86) suffering from new acute stages of chronic bronchitis. The patients have been submitted to a double-blind test and have been subdivided into four groups; each of them was administered a placebo or the a.m. product. Dosage: 200, 400 and 600 mg/d. The following symptoms have been evaluated: cough; dyspnea; bronchial breathings; expectoration; expectorate's viscosity; expectorate's volume. The data have been submitted to a statistic analyses, this research leads to the followings considerations. A dosage of 200 mg/d. is not significantly active on any on the considered parameters. The 400 mg dosage turns out to be noticeably more effective than the placebo on all parameters (except the difficulty in expectoration). A dosage of 600 mg/d. has a significant effect on all the measurable parameters. Finally, a 200 mg dosage of 4-carbomethoxythiazolidine three times a day results to be the best posology in the symptomatic treatment of the respiratory manifestations of chronic bronchitis.

  14. Drug: D06993 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D06993 Formula, Drug Jinsoin Pinellia tuber [DR:D06778], Poria sclerotium [DR:D0678...hinese medicines D06993 Jinsoin Traditional Chinese Medicine in Japan [BR:br08304...] Formulas Formulas for dampness Cough suppressant and expectorant formulas D06993 Jinsoin PubChem: 51091335 ...

  15. Drug: D06907 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available s family) Bambusa tuldoides, Phyllostachys nigra, Phyllostachys bambusoides culm; Standards for non-pharmacopoeial crude drugs... Therapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs... and Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs D06907 Bamboo culm (no...nd expectorants D06907 Bambusae caulis; Phyllostachysis caulis; Tikujyo Crude drugs

  16. Drug: D06724 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available schisandra family) Schisandra fruit Major component: Schizandrin [CPD:C17064] Therapeutic category of drugs ...in Japan [BR:br08301] 5 Crude drugs and Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs...R:br08304] Crude Drugs Drugs for dampness Cough suppressants and expectorants D06724 Schisandra fruit; Schisandra fruit Crude drugs

  17. Drug: D06781 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ceae (rose family) Loquat leaf Major component: Nerolidol [CPD:C09704] Therapeutic category of drugs in Japa...n [BR:br08301] 5 Crude drugs and Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs...rude Drugs Drugs for dampness Cough suppressants and expectorants D06781 Loquat leaf Crude drugs [BR:br08305

  18. Drug: D06701 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available omponent: Trichosanic acid [CPD:C08364] Therapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs an...d Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs D...pness Cough suppressants and expectorants D06701 Trichosanthes root; Trichosanthes root Crude drugs [BR:br08

  19. Perioperative Lung Protection Provided by High-Dose Ambroxol in Patients with Lung Cancer.

    Science.gov (United States)

    Wang, Xin; Wang, Lei; Wang, Huayong; Zhang, Hao

    2015-11-01

    The purpose is to observe the clinical effect of large doses of ambroxol hydrochloride in lung protection during the perioperative period of lung cancer operation. Fifty-six lung cancer patients who have undergone open-thoracic pulmonary lobectomy were divided randomly into two groups, and were given normal and large doses of ambroxol hydrochloride, respectively, during their perioperative period. Statistics based on post-operation clinical observations were analyzed in terms of ease of expectoration and expectoration properties, duration of antibiotics dependence, occurrence of lung complications, and adverse reactions related to ambroxol hydrochloride. On the third and the seventh day, the experimental group showed signs of improvement in terms of ease of expectoration and expectoration properties, compared with the controlled group. In terms of occurrence of post-operation lung complications and duration of antibiotics dependence, the experimental group also performed better. Using large doses of ambroxol hydrochloride would result in better clinical effects than using normal doses in preventing post-operation complications, and its clinical value in lung protection during lung cancer perioperative period calls for further research and promotion.

  20. Clove

    Science.gov (United States)

    Clove is an herb. People use the oils, dried flower buds, leaves, and stems to make medicine. Clove is used for upset stomach and as an ... Expectorants make it easier to cough up phlegm. Clove oil is used for diarrhea, hernia, and bad ...

  1. In vitro study of antiamoebic activity of methanol extract of fruit of ...

    African Journals Online (AJOL)

    The aniseed plant Pimpinella anisum (Saunf-Hindi) is one of the most ancient medicinal plants used by man. Currently, this plant has several uses in the food industry as spice, whereas in the pharmacopoeia, it is used as an expectorant in digestive disturbances, as mild diuretic, and as insect repellent in external use.

  2. Prevalence of HIV/Sputum AFB positivity among patients attending ...

    African Journals Online (AJOL)

    Key words: prevalence, TB, HIV, co-infection, Nigeria. LA PREVALENCE DE LA POSITIVITE DU VIH/EXPECTORATIONS AFB CHEZ LES PATIENTS QUI FREQUENT L'UNIVERSITE HOPITAL D'ENSEIGNEMENT DE BENIN (UBTH), BENIN CITY, NIGERIA. Le virus de l'immunodéficience humaine(VIH) et la tuberculose ...

  3. ~{owering rrrees

    Indian Academy of Sciences (India)

    Flowers are yellow or orange in colour and aggregated into globose head inflorescence. Fruits are globose and yellow when ripe. The bark is bitter, astringent, acrid, antiinflammatory, carminative, diuretic and expectorant. It is useful in fever, strangury, cough, diarrhoea, vomiting and burning sensation. A decoction of leaves ...

  4. Development of a new ultra-high performance liquid chromatography - tandem mass spectrometry method for determination of ambroxol hydrochloride in serum with pharmacokinetic application

    OpenAIRE

    Vujović Maja M.; Jokanović Milan; Nikolić Goran M.

    2016-01-01

    Ambroxol hydrochloride is an expectorant agent, successfully applied in mucolytic therapy for acute and chronic bronchopulmonary diseases. The drug regulates not only mucus secretion but also showed antioxidant, anti-inflammatory and local anesthetic properties. To supplement the pharmacokinetic and toxicological studies of ambroxol, a rapid ultra-high performance liquid chromatography-tandem mass spectrometry method for the quantitation of ambroxol in rabb...

  5. Drug: D01016 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 016.gif Antifungal; Expectorant; Supplement [iodine] Same as: C08219 Therapeutic category: 3221 ATC code: R0...5CA02 S01XA04 V03AB21 Component of Compound iodine glycerin [DR:D04412], Dental iodine glycerin [DR:D04880],

  6. Drug: D07032 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D07032 Formula, Drug Hangekobokuto extract (JP16); Hangekobokuto Pinellia tuber [DR... formulations 52 Traditional Chinese medicines 520 Traditional Chinese medicines 5200 Traditional Chinese medicines D07032 Hangeko...ulas for Qi Formulas for regulating Qi D07032 *Hangekobokuto Formulas for dampnes...s Cough suppressant and expectorant formulas D07032 *Hangekobokuto PubChem: 51091374 ...

  7. Physiotherapy and bronchial mucus transport

    NARCIS (Netherlands)

    van der Schans, CP; Postma, DS; Koeter, GH; Rubin, BK

    Cough and expectoration of mucus are the best-known symptoms in patients with pulmonary disease, The most applied intervention for these symptoms is the use of chest physiotherapy to increase bronchial mucus transport and reduce retention of mucus in the airways, Chest physiotherapy interventions

  8. Nitric oxide production by polymorphonuclear leukocytes in sputum from cystic fibrosis patients with chronic lung infection

    DEFF Research Database (Denmark)

    Kolpen, Mette; Bjarnsholt, Thomas; Moser, Claus

    2010-01-01

    -. In this study, we hypothesized that nitric oxide (NO) is also produced by the NO synthases (NOS) in the O2 consuming PMNs in the endobronchial mucus. Methods and results: This hypothesis was tested on fresh expectorated sputum from chronically infected CF patients by estimating and visualizing the NO production...

  9. The profile of tuberculosis infection at the Babcock University ...

    African Journals Online (AJOL)

    2016-01-23

    Jan 23, 2016 ... open pulmonary tuberculosis via coughing, sneezing, talking or expectorating.[1]. The pathogen is found in ... absence of a BCG scar, cigarette smoking, alcohol use, chronic anaemia, HIV co-infection, and previous ... Tuberculosis can affect any organ system.[5]. Clinical manifestations vary accordingly but.

  10. Drug: D08698 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D08698 Mixture, Drug Platycodon fluidextract - plantago herb extract - peony root e...xtract mixt; Opisezol A (TN) Platycodon fluidextract [DR:D06812], Plantago herb extract [DR:D04333], Peony r...expectorants 2249 Others D08698 Platycodon fluidextract - plantago herb extract - peony root extract mixt PubChem: 96025381 ...

  11. Research

    African Journals Online (AJOL)

    abp

    BAAR) a été réalisé chez tous les patients présentant une toux chronique avec expectorations. Le diagnostic de péricardite tuberculeuse a été retenu chez tous les malades présentant des signes d'insuffisance cardiaque droite ...

  12. Hepatoprotective studies of Coccinia indica Linn. in carbon ...

    African Journals Online (AJOL)

    Cocciana indica Linn (Cucurbitaceae) is widely distributed throughout India. It was employed in ancient system of medicine as anti-inflammatory, anthelmintic, digestant, liver tonic, and expectorant. Though it is traditionally used in jaundice and other hepatic manifestations, there are no reports on their validation and ...

  13. Prevalence and risk factors of complication of endotracheal ...

    African Journals Online (AJOL)

    There was not any case of dysphagia and bloody sputum (blood-streaked expectorant). Also, there was a significant relationship between sore throat and the type of surgery (P˂0.001). On the other hand, there was not any statistically significant relationship between sore throat and other associated risk factors (sex, age, ...

  14. 7 CFR 58.129 - Cleanliness.

    Science.gov (United States)

    2010-01-01

    ... shall keep their hands clean and follow good hygienic practices while on duty. Expectorating or use of... supplies are prepared, stored or otherwise handled. Clean white or light-colored washable or disposable outer garments and caps (paper caps, hard hats, or hair nets acceptable) shall be worn to adequately...

  15. Drug: D04594 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04594 Drug Ammonia water (JP16); Ammonia water (TN) NH4. OH 35.0371 35.0458 D04594...223 Expectorants 2232 Ammonium salts D04594 Ammonia water (JP16) 26 Epidermides 2...64 Analgesics, anti-itchings, astringents, anti-inflammatory agents 2643 Ammonium agents D04594 Ammonia wate

  16. Titratable acidity of beverages influences salivary pH recovery

    Directory of Open Access Journals (Sweden)

    Livia Maria Andaló TENUTA

    2015-01-01

    Full Text Available A low pH and a high titratable acidity of juices and cola-based beverages are relevant factors that contribute to dental erosion, but the relative importance of these properties to maintain salivary pH at demineralizing levels for long periods of time after drinking is unknown. In this crossover study conducted in vivo, orange juice, a cola-based soft drink, and a 10% sucrose solution (negative control were tested. These drinks differ in terms of their pH (3.5 ± 0.04, 2.5 ± 0.05, and 5.9 ± 0.1, respectively and titratable acidity (3.17 ± 0.06, 0.57 ± 0.04 and < 0.005 mmols OH- to reach pH 5.5, respectively. Eight volunteers with a normal salivary flow rate and buffering capacity kept 15 mL of each beverage in their mouth for 10 s, expectorated it, and their saliva was collected after 15, 30, 45, 60, 90, and 120 s. The salivary pH, determined using a mini pH electrode, returned to the baseline value at 30 s after expectoration of the cola-based soft drink, but only at 90 s after expectoration of the orange juice. The salivary pH increased to greater than 5.5 at 15 s after expectoration of the cola drink and at 30 s after expectoration of the orange juice. These findings suggest that the titratable acidity of a beverage influences salivary pH values after drinking acidic beverages more than the beverage pH.

  17. Analysis of Lung Flute–collected Sputum for Lung Cancer Diagnosis

    Science.gov (United States)

    Su, Jian; Anjuman, Nigar; Guarnera, Maria A; Zhang, Howard; Stass, Sanford A; Jiang, Feng

    2015-01-01

    Molecular analysis of sputum can help diagnose lung cancer. We have demonstrated that Lung Flute can be used to collect sputum from individuals who cannot spontaneously expectorate sputum. The objective of this study is to further evaluate the performance of the Lung Flute by comparing the characteristics of parallel samples collected with and without the Lung Flute and the usefulness for diagnosis of lung cancer. Fifty-six early-stage lung cancer patients (40 current smokers and 16 former smokers) and 73 cancer-free individuals (52 current smokers and 21 former smokers) were instructed to spontaneously cough and use Lung Flute for sputum sampling. Sputum cytology and polymerase chain reaction analysis of three miRNAs (miRs-21, 31, and 210) were performed in the specimens. All 92 current smokers and 11 (28.7%) of 37 former smokers spontaneously expectorated sputum and also produced sputum when using the Lung Flute. Twenty-seven former smokers (70.3%) who could not spontaneously expectorate sputum, however, were able to produce sputum when using the Lung Flute. The specimens were of low respiratory origin without contamination from other sources, eg, saliva. There was no difference of sputum volume and cell populations, diagnostic efficiency of cytology, and analysis of the miRNAs in the specimens collected by the two approaches. Analysis of the sputum miRNAs produced 83.93% sensitivity and 87.67% specificity for identifying lung cancer. Therefore, sputum collected by the Lung Flute has comparable features as spontaneously expectorated sputum. Using the Lung Flute enables former smokers who cannot spontaneously expectorate to provide adequate sputum to improve sputum collection for lung cancer diagnosis. PMID:26309391

  18. Analysis of Lung Flute-collected Sputum for Lung Cancer Diagnosis.

    Science.gov (United States)

    Su, Jian; Anjuman, Nigar; Guarnera, Maria A; Zhang, Howard; Stass, Sanford A; Jiang, Feng

    2015-01-01

    Molecular analysis of sputum can help diagnose lung cancer. We have demonstrated that Lung Flute can be used to collect sputum from individuals who cannot spontaneously expectorate sputum. The objective of this study is to further evaluate the performance of the Lung Flute by comparing the characteristics of parallel samples collected with and without the Lung Flute and the usefulness for diagnosis of lung cancer. Fifty-six early-stage lung cancer patients (40 current smokers and 16 former smokers) and 73 cancer-free individuals (52 current smokers and 21 former smokers) were instructed to spontaneously cough and use Lung Flute for sputum sampling. Sputum cytology and polymerase chain reaction analysis of three miRNAs (miRs-21, 31, and 210) were performed in the specimens. All 92 current smokers and 11 (28.7%) of 37 former smokers spontaneously expectorated sputum and also produced sputum when using the Lung Flute. Twenty-seven former smokers (70.3%) who could not spontaneously expectorate sputum, however, were able to produce sputum when using the Lung Flute. The specimens were of low respiratory origin without contamination from other sources, eg, saliva. There was no difference of sputum volume and cell populations, diagnostic efficiency of cytology, and analysis of the miRNAs in the specimens collected by the two approaches. Analysis of the sputum miRNAs produced 83.93% sensitivity and 87.67% specificity for identifying lung cancer. Therefore, sputum collected by the Lung Flute has comparable features as spontaneously expectorated sputum. Using the Lung Flute enables former smokers who cannot spontaneously expectorate to provide adequate sputum to improve sputum collection for lung cancer diagnosis.

  19. Ictus expectoratus: a sign of complex partial seizures usually of non-dominant temporal lobe origin.

    Science.gov (United States)

    Kaplan, P W; Kerr, D A; Olivi, A

    1999-12-01

    Spitting (or expectoration) is rarely seen with seizures. In Western society, spitting is a striking behavioral aberration. A 13-year-old child had intermittent agitated behavior, episodes of rage, spitting and confusion lasting up to 2 minutes. He stood up in church and told the preacher to 'shut up and sit down'. Epilepsy monitoring revealed spitting with polysharp and spike seizures resolved over the right temporal lobe. Magnetic resonance imaging revealed a right temporal lobe ganglioglioma. Spitting seizures resolved after resection. Ictal expectoration is rare. It may occur with epigastric aura, nausea, chewing, swallowing and fumbling. Literature review disclosed 17 cases, 12 of which arose from the non-dominant hemisphere. Most regressed with surgery and anticonvulsants. Copyright 1999 BEA Trading Ltd.

  20. Spatial distribution of microbial communities in the cystic fibrosis lung

    OpenAIRE

    Willner, Dana; Haynes, Matthew R.; Furlan, Mike; Schmieder, Robert; Lim, Yan Wei; Rainey, Paul B.; Rohwer, Forest; Conrad, Douglas

    2011-01-01

    Cystic fibrosis (CF) is a common fatal genetic disorder with mortality most often resulting from microbial infections of the lungs. Culture-independent studies of CF-associated microbial communities have indicated that microbial diversity in the CF airways is much higher than suggested by culturing alone. However, these studies have relied on indirect methods to sample the CF lung such as expectorated sputum and bronchoalveolar lavage (BAL). Here, we characterize the diversity of microbial co...

  1. An Unusual Case of Pulmonary Nocardiosis in Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Zehra Yaşar

    2014-01-01

    Full Text Available Pulmonary nocardiosis is a subacute or chronic necrotizing pneumonia caused by aerobic actinomycetes of the genus Nocardia and rare in immune-competent patients. A 35-year-old male, who had treated with antituberculosis drugs, presented with cough, dyspnea, and expectoration with episodes of hemoptysis with purulent sputum. The diagnosis of nocardiosis was made by microscopic examination of the surgically resected portion of the lung and revealed filamentous Gram-positive bacteria.

  2. Drug: D06987 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available herapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs and Chinese medicine formulations 52 Tradit...uto extract (JP16) Traditional Chinese Medicine in Japan [BR:br08304] Formulas Diaphoretic formula...s Diaphoretic dformulas pungent in flavor and warm in property D06987 *Shoseiryuto Formulas... for dampness Diuretic formulas D06987 *Shoseiryuto Cough suppressant and expectorant formulas D06987 *Shoseiryuto PubChem: 51091329 ...

  3. Mycobacterium tuberculosis drug-resistance in previously treated ...

    African Journals Online (AJOL)

    Ouagadougou. Méthodes: Une centaine et dix patients de tuberculose pulmonaire avec acid-fast bacilles-positif expectorations et en situation de défaillance, abandon de rechute ou de traitement ont été inclus dans l'étude. Quatre-vingt seize souches, y compris 92 (95.8%) M. tuberculose et 4 (4.2%) M. africanum, ont été ...

  4. Diagnosis of Pediatric Pulmonary Tuberculosis by Stool PCR

    OpenAIRE

    Wolf, Hilary; Mendez, Melissa; Gilman, Robert H.; Sheen, Patricia; Soto, Giselle; Velarde, Angie K.; Zimic, Mirko; Escombe, A. Roderick; Montenegro,Sonia; Oberhelman, Richard A.; Evans, Carlton A.

    2008-01-01

    Pediatric pulmonary tuberculosis diagnosis is difficult because young children are unable to expectorate sputum samples. Testing stool for tuberculosis DNA from swallowed sputum may diagnose pulmonary tuberculosis. Hospitalized children with suspected tuberculosis had stool, nasopharyngeal, and gastric aspirates cultured that confirmed pulmonary tuberculosis in 16/236 patients. Twenty-eight stored stools from these 16 children were used to evaluate stool polymerase chain reaction (PCR) for tu...

  5. Kandungan Saponin Buah, Daun dan Tangkai Daun Belimbing Wuluh (Averrhoa Bilimbi L.)

    OpenAIRE

    Fahrunnida, Fahrunnida

    2015-01-01

    In Indonesia, belimbing wuluh (Averrhoa bilimbi L.) has been used for traditional medicine, especially to heal stiff, mumps, rheumatism, ulcers, acne, tinea versicolor, high blood pressure, and dental pain and cough. This property is predicted comes from its secondary metabolites. Saponin is a compound group of secondary metabolites which is known to have antitussives and expectorants effect, antiinflammatory, antibacterial, and cytotoxic activity for cancer therapy. However, scientific infor...

  6. Drug: D01576 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D01576 Drug Oxeladin citrate (JAN) C20H33NO3. C6H8O7 527.273 527.6044 D01576.gif AT...din D01576 Oxeladin citrate (JAN) CAS: 52432-72-1 PubChe...OUGH AND COLD PREPARATIONS R05D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DB Other cough suppressants R05DB09 Oxela

  7. Drug: D06708 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Amygdalin [CPD:C08325] Therapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs and Chinese medici...ne formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs D06708 Apricot kernel (JP16) Traditional Chi...ants and expectorants D06708 Apricot kernel; Kyounin Crude drugs [BR:br08305] Dicot plants: rosids Rosaceae (rose family) D06708 Apricot kernel PubChem: 47208359 ...

  8. Drug: D06774 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available rds for non-pharmacopoeial crude drugs Therapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs and... Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs D0...ss Cough suppressants and expectorants D06774 Fritillaria bulb Crude drugs [BR:br08305] Monocot plants Liliaceae (lily family) D06774 Fritillaria bulb PubChem: 47208425 ...

  9. Drug: D06896 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ory: 5100 Cucurbitaceae (cucumber family) Trichosanthes seed; Standards for non-pharmacopoeial crude drugs M...ajor component: Trichosanic acid [CPD:C08364] Therapeutic category of drugs in Japan [BR:br08301] 5 Crude drugs... and Chinese medicine formulations 51 Crude drugs 510 Crude drugs 5100 Crude drugs... for dampness Cough suppressants and expectorants D06896 Trichosanthis semen; Karonin Crude drugs [BR:br0830

  10. Primary Pulmonary Leiomyoma in a Male

    Directory of Open Access Journals (Sweden)

    Ail Kutluk

    2016-07-01

    Full Text Available Primary pulmonary leiomyoma of the lung is benign in nature and is one of the rarest tumors of mesodermal origin. Because of the increasing number of routine chest roentgenograms, these lesions are being discovered more frequently. Treatment is by conservative surgical resection and carries a favorable prognosis. We presented a 30-year-old patient with expectoration cough and night sweats who undergone resection due to a mass in left lower lobe and diagnosed primary pulmonary leiomyoma.

  11. The history, chemistry and pharmacokinetics of Sanguinaria extract.

    Science.gov (United States)

    Harkrader, R J; Reinhart, P C; Rogers, J A; Jones, R R; Wylie, R E; Lowe, B K; McEvoy, R M

    1990-01-01

    Sanguinaria extract is a mixture of benzophenanthridine alkaloids derived from Sanguinaria canadensis L. (bloodroot). This mixture of alkaloids has a long history of use in tinctures and expectorants in pharmaceutical products. The purity of Sanguinaria extract is well defined. The chemistry and biochemistry of these alkaloids, including the dynamic equilibrium between acid and base forms, and pharmacokinetics of Sanguinaria extract shall be presented when this extract is incorporated into a dentifrice or oral rinse formulation.

  12. Drug: D04338 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04338 Mixture, Drug Dihydrocodeine phosphate - ephedrine hydrochloride - ammmonium... chloride mixt; Sekicode (TN) Dihydrocodeine phosphate [DR:D01481], Ephedrine hydrochloride [DR:D01386], Amm...onium chloride [DR:D01139] Therapeutic category: 2249 Therapeutic category of drugs in Japan [BR:br08301] 2 ...nd expectorants 2249 Others D04338 Dihydrocodeine phosphate - ephedrine hydrochloride - ammmonium chloride mixt PubChem: 17398060 ...

  13. ПРИМЕНЕНИЕ МУКОАКТИВНЫХ ЛЕКАРСТВЕННЫХ СРЕДСТВ В ПРАКТИКЕ ТЕРАПЕВТА

    OpenAIRE

    Ф. Т. Малыхин; А. А. Визель; И. Ю. Визель

    2013-01-01

    Russia is among the countries where using of mucolytic drugs in clinical practice is widespread. In chronic bronchitis, chronic obstructive pulmonary disease, acute respiratory syndrome with prolonged cough, pneumonia, tuberculosis and many other pathologies using of expectorants and mucoregulating drugs is common. Among the synthetic mucolytics benzyalamine bromhexine has been introduced for a long time in practice; and then its derivative — ambroxol hydrochloride which has better pharmacoki...

  14. Drug: D06753 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Mulberrofuran G [CPD:C08738], Cyclomorusin [CPD:C17867], Sanggenon A [CPD:C17869], Sanggenon B [CPD:C17870], San...ggenon C [CPD:C09834], Sanggenon D [CPD:C09835], Sanggenon E [CPD:C17871], a...ne in Japan [BR:br08304] Crude Drugs Drugs for dampness Cough suppressants and expectorants D06753 Mulberry

  15. Traitement par voie endovasculaire d'un faux anévrisme tuberculeux de l'isthme aortique

    OpenAIRE

    Steichen, O; Pellerin, O; Frank, M.; Frank, M; Emmerich, J.; Sapoval, M.; Fiessinger, J.-N; Bura-Rivière, A

    2007-01-01

    International audience; IntroductionAortic aneurysms are a well known but rare complication of tuberculosis. Their major complication is aneurysmal rupture, unforeseeable and lethal.ExegesisChest pain and hemoptoic expectoration revealed a false aneurysm of the aortic isthmus in a 48-year-old man. Endovascular repair with a stent graft was urgently undertaken. Tuberculosis was diagnosed 6 weeks thereafter by the growth of gastric juice cultures and medically treated. Most tuberculous aortic a...

  16. Chest physiotherapy in primary pneumonia.

    OpenAIRE

    Britton, S; Bejstedt, M; Vedin, L

    1985-01-01

    One hundred and seventy one patients with primary pneumonia entered a single blind, placebo controlled trial of physiotherapy. Treatment was allocated at random, physiotherapy consisting of postural drainage, external help with breathing, percussion, and vibration and the controls receiving advice on expectoration, deep breathing, and how to exercise to avoid thrombosis. Principles of pharmaceutical management were the same in the two groups. There was no objective evidence that daily physiot...

  17. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial.

    Science.gov (United States)

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    NCT02329873. Acute exacerbation (AE) of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed. To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD. A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31) were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10-30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration) were assessed at the baseline and at the end of the fourth day. All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L) completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all Prespiratory rehabilitation exercise training package reduced symptoms and enhanced the effectiveness of the care of elderly inpatients with AECOPD.

  18. Breathing-synchronised electrical stimulation of the abdominal muscles in patients with acute tetraplegia: A prospective proof-of-concept study.

    Science.gov (United States)

    Liebscher, Thomas; Schauer, Thomas; Stephan, Ralph; Prilipp, Erik; Niedeggen, Andreas; Ekkernkamp, Axel; Seidl, Rainer O

    2016-11-01

    To examine whether, by enhancing breathing depth and expectoration, early use of breathing-synchronised electrical stimulation of the abdominal muscles (abdominal functional electrical stimulation, AFES) is able to reduce pulmonary complications during the acute phase of tetraplegia. Prospective proof-of-concept study. Spinal cord unit at a level 1 trauma center. Following cardiovascular stabilisation, in addition to standard treatments, patients with acute traumatic tetraplegia (ASIA Impairment Scale A or B) underwent breathing-synchronised electrical stimulation of the abdominal muscles to aid expiration and expectoration. The treatment was delivered in 30-minute sessions, twice a day for 90 days. The target was for nine of 15 patients to remain free of pneumonia meeting Centers for Disease Control and Prevention (CDC) diagnostic criteria. Eleven patients were recruited to the study between October 2011 and November 2012. Two patients left the study before completion. None of the patients contracted pneumonia during the study period. No complications from electrical stimulation were observed. AFES led to a statistically significant increase in peak inspiratory and expiratory flows and a non-statistically significant increase in tidal volume and inspiratory and expiratory flow. When surveyed, 6 out of 9 patients (67%) reported that the stimulation procedure led to a significant improvement in breathing and coughing. AFES appears to be able to improve breathing and expectoration and prevent pneumonia in the acute phase of tetraplegia (up to 90 days post-trauma). This result is being validated in a prospective multicentre comparative study.

  19. Cost-effectiveness analysis of diagnostic options for pneumocystis pneumonia (PCP.

    Directory of Open Access Journals (Sweden)

    Julie R Harris

    Full Text Available Diagnosis of Pneumocystis jirovecii pneumonia (PCP is challenging, particularly in developing countries. Highly sensitive diagnostic methods are costly, while less expensive methods often lack sensitivity or specificity. Cost-effectiveness comparisons of the various diagnostic options have not been presented.We compared cost-effectiveness, as measured by cost per life-years gained and proportion of patients successfully diagnosed and treated, of 33 PCP diagnostic options, involving combinations of specimen collection methods [oral washes, induced and expectorated sputum, and bronchoalveolar lavage (BAL] and laboratory diagnostic procedures [various staining procedures or polymerase chain reactions (PCR], or clinical diagnosis with chest x-ray alone. Our analyses were conducted from the perspective of the government payer among ambulatory, HIV-infected patients with symptoms of pneumonia presenting to HIV clinics and hospitals in South Africa. Costing data were obtained from the National Institutes of Communicable Diseases in South Africa. At 50% disease prevalence, diagnostic procedures involving expectorated sputum with any PCR method, or induced sputum with nested or real-time PCR, were all highly cost-effective, successfully treating 77-90% of patients at $26-51 per life-year gained. Procedures using BAL specimens were significantly more expensive without added benefit, successfully treating 68-90% of patients at costs of $189-232 per life-year gained. A relatively cost-effective diagnostic procedure that did not require PCR was Toluidine Blue O staining of induced sputum ($25 per life-year gained, successfully treating 68% of patients. Diagnosis using chest x-rays alone resulted in successful treatment of 77% of patients, though cost-effectiveness was reduced ($109 per life-year gained compared with several molecular diagnostic options.For diagnosis of PCP, use of PCR technologies, when combined with less-invasive patient specimens such as

  20. Assessment of extracellular dehydration using saliva osmolality.

    Science.gov (United States)

    Ely, Brett R; Cheuvront, Samuel N; Kenefick, Robert W; Spitz, Marissa G; Heavens, Kristen R; Walsh, Neil P; Sawka, Michael N

    2014-01-01

    When substantial solute losses accompany body water an isotonic hypovolemia (extracellular dehydration) results. The potential for using blood or urine to assess extracellular dehydration is generally poor, but saliva is not a simple ultra-filtrate of plasma and the autonomic regulation of salivary gland function suggests the possibility that saliva osmolality (Sosm) may afford detection of extracellular dehydration via the influence of volume-mediated factors. This study aimed to evaluate the assessment of extracellular dehydration using Sosm. In addition, two common saliva collection methods and their effects on Sosm were compared. Blood, urine, and saliva samples were collected in 24 healthy volunteers during paired euhydration and dehydration trials. Furosemide administration and 12 h fluid restriction were used to produce extracellular dehydration. Expectoration and salivette collection methods were compared in a separate group of eight euhydrated volunteers. All comparisons were made using paired t-tests. The diagnostic potential of body fluids was additionally evaluated. Dehydration (3.1 ± 0.5% loss of body mass) decreased PV (-0.49 ± 0.12 L; -15.12 ± 3.94% change), but Sosm changes were marginal (diagnostic accuracy was poor (AUC = 0.77-0.78) for all body fluids evaluated. Strong agreement was observed between Sosm methods (Expectoration: 61 ± 10 mmol/kg, Salivette: 61 ± 8 mmol/kg, p > 0.05). Extracelluar dehydration was not detectable using plasma, urine, or saliva measures. Salivette and expectoration sampling methods produced similar, consistent results for Sosm, suggesting no methodological influence on Sosm.

  1. Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol.

    Science.gov (United States)

    Llor, Carl; Moragas, Ana; Bayona, Carolina; Morros, Rosa; Pera, Helena; Cots, Josep M; Fernández, Yvonne; Miravitlles, Marc; Boada, Albert

    2011-06-21

    Acute bronchitis is one of the most prevalent respiratory infections in primary care, and in more than 90% of the cases antibiotics are prescribed, mainly when purulent expectoration is present. However, this process is usually viral in origin and the benefits of antibiotic treatment are marginal. On the other hand, in recent years bronchitis has been considered more as an inflammatory than an infectious process. Thus, the aim of this study is to evaluate the clinical effectiveness of a schedule of an oral anti-inflammatory compared with an antibiotic regimen and another group assigned to receive a placebo. A total of 420 patients from 15 to 70 years of age with no associated comorbidity, presenting respiratory tract infection of at least one week of evolution, with cough as the predominant symptom, the presence of purulent expectoration and at least one other symptom of the respiratory tract (dyspnoea, wheezing, chest discomfort or pain), with no alternative explanation such as pneumonia, will be included in a prospective, randomised and controlled, clinical trial with placebo. The patients will be randomised to receive one of three treatments: ibuprofen, amoxycillin and clavulanic acid or placebo for 10 days. The main outcome measure is the number of days with frequent cough defined by the symptom diary with a score of 1 or more. This trial is designed to evaluate the number of days with frequent cough with anti-inflammatory treatment compared with antimicrobial treatment and placebo in previously healthy patients with a clinical picture of acute bronchitis and purulent expectoration. It is hypothesized that anti-inflammatory treatment is more effective than antibiotic treatment to reduce cough, which is the most disturbing symptom for patients with this infection. ISRCTN07852892.

  2. Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol

    Directory of Open Access Journals (Sweden)

    Fernández Yvonne

    2011-06-01

    Full Text Available Abstract Background Acute bronchitis is one of the most prevalent respiratory infections in primary care, and in more than 90% of the cases antibiotics are prescribed, mainly when purulent expectoration is present. However, this process is usually viral in origin and the benefits of antibiotic treatment are marginal. On the other hand, in recent years bronchitis has been considered more as an inflammatory than an infectious process. Thus, the aim of this study is to evaluate the clinical effectiveness of a schedule of an oral anti-inflammatory compared with an antibiotic regimen and another group assigned to receive a placebo. Methods and design A total of 420 patients from 15 to 70 years of age with no associated comorbidity, presenting respiratory tract infection of at least one week of evolution, with cough as the predominant symptom, the presence of purulent expectoration and at least one other symptom of the respiratory tract (dyspnoea, wheezing, chest discomfort or pain, with no alternative explanation such as pneumonia, will be included in a prospective, randomised and controlled, clinical trial with placebo. The patients will be randomised to receive one of three treatments: ibuprofen, amoxycillin and clavulanic acid or placebo for 10 days. The main outcome measure is the number of days with frequent cough defined by the symptom diary with a score of 1 or more. Discussion This trial is designed to evaluate the number of days with frequent cough with anti-inflammatory treatment compared with antimicrobial treatment and placebo in previously healthy patients with a clinical picture of acute bronchitis and purulent expectoration. It is hypothesized that anti-inflammatory treatment is more effective than antibiotic treatment to reduce cough, which is the most disturbing symptom for patients with this infection. Trial registration ISRCTN07852892

  3. Drug: D02205 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D02205 Drug Ethylmorphine hydrochloride hydrate (JP16); Ethylmorphine hydrochloride... dihydrate; Ethylmorphine hydrochloride (TN) C19H23NO3. 2HCl. H2O 403.1317 404.328 D02205.gif Analgesic [DS:...6] Therapeutic category of drugs in Japan [BR:br08301] 8 Narcotics 81 Alkaloidal narcotics 811 Opium alkaloids 8114 Morphines D0220...5D COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS R05DA Opium alkaloids and derivatives R05DA01 Ethylmorphine D0220...HER OPHTHALMOLOGICALS S01XA Other ophthalmologicals S01XA06 Ethylmorphine D02205

  4. Italian multicenter study on the treatment of chronic obstructive lung disease with bromhexine. A double-blind placebo-controlled trial.

    Science.gov (United States)

    Valenti, S; Marenco, G

    1989-01-01

    237 out-patients suffering from chronic obstructive lung disease (COLD) were selected from 7 Italian clinical centers. They were randomly allocated to either placebo or bromhexine 30 mg b.i.d. p.o., in a double-blind fashion. Sputum volume and quality, facility of expectoration, cough, dyspnea, auscultatory thoracic symptoms, forced expiratory volume, peak expiratory flow rate and residual volume were evaluated. Bromhexine showed a statistically significant therapeutic activity in comparison to placebo. This action was rapid, marked and effective in determining a modulation of bronchial secretions.

  5. Prospective, Longitudinal Study of Plastic Bronchitis Cast Pathology and Responsiveness to Tissue Plasminogen Activator (tPA)

    OpenAIRE

    Heath, Lauren; Ling, Shelley; Racz, Jennifer; Mane, Gerta; Schmidt, Lindsay; Myers, Jeffrey L.; Tsai, Wan C.; Caruthers, Regine L.; Hirsch, Jennifer C.; Stringer, Kathleen A.

    2011-01-01

    Plastic bronchitis (PB) is a rare disease that often occurs in patients with congenital heart disease (CHD) who have undergone staged single ventricle palliation. It is characterized by the formation of rubbery “casts” in the airways. PB treatment frequently includes inhaled tPA. However, the efficacy of tPA to reduce cast burden is unknown. This is further complicated by our lack of knowledge of cast composition. We obtained spontaneously expectorated PB casts from children (n=4) with CHD an...

  6. Drug: D00848 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00848 Drug Dextromethorphan hydrobromide hydrate (JP16); Dextromethorphan hydrobro...orphan [ATC:R05DA09] D00848 Dextromethorphan hydrobromide (USP) CAS: 6700-34-1 PubChem: 7847913 DrugBank: DB...65], CYP3A4 [HSA:1576] map07235 N-Metyl-D-aspartic acid receptor antagonists Therapeutic category of dr...ents 222 Antitussives 2223 Dextromethorphans D00848 Dextromethorphan hydrobromide hydrate (JP16); Dextromethorphan hydr...WITH EXPECTORANTS R05DA Opium alkaloids and derivatives R05DA09 Dextromethorphan D00848 Dextromethorphan hydrobromide hydr

  7. Pulmonary hydatidosis: An unusual cause of haemoptysis

    Directory of Open Access Journals (Sweden)

    Pandey A

    2007-01-01

    Full Text Available A 28-year-old female patient was referred to us with complaints of massive haemoptysis and cough with expectoration, of two years′ duration. Her chest radiograph, computed tomography scan and video-bronchoscopy revealed a cystic lesion in the right upper and lower zones of the lungs. Aspiration from the cyst fluid was grossly hemorrhagic and full of inflammatory cells. On digestion of the fluid with potassium hydroxide, it showed plenty of hooklets and scolices of Echinococcus granulosus . An intact brood capsule was also seen. Diagnosis of hydatidosis was further confirmed by a positive serological and therapeutic response to albendazole.

  8. New Form of Hypertonic Solution for Nebulization Therapy

    Directory of Open Access Journals (Sweden)

    Olga I. Simonova

    2016-01-01

    Full Text Available Mucolytic, expectorative and antitussive drugs are traditionally used in acute or chronic respiratory episodes affected by acute respiratory infections. Today, preference is given to drugs in a form of solutions for nebulization therapy. The article presents data on the new dosage form of 7% inhalation hypertonic solution in combination with hyaluronic acid used in mucostasis therapy for chronic respiratory diseases. The information on the properties and the favorable effect of hyaluronic acid is provided. We discuss the evidence base of inhalation of the hypertonic solution in combination with hyaluronic acid in cystic fibrosis.

  9. Evaluation of the genotoxic potential of the Hypericum brasiliense (Guttiferae extract in mammalian cell system in vivo

    Directory of Open Access Journals (Sweden)

    Anderson Victorino Espósito

    2005-03-01

    Full Text Available Plants of the genus Hypericum, long used in folk medicine, contain active compounds which present, anti-septic, diuretic, digestive, expectorant, vermifugal, anti-depressive and other properties. The possible clastogenic effect of a H. brasiliense extract was tested in vivo on the bone marrow cells of Wistar rats. The extract was administered by gavage at doses of 50, 150 and 300 mg/kg body weight. Experimental and control animals were submitted to euthanasia 24 h after the treatment for micronucleus (MN and chromosome preparations. H. brasiliense extract did not induce statistically significant increases in the average numbers of MN or chromosome aberrations in the test systems employed.

  10. Associations of symptoms related to isocyanate, ureaformol, and formophenolic exposures with respiratory symptoms and lung function in coal miners

    Energy Technology Data Exchange (ETDEWEB)

    Bertrand, J.P.; Simon, V.; Chau, N. [Houilleres Bassin Lorraine, Freyming Merlebach (France)

    2007-04-15

    The respiratory effects of diphenylmethane diisocyanate (MDI)-based resins and ureaformol- and formophenolic-based resins, used in coal mining, are unknown. This cross-sectional study of 354 miners evaluated respiratory health in miners with MDI-related symptoms (IS) and ureaformol/formophenolic-related symptoms (UFS). The protocol included clinical examination, chest radiograph, questionnaire on respiratory symptoms, smoking habit, job history, resin handling, and spirometry. Resin handling concerned 27.7% of the miners. IS affected 5.6%, and 1.4% also after work. UFS affected 22.6%, and 2.3% also after work. Wheezing affected 35.6%; chronic cough, expectoration, or bronchitis about 10%; dyspnea 5.4%; and asthma 2.8%. The miners with UFS had significantly more frequent chronic cough, expectoration, chronic bronchitis, dyspnea, and wheezing, whereas those with IS at and after work had markedly lower FVC, FEV1, MMEF, FEF50% and FEF25%. These findings raise the possibility of deleterious effects of exposures to MDI and ureaformol/ ormophenolic resins on respiratory health and lung function in coal miners during their working life.

  11. Oral approach-avoidance: affective consequences of muscular articulation dynamics.

    Science.gov (United States)

    Topolinski, Sascha; Maschmann, Ira Theresa; Pecher, Diane; Winkielman, Piotr

    2014-06-01

    Can mouth movements shape attitudes? When people articulate different consonants (e.g., B or K) they press the tongue and the lips against various spots in the mouth. This allows for construction of words that feature systematic wanderings of consonantal stricture spots either from the front to the rear (inward; e.g., BENOKA) or from the rear to the front (outward; e.g., KENOBA) of the mouth. These wanderings of muscular strictures resemble the oral kinematics during either deglution (swallowing-like, inward movement) or expectoration (spitting-like, outward movement). Thus, we predicted that the articulation of inward and outward words induces motivational states associated with deglutition and expectoration--namely, approach and avoidance--which was tested in 9 experiments (total N = 822). Inward words were preferred over outward words, being labeled as nonsense words (Experiments 1, 4, 5, 6, and 9), company names (Experiment 2), or person names (Experiments 3, 7, and 8), with control words falling in between (Experiment 5). As a social-behavioral consequence, ostensible chat partners were more often chosen to interact with when having inward compared to outward names (Experiment 7). The effect was found in German-speaking (Experiments 1-5) and English-speaking (Experiment 6) samples, and it occurred even under silent reading (all experiments) and for negatively labeled targets (names of villains; Experiment 8). Showing articulation simulations as being the causal undercurrent, this effect was absent in aphasia patients who lacked covert subvocalizations (Experiment 9).

  12. [Ambulatory treatment with cefuroxime-axetil of infectious bronchitis in patients sixty years of age or older: comparative study of the combination of amoxicillin and clavulanic acid].

    Science.gov (United States)

    Hugonot, R; Hugonot, L; Pappo, M; Chiche, D

    1990-06-01

    The aim of this multicenter, prospective randomized trial was to compare the efficacy and safety of cefuroxime-axetil and amoxycillin/clavulanic acid for the treatment of infectious bronchitis in the elderly patient. Between January and April 1989, 157 out patients aged 60 years or more and presenting with infectious bronchitis were treated with either cefuroxime-axetil (250 mg bid), or the association amoxycillin/clavulanic acid (500 mg/125 mg bid). The two treatment groups were comparable at the time of inclusion; the mean age was 70 years, 82% of the patients were febrile, 75% presented purulent expectoration, 24% had a history of chronic bronchitis and 19% received symptomatic treatment was NSAIDs. The mean duration of treatment was 9 days. Clinical efficacy was assessed by the investigators. While fever and cough resolved similarly in the two groups, statistically fewer patients presented persistent purulent expectoration in the cefuroxime-axetil treatment group than in the group receiving amoxycillin/clavulanic acid (2% and 13%, respectively, p = 0.03). The proportion of patients who reported at least one side-effect was 3.6% in the cefuroxime-axetil treatment group against 21.6% of those who received the association (p = 0.006).

  13. Throat Swabs and Sputum Culture as Predictors of P. aeruginosa or S. aureus Lung Colonization in Adult Cystic Fibrosis Patients.

    Directory of Open Access Journals (Sweden)

    Darius Seidler

    Full Text Available Due to frequent infections in cystic fibrosis (CF patients, repeated respiratory cultures are obtained to inform treatment. When patients are unable to expectorate sputum, clinicians obtain throat swabs as a surrogate for lower respiratory cultures. There is no clear data in adult subjects demonstrating the adequacy of throat swabs as a surrogate for sputum or BAL. Our study was designed to determine the utility of throat swabs in identifying lung colonization with common organisms in adults with CF.Adult CF subjects (n = 20 underwent bronchoscopy with BAL. Prior to bronchoscopy, a throat swab was obtained. A sputum sample was obtained from subjects who were able to spontaneously expectorate. All samples were sent for standard microbiology culture.Using BAL as the gold standard, we found the positive predictive value for Pseudomonas aeruginosa to be 100% in both sputum and throat swab compared to BAL. However, the negative predictive value for P. aeruginosa was 60% and 50% in sputum and throat swab, respectively. Conversely, the positive predictive value for Staphylococcus aureus was 57% in sputum and only 41% in throat swab and the negative predictive value of S. aureus was 100% in sputum and throat swab compared to BAL.Our data show that positive sputum and throat culture findings of P. aeruginosa reflect results found on BAL fluid analysis, suggesting these are reasonable surrogates to determine lung colonization with P. aeruginosa. However, sputum and throat culture findings of S. aureus do not appear to reflect S. aureus colonization of the lung.

  14. Ambroxol in the 21st century: pharmacological and clinical update.

    Science.gov (United States)

    Malerba, Mario; Ragnoli, Beatrice

    2008-08-01

    Belonging to the group of expectorants, ambroxol is an active substance with a long history that influences parameters considered to be the basis for the physiological production and the transport of the bronchial mucus. Therefore, ambroxol's indication is 'secretolytic therapy in acute and chronic bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport'. The aim of this review is to evaluate the pharmacological and clinical data on the mucokinetic compound ambroxol. The existing database that covers >40 years of pharmacological research and clinical development was analysed. Only studies with adequate study design were evaluated. Ambroxol is shown to exert several activities: i) secretolytic activity (i.e., promotes mucus clearance, facilitates expectoration, and eases productive cough); ii) anti-inflammatory and antioxidant activity; and iii) a local anaesthetic effect through sodium channel blocking at the level of the cell membrane. The reduction on chronic obstructive pulmonary disease exacerbations is consistent and clinically relevant. The anaesthetic effect is a new pharmacological action that could be beneficial in the management of acute respiratory tract infections. The efficacy and safety of ambroxol is well established.

  15. The use of lithium as a marker for the retention of liquids in the oral cavity after rinsing.

    Science.gov (United States)

    Hanning, Sara M; Kieser, Jules A; Ferguson, Martin M; Reid, Malcolm; Medlicott, Natalie J

    2014-01-01

    The aim of this study was to validate the use of lithium as a marker to indicate the retention of simple liquids in the oral cavity and use this to determine how much liquid is retained in the oral cavity following 30 s of rinsing. This is a validation study in which saliva was spiked with known concentrations of lithium. Twenty healthy participants then rinsed their mouths with either water or a 1 % w/v carboxymethylcellulose (CMC) solution for 30 s before expectorating into a collection cup. Total volume and concentration of lithium in the expectorant were then measured, and the percentage of liquid retained was calculated. The mean amount of liquid retained was 10.4 ± 4.7 % following rinsing with water and 15.3 ± 4.1 % following rinsing with 1 % w/v CMC solution. This difference was significant (p < 0.01). Lithium was useful as a marker for the retention of liquids in the oral cavity, and a value for the amount of water and 1 % w/v CMC solution remaining in the oral cavity following a 30-s rinse was established. The present study quantifies the retention of simple fluids in the oral cavity, validating a technique that may be applied to more complex fluids such as mouth rinses. Further, the application of this method to specific population groups such as those with severe xerostomia may assist in developing effective saliva substitutes.

  16. A device for the collection of submandibular saliva.

    Science.gov (United States)

    Hanning, Sara; Motoi, Lidia; Medlicott, Natalie; Swindells, Stephen

    2012-03-01

    The objective of this study was to describe the construction of a non-invasive device for the collection of submandibular saliva. Preliminary tests were carried out on saliva collected from a single donor in order to determine whether the rheological properties of submandibular saliva collected using the device were comparable to whole saliva collected using the expectoration (or 'spit') method. The device collected a lower quantity of saliva than that collected using the expectoration method. Stimulated saliva collected using the device had a pH close to that of unstimulated saliva because the sealed collection unit in the device minimised contamination. Saliva exhibited shear-thinning behaviour regardless of the method of collection, although that collected using the device was more viscous. The viscoelasticity of saliva collected using the two methods was different, probably as a result of differences in composition. This difference was greater with stimulated saliva. Despite the discrepancies between whole saliva and submandibular saliva, the device provides a non-invasive method for the collection of high-quality saliva over extended periods.

  17. Acute Respiratory Failure Caused by Hepatopulmonary Fistula in a Patient with Hepatocellular Carcinoma.

    Science.gov (United States)

    Lee, Jungsil; Kim, Yoon Jun; Kim, Hyung-Jun; Kim, Jee-Min; Kim, Young-Chan; Choi, Sun Mi

    2016-07-01

    A 59-year-old man presented with acute dyspnea following sudden productive cough and expectoration of a full cup of "blood-tinged" sputum. He had been diagnosed with hepatitis B virus-related hepatocellular carcinoma and had received transarterial chemoembolization 5 years ago for a 20-cm hepatic mass; he denied any history of hematemesis and the last esophagogastroduodenoscopy from a year ago showed absence of varix. Chest computed tomography (CT) with angiography showed new appearance of right basal lung consolidation but no bleeding focus. Despite the use of systemic antibiotics, the patient developed respiratory failure on day 7 of hospitalization. After intubation, a massive amount of brown sputum with anchovy-paste-like consistency was suctioned via the endotracheal tube. Bronchoscopic toileting was performed and the patient was extubated. In the ward, he continued to expectorate the brown sputum. On day 25 of hospitalization, a repeat CT scan showed simultaneous disappearance of the pneumonic consolidation and the necrotic fluid within the hepatic mass, suggesting the presence of a fistula. He has continued to receive systemic antibiotics, sorafenib, and entecavir, and follow up by respiratory and hepato-oncology specialists.

  18. CT findings of plastic bronchitis in children after a Fontan operation

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    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Jhang, Won Kyoung; Kim, Young Hwee; Ko, Jae Kon; Park, In Sook [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea); Park, Jeong-Jun; Yun, Tae-Jin; Seo, Dong-Man [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. To describe the CT findings in plastic bronchitis in children after a Fontan operation. Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes. (orig.)

  19. [The combined drug ascoril in the treatment of patients with chronic obstructive pulmonary disease concurrent with coronary heart disease].

    Science.gov (United States)

    Grigor'eva, N Iu; Kuznetsov, A N; Koroleva, T V; Koroleva, M E

    2013-01-01

    To evaluate the clinical efficacy of the combined drug ascoril (Glenmark, India) in patients with grade I-Ii chronic obstructive pulmonary disease (COPD) concurrent with coronary heart disease (CHD). Sixty patients, including 12 (20%) women and 48 (80%) men, aged 43 to 68 years (mean age 55.1 +9.9 years), with COPD were examined. The patients were divided into 2 groups. Group 1 used the combined broncholytic and expectorant drug ascoril and Group 2 took mucolytic agent ambroxol. The follow-up period was 7 days. On day 2 of ascoril treatment, all the patients showed a significant reduction in the intensity of cough that was completely relieved in 26 (87%) patients by treatment day 7. Prior to ascoril treatment, heart rate (HR) was 64.4+/-5.5 beats/min. A significant increase in HR to 72.7+/-10.1 beats/min was observed 20 min after the first drug intake (p < 0.05) and a decrease to 68.6+/-10.5 beats/min was seen after 60 min. On treatment day 7, HR was 63.0+/-6.5 beats/min, which was similar to that before ascoril treatment (p = 0.6). In the patients with COPD concurrent with CHD, the combined drug ascoril exerts broncholytic and expectorant effects, with no pronounced negative action on HR.

  20. Effects of N-acetylcysteine on asthma exacerbation.

    Science.gov (United States)

    Aliyali, Masoud; Poorhasan Amiri, Ali; Sharifpoor, Ali; Zalli, Fatemeh

    2010-06-01

    Airway mucus hypersecretion and increased oxidative stress are clinical and pathophysiological features of asthma exacerbation. We studied effects of N-acetylcysteine (NAC) as a mucolytic and antioxidant agent in asthma exacerbation. In this randomized, single-blinded, placebo-controlled study 50 patients ( 17 male, 33 female, mean age 48.94+/-13.68) with asthma exacerbation were randomized to receive either oral 600 mg b.d. N-acetylcysteine or placebo in addition to standard treatment during 5 days hospitalization. Daily measurements of wheezing, dyspnea, cough, sputum, expectoration, night sleep scores and morning PEFR were performed. There was no significant difference in wheezing score between patients assigned NAC and those assigned placebo in day 5(0.84[SD 0.94] VS 0.87[SD 0.79]) and also in cough score (0.72[SD 0.84] VS 0.79[SD 0.97]), dyspnea score (0.84[SD 1.06] VS 0.91[SD 1.01]), sputum score(0.79[SD 0.83] VS 0.62[SD 0.71]), expectoration score(0.79[SD 0.97] VS 0.83[SD 1.09]), night sleep score(1[SD 1.17] VS 0.67[SD 0.98] and morning PEFR (256[SD 96.36] VS 282[SD 98.86]). We concluded that addition of N-acetylcysteine to usual asthma medication has no significant effect in treatment of asthma exacerbation.

  1. Etude Par Ponction Tracheale De La Flore Bacterienne Des Pneumopathies Infectieuses.

    Science.gov (United States)

    Schoutens, E; Koster, J P; Arouete, A; Tombroff, M; Yourassowsky, E

    1971-01-01

    The authors analyse the bacteriological data gathered by 100 successive tracheal Punctures and compare these results to those obtained by sputum cultures, which had either been collected by routine or when withdrawing the catheter for tracheal aspiration. This plain and not hazardous technique allows to draw the following conclusions : 1) The culture of routinely collected sputum at the patient's bed-side often misleads the physician (6 times on 10) whereas newly expectorated sputum brought immediately to the laboratory more truly shows the tracheo-bronchic flora (valuable results in 75 % of the cases). 2) The tracheal puncture, which reduces the causes of errors, due to the contamination of the sputum by the rhino-pharyngeal flora, to a minimum, particularly is indicated in the following cases : patients who do not expectorate (including suspects of pulmonary tuberculosis), instantly earnest pneumopathia, bad response to applied antibiotic therapy, tests of the true efficiency of an antibiotic therapy. 3) The bacteriological study of these punctures performed on patients, who caused therapeutical problems and who had been submitted to antibiotic therapies evidenced the following data : 40 % of the punctures were sterile, 39 % showed one single germ (18 Gram negative, 16 Gram positive, 2 BK, 3 aspergillus), 15 % showed 2 simultaneous germs and 6 % were not significant.

  2. [Effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China].

    Science.gov (United States)

    Fan, Ming-Yue; Tang, Xu; Huang, Wei; Dai, Hua; Liu, Xing-Can; Xia, Yin-Yin; Meng, Pan; Zhang, Rui-Yuan; Guo, Yu-Ming; Cheng, Shu-Qun

    2017-04-01

    To investigate the effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China. The main urban area of Chongqing was divided into polluted area and clean area according to the air pollution data shown on the Environmental Protection Agency Website of Chongqing between 2010 and 2015. A cluster sampling method was used to select 695 third- or fourth-grade children from 2 primary schools in the clean or polluted area as study subjects, with 313 children from the clean area and 382 children from the polluted area. Pulmonary function was examined for all children and a standard American epidemiological questionnaire (ATS-DLD-78-C) was used to investigate the prevalence of respiratory diseases and symptoms. Compared with the clean area, the polluted area had significantly higher concentrations of inhalable particles (PM10), fine particulate matter (PM2.5), and nitric oxide (NOX) (Ppolluted area had significantly higher risks of cough (OR=1.644), cough during cold (OR=1.596), expectoration during cold (OR=2.196), persistent expectoration (OR=1.802), and wheezing (OR=2.415). The boys and girls in the clean area had significantly higher forced vital capacity and forced expiratory volume in one second than those in the polluted area (Ppollution in the main urban area of Chongqing is associated with the increased prevalence of respiratory symptoms in school-aged children and has certain effect on children's pulmonary function.

  3. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

    Directory of Open Access Journals (Sweden)

    Liao LY

    2015-08-01

    Full Text Available Lin-Yu Liao,1,2 Kuei-Min Chen,2 Wei-Sheng Chung,3 Jung-Yien Chien4 1Department of Nursing, Chest Hospital, Ministry of Health and Welfare, Rende District, Tainan, 2College of Nursing, Kaohsiung Medical University, Sanmin District, Kaohsiung, 3Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, 4Department of Medicine, Chest Hospital, Ministry of Health and Welfare, Rende District, Tainan, Taiwan Clinical trials identifier: NCT02329873 Background: Acute exacerbation (AE of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed.Objective: To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD.Methods: A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31 were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10–30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration were assessed at the baseline and at the end of the fourth day.Results: All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all P<0.05. Within-group comparisons revealed that the dyspnea, cough, and exercise tolerance significantly improved in the experimental group by the end of the fourth

  4. The bioavailability and airway clearance of the steroid component of budesonide/formoterol and salmeterol/fluticasone after inhaled administration in patients with COPD and healthy subjects: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Borgström Lars

    2009-10-01

    Full Text Available Abstract Background Airway absorption and bioavailability of inhaled corticosteroids (ICSs may be influenced by differences in pharmacokinetic properties such as lipophilicity and patient characteristics such as lung function. This study aimed to further investigate and clarify the distribution of budesonide and fluticasone in patients with severe chronic obstructive pulmonary disease (COPD by measuring the systemic availability and sputum concentration of budesonide and fluticasone, administered via combination inhalers with the respective long-acting β2-agonists, formoterol and salmeterol. Methods This was a randomized, double-blind, double-dummy, two-way crossover, multicenter study. Following a run-in period, 28 patients with severe COPD (mean age 65 years, mean forced expiratory volume in 1 second [FEV1] 37.5% predicted normal and 27 healthy subjects (mean age 31 years, FEV1 103.3% predicted normal received two single-dose treatments of budesonide/formoterol (400/12 μg and salmeterol/fluticasone (50/500 μg, separated by a 4–14-day washout period. ICS concentrations were measured over 10 hours post-inhalation in plasma in all subjects, and over 6 hours in spontaneously expectorated sputum in COPD patients. The primary end point was the area under the curve (AUC of budesonide and fluticasone plasma concentrations in COPD patients relative to healthy subjects. Results Mean plasma AUC values were lower in COPD patients versus healthy subjects for budesonide (3.07 μM·hr versus 6.21 μM·hr and fluticasone (0.84 μM·hr versus 1.50 μM·hr, and the dose-adjusted AUC (geometric mean ratios in healthy subjects and patients with severe COPD for plasma budesonide and fluticasone were similar (2.02 versus 1.80; primary end point. In COPD patients, the Tmax and the mean residence time in the systemic circulation were shorter for budesonide versus fluticasone (15.5 min versus 50.8 min and 4.41 hrs versus 12.78 hrs, respectively and Cmax was

  5. APPLICATION OF THE COMBINED MEDICATION BASED ON THE MEDICINAL HERBS WITH CODEINE IN TREATMENT AGAINST THE ACUTE RESPIRATORY DISEASES AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    V.N. Timchenko

    2007-01-01

    Full Text Available The article provides the findings of the observation over children (n = 78 aged between 2 and 16 with the acute respiratory infection accompanied by poorly or unproductive cough. 40 patients received the combined medication based on the medicinal herbs with codeine (Codelac Phyto as the complex therapy. In other cases (n = 38, children received other expectorant medication and/or mucolytics. It shows that the introduction of the combined medication with codeine into therapy of children with acute respiratory infections conduces to faster decrease of the cough intensity and health improvement, as well as the reduction of the unproductive and productive cough duration.Key words: children, respiratory infections, cough, treatment, codeine.

  6. Biological activity of Terminalia arjuna on Human Pathogenic Microorganisms

    Directory of Open Access Journals (Sweden)

    Tariq Javed

    2016-01-01

    Full Text Available World’s population relies chiefly on traditional medicinal plants, using their extracts or active constituents. Terminalia arjuna of family Combretaceae reported to be effective as aphrodisiac, expectorant, tonic, styptic, antidysenteric, sweet, acrid, purgative, laxative, astringent, diuretic, astringent, cirrhosis, cardioprotective and cancer treatment.   In present study, antibacterial, antifungal, brine shrimp lethality and phytotoxic effect of Terminalia arjuna was performed. Our results showed that methanolic extract of Terminalia arjuna leaves has moderate antifungal effect against Microsporm canis and fruit extract possess good antibacterial activity against Staphylococus aureus  and  Preudomonas aeroginosa. Moreover, Dichloromethane extract of Terminalia arjuna bark and fruit posses moderate phytotoxic activity. 

  7. Eight Years Follow-up of a Case with Idiopathic Pulmonary Hemosiderosis After Corticosteroid Therapy

    Science.gov (United States)

    Kahraman, Hasan; Köksal, Nurhan; Özkan, Fuat

    2012-01-01

    Idiopathic pulmonary hemosiderosis is characterized by recurrent episodes of alveolar hemorrhage, hemoptysis, and secondary iron deficiency anemia with unknown etiology. It generally emerges in childhood and adolescence periods but rarely found in adulthood. Definite diagnosis is established by appearing the hemosiderin-laden macrophages at sputum, bronchoalveolar lavage, or open lung biopsy. We reported a male patient who was born in 1975, expectorated blood since 1995, and was diagnosed in 1998. He received many blood replacements. He admitted to our clinic in 2003 with complaints of coughing up blood, shortness of breath, and tiredness. We gave the corticosteroid therapy to patient for 6-month period. After treatment, the patient did not have any complaints. Clinicians should keep in mind that idiopathic pulmonary hemosiderosis may differ in localization on chest X-ray and corticosteroid treatment should be started when diagnosis is established. PMID:22393549

  8. [Use of pulmonary rehabilitation in the treatment of decreased respiratory muscle strength].

    Science.gov (United States)

    Neumannová, Kateřina

    2015-01-01

    Decreased respiratory muscle strength could lead to other health problems, which can decrease the quality of life of those patients. Ineffective expectoration and dyspnoea during physical activities and during activity of daily living are the most frequent disorders associated with decreased respiratory muscle strength. Multidisciplinary treatment including pulmonary rehabilitation programme is very important for those patients. Ventilatory muscle training (strength and endurance type of training), airway clearance techniques - active (e.g. autogenic drainage, instrumental techniques) and passive (e.g. manual thoracic compression, mechanical insufflator/exsufflator machine) and exercise training are the most frequent used techniques in these patients. Assessment of all respiratory muscles function - especially their respiratory and postural function - is important at the beginning of rehabilitation treatment.

  9. A review on plant Cordia obliqua Willd. (Clammy cherry).

    Science.gov (United States)

    Gupta, Richa; Gupta, Ghanshyam Das

    2015-01-01

    Cordia obliqua Willd. plant (Common name-Clammy Cherry) belongs to family Boraginaceae. It is a medium-sized deciduous tree and very vigorous in growth. According to traditional system, it possesses anthelmintic, purgative, diuretic, expectorant, antipyretic, hepatoprotective and analgesic action. The fruits are edible and used as pickle. The gum obtained from mucilage is used for pasting sheets of paper and as matrix forming material in tablet formulations. Phytochemical investigations show the presence of alkaloids, flavonoids, phenolics, tannins and reducing sugar. Evaluation of pharmacological activities confirmed C. obliqua plant as antimicrobial, hypotensive, respiratory stimulant, diuretic and anti-inflammatory drug. A number of traditional activities of this plant still need scientific approval which will increase its medicinal potential. This review presents the Pharmacognostic properties, phytochemical constituents, traditional uses and biological activities reported for the plant and it will be helpful to explore the knowledge about Cordia obliqua Willd. for the researchers.

  10. The Genus Gnaphalium L. (Compositae: Phytochemical and Pharmacological Characteristics

    Directory of Open Access Journals (Sweden)

    Haibo Shi

    2013-07-01

    Full Text Available The genus Gnaphalium, a herb distributed worldwide, comprises approximately 200 species of the Compositae (Asteraceae family that belongs to the tribe Gnaphalieae. Some species are traditionally used as wild vegetables and in folk medicine. This review focuses on the phytochemical investigations and biological studies of plants from the genus Gnaphalium over the past few decades. More than 125 chemical constituents have been isolated from the genus Gnaphalium, including flavonoids, sesquiterpenes, diterpenes, triterpenes, phytosterols, anthraquinones, caffeoylquinic acid derivatives, and other compounds. The extracts of this genus, as well as compounds isolated from it, have been demonstrated to possess multiple pharmacological activities such as antioxidant, antibacterial and antifungal, anti-complement, antitussive and expectorant, insect antifeedant, cytotoxic, anti-inflammatory, antidiabetic and antihypouricemic properties. The present review compiles the information available on this genus because of its relevance to food and ethnopharmacology and the potential therapeutic uses of these species.

  11. Evaluasi Kesesuaian Dosis pada Pasien Pediatri Bronkitis Akut di Rumah Sakit Tentara Kartika Husada Kubu Raya

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    Variandini Aldhila Kharis

    2017-08-01

    Full Text Available Selection and usage of rational drugs determine the success of expected therapeutic effect, especially for pediatrics. Acute bronchitis in pediatrics is one of the highest incidents of Acute Respiratory Infection (ARI in Army Hospital Kartika Husada Kubu Raya. This study aimed to evaluate rationality of drug doses conformity in outpatient pediatric acute bronchitis in Army Hospital Kartika Husada Kubu Raya on 2015. This research was a descriptive observational research with cross-sectional design. The sample was taken with purpossive sampling amounted to 36 prescriptions. Then the evaluation of drug doses conformity was counted based the literature. The results showed that drugs which were used for acute bronchitis were mucolitics and expectorants, antibiotics, bronchodilators, multivitamins, decongestans, analgesics, and antihistamins. The result of drug dosage conformity evaluation showed that the under-dose drug item (R/ was 51%, over-dose was 15% and appropriate dose was 34%.

  12. PRIMARY PULMONARY CHORIOCARCINOMA – CASE REPORT

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    Biljana Lazović

    2010-12-01

    Full Text Available Literature has described only twenty-two cases of primary pulmonary choriocarcinoma. Unlike gestational choriocarcinoma which responds well to chemotherapy and has good prognosis, even in cases when detected later, pulmonary choriocarcinoma leads rapidly to fatal outcome. The reason is unknown. This paper presents a case of thirty-four-old young woman with clinical presentation of cough, expectoration, occasionally with hemoptisis, pleural pain, lack of breath and fever, with laboratory findings of pleural effusion on the left, which was treated as a case of tuberculosis for three months. Gynecological finding was regular. Progressive, rapid deterioration of general condition, degree of dispnea, hemoptisis episode led to respiratory failure before having appied the appropriate therapy. In cases of haemoptisis, one should think about this rare malignant entity and check the level of human chorionic gonadotropin in women.

  13. Unstable Simple Volatiles and Gas Chromatography-Tandem Mass Spectrometry Analysis of Essential Oil from the Roots Bark of Oplopanax Horridus Extracted by Supercritical Fluid Extraction

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    Li Shao

    2014-11-01

    Full Text Available Volatile oil from the root bark of Oplopanax horridus is regarded to be responsible for the clinical uses of the title plant as a respiratory stimulant and expectorant. Therefore, a supercritical fluid extraction method was first employed to extract the volatile oil from the roots bark of O. horridus, which was subsequently analyzed by GC/MS. Forty-eight volatile compounds were identified by GC/MS analysis, including (S,E-nerolidol (52.5%, τ-cadinol (21.6% and S-falcarinol (3.6%. Accordingly, the volatile oil (100 g was subjected to chromatographic separation and purification. As a result, the three compounds, (E-nerolidol (2 g, τ-cadinol (62 mg and S-falcarinol (21 mg, were isolated and purified from the volatile oil, the structures of which were unambiguously elucidated by detailed spectroscopic analysis including 1D- and 2D-NMR techniques.

  14. The effect of a brief salivary α-amylase exposure during chewing on subsequent in vitro starch digestion curve profiles.

    Science.gov (United States)

    Woolnough, James W; Bird, Anthony R; Monro, John A; Brennan, Charles S

    2010-07-26

    There is inconsistency between current in vitro digestion methods with regard to accommodation of a (salivary) α-amylase exposure during the oral phase. The effect of a salivary α-amylase pre-exposure on subsequent in vitro starch digestion curve profiles for various foods was investigated. Foods were chewed, expectorated and the boluses left to rest for 0-15 min. During pancreatic digestion, aliquots were taken and hydrolysis curves constructed for comparison against those of the same foods comminuted with a manually-operated chopper, hence spared exposure to saliva. Hydrolysate aliquots taken at T(0) (time zero) of the digestion of chewed samples contained higher levels of glucose and dextrins compared with chopped samples. Pancreatin activity immediately overwhelmed differences in sugar released due to salivary amylase activity. Within 10 min no differences were detectable between hydrolysis curves for chewed and chopped foods. Salivary amylase pretreatment does not contribute to the robustness or relative accuracy of in vitro methods.

  15. Severe Pleuropulmonary Paragonimiasis Caused by Paragonimus mexicanus Treated as Tuberculosis in Ecuador.

    Science.gov (United States)

    Calvopina, Manuel; Romero-Alvarez, Daniel; Macias, Rubén; Sugiyama, Hiromu

    2017-01-11

    A 30-year-old male, from a subtropical region of Ecuador, was hospitalized with a 5-year history of persistent cough with rusty brown sputum, chest pain, and progressive dyspnea. The patient underwent thoracic surgery 3 years ago for pleural effusion and subsequently received a 9-month regimen treatment of tuberculosis. However, there was no clinical resolution and symptoms became progressively worse. A chest radiograph and computerized tomography scan showed several small nodules in both lungs. Eggs of Paragonimus spp. were observed in sputum smears, but the smears were negative for acid-fast bacilli. Molecular characterization of eggs by the internal transcribed spacer-2 regions identified them as Paragonimus mexicanus The patient was treated with praziquantel and tested negative parasitologically for 12 months. There was clinical resolution of the cough and expectoration, but dyspnea and chest pain persisted. © The American Society of Tropical Medicine and Hygiene.

  16. Flavonoid Derivatives from the Aerial Parts of Trifolium trichocephalum M. Bieb. and Their Antioxidant and Cytotoxic Activity

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    Gülin Renda

    2017-09-01

    Full Text Available Trifolium L. species with a rich isoflavone content have been used as expectorant, analgesic, antiseptic, tonic, and wound-healer in folk medicine. The aim of the study is to evaluate pharmacological properties of the extracts and isolated compounds of T. tricocephalum. Phytochemical investigation of the aerial parts of T. trichocephalum led to the isolation of daidzein, genistein, quercetin, and daidzein 4'-O-β-glucoside for the first time from this species. Isolated compounds along with the methanol extract, water, ethyl acetate and chloroform subextracts were tested for their radical scavenging and cytotoxic activity which was evaluated by MTT assay. According to the results of activity tests, extracts showed a concentration-dependent radical scavenging activity as well as cytotoxic effect on HepG2 cells at 400 μg/mL, whereas the compounds did not exert any obvious cytotoxic effect at tested concentrations.

  17. Tuberculosis in Sheltered Homeless Population of Rome: An Integrated Model of Recruitment for Risk Management

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    Patrizia Laurenti

    2012-01-01

    Full Text Available The authors show the results of an integrated model for risk management of tuberculosis in a sample of sheltered homeless in Rome. Tuberculin skin test (TST was used for evaluating the prevalence of latent infection (LTBI. In TST positives, expectorate was collected and chest X-ray was achieved. Multiple logistic regression analysis was performed to investigate determinants of infection. Out of 288 recruited subjects, 259 returned for the TST reading; 45.56% were positive and referred to a specialized center; 70 accessed the health facility and completed the clinical pathway. The risk factors associated to LTBI were male gender (OR=3.72, age over 60 years (OR=3.59, immigrant status (OR=3.73, and obesity (OR=2.19. This approach, based on an integrated social network, guarantees high adherence to screening (89.93%, allowing patients testing positive for latent tuberculosis infection to be diagnosed and rapidly referred to a specialized center.

  18. Ambroxol therapy in simple chronic bronchitis: effects on subjective symptoms and ventilatory function.

    Science.gov (United States)

    Ericsson, C H; Juhász, J; Jönsson, E; Mossberg, B

    1986-10-01

    Ambroxol, a metabolite of bromhexine, was investigated in a double-blind, controlled trial using parallel groups. We studied the effects of 60 mg and 120 mg daily versus placebo in subjects with simple chronic bronchitis. Possible therapeutic effects were evaluated by means of interviews on subjective drug effects and current respiratory symptomatology, patient diary cards, and lung function tests. Ninety-seven subjects entered the study and 92 completed satisfactorily. Comparison with the placebo group at the end of the study showed that significantly more subjects in the 120 mg ambroxol group reported improvement in respiratory symptoms, principally improved expectoration. Subjects in the 120 mg group tended to prefer the treatment period when compared to placebo but the diary cards did not indicate significant changes. Lung function values were mainly normal and did not change during treatment. We conclude that the drug had a symptomatic effect and that further studies in more severely affected patients would be worthwhile.

  19. Impact of the Breakdown Behavior on Chinese Traditional Stewed Pork with Brown Sauce: Physical Properties Using Microstructural Analysis

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    Dengyong Liu

    2017-01-01

    Full Text Available The potential physics differences of Chinese traditional stewed pork during mastication were investigated. Ten subjects chewed and expectorated the fat and lean layers of stewed pork with brown sauce at different stages of mastication. The produced boluses were analyzed for their physical properties. The results suggested the subjects’ saliva secretion and moisture content of the boluses during mastication increased significantly depending on subjects and food types studied (P<0.05 and led to increase of bolus apparent particle size because of saliva uptake. Bolus first peak force tended to decrease significantly, whereas bolus flowability increased significantly during mastication (P<0.05. Further, microstructure of boluses revealed series processing was conducted by comminution, aggregation, hydration, and dilution. The boluses ready-to-swallow possessed a higher flowability and a homogenetic matrix. Therefore, the changes in physics and microstructure of bolus contributed to dynamic texture perception of traditional Chinese stewed pork with brown sauce.

  20. Wegener′s granulomatosis disease mimicking pulmonary tuberculosis

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    Naveen Pandhi

    2015-01-01

    Full Text Available Wegener′s granulomatosis (WG is an uncommon autoimmune disease with multi-system involvement that manifests as vasculitis, granulomatosis, and necrosis. While its standard form involves the upper and lower respiratory tracts and kidneys, it may essentially involve any organ. We present a case in a young female patient presenting with symptoms of cough with expectoration, fever, dyspnea and chest discomfort, having cavitating lesion in right upper lobe and nodule in left upper lobe with bilateral paranasal sinus involvement on computed tomography. Allergic rhino-sinusitis with pulmonary tuberculosis was suspected, and patient was investigated further. Upon further investigation, renal involvement was detected, and serology revealed cytoplasmic antineutrophil cytoplasmic antibody. WG was suspected and was proven by histopathology of nasal tissue which revealed necrotizing granulomas.

  1. The microorganisms in chronically infected end-stage and non-end-stage cystic fibrosis patients

    DEFF Research Database (Denmark)

    Rudkjøbing, Vibeke Børsholt; Thomsen, Trine Rolighed; Alhede, Morten

    2012-01-01

    Patients suffering from cystic fibrosis (CF) develop chronic lung infections because of highly viscous mucus, where bacteria can form biofilms. In this study, we investigated the microorganisms present in the lungs of end-stage and non-end-stage patients using standard culturing techniques...... and molecular methods. Tissue and sputum samples (n = 34) from explanted lungs of five end-stage patients were examined along with routine expectorates (n = 15) from 13 patients with non-end-stage CF, representing earlier stages of chronic lung infections. Previously, using peptide nucleic acid (PNA......) fluorescence in situ hybridization (FISH), we have shown that Pseudomonas aeruginosa was the sole pathogen in end-stage CF lungs (Pediatr Pulmonol 2009, 44: 547). In this study, this tendency was supported by the results of real-time PCR, confirming previous results obtained by standard culturing and 16S r...

  2. The antitussive activity of polysaccharides from Althaea officinalis l., var. Robusta, Arctium lappa L., var. Herkules, and Prunus persica L., Batsch.

    Science.gov (United States)

    Sutovska, M; Nosalova, G; Franova, S; Kardosova, A

    2007-01-01

    The therapy of pathological type of cough presents serious medical problem. The aim of experiments was to investigate polysaccacharide influence on experimentally induced cough. The purified and/or modified polysaccharides from the flowers and plants, characterized by chemical composition and molecular properties were subjected to tests for antitussive activity on cough, induced mechanically in conscious cats of both sexes. The results revealed that the tested polysaccharides exhibited statistically significant cough-suppressing activity, which was noticeably higher than that of the non-narcotic drug used in clinical practice to treat coughing. The most expressive antitussive activity was observed with the polysaccharide from marsh mallow, containing the highest proportion of the uronic acid constituent. Negative influence of the tested compounds on expectoration was negligible when compared to that of codeine. Antitussive activity of various plant polysaccharides was confirmed. These results allow ranging them among prospective antitussive agents (Tab. 2, Fig. 6, Ref. 15) Full Text (Free, PDF) www.bmj.sk.

  3. Sex bias in diagnostic delay in bronchiectasis: An analysis of the Spanish Historical Registry of Bronchiectasis.

    Science.gov (United States)

    Girón, Rosa Ma; de Gracia Roldán, Javier; Olveira, Casilda; Vendrell, Montserrat; Martínez-García, Miguel Ángel; de la Rosa, David; Máiz, Luis; Ancochea, Julio; Vázquez, Liliana; Borderías, Luis; Polverino, Eva; Martínez-Moragón, Eva; Rajas, Olga; Soriano, Joan B

    2017-11-01

    Diagnostic delay is common in most respiratory diseases, particularly in bronchiectasis. However, sex bias in diagnostic delay has not been studied to date. Assessment of diagnostic delay in bronchiectasis by sex. The Spanish Historical Registry of Bronchiectasis recruited adults diagnosed with bronchiectasis from 2002 to 2011 in 36 centres in Spain. From a total of 2113 patients registered we studied 2099, of whom 1125 (53.6%) were women. No differences were found for sex or age (61.0 ± 20.6, p = 0.88) or for localization of bronchiectasis ( p = 0.31). Bronchiectasis of unknown aetiology and secondary to asthma, childhood infections and tuberculosis was more common in women (all ps 2 years). Independent factors associated with this sex bias were age at onset of symptoms, smoking history, daily expectoration and reduced lung function.

  4. The Styracaceae

    Directory of Open Access Journals (Sweden)

    Patrícia M. Pauletti

    Full Text Available The Styracaceae contains 11 genera and approximately 160 species consisting of small trees and shrubs, mostly native to tropical and subtropical regions. This family is well-known by the genus Styrax, which is notorious due to the production of resinous material, a pathological product, harvested by making incisions into the tree’s bark. The gum is used in perfumes, as antiseptic, expectorant, incense, and fumigating material. This paper reviews the phytochemical and biological studies carried out on 11 species of this family. A total of 92 papers were consulted, and 130 compounds were described, thus these data indicate that Styrax is by far the largest genus in the family, and the only which has been extensively investigated.

  5. Recent advances in alternative therapies.

    Science.gov (United States)

    Ziment, I

    2000-01-01

    Complementary and alternative medicine (CAM) is becoming more popular, and CAM remedies are used instead of, or integrated with, orthodox allopathic therapies by many patients with asthma. Although most CAM remedies may have no discernible effects when analyzed by conventional medical techniques, some double-blind controlled studies do suggest that a meaningful benefit can be obtained with acupunture and homeopathic management in asthma. Herbal medicine is more popular, despite little evidence that the vast majority of herbs for asthma have any useful effects other than a nonspecific expectorant action. Dietary adjustment may benefit a small percentage of patients with asthma, but extreme measures are very rarely indicated. Formal pyschologic approaches can help some patients by reducing anxiety. Although most CAM approaches are harmless, the lack of benefit of many remedies and the potential harm from some of them must be recognized.

  6. Physico-chemical and biological properties of ambroxol under irradiation

    Science.gov (United States)

    Tamba, Maurizio; Torreggiani, Armida

    2001-01-01

    Physico-chemical properties of Ambroxol (AM), a potential antioxidant drug from the expectorant class, were investigated by radiation chemical and spectroscopic studies. The pulse radiolysis experiments showed that AM is a good scavenger of the primary water radical species, particularly e aq- and ·OH radicals. The ·OH attack, preferentially addressed to the ring positions activated by the -NH 2 group and occupied by bromine atoms, leads to hydroxycyclohexadienyl radicals. The molecule stabilisation may be achieved by a dehalogenation reaction to give phenoxyl radicals. The ·OH attack to AM is not affected by Cu(II) ions, which interact only weakly with the drug as evidenced by IR and Raman spectroscopy. Survival experiments on E. coli B/r cells irradiated in the presence of AM showed a radiosensitising effect of AM in anoxia. Some possible mechanisms of radiosensitisation are outlined.

  7. [New drugs for horses and production animals in 2016].

    Science.gov (United States)

    Emmerich, Ilka Ute

    2017-06-20

    In 2016, only one newly developed active pharmaceutical ingredient for horses and food-producing animals was released on the German market for veterinary drug products. The immunomodulator Pegbovigrastim is now available as an injection solution for cattle (Imrestor®). Four established veterinary active pharmaceutical ingredients are available for further species: the ectoparasitic Amitraz (Apitraz®) from the triazapentadiene group was additionally authorized for honeybees, the expectorant Bromhexine (Exflow® Vet) for chickens, turkeys and ducks and the macrolide antibiotic Gamithromycin (Zactran®) for pigs. The dopamine D2 receptor agonist Cabergolin (Velactis®) was released for dairy cattle. However, the authorization was suspended a few months after market introduction because of severe side effects. Additionally, one veterinary drug with a new combination of active ingredients as well as one active substance in mono-preparation have been launched on the market for horses and food producing animals.

  8. Cardiovascular effects of saffron and its active constituents: A review article

    Directory of Open Access Journals (Sweden)

    B. Marjan Razavi

    2014-03-01

    Full Text Available (Crocus sativus L. Commonly known as saffron, is a perennial stem less herb of the iridaceae family, widely cultivated in Iran and other countries. It is used as a flavoring and coloring agent for many thousands of years. In traditional medicine, saffron has been used for various purposes including abortion, as a fever reducer, an analgesic, expectorant, antispasmodic, aphrodisiac, sedative, digestive and a carminative. Various pharmacological studies have been described that saffron and its constituents exhibit different beneficial properties, including antioxidant, anticancer, anticonvulsant, antiischemic, antigenotoxic, antidote, antiapoptotic, antitussive, antidepressive, sedative and hypnotic, hypolipidemic, antinociceptive and antiinflammatory effects. Research projects have also revealed that saffron also exhibits protective effects against cardiovascular diseases including cardiac ischemia, arrhythmia, hypertension and atherosclerosis. In this review article, the effects of saffron and its active constituents on cardiovascular system were introduced.

  9. Primary Pharmacological and Other Important Findings on the Medicinal Plant “Aconitum Heterophyllum” (Aruna

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    Debashish Paramanick

    2017-06-01

    Full Text Available Abstract: Aconitum Heterophyllum (A. Heterophyllum is an indigenous medicinal plant of India and belongs to the family Ranunculaceae. A. Heterophyllum is known to possess a number of therapeutic effects. For very ancient times, this plant has been used in some formulations in the traditional healing system of India, i.e., Ayurveda. It is reported to have use in treating patients with urinary infections, diarrhea, and inflammation. It also has been used as an expectorant and for the promotion of hepatoprotective activity. The chemical studies of the plant have revealed that various parts of the plant contain alkaloids, carbohydrates, proteins and amino acids, saponins, glycosides, quinones, flavonoids, terpenoids, etc. In the present study, a comprehensive phytochemistry and pharmacognosy, as well as the medicinal properties, of A. Heterophyllum are discussed. Abstract: Scientific information on the plant was collected from various sources,

  10. Therapeutic options for acute cough due to upper respiratory infections in children.

    Science.gov (United States)

    Paul, Ian M

    2012-02-01

    Cough due to upper respiratory tract infections (URIs) is one of the most frequent complaints encountered by pediatric health-care providers, and one of the most disruptive symptoms for children and families. Despite the frequency of URIs, there is limited evidence to support the few therapeutic agents currently available in the United States (US) to treat acute cough due to URI. Published, well-designed, contemporary research supporting the efficacy of narcotics (codeine, hydrocodone) and US Food and Drug Administration (FDA)-approved over-the-counter (OTC) oral antitussives and expectorants (dextromethorphan, diphenhydramine, chlophedianol, and guaifenesin) is absent for URI-associated pediatric cough. Alternatively, honey and topically applied vapor rubs may be effective antitussives.

  11. A NEW VARIETY OF ORIGANUM VULGARE L. – DENIS, CREATED AT VRDS BACĂU IN ECOLOGIC AGRICULTURE CONDITION, CERTIFIED IN 2007 YEAR

    Directory of Open Access Journals (Sweden)

    FALTICEANU MARCELA

    2008-11-01

    Full Text Available Oregano is a perennial plant of 0,6 – 0,8m high. The flowers are small, coloured in red till lilac-lavender. It blossom from July till September, being pollinated by bees. The utility rate of plants is 3 : 5.In the literature is mentioned as a plants with multiple uses: culinary (as a condiment plant or for the preparation of a aromatised tea, the leaves can be consumed fresh or cooked; ornamental (is decorative through port, bush and flowers: often is cultivated in pots; medicinal (is has an antiseptically and expectorant effects, being used also in affections of respiratory systems, indigestions, arthritis, aromatherapy etc; melliferous (is a good melliferous plant; in biologic agriculture (with repellent effect for insects, is recommended for association with many vegetable species, also because the plants cover very well the soil, thus providing an herbicide effect; cosmetics (perfume, soap, spay industry.

  12. Potential pharmacological and toxicological basis of the essential oil from Mentha spp.

    Directory of Open Access Journals (Sweden)

    IZA TEIXEIRA ALVES PEIXOTO

    2010-06-01

    Full Text Available

    During the past few years, interest in the potential clinical and pharmacological basis of the efficacy and safety of herbal medicines has increased greatly, due to widespread domestic self-medication with these agents. Some authors have analyzed the use of Mentha ssp. in the pharmacological industry. The essential oil from Mentha spp. is used to treat discomfort of the gastrointestinal tract, irritable bowel syndrome, myalgia and neuralgia, as well as oral mucosal inflammation, and also as an expectorant, an antimicrobial and an ingredient in many analgesic creams. The essential oil also contains chemical compounds that are associated with side effects such as nausea, vomiting, allergic reactions, flushing and headaches. Therefore, the purpose of the present review was to examine the literature on the efficacy and safety of the possible clinical and pharmacological uses of the essential oil from Mentha spp. in human beings. Keywords: Mentha spp. Antimicrobial activity. Essential oil.

  13. [Investigation and analysis of factors that affect the health of children in the plastic recycling and regeneration processing region].

    Science.gov (United States)

    Wang, Juanli; Li, Liping; Lu, Yaogui

    2014-09-01

    To investigate the main influential factors for the health of children in the plastic waste recovery and recycling area. A cross-sectional survey was performed among children aged 9∼17 years from three natural villages engaged in plastic waste recovery and recycling and four control villages engaged in planting. The health status of children was investigated by random household survey using a face-to-face questionnaire, and the main influential factors were analyzed accordingly. The incidence rates of respiratory symptoms (cough and expectoration, nasal congestion, and sore throat) (78.4%, 69/88) and digestive diseases (gastrointestinal disease and liver disease) (14.8%, 13/88) in the waste processing area were significantly higher than those in the control area (64.0%, 71/111; 6.3%, 7/111) (P plastic can be smelt around the residential area.

  14. Evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes

    Energy Technology Data Exchange (ETDEWEB)

    M' ose, J.R.; Fischer, G.

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. In urban settings, it appears that large ions may be more prevalent and, therefore, are inhaled an increasing extent. They stick to the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements in reduced. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases. The study also examines the effects of living in a high-rise building with respect to the different microclimates that may exist at different altitudes.

  15. Chest physiotherapy in primary pneumonia.

    Science.gov (United States)

    Britton, S; Bejstedt, M; Vedin, L

    1985-01-01

    One hundred and seventy one patients with primary pneumonia entered a single blind, placebo controlled trial of physiotherapy. Treatment was allocated at random, physiotherapy consisting of postural drainage, external help with breathing, percussion, and vibration and the controls receiving advice on expectoration, deep breathing, and how to exercise to avoid thrombosis. Principles of pharmaceutical management were the same in the two groups. There was no objective evidence that daily physiotherapy helped during the acute phase of the disease. On the contrary, in younger patients, smokers, and patients with interstitial pneumonia physiotherapy appeared to prolong the duration of fever as well as the hospital stay. It is concluded that chest physiotherapy is at best useless in patients with primary infectious pneumonia. PMID:3924221

  16. Extramedullary Plasmacytoma of the Nasal Cavity Report of Three Cases With Review of the Literature

    Science.gov (United States)

    Ashraf, Mohamad Javad; Azarpira, Negar; Khademi, Bighan; Abedi, Elham; Hakimzadeh, Afsoon; Valibeigi, Bita

    2013-01-01

    Extramedullary plasmacytoma is a rare neoplasm characterized by monoclonal proliferation of plasma cells. Most lesions occur in the head and neck, primarily in the upper aerodigestive tract. The nasal cavity and nasal septum are the most common sites of occurrence. In this report, three patients admitted in our clinic with history of nasal obstruction and/or epistaxis. Patients were diagnosed with extramedullary plasmacytoma and mass were completely excised. This entity usually occurred in 5th-6th decade of life. One of our patients, a young man, was completely asymptomatic and following a paroxysm of coughing, a polypoid mass was expectorated. The clinical and histopathologic findings of plasmacytoma are discussed. In order to exclude systemic involvement, systematic approach using clinical, laboratory, and radiologic investigations was performed. Extramedullary plasmacytoma of the nasal cavity is rare and should be considered in the differential diagnosis of nasal cavity masses especially in young age group. PMID:24083014

  17. [The specific features of detection, clinical picture, and treatment of pulmonary tuberculosis in patients with mental diseases].

    Science.gov (United States)

    Odinets, V S; Baronova, O D; Novikova, T I

    2009-01-01

    One hundred and thirteen patients with pulmonary tuberculosis and mental disease and 127 tuberculosis patients without mental diseases were studied. Patients with mental diseases were observed to have asymptomatic pulmonary tuberculosis with insignificant expectoration, which made the microbiological diagnosis of tuberculosis difficult. The basic method for detection of tuberculosis is to make a fluorographic study every 6 months, which enables active detection of more than 92% of new cases of tuberculosis as minor forms. The efficiency of treatment for tuberculosis concurrent with mental diseases was high: bacterial discharge ceased in 93.3% of cases, decay cavities closed in 80%, which was associated with the possibility of performing long-term continuous treatment in the inpatient setting.

  18. Severe Pleuropulmonary Paragonimiasis Caused by Paragonimus mexicanus Treated as Tuberculosis in Ecuador

    Science.gov (United States)

    Calvopina, Manuel; Romero-Alvarez, Daniel; Macias, Rubén; Sugiyama, Hiromu

    2017-01-01

    A 30-year-old male, from a subtropical region of Ecuador, was hospitalized with a 5-year history of persistent cough with rusty brown sputum, chest pain, and progressive dyspnea. The patient underwent thoracic surgery 3 years ago for pleural effusion and subsequently received a 9-month regimen treatment of tuberculosis. However, there was no clinical resolution and symptoms became progressively worse. A chest radiograph and computerized tomography scan showed several small nodules in both lungs. Eggs of Paragonimus spp. were observed in sputum smears, but the smears were negative for acid-fast bacilli. Molecular characterization of eggs by the internal transcribed spacer-2 regions identified them as Paragonimus mexicanus. The patient was treated with praziquantel and tested negative parasitologically for 12 months. There was clinical resolution of the cough and expectoration, but dyspnea and chest pain persisted. PMID:27879464

  19. The Influence of Carbohydrate Mouth Rinse on Self-Selected Intermittent Running Performance.

    Science.gov (United States)

    Rollo, Ian; Homewood, George; Williams, Clyde; Carter, James; Goosey-Tolfrey, Vicky L

    2015-12-01

    This study investigated the influence of mouth rinsing a carbohydrate solution on self-selected intermittent variable-speed running performance. Eleven male amateur soccer players completed a modified version of the Loughborough Intermittent Shuttle Test (LIST) on 2 occasions separated by 1 wk. The modified LIST allowed the self-selection of running speeds during Block 6 of the protocol (75-90 min). Players rinsed and expectorated 25 ml of noncaloric placebo (PLA) or 10% maltodextrin solution (CHO) for 10 s, routinely during Block 6 of the LIST. Self-selected speeds during the walk and cruise phases of the LIST were similar between trials. Jogging speed was significantly faster during the CHO (11.3 ± 0.7 km · h(-1)) than during the PLA trial (10.5 ± 1.3 km · h(-1)) (p = .010); 15-m sprint speeds were not different between trials (PLA: 2.69 ± 0.18 s: CHO: 2.65 ± 0.13 s) (F(2, 10), p = .157), but significant benefits were observed for sprint distance covered (p = .024). The threshold for the smallest worthwhile change in sprint performance was set at 0.2 s. Inferential statistical analysis showed the chance that CHO mouth rinse was beneficial, negligible, or detrimental to repeated sprint performance was 86%, 10%, and 4%, respectively. In conclusion, mouth rinsing and expectorating a 10% maltodextrin solution was associated with a significant increase in self-selected jogging speed. Repeated 15-m sprint performance was also 86% likely to benefit from routinely mouth rinsing a carbohydrate solution in comparison with a taste-matched placebo.

  20. [Correlation factors of 127 times pre-crisis state in patients with myasthenia gravis].

    Science.gov (United States)

    Ou, C Y; Ran, H; Qiu, L; Huang, Z D; Lin, Z Z; Deng, J; Liu, W B

    2017-10-10

    Objective: To investigate the clinical features of the Pre-Crisis State and analyze the correlated risk factors of Pre-Crisis State of myasthenia crisis. Methods: We included 93 patients with myasthenia gravis (MG) who experienced 127 times Pre-Crisis State between October 2007 and July 2016. Those patients were hospitalized in the MG specialize center, Department of Neurological Science, first Affiliated Hospital of Sun Yat-sen University. The information of the general situation, the clinical manifestations and the blood gas analysis in those patients were collected using our innovated clinical research form. Statistic methods were applied including descriptive analysis, univariate logistic analysis, multivariate correlation logistic analysis, etc. Results: (1)The typical features of MG Pre-Crisis State included: dyspnea (127 times, 100% not requiring intubation or non-invasive ventilation), bulbar-muscle weakness (121 times, 95.28%), the increased blood partial pressure of carbon dioxide (PCO(2)) (94 times, 85.45%), expectoration weakness (99 times, 77.95%), sleep disorders (107 times, 84.25%) and the infection (99 times, 77.95%). The occurrence of dyspnea in combination with bulbar-muscle weakness (P=0.002) or the increased blood PCO(2) (P=0.042) often indicated the tendency of crisis. (2) The MG symptoms which were proportion to the occurrence of crisis includes: bulbar-muscle weakness (P=0.028), fever (P=0.028), malnutrition (P=0.066), complications (P=0.071), excess oropharyngeal secretions (P=0.005) and the increased blood PCO(2) (P=0.007). The perioperative period of thymectomy would not increase the risk of crisis. Conclusions: Dyspnea indicates the occurrence of the Pre-Crisis State of MG. In order to significantly reduce the morbidity of myasthenia crisis, the bulbar-muscle weakness, the increased blood PCO(2), expectoration weakness, sleep disorders, infection & fever and excess oropharyngeal secretions should be treated timely.

  1. Sputum microscopy for the diagnosis of HIV-associated pulmonary tuberculosis in Tanzania

    Directory of Open Access Journals (Sweden)

    Lyimo Johnson

    2008-02-01

    Full Text Available Abstract Background In many resource poor settings only sputum microscopy is employed for the diagnosis of HIV-associated pulmonary tuberculosis; sputum culture may not be available. Methods We determined the diagnostic accuracy of sputum microscopy for active case finding of HIV-associated pulmonary tuberculosis using TB culture as the reference standard. Results 2216 potential subjects screened for a TB vaccine trial submitted 9454 expectorated sputum specimens: 212 (2.2% were sputum culture positive for Mycobacterium tuberculosis (MTB, 31 (0.3% for non-tuberculous mycobacteria, and 79 (0.8% were contaminated. The overall sensitivity of sputum microscopy was 61.8% (131/212 and specificity 99.7% (9108/9132. Sputum microscopy sensitivity varied from 22.6% in specimens with 100 CFU/specimen plus confluent growth. The incremental diagnostic value for sputum microscopy was 92.1%, 1.8% and 7.1% for the first, second and third specimens, respectively. The positive predictive value and negative predictive values for sputum microscopy were 84.5% and 99.1%, respectively. The likelihood ratio (LR of a positive sputum microscopy was 235.1 (95% CI 155.8 – 354.8, while the LR of a negative test was 0.38 (95CI 0.32 – 0.45. The 212 positive sputum cultures for MTB represented 103 patients; sputum microscopy was positive for 57 (55.3% of 103 patients. Conclusion Sputum microscopy on 3 expectorated sputum specimens will only detect 55% of culture positive HIV-infected patients in active screening for pulmonary tuberculosis. Sensitivity is higher in patients with greater numbers of CFUs in the sputum. Culture is required for active case finding of HIV- associated pulmonary tuberculosis.

  2. [Theoretical basis and clinical benefits of dry salt inhalation therapy].

    Science.gov (United States)

    Endre, László

    2015-10-11

    Dry salt inhalation (halotherapy) reproduces the microclimate of salt caves, with beneficial effect on health. Sodium chloride crystals are disrupted into very small particles (with a diameter less than 3 µm), and this powder is artificially exhaled into the air of a comfortable room (its temperature is between 20-22 °C, and the relative humidity is low). The end-concentration of the salt in the air of the room will be between 10-30 mg/m(3). The sick (or healthy) persons spend 30-60 minutes in this room, usually 10-20 times. Due to the greater osmotic pressure the inhaled salt diminishes the oedema of the bronchial mucosa, decreases its inflammation, dissolves the mucus, and makes expectoration easier and faster (expectoration of air pollution and allergens will be faster, too). It inhibits the growth of bacteria and, in some case, kills them. Phagocyte activity is also increased. It has beneficial effect on the well being of the patients, and a relaxation effect on the central nervous system. It can prevent, or at least decrease the frequency of the respiratory tract inflammations. It produces better lung function parameters, diminishes bronchial hyperreactivity, which is the sign of decreasing inflammation. Its beneficial effect is true not only in inflammation of the lower respiratory tract, but also in acute or chronic upper airways inflammations. According to the international literature it has beneficial effect for some chronic dermatological disease, too, such as psoriasis, pyoderma and atopic dermatitis. This treatment (called as Indisó) is available under medical control in Hungary, too.

  3. [Pharmacological effects of N-acetyl-L-cysteine on the respiratory tract. (I). Quantitative and qualitative changes in respiratory tract fluid and sputum (author's transl)].

    Science.gov (United States)

    Kogi, K; Saito, T; Kasé, Y; Hitoshi, T

    1981-06-01

    The following three experiments were performed to determine the effects of N-acetyl-L-cysteine (NAC) on the quantity and quality of respiratory tract fluid (RTF) and sputum. All drugs used were administered into the stomach through a gastric tube. 1) Indirect measurement of bronchial secretion in rats, which was expressed by the amounts of dye excreted into the respiratory tract, was carried out according the the Sakuno's method, with some modification. Some expectorants of the secretomotor type, such as bromhexine and pilocarpine, significantly increased the secretion, even at low doses. On the other hand, mucolytic agents such as NAC augmented the secretion only in doses of 500 to 1500 mg/kg. 2)As a direct method of measurements, Kasé's modification of Perry and Boyd's method was used to collect RTF, quantitatively, from rabbits. The RTF of healthy rabbits was colorless and watery. The administration of NAC in doses of 500 to 1500 mg/kg augmented the output volume and RTF became slightly turbid, probably due to an increase in the viscous mucus. 3) Rabbits with subacute bronchitis were prepared by long-term exposure to air contaminated with SO2 gas and sputa were collected before and after administration of NAC, respectively, according to the Kase's method. The sputa were opalescent and viscous gel included nodular masses. The administration of NAC, 1000 and 1500 mg/kg resulted in a dose dependent decrease in the relative viscosity. The percent-decreased in viscosity with NAC was statistically correlated with that in amounts of dry matter, those in protein and polysaccharide in the sputa. From the results described above, it was concluded that NAC given into the stomach can liquefy sputum by splitting mucoprotein disulphide linkages, that is, altering the rheological characteristics of sputum to facilitate expectoration.

  4. Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines.

    Science.gov (United States)

    Braman, Sidney S

    2006-01-01

    Chronic bronchitis is a disease of the bronchi that is manifested by cough and sputum expectoration occurring on most days for at least 3 months of the year and for at least 2 consecutive years when other respiratory or cardiac causes for the chronic productive cough are excluded. The disease is caused by an interaction between noxious inhaled agents (eg, cigarette smoke, industrial pollutants, and other environmental pollutants) and host factors (eg, genetic and respiratory infections) that results in chronic inflammation in the walls and lumen of the airways. As the disease advances, progressive airflow limitation occurs, usually in association with pathologic changes of emphysema. This condition is called COPD. When a stable patient experiences a sudden clinical deterioration with increased sputum volume, sputum purulence, and/or worsening of shortness of breath, this is referred to as an acute exacerbation of chronic bronchitis as long as conditions other than acute tracheobronchitis are ruled out. The purpose of this review is to present the evidence for the diagnosis and treatment of cough due to chronic bronchitis, and to make recommendations that will be useful for clinical practice. Recommendations for this section of the review were obtained from data using a National Library of Medicine (PubMed) search dating back to 1950, performed in August 2004, of the literature published in the English language. The search was limited to human studies, using the search terms "cough," "chronic bronchitis," and "COPD." The most effective way to reduce or eliminate cough in patients with chronic bronchitis and persistent exposure to respiratory irritants, such as personal tobacco use, passive smoke exposure, and workplace hazards is avoidance. Therapy with a short-acting inhaled beta-agonist, inhaled ipratropium bromide, and oral theophylline, and a combined regimen of inhaled long-acting beta-agonist and an inhaled corticosteroid may improve cough in patients with

  5. STUDY OF COMMUNITY-ACQUIRED BACTERIAL PNEUMONIAS PRESENTING TO TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Ramakrishna Rachakonda

    2017-11-01

    Full Text Available BACKGROUND Patients attending the Pulmonology OPD with symptoms of cough with expectoration of more than 10 days with pulmonary shadows suggestive of pneumonia were included in our study. Patients’ positive for AFB in the sputum and symptoms suggestive of tuberculosis were excluded. MATERIALS AND METHODS 156 patients diagnosed to have pneumonia were included in the study. Patients having a history of cough with expectoration and fever for 10 days or more were subjected to clinical, radiological and sputum examination. Patients in whom tuberculosis was excluded by clinical, radiological and sputum examination and having associated shadows in the chest x-ray above 20 years of age were taken into the study and subjected to thorough clinical examination, haematological and biochemical examination. Sputum was sent for Gram stain and culture and sensitivity. Sensitivity pattern of the organisms isolated were studied. RESULTS 85% of patients belong to 40 years and above age group. 73.12% of these patients are males and rest are females. 54% of the patients presented as bronchopneumonia by Radiology. Bilateral lesions present in 55% of patients followed by right-sided lesions in 26% and left-sided lesions in 19%. Cough, expectoration, fever and chest pain were the common symptoms and nearly all the patients had symptoms. Increased white cell count at the time of admission correlated with increased duration of hospital stay and is statistically significant (the p-value is <0.00001. Active and passive smoking is associated with pneumonia and the value is statistically significant (p<0.00001. Presence of comorbidities is associated with increased hospital stay and the value is statistically significant (p<0.00001. Individual comorbidities are not associated with increased prevalence of pneumonia. Presence of comorbidities compared to absence of comorbidities showed a statistically significant correlation (p value <0.00001. 48% of the patients were

  6. Viscoelastic properties of bronchial mucus after respiratory physiotherapy in subjects with bronchiectasis.

    Science.gov (United States)

    Ramos, Ercy M C; Ramos, Dionei; Moreira, Graciane L; Macchione, Mariangela; Guimarães, Eliane T; Rodrigues, Fernanda Maria M; de Souza, Altay Alves Lino; Saldiva, Paulo H N; Jardim, José R

    2015-05-01

    Previous studies have evaluated the effectiveness of postural drainage (PD), percussion (PERC), the coughing technique (CT), and other types of coughing in subjects with bronchiectasis. However, the application times of these techniques and the quality of the expectorated mucus require further study. The aim of our study was to evaluate the effectiveness of PD, percussion, CT, and huffing in subjects with bronchiectasis and assess the quantity and quality of bronchial mucus produced (measurement of wet and dry weight and determination of viscoelastic properties). Twenty-two subjects with stable bronchiectasis (6 men; mean age: 51.5 y) underwent 4 d of experimental study (CT, PD+CT, PD+PERC+CT, and PD+huffing). The techniques were performed in 3 20-min periods separated by 10 min of rest. Before performing any technique (baseline) and after each period (30, 60, and 90 min), expectorated mucus was collected for analysis of viscoelasticity. A significant increase in the dry weight/wet weight ratio was found after 60 min of PD+PERC+CT (P = .01) and 90 min of PD+huffing (P = .03) and PD+PERC+CT (P = .007) in comparison with CT. PD+PERC+CT and PD+huffing led to the greatest removal of viscoelastic mucus at 60 min (P = .02 and P = .002, respectively) and continued to do so at 90 min (P = .02 and P = .01, respectively) in comparison with CT. An interaction effect was found, as all techniques led to a greater removal of elastic mucus in comparison with CT at 60 min (PD+CT, P = .001; PD+PERC+CT, P < .001; PD+huffing, P < .001), but only PD+PERC+CT and PD+huffing led to a greater removal of elastic mucus than CT at 90 min (P < .001 and P = .005, respectively). PD+PERC+CT and PD+huffing performed similarly regarding the removal of viscoelastic mucus in 2 and 3 20-min periods separated by 10 min of rest. PD+PERC+CT led to the greatest removal of mucus in the shortest period (2 20-min periods separated by 10 min of rest). Copyright © 2015 by Daedalus Enterprises.

  7. [The new possibility for the treatment of acute cough].

    Science.gov (United States)

    Klyachkina, I L

    2015-01-01

    Acute cough associated with influenza and acute respiratory viral infection (ARVI) is one of the most common complaints prompting the patient to visit a general practitioner or an otorhinolaryngologist based at the outpatient clinic. Acute cough during ARVI in the practically healthy subjects is as a rule non-productive, frequently dry, and becomes resolved within 2-3 weeks. In certain cases, however, the cough during ARVI can be productive with the well apparent abnormal expectoration of sputum especially in the aged and elderly subjects, young children, and patients suffering from the chest injuries, dry pleuritis, and other disorders. The early prescription of mucoactive preparations can prevent the development of subacute cough. In such cases, it is recommended to use the mucokinetic ambroxol that improves the mucociliary clearance (MCC) and does not require strong exertion for sputum expectoration. An important aspect in the mechanism of action of ambroxol is the stimulation of surfactant production, antioxidation effect, the improvement of rheological properties of bronchial mucus, ant-inflammatory and antiviral effects. The application of the new pharmaceutical dose form of ambroxol, neo-bronchol (orally disintegrating tablets), produces a very rapid effect (within 1 day after the intake) due to the fast absorption of this medication in the oral cavity, its rapid penetration into the circulatory system and achievement of the high concentration in blood plasma. The volatile metabolites of ambroxol that form as a result of tablet disintegration, such as ambroxol itself, menthol, and cineol, exert the mucolytic, antiseptic, and antibacterial actions, after they reach the trachea and bronchi. Irrigation of the receptors present in the inflamed mucous membrane of the larynx, pharynx, and nasal cavity, with these volatile substances produces an immediate cough-suppressive effect. It is concluded that the preparations of neo-bronchol (orally disintegrating tablets

  8. Use of autologous platelet rich plasma (PRP) in stopping massive hemoptysis at the Lung Center of the Philippines: a pilot study.

    Science.gov (United States)

    Sarmiento, Armand Gregorio C; Danguilan, Jose Luis J; Mariano, Zenaida M; Barzaga, Maria Teresa A

    2017-01-01

    The purpose of this study is to determine the effect of using autologous platelet rich plasma (PRP) in patients having massive hemoptysis within a period of one week. This is a prospective cohort study involving 20 consecutive patients admitted who met the criteria for massive hemoptysis from July to October 2011. After stabilizing the patient, fiberoptic bronchoscopy (FOB) was performed for localization of bleeding within 6 hours from diagnosis. A 50mL of blood was extracted from the patient whom was to be used for autologous PRP concentrate. After identifying the anatomic site of bleeding, autologous PRP concentrate was instilled on the affected bronchus and was allowed to stay for 5 minutes after instillation. Patients were then monitored from the time the bleeding stopped in the first 24 hours, 2 days and 7 days respectively. Mean age of the study population with massive hemoptysis was 47 years old (SD 17.3). Majority of cases were male 18 out of 20 (90%) and smokers 14 (70%) with a normal BMI (75%). Identification of bleeding site was more commonly seen on the right upper lobe 9 out of 20 (45%). Overall, 14 out of 20 patients (70%) were reported to have stopped bleeding immediately. Subsequent hospital days showed that 8 out of 20 patients (40%) had no hemoptysis. However, one [1] post-tuberculosis (TB) bronchiectatic patient had recurrence of massive hemoptysis, approximately 250 mL per expectorate, expired within the 7 days observation and one patient had lobectomy on the 2nd day. The rest had non-massive hemoptysis wherein their expectorations were only streaks of blood. Moreover, there was one [1] patient who had recurrence of massive hemoptysis 1 week after autologous PRP infusion and was eventually intubated. Majority of the subjects, eleven [11] were diagnosed to have post-TB bronchiectasis. The rest of the patients were worked-up prior to operation. Overall, it was observed that the use of autologous PRP was able to stop bleeding in 40% of the study

  9. Report on a study of fires with smoke gas development : determination of blood cyanide levels, clinical signs and laboratory values in victims.

    Science.gov (United States)

    Geldner, G; Koch, E M; Gottwald-Hostalek, U; Baud, F; Burillo, G; Fauville, J-P; Levi, F; Locatelli, C; Zilker, T

    2013-08-01

    This is a report on an international non-interventional study of patients exposed to fires with smoke development in closed rooms. The objective of the study was to document clinical symptoms, relevant laboratory values and blood cyanide concentrations from fire victims in order to confirm or rule out presumptive correlations between the individual parameters. The study was conducted in five European countries with patients being included if they presented with the characteristic clinical signs, such as soot deposits and altered neurological status. Venous blood samples were taken from victims prior to administration of an antidote in all cases and determination of cyanide concentration was performed in a central laboratory using high performance liquid chromatography. Data from 102 patients (62 % male, average age 49 years) were included in the evaluation with no blood samples being available for analysis from 2 patients. In 25 patients the blood cyanide concentration was below the limit of detection of 1.2 μmol/l. Cyanide levels between 1.2 and 10 μmol/l were measured in 54 patients, 7 patients had values between 10 and 20 μmol/l, 4 patients between 20 and 40 μmol/l while levels above 40 μmol/l were determined in 10 patients. The results of the study could not demonstrate that the cyanide level was influenced either by the interval between smoke exposure and blood sampling or the duration presence at the fire scene. The following clinical signs or laboratory values were recorded as relevant for increased and possibly toxic cyanide levels: respiratory arrest, dyspnea, resuscitation requirement, tracheal intubation, respiratory support measures, low Glasgow coma scale (GCS) score and respiratory frequency. A correlation between cyanide concentration and the total amount of soot deposits on the face and neck, in the oral cavity and in expectoration was confirmed. A correlation between cyanide and carboxyhemoglobin (COHb) levels in the blood of fire victims was

  10. [Clinical manifestations and gene analysis of 2 Chinese children with cystic fibrosis].

    Science.gov (United States)

    Liu, Jin-rong; Peng, Yun; Zhao, Yu-hong; Wang, Wei; Guo, Yan; He, Jian-xin; Zhao, Shun-ying; Jiang, Zai-fang

    2012-11-01

    Cystic fibrosis (CF) is rare in Chinese mainland. We present two cases of CF patients diagnosed by gene analysis. Their clinical manifestations and genetic mutation features are analyzed in this article. It will be of special interest to pediatricians in recognition of CF. The clinical material of two CF patients who were diagnosed by gene analysis was retrospectively analyzed. The first patient is a 13-year-old girl. She had a complaint of recurrent fever and cough for 6 months, expectoration for 2 months and hemoptysis for 20 days. After 3 months of her birth, she was operated on for bullae of lung. She was susceptible to upper respiratory tract infection. There was no family history of recurrent wheeze and other special diseases. Aspergillus fumigatus specific IgE was at grade 3 and aspergillus fumigatus IgG was high. Pseudomonas aeruginosa was positive in sputum culture. Sweat testing was performed and Na+ was higher. Pulmonary CT indicated bronchiectasis. Nasal sinus CT showed optical density of soft tissue within maxillary sinus and chronic bilateral sinusitis. The electron microscopy of cilia suggested immobile cilia syndrome. A heterozygotic mutation (263T > G, 2909G > A) was found after CFTR genetic mutation analysis. Both her parents were carriers. She was treated with inhalation of nebulized hypertonic saline and postural drainage for a long time. And she got better during a follow up period of 1 year. The second patient was a 10-year-old girl who complained of recurrent expectoration for 3 years and shortness of breath for half a year. She had a history of sinusitis and steatorrhea. The family history was normal. Both the lipase and insulin level in blood serum was lower.Pseudomonas aerugino and Aspergillus fumigatus were both positive in sputum culture. Aspergillus fumigatus IgE was normal. Pulmonary CT indicated bronchiolitis and bronchiectasis. Nasal sinus CT showed bilateral maxillary sinusitis. CFTR genetic mutation analysis revealed a homozygous

  11. Mucoactive agents for airway mucus hypersecretory diseases.

    Science.gov (United States)

    Rogers, Duncan F

    2007-09-01

    Airway mucus hypersecretion is a feature of a number of severe respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). However, each disease has a different airway inflammatory response, with consequent, and presumably linked, mucus hypersecretory phenotype. Thus, it is possible that optimal treatment of the mucus hypersecretory element of each disease should be disease-specific. Nevertheless, mucoactive drugs are a longstanding and popular therapeutic option, and numerous compounds (eg, N-acetylcysteine, erdosteine, and ambroxol) are available for clinical use worldwide. However, rational recommendation of these drugs in guidelines for management of asthma, COPD, or CF has been hampered by lack of information from well-designed clinical trials. In addition, the mechanism of action of most of these drugs is unknown. Consequently, although it is possible to categorize them according to putative mechanisms of action, as expectorants (aid and/or induce cough), mucolytics (thin mucus), mucokinetics (facilitate cough transportability), and mucoregulators (suppress mechanisms underlying chronic mucus hypersecretion, such as glucocorticosteroids), it is likely that any beneficial effects are due to activities other than, or in addition to, effects on mucus. It is also noteworthy that the mucus factors that favor mucociliary transport (eg, thin mucus gel layer, "ideal" sol depth, and elasticity greater than viscosity) are opposite to those that favor cough effectiveness (thick mucus layer, excessive sol height, and viscosity greater than elasticity), which indicates that different mucoactive drugs would be required for treatment of mucus obstruction in proximal versus distal airways, or in patients with an impaired cough reflex. With the exception of mucoregulatory agents, whose primary action is unlikely to be directed against mucus, well-designed clinical trials are required to unequivocally determine the

  12. Standardization of the manufacturing procedure for Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine.

    Science.gov (United States)

    Su, Tao; Zhang, Wei-Wei; Zhang, Ya-Ming; Cheng, Brian Chi-Yan; Fu, Xiu-Qiong; Li, Ting; Guo, Hui; Li, Ya-Xi; Zhu, Pei-Li; Cao, Hui; Yu, Zhi-Ling

    2016-12-04

    Pinelliae Rhizoma (PR), the dried tuber of Pinellia ternata (Thunb.) Breit., is a traditional Chinese medicinal herb. It is commonly used for treating cancer, cough and phlegm. To treat cancer, Chinese medicine practitioners often use raw PR; while to treat cough and phlegm, they usually use Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine (PRZA, raw PR processed with ginger juice and alumen as adjuvant materials). Currently, the producing protocol of PRZA varies greatly among different places in China. This study aims to standardize the manufacturing procedure for PRZA. We also evaluated the impact of processing on the bioactivities and chemical profile of raw PR. We used the orthogonal design to optimize the manufacturing procedure of PRZA at bench scale, and validated the optimized procedure in pilot-scale production. The MTT assay was used to compare the cytotoxicities of raw PR and PRZA in hepatocellular carcinoma HepG2 cells. Animal models (ammonia liquor-induced cough model and phenol red secretion model) were used to compare the antitussive and expectorant effects of raw PR and PRZA, respectively. The chemical profiles of raw PR and PRZA samples were compared using a newly developed ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS) method. The standardized manufacturing procedure for PRZA is as follows: soak raw PR in water until the center of the cut surface is devoid of a dry core, after that, boil the herb in water (for each 100kg raw PR, 12.5kg alumen and 25L freshly squeezed ginger juice are added) for 6h, and then take out and dry them. The cytotoxicity of PRZA was less potent than that of raw PR. Intragastric administration of raw PR or PRZA demonstrated antitussive and expectorant effects in mice. These effects of PRZA were more potent than that of raw PR at the dose of 3g/kg. By comparing the chemical profiles, we found that six peaks were lower, while nine other peaks were higher in PRZA than

  13. A Comparison of 2 Respiratory Devices for Sputum Clearance in Adults With Non-Cystic Fibrosis Bronchiectasis.

    Science.gov (United States)

    Silva, Yasmin R; Greer, Tracy A; Morgan, Lucy C; Li, Frank; Farah, Claude S

    2017-10-01

    Airway clearance techniques are a vital part of routine care for patients with bronchiectasis. There is no clear superior modality. The Flutter combines oscillations (6-20 Hz) and positive expiratory pressure; the Lung Flute combines positive expiratory pressure and low frequency acoustic waves (18-22 Hz), to augment clearance. This project aimed to compare these devices. This was a randomized crossover study of adult subjects with stable non-cystic fibrosis bronchiectasis (expectorating > 25 mL/d). Subjects attended 2 separate out-patient visits, 1 week apart, and completed a supervised sputum clearance regime and Lickert scale (8 questions regarding subjects' perception of the experience using each device). Total sputum expectorated during supervised intervention (T1) and after 30 min from the end of T1 (T2) was recorded as wet sputum weight. Total wet sputum weight desiccated in a microwave (10 min at 300 watts), allowed measurement of total dry sputum weight. Data were compared using paired t test. We recruited 40 subjects with a mean ± SD age of 63 ± 16 y. Overall, there was no significant difference in wet sputum weight (Flutter, 5.78 ± 6.47 g; Lung Flute, 5.75 ± 0.22 g) and dry sputum weight (Flutter, 0.40 ± 0.86 g; Lung Flute, 0.22 ± 0.21 g). At T1, wet sputum weight was higher for the Flutter (5.10 ± 6.26 g) compared with the Lung Flute (3.74 ± 3.44 g) (P = .038). At T2, wet sputum weight was higher for the Lung Flute (2.02 ± 3.01 g) compared with the Flutter (0.68 ± 0.75 g) (P = .001). Subjects perceived the Flutter as being significantly better at clearing secretions (P = .01), easy to understand (P = .03), and simple to use (P = .01) compared with the Lung Flute. Both devices were well-tolerated and successfully augmented secretion clearance. Most subjects preferred the Flutter because of increased speed of secretion clearance, and greater ease of use. Copyright © 2017 by Daedalus Enterprises.

  14. Anti-obesity action of gingerol: effect on lipid profile, insulin, leptin, amylase and lipase in male obese rats induced by a high-fat diet.

    Science.gov (United States)

    Saravanan, Ganapathy; Ponmurugan, Ponnusamy; Deepa, Machampalayam Arumugam; Senthilkumar, Balasubramanian

    2014-11-01

    Obesity represents a rapidly growing threat to the health of populations and diet intervention has been proposed as one of the strategies for weight loss. Ginger and its constituents have been used for their anti-flatulent, expectorant and appetising properties and they are reported to possess gastro-protective and cholesterol-lowering properties. The present study investigated the effects of gingerol on the changes in body weight, serum glucose, insulin, insulin resistance and lipid profile in plasma and liver as well as on the activity of amylase, lipase and leptin in high-fat diet (HFD)-induced obese rats. HFD-induced obese rats were treated orally with gingerol (25, 50 and 75 mg kg(-1) ) once daily for 30 days. A lorcaserin-treated group (10 mg kg(-1) ) was included for comparison. The levels of body weight, glucose, lipid profile and insulin, insulin resistance, leptin, amylase and lipase were increased significantly (P gingerol and fed a HFD showed significantly (P gingerol was more pronounced than that of the dose 25 mg kg(-1) and 50 mg kg(-1) . The lorcaserin-treated group also manifested similar effects to those of gingerol. These findings suggested that ginger supplementation suppresses obesity induced by a high fat diet and it might be a promising adjuvant therapy for the treatment of obesity and its complications. © 2014 Society of Chemical Industry.

  15. What's in and what's out in branding? A novel articulation effect for brand names.

    Science.gov (United States)

    Topolinski, Sascha; Zürn, Michael; Schneider, Iris K

    2015-01-01

    The present approach exploits the biomechanical connection between articulation and ingestion-related mouth movements to introduce a novel psychological principle of brand name design. We constructed brand names for diverse products with consonantal stricture spots either from the front to the rear of the mouth, thus inwards (e.g., BODIKA), or from the rear to the front, thus outwards (e.g., KODIBA). These muscle dynamics resemble the oral kinematics during either ingestion (inwards), which feels positive, or expectoration (outwards), which feels negative. In 7 experiments (total N = 1261), participants liked products with inward names more than products with outward names (Experiment 1), reported higher purchase intentions (Experiment 2), and higher willingness-to-pay (Experiments 3a-3c, 4, 5), with the price gain amounting to 4-13% of the average estimated product value. These effects occurred across English and German language, under silent reading, for both edible and non-edible products, and even in the presence of a much stronger price determinant, namely fair-trade production (Experiment 5).

  16. Studies on Chromatographic Fingerprint and Fingerprinting Profile-Efficacy Relationship of Polygoni Perfoliati Herba

    Science.gov (United States)

    Tian, Li; Chen, Hua-Guo; Zhao, Chao; Gong, Xiao-Jian

    2013-01-01

    Polygoni Perfoliati Herba is widely used in China with antibacterium, anti-inflammatory, expectorant, antitumor, and antivirus activities. To reveal the mechanisms of the activities of Polygoni Perfoliati Herba, the relationship between the fingerprinting profile and its bioactivities was investigated. In the present study, high-performance liquid chromatographic (HPLC) fingerprinting method was developed. The established method was applied to analyze 51 batches of Polygoni Perfoliati Herba samples collected from different locations or in different harvesting times in China. Chemometrics, including similarity analysis, hierarchical clustering analysis, and principal component analysis, were used to express their similarities. It was found that similarity values of the samples were in the range of 0.432–0.998. The results of analgesic tests indicated that Polygoni Perfoliati Herba could significantly inhibit pain induced by hot plate and acetic acid in mice. The results of anti-inflammatory tests showed that Polygoni Perfoliati Herba had good anti-inflammatory effects (P < 0.01) in two models including dimethyl benzene-induced ear edema and acetic acid-induced peritoneal permeability in mice. Combining the results from chromatographic fingerprints with those from bioactivities, we found that seven peaks from Polygoni Perfoliati Herba were mainly responsible for analgesic and anti-inflammatory activities. PMID:24023580

  17. Microscopic Analysis and Quality Assessment of Induced Sputum From Children With Pneumonia in the PERCH Study.

    Science.gov (United States)

    Murdoch, David R; Morpeth, Susan C; Hammitt, Laura L; Driscoll, Amanda J; Watson, Nora L; Baggett, Henry C; Brooks, W Abdullah; Deloria Knoll, Maria; Feikin, Daniel R; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; O'Brien, Katherine L; Scott, J Anthony G; Thea, Donald M; Ahmed, Dilruba; Awori, Juliet O; DeLuca, Andrea N; Ebruke, Bernard E; Higdon, Melissa M; Jorakate, Possawat; Karron, Ruth A; Kazungu, Sidi; Kwenda, Geoffrey; Hossain, Lokman; Makprasert, Sirirat; Moore, David P; Mudau, Azwifarwi; Mwaba, John; Panchalingam, Sandra; Park, Daniel E; Prosperi, Christine; Salaudeen, Rasheed; Toure, Aliou; Zeger, Scott L; Howie, Stephen R C

    2017-06-15

    It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and high numbers of polymorphonuclear (PMN) cells are regarded as indicative of a lower respiratory tract specimen. However, these quality ratings have never been evaluated for induced sputum specimens from children with suspected pneumonia. We evaluated induced sputum Gram stain smears and cultures from hospitalized children aged 1-59 months enrolled in a large study of community-acquired pneumonia. We hypothesized that a specimen representative of the lower respiratory tract will contain smaller quantities of oropharyngeal flora and be more likely to have a predominance of potential pathogens compared to a specimen containing mainly saliva. The prevalence of potential pathogens cultured from induced sputum specimens and quantity of oropharyngeal flora were compared for different quantities of SECs and PMNs. Of 3772 induced sputum specimens, 2608 (69%) had 25 PMNs per LPF, measures traditionally associated with specimens from the lower respiratory tract in adults. Using isolation of low quantities of oropharyngeal flora and higher prevalence of potential pathogens as markers of higher quality, 25 PMNs per LPF) was the microscopic variable most associated with high quality of induced sputum. Quantity of SECs may be a useful quality measure of induced sputum from young children with pneumonia.

  18. Comparison of Ambient and Atmospheric Pressure Ion Sources for Cystic Fibrosis Exhaled Breath Condensate Ion Mobility-Mass Spectrometry Metabolomics

    Science.gov (United States)

    Zang, Xiaoling; Pérez, José J.; Jones, Christina M.; Monge, María Eugenia; McCarty, Nael A.; Stecenko, Arlene A.; Fernández, Facundo M.

    2017-08-01

    Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the gene that encodes the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The vast majority of the mortality is due to progressive lung disease. Targeted and untargeted CF breath metabolomics investigations via exhaled breath condensate (EBC) analyses have the potential to expose metabolic alterations associated with CF pathology and aid in assessing the effectiveness of CF therapies. Here, transmission-mode direct analysis in real time traveling wave ion mobility spectrometry time-of-flight mass spectrometry (TM-DART-TWIMS-TOF MS) was tested as a high-throughput alternative to conventional direct infusion (DI) electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) methods, and a critical comparison of the three ionization methods was conducted. EBC was chosen as the noninvasive surrogate for airway sampling over expectorated sputum as EBC can be collected in all CF subjects regardless of age and lung disease severity. When using pooled EBC collected from a healthy control, ESI detected the most metabolites, APCI a log order less, and TM-DART the least. TM-DART-TWIMS-TOF MS was used to profile metabolites in EBC samples from five healthy controls and four CF patients, finding that a panel of three discriminant EBC metabolites, some of which had been previously detected by other methods, differentiated these two classes with excellent cross-validated accuracy.

  19. Study on diuretic activity of saffron (stigma of Crocus sativus L. Aqueous extract in rat

    Directory of Open Access Journals (Sweden)

    Nabi Shariatifar

    2014-01-01

    Full Text Available Saffron is the most expensive spice in the world and consists of the dried stigmas of Crocus sativus L. It is used as food coloring and flavoring in food industry and traditional cooking and also in folk medicine as antispasmodic, carminative, stomachic, expectorant, aphrodisiac and cardiotonic. The present study has evaluated the diuretic activity of aqueous extract of dried saffron (stigma of Crocussativus in rat. Aqueous extracts of saffron were administered to experimental rats orally as doses of 60, 120 and 240 mg/kg body weight (BW and compared with hydrochlorothiazide (10 mg/kg B.W., intraperitoneally, a potent diuretic as positive control and normal saline solution as placebo for control group. The measured parameters for diuretic activity were total urine volume, urine electrolytes concentration such as sodium and potassium, creatinine and urea concentration. The treated rats with aqueous extract of saffron as doses of 120 and 240 mg/kg BW showed higher urine output when compared to the control group. Also, it has shown a significant dose-dependent increase in the excretion of electrolytes when compared to the control group. Our findings proved the diuretic activity of saffron which is used in traditional medicine, it can be an effective and safe strategy for related dysfunction. Also further studies are needed to identify the mechanisms of action, probably other effects and interactions with other medicines.

  20. [Correlation analysis on combined medication with of Xiyanping injection in treatment of lung infection in real world].

    Science.gov (United States)

    Yin, Xiu-ping; Xie, Yan-ming; Zhi, Ying-jie; Yang, Wei; Wang, Zhi-fei; Huo, Jian

    2015-06-01

    To analyze the regularity in combined medication with Xiyanping injection (Xiyanping for short) in the real world by as- sociation rules. Totally 5 822 patients using Xiyanping injection was collected from the 18 Class III Grade I hospitals nationwide to study the combined medication information of the patient with lung infection and make the analysis by using association rules and Apriori. According to the results, major drugs combined with Xiyanping in treatment of lung infection included compound amino acid, inosine, coenzyme A, cytidine triphosphate, vitamin C. Common drugs combined with Xiyanping can be divided into 5 categories: nutrition support therapy (vitamin C, compound amino acid) , coenzymes (coenzyme A, cytidine triphosphate, inosine), expectorants and antiasthmatics (ambroxol, salbutamol, doxofylline), hormones (dexamethasone, budesonide), antibiotics (mainly cefminox). The main combined medicines mostly conformed to the regularity for drugs treating lung infection. In addition, there were two most common medical combination models: the model for Xiyanping combined a single medicine is Xiyanping + nutrition support therapy, while the model for Xiyanping combined two or more than two medicines is Xiyanping + nutrition support therapy + coenzyme. Pharmacologically, Xiyanping is mostly combined with western medicines with similar pharmacological effects to substitute or supplement the antibiotic effect in treating lung infection. However, further studies shall be conducted for the safety and rationality of the combined medication based on clinical practices, in order to provide reference for clinical medication.

  1. Anomalies of Pulmonary Circulation as a Cause of Hemoptysis: A Series of Unusual Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Kamini Gupta

    2015-05-01

    Full Text Available The expectoration of blood originating from the lower respiratory tract, called hemoptysis, is a common clinical condition with many potential etiologies. Massive hemoptysis is life threatening and needs urgent intervention. Multidetector computed tomography (MDCT is a useful non-invasive imaging modality for the initial assessment of hemoptysis. Using MDCT with multiplanar reformatted images has improved the diagnosis and management of hemoptysis by providing a more precise depiction of bronchial and non-bronchial systemic arteries than conventional computed tomography (CT. In 95% of hemoptysis cases, the systemic arterial system is the origin of bleeding and pulmonary vascular anomalies are a rare cause. Among these, pulmonary arteriovenous malformation, hereditary hemorrhagic telangiectasia, and Osler-Weber-Rendu disease are well known entities. However, primary anomalies affecting pulmonary vessels in the mediastinum or diseases secondarily affecting the pulmonary vessels are unusual causes. Here we present three cases where patients had pulmonary vascular anomalies causing hemoptysis. These patients had decreased pulmonary arterial pressures leading to bronchial and systemic arterial hypertrophy and development of bronchopulmonary collaterals. Secondary CT signs in the parenchyma and mediastinum (mosaic attenuation, ground glass haze, subpleural interstitial thickening, and hypertrophied bronchial arteries were similar in all patients. Hence, evaluation of the MDCT images for primary abnormality led to the diagnosis.

  2. Manual evaluation of the diaphragm muscle.

    Science.gov (United States)

    Bordoni, Bruno; Marelli, F; Morabito, B; Sacconi, B

    2016-01-01

    The respiratory diaphragm is the most important muscle for breathing. It contributes to various processes such as expectoration, vomiting, swallowing, urination, and defecation. It facilitates the venous and lymphatic return and helps viscera located above and below the diaphragm to work properly. Its activity is fundamental in the maintenance of posture and body position changes. It can affect the pain perception and emotional state. Many authors reported on diaphragmatic training by using special instruments, whereas only a few studies focused on manual therapy approaches. To the knowledge of the authors, the existing scientific literature does not exhaustively examines the manual evaluation of the diaphragm in its different portions. A complete evaluation of the diaphragm is mandatory for several professional subjects, such as physiotherapists, osteopaths, and chiropractors not only to elaborate a treatment strategy but also to obtain information on the validity of the training performed on the patient. This article aims to describe a strategy of manual evaluation of the diaphragm, with particular attention to anatomical fundamentals, in order to stimulate further research on this less explored field.

  3. Evaluations of thyme extract effects in human normal bronchial and tracheal epithelial cell lines and in human lung cancer cell line.

    Science.gov (United States)

    Oliviero, Marinelli; Romilde, Iannarelli; Beatrice, Morelli Maria; Matteo, Valisi; Giovanna, Nicotra; Consuelo, Amantini; Claudio, Cardinali; Giorgio, Santoni; Filippo, Maggi; Massimo, Nabissi

    2016-08-25

    Thyme (Thymus vulgaris) is used traditionally to prepare herbal remedies possessing expectorant, mucolytic, antitussive and antispasmodic properties. The aim of the present study was to investigate the effects of a standardized hydroalcoholic extract of thyme on primary human airway (bronchial/tracheal) epithelial cell lines in a model of lung inflammation induced by LPS. In addition, the effects of thyme extract on human lung cancer cell line (H460) were analysed. Thyme extract showed significant anti-inflammatory properties by reducing the NF-κB p65 and NF-κB p52 transcription factors protein levels followed by the decrease of pro-inflammatory cytokines (IL-1 beta and IL-8), and Muc5ac secretion in human normal bronchial and tracheal epithelial cells. Moreover, the extract showed cytotoxic effects on H460 cancer cells, modulated the release of IL-1 beta, IL-8 and down-regulated NF-κB p65 and NF-κB p52 proteins. Taken together, these results substantiated the traditional uses of thyme in the treatment of respiratory diseases. Thyme extract might be an effective treatment of chronic diseases based on inflammatory processes when hypersecretion of mucus overwhelms the ciliary clearance and obstructs airways, causing morbidity and mortality. Moreover thyme extract, evaluated in H460 lung cancer cell line, demonstrated to induce cell cytotoxicity in addition to reduce inflammatory cell signals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. An interesting newborn case of fructose 1-6 diphosphatase deficiency triggered after thyme juice ingestion.

    Science.gov (United States)

    Erol, Sara; Aydin, Banu; Dilli, Dilek; Okumuş, Nurullah; Zenciroğlu, Ayşegül; Gündüz, Mehmet

    2014-01-01

    Herbs have been used for centuries to prevent and control many diseases. The biggest challenge and problem is lack of information about the effect of herbs and its side effects. Thyme (thymus vulgaris) is a small shrubby plant with a strong, spicy taste, and odor. Thyme has carminative, diaphoretic, expectorant, sedative, antibacterial and antifungal properties. It also has antispasmodic effects; tea made by infusing the herb in water or thyme juice ready-to-use is traditionally frequently used for infantile colic in our country. A fourteen-day-old male newborn was admitted to the emergency department with severe respiratory distress. There was a history of 50 mL of thyme juice (added table sugar) ingestion given for his infantile colic two hours before admission. He had hypoglycemia, hyperuricemia, and lactic acidosis. Further investigation confirmed fructose 1-6 diphosphatase deficiency in the patient. We thought that lactic acidosis may have been triggered by fructose added to the thyme water to sweeten its taste. However, phenolic compounds of thyme juice may also cause acidosis.

  5. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger.

    Science.gov (United States)

    Mérol, Jean-Claude; Charpiot, Anne; Langagne, Thibault; Hémar, Patrick; Ackerstaff, Annemieke H; Hilgers, Frans J M

    2012-02-01

    Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Randomized controlled trial (RCT). Fifty-three patients were randomized into the standard (control) EH (N = 26) or the experimental HME arm (N = 27). Compliance, pulmonary and sleeping problems, patients' and nursing staff satisfaction, nursing time, and cost-effectiveness were assessed with trial-specific structured questionnaires and tally sheets. In the EH arm data were available for all patients, whereas in the HME arm data were incomplete for four patients. The 24/7 compliance rate in the EH arm was 12% and in the HME arm 87% (77% if the four nonevaluable patients are considered noncompliant). Compliance and patients' satisfaction were significantly better, and the number of coughing episodes, mucus expectoration for clearing the trachea, and sleeping disturbances were significantly less in the HME arm (P < .001). This was also the case for nursing time and nursing staff satisfaction and preference. This RCT clearly shows the benefits of immediate postoperative airway humidification by means of an HME over the use of an EH after TLE. This study therefore underlines that HMEs presently can be considered the better option for early postoperative airway humidification after TLE. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  6. Chronic adherence to heat and moisture exchanger use in laryngectomized patients.

    Science.gov (United States)

    Pedemonte-Sarrias, Gabriel; Villatoro-Sologaistoa, Juan Carlos; Ale-Inostroza, Paulina; López-Vilas, Montserrat; León-Vintró, Xavier; Quer-Agustí, Miquel

    2013-01-01

    Total laryngectomy leads to pulmonary problems such as excessive sputum production, forced expectoration and increased coughing. The use of a heat and moisture exchanger (Provox(®) HME) reduces these symptoms. The aim of this study was to quantify chronic adherence to HME use in laryngectomized patients. A prospective study of 115 patients laryngectomized at our centre during 2005-2011 was performed. Of the 115 patients, 90 (78.2%) used the HME consistently and 25 (21.8%) abandoned its use. The most common causes of desertion were adhesion problems due to mucus and skin irritation. Of the 30 patients with voice prostheses, 90% of them used the HME system regularly. Voice prosthesis use (P=.05) and early indication in postoperative laryngectomy (P=.001) were factors significantly associated with chronic HME use. There is high adherence (78.2%) to heat and moisture exchanger (Provox(®) HME) use in laryngectomized patients. Chronic HME use was higher in patients with voice prosthesis and the ones with early indication in postoperative period. The major causes of abandonment were related to problems with the adhesive. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. [Pulmonary rehabilitation after total laryngectomy using a heat and moisture exchanger (HME)].

    Science.gov (United States)

    Lorenz, K J; Maier, H

    2009-08-01

    A complete removal of the larynx has profound consequences for a patient. Since laryngectomy involves the separation of the upper airway from the lower airway, it not only implies a loss of the voice organ but also leads to chronic lung problems such as increased coughing, mucus production and expectoration. In addition, laryngectomees complain of fatigue, sleeping problems, a reduced sense of smell and taste, and a loss of social contact. A heat and moisture exchanger (HME) cassette can replace a function of the upper airway which consists in conditioning inspired air. It can improve pulmonary symptoms in three ways. 1. An HME cassette heats and moisturises inhaled air and thus creates nearly physiological conditions in the region of the deep airway. 2. The use of an HME cassette leads to an increase in breathing resistance, thereby reducing dynamic airway compression and improving lung ventilation. 3. An HME cassette acts as a filter and removes larger particles from incoming air. This review examines the current understanding of lung physiology after laryngectomy and assesses the effects of HME cassettes on the conditioning of respiratory air, lung function and psychosocial problems. Georg Thieme Verlag KG Stuttgart, New York.

  8. Tuberculose pulmonaire à Brazzaville en hospitalisation pneumologique: impact du diagnostic tardif à l’infection au VIH sur les anomalies radiographiques

    Science.gov (United States)

    Bemba, Esthel Lee Presley; Bopaka, Régis Gothard; Moyikoua, Régis; Ossibi-Ibara, Rolland; Ebenga-Somboko, Norela Bibiane; Toungou, Syn Nerval; Matondot, Paunel God’hervé; Ossale-Abacka, Boris Kevin; Okemba-Okombi, Franck Hardain; Mboussa, Joseph

    2016-01-01

    L’objectif de notre étude était de décrire les différents aspects radiographiques de la tuberculose pulmonaire selon le degré de l’immunodépression chez les patients VIH. Nous rapportons une étude rétrospective de 80 patients VIH positif non traités présentant une tuberculose pulmonaire, hospitalisés dans le service de Pneumo-phtisiologie de Brazzaville de Janvier 2013 à Janvier 2014. Notre échantillon était composé de 44 femmes (55%) et 36 hommes (45%) soit un sex ratio de 0,81. La moyenne d’âge était de 37,5±9,17ans, la moyenne du Taux de CD4 était de 153,13±86,6cell/mm3. La microscopie des expectorations à la recherche des bacilles acido-alcoolo-résistants était positive dans 75% des cas chez les patients ayant un taux de lymphocytes T CD4>200cell/ mm3. Les adénopathies médiastinales, les atteintes moyennes, inferieures du champ pulmonaire et la miliaire étaient plus fréquentes chez les patients ayant un taux de lymphocytes T CD4tuberculose. PMID:27800112

  9. Diversity of foliar endophytic fungi from the medicinal plant Sapindus saponaria L. and their localization by scanning electron microscopy.

    Science.gov (United States)

    García, Adriana; Rhoden, Sandro A; Rubin Filho, Celso J; Nakamura, Celso V; Pamphile, João A

    2012-01-01

    Endophytic fungi inhabit vegetable tissues or organs, without causing them any harm. Endophytes can co-evolve with plant hosts and possess species-specific interactions. They can protect the plant from insect attacks and diseases, and are also able to produce substances of biotechnological interest. In folk medicine, the bark, roots and fruits of Sapindus saponaria is used to produce substances with anxiolytic, astringent, diuretic and expectorant properties, as well as tonics, blood depuratives and cough medicine. This study evaluated the diversity of endophytic fungi present in the leaves of S. saponaria L. and observed the colonization of host plants by endophytes, using light and scanning electron microscopy. We verified that these fungi are found in intercellular and intracellular spaces. The genera of some isolates of S. saponaria were identified mainly by sequencing of ITS region of rDNA and, when possible, also by their microscopic features, as follows: Cochliobolus, Alternaria, Curvularia, Phomopsis, Diaporthe and Phoma. Phylogenetic analysis showed the existence of genetic variability of the genera Phomopsis and Diaporthe and interspecific variation among the Curvularia, Alternaria and Phoma, belonging to family Pleosporaceae.

  10. Effects of Ferula assa-foetida extract on spermatogenesis of rats

    Directory of Open Access Journals (Sweden)

    2017-11-01

    Full Text Available Background and objectives: Ferula assa-foetida is an herbaceous perennial plant which belongs to Apiaceae family. It is native to the east and central parts of Iran. This old traditional medicine has been used as antispasmodic, carminative, expectorant, laxative, sedative, stimulant, emmenagogue and vermifuge. In addition to the several therapeutic effects of the plant, it is known as an aphrodisiac herb traditionally; therefore, the present study has evaluated the effect of hydro-alcoholic extract of F. assa-foetida on spermatogenesis of rats. Methods: The seeds of the plant (500 g were identified and extracted by aqueous ethanol 80% using maceration methods (3×48 h.Adult male rats (6 weeks were orally treated with 50 mg/kg body weight of extract for 6 weeks. The extract was dispersed in distilled water. Control group received distilled water for the same duration. Some fertility parameters including sperm count, morphology and mobility of sperms with serum levels of testosterone, estrogen, luteinizing hormone (LH and follicle-stimulating hormone (FSH were evaluated using immunoassay methods.  Results: Sperm parameters and levels of testosterone and LH were significantly improved in the treated group compared to the control group. Conclusion: The results revealed that extract of F. assa-foetida significantly (p

  11. Clinical efficacy of the transdermal tulobuterol patch in patients with chronic obstructive pulmonary disease: a comparison with slow-release theophylline.

    Science.gov (United States)

    Minami, Shuwa; Kawayama, Tomotaka; Ichiki, Masao; Nishiyama, Mamoru; Sueyasu, Yoshiko; Gohara, Rumi; Kinoshita, Masaharu; Koga, Hideyuki; Iwanaga, Tomoaki; Aizawa, Hisamichi

    2008-01-01

    There is insufficient evidence for the efficacy of a transdermal tulobuterol patch (TP), although combination therapy with bronchodilators is recommended for chronic obstructive pulmonary disease (COPD). A randomized, controlled crossover study was conducted to evaluate the clinical efficacy and safety of the TP in 16 patients with COPD. Slow-release theophylline was used as a control drug. Following a 2-week run-in period, patients were randomly allocated to two groups by the envelope method; they then received the TP and theophylline for 4 weeks each by the crossover method. Pulmonary function tests, peripheral blood examination, and electrocardiography were performed before and after each treatment period. Patients recorded in diaries their symptom scores, numbers of administrations of inhaled beta(2) agonists, and presence/absence of adverse reactions. Patients receiving TP exhibited significant improvement in the number and ease of sputum expectoration and in cough frequency score and wheezing severity score compared with baseline (ptheophylline was non-significant. Assessment of quality of life by the St. George's Hospital Respiratory Questionnaire revealed that treatment with TP was associated with significant improvement in symptoms, impact, and total scores compared with baseline (ptheophylline gave only a non-significant improvement in total score. Neither drug caused significant changes in the results of physiological examinations or in pulse or blood pressure. There was no difference in safety between the treatments. Treatment of COPD patients with TP is more effective than with theophylline.

  12. Benefits of interventions for respiratory secretion management in adult palliative care patients-a systematic review.

    Science.gov (United States)

    Arcuri, Juliano Ferreira; Abarshi, Ebun; Preston, Nancy J; Brine, Jenny; Pires Di Lorenzo, Valéria Amorim

    2016-08-09

    Respiratory secretions impact negatively on palliative patients. Unfortunately, a gold standard therapy is not yet available. The purpose of this study was to identify which interventions are in use to control respiratory secretions in patients with chronic disease with a poor prognosis and verify their effects on outcomes relevant for palliative care patients. A systematic review of the literature with narrative summary was conducted. We searched eight electronic databases in April (6th), 2016. Citation-tracking and reference list searches were conducted. We included randomized controlled trials, crossover trials, observational and qualitative studies regarding interventions for respiratory secretion management in adult patients with chronic diseases that met inclusion criteria indicating short prognosis. Six randomized controlled trials, 11 observational studies, ten crossover trials and one qualitative study were found. Interventions included mechanical insufflation-exsufflation (MIE), expiratory muscle training, manually-assisted cough, tracheotomy, chest physiotherapy, suctioning, air stacking, electrical stimulation of abdominal muscles, nebulized saline, positive expiratory pressure masks, percussive ventilation, high frequency chest wall oscillations. The interventions with most promising benefits to patients in palliative care were manually-assisted cough and mechanical insufflation-exsufflation to promote expectoration and percussive ventilation to improve mucous clearance. Therapies, such as manually assisted cough, mechanical insufflation-exsufflation and percussive ventilation, which aim to deal with respiratory secretion, were the most promising treatment for use in palliative care for specific diseases. Nevertheless, the evidence still needs to improve in order to identify which treatment is the best.

  13. An unusual cause of fungal pneumonia

    Directory of Open Access Journals (Sweden)

    S Dharmic

    2015-01-01

    Full Text Available A 65 year old female, known asthmatic on steroids intermittently, with no other co-morbidity presented with fever, breathlessness and cough with mucoid expectoration of ten days duration with bilateral crepts, went for Type II respiratory failure and was intubated followed by tracheostomy in view of prolonged ventilator support. In spite of high end antibiotics as per sputum culture sensitivity, weaning off the ventilator was not possible. Blood investigations revealed leucocytosis with neutrophilic predominance and I g E levels were within normal limits. CT chest showed multiple patchy consolidations of the right upper, middle and lower lobes with ground glass appearance and enlarged mediastinal lymph nodes. Work up for retrovirus, tuberculosis and Sputum for KOH mount was negative. No evidence of sputum and blood eosinophilia. BAL sample grew Curvularia species. Fluconazole 150mg OD was added. Serial imaging of the chest showed resolution of the consolidation and was weaned off the ventilator and was comfortable on room air. Pneumonia caused by Curvularia, in an immune competent patient is very rare. Even in broncho pulmonary involvement these fungi usually occur in allergic conditions as in ABPA than appearing as a solitary cause for lung infection. But if diagnosed and treated early, will respond well to triazoles. This case report highlights a unilateral fungal pneumonia with dramatic clinical improvement post treatment once the rare causative organism was identified.

  14. [The value of physical therapy with VRP 1-Desitin ("Flutter")].

    Science.gov (United States)

    Lindemann, H

    1992-12-01

    Preliminary examinations with an innovative device for physiotherapy, VRP 1-Desitin ("Flutter"), in patients suffering from chronic mucus retention and bronchial collapse gave encouraging results. Therefore, we tried to confirm these findings and to evaluate the use of this new physiotherapy. It is based on oscillations of air in the respiratory tract during expiration (rate about 2 to 32 Hertz) diminishing adhesiveness of bronchial mucus and bronchial collapse. Pressure and flow changing depend on the position of mouth-piece and effort of breathing. In order to establish the efficiency of the VRP 1 a comparing investigation was initiated. 20 patients with cystic fibrosis, aged 7 to 28 years, performed physiotherapy with VRP 1 and autogenic drainage (AD), respectively, in a randomized order one after another, each physiotherapy taking twenty minutes. The expectorated sputum was weighed by means of a precision balance. Mean values during VRP 1 treatment were 5.0 g (range 0 to 12.0 g), during AD 4.8 g (range 0 to 11.7 g). There was no statistical difference (p VRP 1 physiotherapy is as effective as AD with respect to sputum elimination. In opposite to other methods not requiring a helping person it is simple to teach and to learn. It may be performed by young children (> or = 3 years) and adults, also in combination with inhalation. Thus, VRP 1 appears to be a real enrichment in physiotherapy.

  15. Diagnostic value of using multiplanar reformation images: Case report for rare endotracheal hamartomas.

    Science.gov (United States)

    Xiang, Zhiming; Ai, Zhu; Zhong, Guimian; Deng, Yu; Malhi, Harshawn; Palmer, Suzanne; Zee, Chishing

    2017-10-01

    Pulmonary hamartomas are the most common benign tumor of the lung. Two types of pathologically similar hamartomas exist based on their location. These tumors have a low incidence, are rarely reported and frequently misdiagnosed because of lack of familiarity and/or understanding concerning their imaging features. Seventeen patients received treatment between June 2007 and May 2013 and had complete medical records. All of them had different degrees of cough and expectoration. Other symptoms include fever (5 cases), hemoptysis (4 cases), chest pain (3 cases), shortness of breath (2 cases), and dyspnea (1 case). These patients all have pathologically confirmed, and informed the diagnosis of endobronchial hamartoma. Unenhanced and enhanced CT scans were performed using Toshiba Aquilion 64-slice and GE Lightspeed 64-slice CT scanners. The scan was performed from the superior thoracic aperture to the lateral costophrenic angle. The transaxial CT data was inserted into a Volume Wizard workstation to reconstruct images using MPR technique. The relationship between the location of the tumor and bronchi was clearly displayed on the axial images in only 2 patients. In all 17 patients, reconstructed MPR images were able to display the tumor parallel to the long axis of bronchi, thus facilitating in tumor identification and positioning along the bronchial tree. MPR images are valuable tools in the diagnosis of endobronchial hamartomas. Chiefly, these reconstructions aid in the detection of intratumoral fat/calcification and clearly demonstrate the tumors relationship and effect with the adjacent bronchi.

  16. Candida Species Prevalence Profile in HIV Seropositive Patients from a Major Tertiary Care Hospital in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Monika Maheshwari

    2016-01-01

    Full Text Available Candida is a common opportunistic pathogen during the course of human immunodeficiency virus (HIV disease progression. Changes in the clinical severity of candidiasis and the Candida species prevalence profile may be a reflection of immunological changes in HIV positive patients. The aim of this study was to document the changing pattern of Candida species prevalence profile in HIV seropositive patients from a tertiary care hospital in North India. One hundred and twenty HIV seropositive subjects were recruited for Candida microbial screening. Clinical specimens including blood, oral swabs, expectorated or induced sputum/bronchoalveolar lavage specimens, and urine were collected depending on the patient’s symptoms. A total of 128 Candida isolates were obtained from 88 cases and 7 different Candida species were identified. C. albicans (50% was the most common species isolated followed by C. glabrata (17% and C. dubliniensis (12.5%. Other species isolated were C. parapsilosis (7.8%, C. krusei, C. tropicalis (4.6% each, and C. kefyr (3%. Strong clinical suspicion along with optimal sampling of an accurate diagnosis of Candida species involved would go a long way in decreasing the morbidity associated with non-albicans Candida species.

  17. Decontamination of radioactive materials (part II)

    Energy Technology Data Exchange (ETDEWEB)

    Akashi, Makoto; Shimomura, Satoshi; Hachiya, Misao [National Inst. of Radiological Sciences, Chiba (Japan)

    1998-06-01

    Drifting agents accelerate the exchange process and thus promote to eliminate radioactive materials from human body. The earlier is the administration of the agent, the more effective is the elimination. Against the uptake of radioiodine by thyroid, anti-thyroid drug like NaI, Lugol`s iodine solution, propylthiouracil and methimazole are recommended. Ammonium chloride can be a solubilizer of radioactive strontium. Diuretics may be useful for excretion of radioisotopes of sodium, chlorine, potassium and hydrogen through diuresis. Efficacy of expectorants and inhalants is not established. Parathyroid extract induces decalcification and thus is useful for elimination of 32P. Steroids are used for compensating adrenal function and for treatment of inflammation and related symptoms. Chelating agents are useful for removing cations and effective when given early after contamination. EDTA and, particularly, DTPA are useful for elimination of heavy metals. For BAL (dimercaprol), its toxicity should be taken into consideration. Penicillamine is effective for removing copper and deferoxamine, for iron. Drugs for following radioisotopes are summarized: Am, As, Ba, Br, Ca, Cf, C, Ce, Cs, Cr, Co, Cm, Eu, fission products, F, Ga, Au, H, In, I, Fe, Kr, La, PB, Mn, Hg, Np, P, Pu, Po, K, Pm, Ra, Rb, Ru, Sc, Ag, Na, Sr, S, Tc, Th, U, Y, Zn and Zr. Lung and bronchia washing are effective for treatment of patients who inhaled insoluble radioactive particles although their risk-benefit should be carefully assessed. The present review is essentially based of NCRP Report No.65. (K.H.) 128 refs.

  18. Invasive pulmonary aspergillosis: A study of 39 cases at autopsy

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    Vaideeswar P

    2004-01-01

    Full Text Available Background: Aspergillus is a common cause of invasive mycosis, especially in immunocompromised or immunosuppressed individuals. Aims: To study the incidence of invasive pulmonary aspergillosis and evaluate the predisposing factors and clinico-pathological manifestations. Settings and Design: Retrospective analysis of autopsy material from a tertiary care hospital. Material and Methods: All autopsies performed over a 12-year period were reviewed and cases with invasive aspergillosis were analysed with respect to their clinical presentation, predisposing factors, gross and histological features, complications and causes of death. Results: Among a total of 20475 autopsies performed in 12 years, 39 patients (0.19 % had invasive pulmonary aspergillosis. There were 28 males and 11 females. Their ages ranged from five months to 67 years. Dyspnoea, fever, cough with mucopurulent expectoration, chest pain and haemoptysis were commonly encountered symptoms. Forty-one per cent of the patients had no respiratory symptoms. Fungal aetiology was not entertained clinically in any of the patients. The major underlying conditions were prolonged antibiotic therapy, steroid therapy, and renal transplantation, often associated with underlying lung diseases. Pneumonia, abscesses, vascular thrombosis and infarction were common findings at autopsy. Antecedent tuberculosis, mucormycosis, Pneumocystis carinii pneumonia and Cytomegalovirus infection were also present. In most cases, death was related to extensive pulmonary involvement or fungal dissemination. Conclusion: A diagnosis of invasive pulmonary aspergillosis should always be borne in mind whenever one is dealing with recalcitrant lung infections even with subtle immunosuppression. Radiological investigations and serologic markers can be utilised for confirmation and prompt therapy.

  19. Rapid development of pulmonary cavitation as manifestation of a candida species

    Energy Technology Data Exchange (ETDEWEB)

    Rix, E.; Bickel, R.H.; Baldauf, G.

    1987-01-01

    The roentgenologic pattern of the pulmonary manifestation of candida species, resulting in a rapid development of pulmonary cavitations with mycetoma-like structures, was described in three patients. All patients, undergoing antineoplastic chemotherapy because of acute leukemia, presented with fever and expectoration, which were resistant to various antibiotic regimes. Cultures of blood and urine were sterile; but Torulopsis glabrata, a candida species, was found in multiple cultures of the sputum of all patients and also in a bronchoscopic lavage obtained from one patient after reconstitution of the granulopoesis. The roetgenologic appearance of the infiltrates was accompanied by a rise of the Ig-M immunoglobulins against candida. Following intravenous treatment with amphotericin B a reduction of the cavitation and of the infiltrates to small residues was observed. Simultaneously the body temperature and the sputum became normal and a fall in the immunoglobulin titers was found. The diagnostic problems of pulmonary cavitation and especially of pulmonary mycosis in immuosuppressed and therapy-induced granulocytopenic and thrombocytopenic patients with acute leukemia were discussed.

  20. Diagnosis of pediatric pulmonary tuberculosis by stool PCR.

    Science.gov (United States)

    Wolf, Hilary; Mendez, Melissa; Gilman, Robert H; Sheen, Patricia; Soto, Giselle; Velarde, Angie K; Zimic, Mirko; Escombe, A Roderick; Montenegro, Sonia; Oberhelman, Richard A; Evans, Carlton A

    2008-12-01

    Pediatric pulmonary tuberculosis diagnosis is difficult because young children are unable to expectorate sputum samples. Testing stool for tuberculosis DNA from swallowed sputum may diagnose pulmonary tuberculosis. Hospitalized children with suspected tuberculosis had stool, nasopharyngeal, and gastric aspirates cultured that confirmed pulmonary tuberculosis in 16/236 patients. Twenty-eight stored stools from these 16 children were used to evaluate stool polymerase chain reaction (PCR) for tuberculosis diagnosis compared with 28 stool samples from 23 healthy control children. Two DNA extraction techniques were used: fast-DNA mechanical homogenization and Chelex-resin chemical extraction. DNA was tested for tuberculosis DNA with a hemi-nested IS6110 PCR. PCR after Fast-DNA processing was positive for 6/16 culture-proven tuberculosis patients versus 5/16 after Chelex extraction (sensitivity 38% and 31%, respectively). All controls were negative (specificity 100%). If sensitivity can be increased, stool PCR would be a rapid, non-invasive, and relatively bio-secure initial test for children with suspected pulmonary tuberculosis.

  1. A case of lower respiratory tract infection caused by Neisseria weaveri and review of the literature.

    Science.gov (United States)

    Panagea, S; Bijoux, R; Corkill, J E; Al Rashidi, F; Hart, C A

    2002-02-01

    Neisseria weaveri (formerly CDC [Centers for Disease Control and Prevention] group M-5 is part of the normal canine oral flora. Infections in humans are usually associated with dog bite wounds. Very rarely the organism has been isolated from sites other than wounds, or from deep seated infections. A 60-year-old man was admitted to our hospital because of an acute exacerbation of his bronchiectasis. Gram stain of bronchial washings and expectorated sputum showed numerous polymorphs and Gram-negative bacilli. Routine bacterial culture yielded a heavy pure growth of a Gram-negative rod-shaped organism that was strongly oxidase and catalase positive, indole negative, non-motile and did not ferment carbohydrates. The organism was identified as N. weaveri by using 16S rRNA sequencing. The patient was treated with a 3 weeks course of ofloxacin and had a good response. Sputum culture after treatment yielded normal respiratory flora only. To our knowledge, this is the first reported case of lower respiratory tract infection caused by N. weaveri. Copyright 2002 The British Infection Society.

  2. Comparative Metabolite Profiling of Triterpenoid Saponins and Flavonoids in Flower Color Mutations of Primula veris L.

    Science.gov (United States)

    Apel, Lysanne; Kammerer, Dietmar R; Stintzing, Florian C; Spring, Otmar

    2017-01-13

    Primula veris L. is an important medicinal plant with documented use for the treatment of gout, headache and migraine reaching back to the Middle Ages. Triterpenoid saponins from roots and flowers are used in up-to-date phytotherapeutic treatment of bronchitis and colds due to their expectorant and secretolytic effects. In addition to the wild type plants with yellow petals, a red variant and an intermediate orange form of Primula veris L. have recently been found in a natural habitat. The secondary metabolite profiles of roots, leaves and flowers of these rare variants were investigated and compared with the wild type metabolome. Two flavonoids, six flavonoid glycosides, four novel methylated flavonoid glycosides, five anthocyanins and three triterpenoid saponins were identified in alcoholic extracts from the petals, leaves and roots of the three variants by high performance liquid chromatography (HPLC)-diode array detection (DAD)/mass spectrometry (MS n ) analyses. Anthocyanins were detected in the petals of the red and orange variety, but not in the wild type. No other effects on the metabolite profiles of the three varieties have been observed. The possibility is discussed that a regulatory step of the anthocyanin biosynthetic pathway may have been affected by mutation thus triggering color polymorphism in the petals.

  3. The genus Prevotella in cystic fibrosis airways.

    Science.gov (United States)

    Field, Tyler R; Sibley, Christopher D; Parkins, Michael D; Rabin, Harvey R; Surette, Michael G

    2010-08-01

    Airway disease resulting from chronic bacterial colonization and consequential inflammation is the leading cause of morbidity and mortality in patients with Cystic Fibrosis (CF). Although traditionally considered to be due to only a few pathogens, recent re-examination of CF airway microbiology has revealed that polymicrobial communities that include many obligate anaerobes colonize lower airways. The purpose of this study was to examine Prevotella species in CF airways by quantitative culture and phenotypic characterization. Expectorated sputum was transferred to an anaerobic environment immediately following collection and examined by quantitative microbiology using a variety of culture media. Isolates were identified as facultative or obligate anaerobes and the later group was identified by 16S rRNA sequencing. Prevotella spp. represented the majority of isolates. Twelve different species of Prevotella were recovered from 16 patients with three species representing 65% of isolates. Multiple Prevotella species were often isolated from the same sputum sample. These isolates were biochemically characterized using Rapid ID 32A kits (BioMérieux), and for their ability to produce autoinducer-2 and beta-lactamases. Considerable phenotypic variability between isolates of the same species was observed. The quantity and composition of Prevotella species within a patients' airway microbiome varied over time. Our results suggest that the diversity and dynamics of Prevotella in CF airways may contribute to airway disease. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  4. Role of bronchoalveolar lavage for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates.

    Science.gov (United States)

    Sun, Xue-Feng; Liu, Yong-Jian; Xiao, Yi; Xu, Wen-Bing

    2014-10-01

    The aims of the study were to evaluate the effectiveness of bronchoalveolar lavage (BAL) for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates and to evaluate factors that affect the diagnostic yield. A retrospective study was performed in patients with rheumatic autoimmune diseases and lung infiltrates whose BALs were sent for microbial assays at Peking Union Medical College Hospital from January 2009 to June 2013. Patient characteristics, clinical symptoms, medication history, laboratory parameters, radiographic findings, lung lobe lavaged, and diagnostic yield were retrieved. Seventy BALs were performed in 69 patients. The overall diagnostic yield of BAL for pulmonary infection was 17.1% (12/70), sensitivity was 35.5%, and specificity was 97.4%. Twelve microorganisms were isolated from 12 different BALs conforming to diagnostic criteria, including 4 Aspergillus, 3 Pneumocystis jirovecii, 3 gram-negative bacilli, 1 gram-positive coccus, and 1 mycobacterium. Patients with clinical symptoms of fever, cough, or expectoration had a higher diagnostic yield than patients without either symptom (25.6% vs 3.7%, P = 0.042). Patients with ground-glass opacity, mass, or consolidation radiographically had a higher yield than did patients with reticular or nodular infiltrates (20.3% vs 0, P rheumatic autoimmune diseases and lung infiltrates, especially in cases where initial antimicrobial therapy is ineffective. Opportunistic pathogens are important in patients with rheumatic autoimmune diseases and lung infiltrates and should be considered when antibacterial treatment is ineffective.

  5. [A case of pharyngolaryngeal edema after posterior occipito-cervical operation].

    Science.gov (United States)

    Takara, Itaru; Takechi, Akiko; Sugahara, Kazuhiro

    2004-10-01

    A 70-year-old female developed respiratory failure due to pharyngolaryngeal edema after posterior occipito-cervical fusion. She had a history of total thyroidectomy with bilateral neck dissection for advanced thyroid cancer associated with multiple lung metastases. However, her general condition was good, and she was not in cachexia. Her pulmonary function test revealed %VC of 54% and %FEV1.0 of 79%. This posterior occipito-cervical fusion was necessary for pain relief. Twenty-four hours after surgery she suddenly showed dyspnea, requiring tracheal intubation, and was supported by mechanical ventilation. The pharyngolaryngeal edema was recognized with bronchoscopy from the lower larynx with arytenoid region to nasal choana. In several days she recovered from pharyngolaryngeal edema and was extubated. She was discharged from ICU after close observation for 24 hours after extubation. She developed respiratory distress again due to difficulty in sputum expectoration, resulting in emergency tracheostomy an the floor at midnight. In this case, pharyngolaryngeal edema may have been caused by disturbance of lymphatic flow due to posterior occipito-cervical fusion in a patient with a past history of bilateral neck dissection. We also reviewed the literature in this report.

  6. Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo.

    Science.gov (United States)

    Olivieri, D; Zavattini, G; Tomasini, G; Daniotti, S; Bonsignore, G; Ferrara, G; Carnimeo, N; Chianese, R; Catena, E; Marcatili, S

    1987-01-01

    In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis.

  7. Prospective, longitudinal study of plastic bronchitis cast pathology and responsiveness to tissue plasminogen activator.

    Science.gov (United States)

    Heath, Lauren; Ling, Shelley; Racz, Jennifer; Mane, Gerta; Schmidt, Lindsay; Myers, Jeffrey L; Tsai, Wan C; Caruthers, Regine L; Hirsch, Jennifer C; Stringer, Kathleen A

    2011-12-01

    Plastic bronchitis (PB) is a rare disease that often occurs in patients with congenital heart disease (CHD) who have undergone staged single-ventricle palliation. It is characterized by the formation of rubbery "casts" in the airways. PB treatment frequently includes inhaled tissue plasminogen activator (tPA). However, the efficacy of tPA to reduce cast burden is unknown. This is further complicated by our lack of knowledge of cast composition. We obtained spontaneously expectorated PB casts from children (n = 4) with CHD and one adult patient with idiopathic PB. Pathological assessment was made from paraffin-preserved samples. Casts were treated with phosphate-buffered saline (PBS) or tPA. Cast response to tPA was assessed by changes in cast weight and the production of fibrin D-dimer. Independent of dose, tPA reduced cast weight compared with PBS-treatment (P = 0.001) and increased D-dimer levels. Histological staining showed that PB casts from all patients were composed of fibrin and contained notable numbers of lymphocytes. Cast composition did not change over time. Collectively, these data support that in our PB patients, casts are composed of fibrin and are responsive to tPA treatment. This makes inhaled tPA a potentially viable option for symptomatic relief of PB while we work to unravel the complexity of PB pathogenesis.

  8. Isolated Unilateral Absent Branch Pulmonary Artery with Peripheral Pulmonary Stenosis and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Sunil Abhishek B

    2017-09-01

    Full Text Available Isolated Unilateral Absent Pulmonary Artery (UAPA is a rare congenital anomaly. It is usually associated with congenital heart defects. A 45 year old male patient presented with complaints of fever with cough and expectoration for 15 days and retrosternal chest discomfort for the previous 2 days. ECG showed diffuse ST segment depression with T wave inversion in the inferior and lateral leads. Coronary Angiogram done through the right femoral approach revealed diffusely diseased Left Anterior Descending (LAD artery that was totally cut off at the mid segment. The Left Circumflex (LCx artery was providing blood supply to the right middle and lower lung areas. There was another collateral arising from the Left Subclavian Artery supplying the right middle and lower lung areas. The left pulmonary artery was normal, but branches supplying the middle and lower lobes of the right lung were absent and the upper lobe branch had pulmonary stenosis. UAPA is a rare clinical entity; collaterals from coronaries are extremely rare in this condition and till now there has not been any case report of unilateral absent branch pulmonary artery with peripheral stenosis of other branches, on the affected side and associated coronary artery disease.

  9. Intra-oral adsorption and release of aroma compounds following in-mouth wine exposure.

    Science.gov (United States)

    Esteban-Fernández, Adelaida; Rocha-Alcubilla, Nuria; Muñoz-González, Carolina; Moreno-Arribas, María Victoria; Pozo-Bayón, María Ángeles

    2016-08-15

    Wine "after-odour" defined as the long lasting aroma perception that remains after wine swallowing is an outstanding characteristic in terms of wine quality but a relatively unstudied phenomenon. Among the different parameters that might affect wine after-odour, the adsorption of odorants by the oral mucosa could be important but has been little explored. In this work, the impact of the chemical characteristics of aroma compounds on intra-oral adsorption was assessed by an in vivo approach that determined the amounts of odorants remaining in expectorated wine samples. In addition, the subsequent aroma release after in-mouth wine exposure was studied by means of intra-oral SPME/GC-MS using three different panellists. Oral adsorption of the aroma compounds added to the wines ranged from 6% to 43%, depending on their physicochemical characteristics. A progressive intra-oral aroma decrease at different decay rates depending on compound type and panellist was also found. The strength of the aroma-oral mucosa interactions seems to explain these results more than the amount of compound adsorbed by the oral mucosa. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Increased prevalence and altered species composition of filamentous fungi in respiratory specimens from cystic fibrosis patients.

    Science.gov (United States)

    Nielsen, Signe M; Kristensen, Lise; Søndergaard, Annette; Handberg, Kurt J; Stenderup, Jørgen; Nørskov-Lauritsen, Niels

    2014-10-01

    Filamentous fungi cultured from respiratory tract specimens submitted to the department of clinical microbiology, Aarhus University Hospital, during 2010 were identified by morphology and by internal transcribed spacer (ITS) sequencing. Of 343 fungal isolates, discrepancies between identification methods were observed for four isolates (1.2%), while identification to species was achieved only with ITS sequencing for 16 isolates (4.7%). Filamentous fungi were isolated from 15% of cystic fibrosis (CF) respiratory samples in contrast to 2% of non-CF samples. From CF patients, a total of nine different species were found in 188 samples from 48 patients, whereas from non-CF patients, 24 different species were found in 155 samples from 111 patients. CF was associated with a significant overrepresentation of Aspergillus fumigatus and Scedosporium species; in contrast, the frequency of Penicillium spp. and other putative contaminants were significantly increased in non-CF patients. The altered species variation of filamentous fungi in CF respiratory specimens is contradictory to a scenario of incidentally inhaled spores, trapped in the viscous airway mucus of these patients and subsequently expectorated; rather, our data most likely reflect both an increased prevalence and an increased proportion of truly colonizing fungi in this patient group. © 2014 APMIS. Published by John Wiley & Sons Ltd.

  11. The Effect of a Brief Salivary α-Amylase Exposure During Chewing on Subsequent in Vitro Starch Digestion Curve Profiles

    Science.gov (United States)

    Woolnough, James W.; Bird, Anthony R.; Monro, John A.; Brennan, Charles S.

    2010-01-01

    There is inconsistency between current in vitro digestion methods with regard to accommodation of a (salivary) α-amylase exposure during the oral phase. The effect of a salivary α-amylase pre-exposure on subsequent in vitro starch digestion curve profiles for various foods was investigated. Foods were chewed, expectorated and the boluses left to rest for 0–15 min. During pancreatic digestion, aliquots were taken and hydrolysis curves constructed for comparison against those of the same foods comminuted with a manually-operated chopper, hence spared exposure to saliva. Hydrolysate aliquots taken at T0 (time zero) of the digestion of chewed samples contained higher levels of glucose and dextrins compared with chopped samples. Pancreatin activity immediately overwhelmed differences in sugar released due to salivary amylase activity. Within 10 min no differences were detectable between hydrolysis curves for chewed and chopped foods. Salivary amylase pretreatment does not contribute to the robustness or relative accuracy of in vitro methods. PMID:21152272

  12. Mosquitoes Transmit Unique West Nile Virus Populations during Each Feeding Episode.

    Science.gov (United States)

    Grubaugh, Nathan D; Fauver, Joseph R; Rückert, Claudia; Weger-Lucarelli, James; Garcia-Luna, Selene; Murrieta, Reyes A; Gendernalik, Alex; Smith, Darci R; Brackney, Doug E; Ebel, Gregory D

    2017-04-25

    Arthropod-borne viruses (arboviruses), such as Zika virus, chikungunya virus, and West Nile virus (WNV), pose continuous threats to emerge and cause large epidemics. Often, these events are associated with novel virus variants optimized for local transmission that first arise as minorities within a host. Thus, the conditions that regulate the frequency of intrahost variants are important determinants of emergence. Here, we describe the dynamics of WNV genetic diversity during its transmission cycle. By temporally sampling saliva from individual mosquitoes, we demonstrate that virus populations expectorated by mosquitoes are highly diverse and unique to each feeding episode. After transmission to birds, however, most genetic diversity is removed by strong purifying selection. Further, transmission of potentially mosquito-adaptive WNV variants is strongly influenced by genetic drift in mosquitoes. These results highlight the complex evolutionary forces a novel virus variant must overcome to alter infection phenotypes at the population level. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  13. Enzyme Enhancers for the Treatment of Fabry and Pompe Disease

    Science.gov (United States)

    Lukas, Jan; Pockrandt, Anne-Marie; Seemann, Susanne; Sharif, Muhammad; Runge, Franziska; Pohlers, Susann; Zheng, Chaonan; Gläser, Anne; Beller, Matthias; Rolfs, Arndt; Giese, Anne-Katrin

    2015-01-01

    Lysosomal storage disorders (LSD) are a group of heterogeneous diseases caused by compromised enzyme function leading to multiple organ failure. Therapeutic approaches involve enzyme replacement (ERT), which is effective for a substantial fraction of patients. However, there are still concerns about a number of issues including tissue penetrance, generation of host antibodies against the therapeutic enzyme, and financial aspects, which render this therapy suboptimal for many cases. Treatment with pharmacological chaperones (PC) was recognized as a possible alternative to ERT, because a great number of mutations do not completely abolish enzyme function, but rather trigger degradation in the endoplasmic reticulum. The theory behind PC is that they can stabilize enzymes with remaining function, avoid degradation and thereby ameliorate disease symptoms. We tested several compounds in order to identify novel small molecules that prevent premature degradation of the mutant lysosomal enzymes α-galactosidase A (for Fabry disease (FD)) and acid α-glucosidase (GAA) (for Pompe disease (PD)). We discovered that the expectorant Ambroxol when used in conjunction with known PC resulted in a significant enhancement of mutant α-galactosidase A and GAA activities. Rosiglitazone was effective on α-galactosidase A either as a monotherapy or when administered in combination with the PC 1-deoxygalactonojirimycin. We therefore propose both drugs as potential enhancers of pharmacological chaperones in FD and PD to improve current treatment strategies. PMID:25409744

  14. Ambroxol as a pharmacological chaperone for mutant glucocerebrosidase.

    Science.gov (United States)

    Bendikov-Bar, Inna; Maor, Gali; Filocamo, Mirella; Horowitz, Mia

    2013-02-01

    Gaucher disease (GD) is characterized by accumulation of glucosylceramide in lysosomes due to mutations in the GBA1 gene encoding the lysosomal hydrolase β-glucocerebrosidase (GCase). The disease has a broad spectrum of phenotypes, which were divided into three different Types; Type 1 GD is not associated with primary neurological disease while Types 2 and 3 are associated with central nervous system disease. GCase molecules are synthesized on endoplasmic reticulum (ER)-bound polyribosomes, translocated into the ER and following modifications and correct folding, shuttle to the lysosomes. Mutant GCase molecules, which fail to fold correctly, undergo ER associated degradation (ERAD) in the proteasomes, the degree of which is one of the factors that determine GD severity. Several pharmacological chaperones have already been shown to assist correct folding of mutant GCase molecules in the ER, thus facilitating their trafficking to the lysosomes. Ambroxol, a known expectorant, is one such chaperone. Here we show that ambroxol increases both the lysosomal fraction and the enzymatic activity of several mutant GCase variants in skin fibroblasts derived from Type 1 and Type 2 GD patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Human Coronaviruses HCoV-NL63 and HCoV-HKU1 in Hospitalized Children with Acute Respiratory Infections in Beijing, China

    Directory of Open Access Journals (Sweden)

    Li-Jin Cui

    2011-01-01

    Full Text Available The human coronaviruses (HCoVs HCoV-NL63 and HCoV-HKU1 are two recently discovered coronaviruses that circulate widely and are associated with acute respiratory infections (ARI. We detected HCoV-NL63 and HCoV-HKU1 in specimens collected from May 2008 to March 2010 from patients with ARI aged <7.75 years of age attending the Beijing Children's Hospital. Thirty-two (8.4% and 57 (14.9% of 382 specimens tested positive for HCoV-NL63 and HCoV-HKU1, respectively, by real-time RT-PCR. Use of a Luminex xTAG RVP Fast kit showed that coinfection with respiratory syncytial virus and parainfluenza 3 virus was common among patients infected with either virus type. In HCoV-HKU1-infected patients, the predominant clinical symptoms were cough, fever, and expectoration. In HCoV-NL63-infected patients they were cough, fever, and rhinorrhea. Phylogenetic studies showed that the HCoV-HKU1 nucleoprotein gene was relatively conserved compared to NCBI reference sequences, while the 1ab gene of HCoV-NL63 showed more variation.

  16. [Costs estimation of tuberculosis cases detection. La Habana Vieja Municipality, Cuba. 2002].

    Science.gov (United States)

    Peralta Pérez, Mariana; Gálvez González, Ana M; González Ochoa, Edilberto

    2007-01-01

    The Cuban Tuberculosis Control Program has been able to significantly reduce the tuberculosis cases incidence in all its forms. La Habana Vieja municipality has maintained the highest incidence in Havana City province during 5 years and one of the highest in the country. To estimate the cost of Tuberculosis cases detection in Habana Vieja municipality, in the year 2002. A descriptive retrospective study to estimate the costs with social perspective was carried out. The costs of cases detection and their departures in health facilities were considered. For patients with cough/expectoration > or =14 days (RS+14) the pocket expense and monetary losses for labour absences were considered. Costs were expressed in equivalent Cuban pesos to American dollars (1 CUC = 1 USD). Information from official records in health institutions and from interviews to workers and RS+14 was obtained. Social cost of tuberculosis cases detection for an RS+14 was in average 24,11 CUC, and institutional cost was 12,55; for clinical investigation 0.37; for sputum smear microscopy 2,25; for culture 7,05; for thorax X-ray 1,67; for notification 3,07; and for registering 0,36. The biggest costs were observed in sputum smear microscopies and cultures performance; salaries and reagents were the issues contributing more in that cost. The results obtained in this study could be extrapolated to other municipalities in the country with social and economic conditions similar to La Habana Vieja.

  17. The Effect of a Brief Salivary α-Amylase Exposure During Chewing on Subsequent in Vitro Starch Digestion Curve Profiles

    Directory of Open Access Journals (Sweden)

    Charles S. Brennan

    2010-07-01

    Full Text Available There is inconsistency between current in vitro digestion methods with regard to accommodation of a (salivary α-amylase exposure during the oral phase. The effect of a salivary α-amylase pre-exposure on subsequent in vitro starch digestion curve profiles for various foods was investigated. Foods were chewed, expectorated and the boluses left to rest for 0–15 min. During pancreatic digestion, aliquots were taken and hydrolysis curves constructed for comparison against those of the same foods comminuted with a manually-operated chopper, hence spared exposure to saliva. Hydrolysate aliquots taken at T0 (time zero of the digestion of chewed samples contained higher levels of glucose and dextrins compared with chopped samples. Pancreatin activity immediately overwhelmed differences in sugar released due to salivary amylase activity. Within 10 min no differences were detectable between hydrolysis curves for chewed and chopped foods. Salivary amylase pretreatment does not contribute to the robustness or relative accuracy of in vitro methods.

  18. Bronchitis (acute).

    Science.gov (United States)

    Wark, Peter

    2011-06-20

    Acute bronchitis affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens. The role of smoking or of environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear. One third of people may have longer-term symptoms or recurrence. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute bronchitis in people without chronic respiratory disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics (macrolides, tetracyclines, cephalosporins, penicillins, or trimethoprim-sulfamethoxazole [co-trimoxazole]), antihistamines, antitussives, beta(2) agonists (inhaled or oral), and expectorants/mucolytics.

  19. [Acute silicosis. An infrequent pneumoconiosis].

    Science.gov (United States)

    Méndez-Vargas, María Martha; Soto-de la Fuente, Andrés Eduardo; Soto-Vera, Eduardo Andrés; Leo-Méndez, Rodolfo

    2015-01-01

    Acute Silicosis was first described in 1900 by Betts. It's also denominated as silicoproteinosis. It's an infrequent way of pneumoconiosis which is produced when sandblasting. 27 year old male who has been working for four years in a glass shop, etching them through sandblasting. Four years before with dyspnea on exertion rapidly progressing. Coughing spell, emetic and wheezing, with daily hyaline expectoration of 50 cc, yearly weight loss of 44 lbs and intense chest pain. Breathing rates 36X'. He was polypneic, with basal bilateral crackling rales. Thorax X-rays shows Mengeaux Festoon, right lung apex, rounded opacities between 3 and 10 mm in diameter, type 2/2 r/r in the ILO 2000 Classification. Opacities in the left lung flux to mix into a honeycomb shape type B silicoma. Cardiac silhouette frayed and Grade 1 Cardiomegaly. Dies five years after his condition started. This kind of operations should be prohibited unless an industrial safety program using a Self-Contained Breathing Apparatus (SCBA) is applied.

  20. Mycobacterium sherrisii Lung Infection in a Brazilian Patient with Silicosis and a History of Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Carolina de Oliveira Abrão

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTM diseases became relevant with the emergence and spread of HIV and are also related to lung infection in non-HIV individuals with structural lung diseases. Mycobacterium sherrisii is a NTM first characterized in 2004. Only a few cases have been reported. The aim of this case report is to describe the first detailed case of infection with M. sherrisii in a patient with silicosis and history of pulmonary tuberculosis. A 50-year-old HIV-negative white male, previous smoker, with silicosis and a history of treated pulmonary tuberculosis developed a worsening of cough and expectoration pattern, and two sputum samples were positive for acid-fast bacilli. Presumptive treatment for pulmonary tuberculosis was initiated with rifampin, isoniazid, pyrazinamide, and ethambutol, but, at month 5 of treatment, despite correct medication intake and slight improvement of symptoms, sputum bacilloscopy remained positive. Sputum cultures were positive Mycobacterium sherrisii. Treatment regimen was altered to streptomycin (for 2 months, ethambutol, clarithromycin, rifabutin, and trimethoprim-sulfamethoxazole. M. sherrisii should be considered a possible etiological agent of lung infections in patients with pneumoconiosis and history of tuberculosis.

  1. [Clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in treatment of silicosis].

    Science.gov (United States)

    Miao, Rong-ming; Sun, Xian-feng; Zhang, Ying-yi; Wu, Wei; Fang, Zhong-hua; Zhao, Rui; Zhao, Dao-kun; Qian, Gui-liang; Ji, Jie

    2013-11-01

    To observe the clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in the treatment of silicosis. A total of 96 patients with silicosis were randomly divided into treatment group (49 cases) and control group (47 cases). Both groups were given routine therapy including anti-inflammatory, antitussive, and antiasthmatic drugs, and the patients in treatment group were given tetrandrine combined with acetylcysteine effervescent tablets at the same time. Tetrandrine (100 mg) was orally administrated twice a day, and there was a one-day interval between every 6 days' continuous administration; totally, there were four courses of treatment, with 3 months for each course, and there was a one-month break between each course. Acetylcysteine effervescent tablets (600 mg) were taken twice a day; each course of treatment was 12 days, and there were four courses; for the first two months, there was one course per month, and then one course every other two months for the rest of time. Clinical symptoms, pulmonary ventilation function, serum superoxide dismutase (SOD) and changes in X-ray findings were observed. After treatment, the treatment group had significantly increased rates of improvements in cough, expectoration, chest congestion and pain, and dyspnea compared with the control group (P silicosis. The combination of tetrandrine and acetylcysteine effervescent tablets show some effect in the treatment of silicosis. It can be an effective option for treating silicosis as there are no other specific remedies.

  2. Isolated secondary fungal infections of pleural cavity

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    Makbule Ergin

    2013-12-01

    Full Text Available Objectives: Pleural fungal infections are rare, but the incidence has been increasing with immunosuppressant diseases and use of immunosuppressive medications. In this report, we present 6 patients with pleural effusions that have been determined fungal infection. Methods: The medical records of patients with followed and treated due to fungal infection of the pleural were retrospectively reviewed. Result: The 6 cases whom was 58 of the value median for age were treated as surgical and medical due to fungal infection of the pleural cavity. Dyspnea, cough and chest pain were the most common symptoms. Fever, night sweats and expectoration are relatively rare. In 4 patients, the infections of pleural cavity developed on the bases of rheumatoid arthritis, tuberculosis, pleural mesothelioma and esophagopleural fistula. In two patients had isolated fungal infections. Cultural positivity was seen in 5 patients. Fungal hyphae were determined by cytopathology in all of the patients. As a surgical procedure, all of the patients underwent decortication or pleural biopsy and pleural irrigation. In all patients, antifungal agents were added to surgical procedures. Full recovery of infection was seen in 5 patients. One patient died. Conclusion: In immunosuppressive patients, the incidence of pleural effusions due to or associated with fungal infections are more common. Addition to culture of pleural fluid, histopathological evaluation of pleura will aid diagnosis. J Clin Exp Invest 2013; 4 (4: 443-446

  3. Acquired hemophilia A in a patient associated with community-acquired pneumonia.

    Science.gov (United States)

    Cheng, Qiansong; Yu, Guohui; Ye, Yongqing

    2013-10-01

    Acquired hemophilia A (AHA) is a rare disease induced by autoantibodies to factor VIII (FVIII) and may be correlated with pregnancy, underlying malignancies, autoimmune diseases or drug administration. An 81-year-old man who presented with cough, expectoration, hemoptysis and multiple ecchymoses was diagnosed with community-acquired pneumonia by computed tomography scan. Respiratory symptoms were ameliorated after the application of antibiotics. Despite repeated infusion of fresh frozen plasma and cryoprecipitate, his prolonged activated partial thromboplastin time (APTT) maintained in the 75-110-s range and ecchymoses were not ameliorated. Then, he was transferred to the department of hematology. Based on a prolonged APTT, decreased level of FVIII and presence of antibodies against FVIII, the patient was diagnosed with AHA. Then the patient was treated with activated prothrombin complex concentrates, prednisone and intravenous immunoglobulin, resulting in a complete remission of the bleeding, recovering the FVIII level and negativity for FVIII antibody titers. Here, we investigate this novel case retrospectively and review the relevant literature.

  4. [Treatment of cough in respiratory tract infections - the effect of combining the natural active compounds with thymol].

    Science.gov (United States)

    Schönknecht, Karina; Krauss, Hanna; Jambor, Jerzy; Fal, Andrzej M

    Cough is one of the characteristic symptoms of upper respiratory tract infections (URI). Herbal medicines are often used in the treatment of the cough associated with infection and to accelerate recovery or support the immune system. An example of such products are extracts of thyme and primrose, and also their combination with thymol. Thymus vulgaris is a spasmolytic, antimicrobial, anti-inflammatory, immunomodulatory and antioxidant agent. The most important component responsible for the activity of thyme is thymol contained in the volatile thyme oil. Primrose is, most of all, a saponine agent with expectorant and secretolytic activity, showing also spasmolytic, anti-inflammatory and antimicrobial effects. Because of the additive effects of the mentioned extracts and their wide activity profile they are often used as a combination drug. The use of this combination was assessed in the URI with the effects of alleviation of cough and dyspnea, and shortening the length of the disease. The effectiveness of the drug containing the extracts of thyme and primrose with the addition of thymol (Bronchosol®) was comparable to synthetic ambroxol and its safety has been proved. Moreover, the in-vitro antibacterial and antifungal effects of this drug have been evaluated.

  5. Comparative study of community-acquired pneumonia caused by Streptococcus pneumoniae, Legionella pneumophila or Chlamydia pneumoniae.

    Science.gov (United States)

    Sopena, Nieves; Pedro-Botet, Maria Luisa; Sabrià, Miquel; García-Parés, Delia; Reynaga, Esteban; García-Nuñez, Marian

    2004-01-01

    The objective of this study was to compare epidemiological data and clinical presentation of community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae, Legionella pneumophila or Chlamydia pneumoniae. From May 1994 to February 1996, 157 patients with S. pneumoniae (n = 68), L. pneumophila (n = 48) and C. pneumoniae (n = 41) pneumonia with definitive diagnosis, were prospectively studied. The following comparisons showed differences at a level of at least p pneumoniae pneumonia had more frequently underlying diseases (HIV infection and neoplasm) and those with C. pneumoniae pneumonia were older and had a higher frequency of chronic obstructive pulmonary disease (COPD), while L. pneumophila pneumonia prevailed in patients without comorbidity, but with alcohol intake. Presentation with cough and expectoration were significantly more frequent in patients with S. pneumoniae or C. pneumoniae pneumonia, while headache, diarrhoea and no response to betalactam antibiotics prevailed in L. pneumophila pneumonia. However, duration of symptoms > or = 7 d was more frequent in C. pneumoniae pneumonia. Patients with CAP caused by L. pneumophila presented hyponatraemia and an increase in CK more frequently, while AST elevation prevailed in L. pneumophila and C. pneumoniae pneumonia. In conclusion, some risk factors and clinical characteristics of patients with CAP may help to broaden empirical therapy against atypical pathogens until rapid diagnostic tests are available.

  6. Why does the sense of smell vanish in the mouth? Testing predictions from two accounts.

    Science.gov (United States)

    Stevenson, Richard J; Mahmut, Mehmet

    2015-08-01

    When participants perceive flavor they do not recognise the role of smell. We examined two possible accounts of why: (1) a common attentional channel activated by taste; and (2) prior learning between taste and smell. Participants were asked to sniff food-related odors with a fluid in their mouth and profile each odor after expectorating. This process was later repeated for each odor, with some odors experienced with water on both occasions, and others with water on one occasion and sucrose (weak or strong) on the other. We investigated how reliable these odor profiles were and whether they were influenced by prior odor-taste learning (indexed by odor sweetness). For non-sweet smells, the presence of a tastant significantly improved profile reliability relative to water in the mouth. For sweet smells, tastant had no effect, which we suggest represents a cancelling out of the beneficial effects of the common attentional channel by the detrimental effects of prior learning. Thus, both mechanisms may contribute to masking the modal identity of smell thereby contributing to flavor binding.

  7. Mouth-watering words: Articulatory inductions of eating-like mouth movements increase perceived food palatability.

    Science.gov (United States)

    Topolinski, Sascha; Boecker, Lea

    2016-04-01

    We explored the impact of consonantal articulation direction of names for foods on expected palatability for these foods (total N = 256). Dishes (Experiments 1-2) and food items (Experiment 3) were labeled with names whose consonants either wandered from the front to the back of the mouth (inward, e.g., PASOKI) or from the back to the front of the mouth (outward; e.g., KASOPI). Because inward (outward) wandering consonant sequences trigger eating-like (expectoration-like) mouth movements, dishes and foods were rated higher in palatability when they bore an inward compared to an outward wandering name. This effect occurred already under silent reading and for hungry and satiated participants alike. As a boundary condition, this articulation effect did occur when also additional visual information on the product was given (Experiment 3), but vanished when this visual information was too vivid and rich in competing palatability cues (Experiment 2). Future marketing can exploit this effect by increasing the appeal of food products by using inward wandering brand names, that is, names that start with the lips and end in the throat. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Sarcoidosis and multiple myeloma: Concurrent presentation of an unusual association

    Directory of Open Access Journals (Sweden)

    Vidya Nair

    2016-01-01

    Full Text Available Literature on concurrent association of sarcoidosis with lymphoproliferative malignancies other than lymphoma e.g. multiple myeloma is meager. The rarity of the situation prompted us to report this patient who was a 51-year-old woman with a 2-years history of breathlessness, cough with expectoration, chest pain and backache. Initial evaluation revealed mild anemia, increased alkaline phosphatase with chest skiagram showing both lower zone non homogenous opacities with calcified hilar lymph nodes. CECT chest showed mediastinal with bilateral hilar lymphadenopathy, parenchymal fibrosis, traction bronchiectasis, ground glass opacities, septal and peribronchovascular thickening affecting mid and lower lung zones bilaterally. MRI Dorsolumbar spine was suggestive of marrow infiltrative disorder. EBUS FNA of intrathoracic nodes, EBB and TBLB confirmed sarcoidosis. PET CT revealed hyper metabolic activity in lung, multiple lymph nodes and lytic bone lesions. Serum protein electrophoresis and immunofixation revealed a monoclonal paraprotein, immunoglobulin IgG kappa type. Bone marrow biopsy revealed an increase in plasma cells (15%, but no granulomas. Diagnosis of Indolent or multiple myeloma with sarcoidosis was established. 12 cases of sarcoidosis and multiple myeloma have been reported in literature, and mostly preceding the onset of multiple myeloma by many years, in our case both were diagnosed concurrently.

  9. Mouth rinsing improves cycling endurance performance during Ramadan fasting in a hot humid environment.

    Science.gov (United States)

    Che Muhamed, Ahmad Munir; Mohamed, Nazirah Gulam; Ismail, Norjana; Aziz, Abdul Rashid; Singh, Rabindarjeet

    2014-04-01

    This study examined the effect of mouth rinsing during endurance cycling in a hot humid environment (32 °C and 75% relative humidity) on athletes in the Ramadan fasted state. Nine trained adolescent male cyclists completed 3 trials that consisted of a carbohydrate mouth-rinse (CMR), a placebo mouth-rinse (PMR), and a no-rinse (NOR) trial during the last 2 weeks of Ramadan. Each trial consisted of a preloading cycle at 65% peak rate of oxygen consumption for 30 min followed by a 10-km time trial (TT10 km) under hot humid condition. During the CMR and PMR trials, each cyclist rinsed his mouth with 25 mL of the solution for 5 s before expectorating the solution pre-exercise, after 5, 15, and 25 min of the preloading cycle, and 15 s prior to the start of TT10 km. Time to complete the TT10 km was significantly faster in the CMR and PMR trials compared with the NOR trial (12.9 ± 1.7 and 12.6 ± 1.7 vs. 16.8 ± 1.6 min, respectively; p benefits compared with a no-rinse condition on TT10 km performance in acute Ramadan fasted subjects during endurance cycling in a heat stress environment.

  10. Detection of Sputum by Interpreting the Time-frequency Distribution of Respiratory Sound Signal Using Image Processing Techniques.

    Science.gov (United States)

    Niu, Jinglong; Shi, Yan; Cai, Maolin; Cao, Zhixin; Wang, Dandan; Zhang, Zhaozhi; Zhang, Xiaohua Douglas

    2017-10-13

    Sputum in the trachea is hard to expectorate and detect directly for the patients who are unconscious, especially those in Intensive Care Unit (ICU). Medical staff should always check the condition of sputum in the trachea. This is time-consuming and the necessary skills are difficult to acquire. Currently, there are few automatic approaches to serve as alternatives to this manual approach. We develop an automatic approach to diagnose the condition of the sputum. Our approach utilizes a system involving a medical device and quantitative analytic methods. In this approach, the time-frequency distribution of respiratory sound signals, determined from the spectrum, is treated as an image. The sputum detection is performed by interpreting the patterns in the image through the procedure of preprocessing and feature extraction. In this study, 272 respiratory sound samples (145 sputum sound and 127 non-sputum sound samples) are collected from 12 patients. We apply the method of leave-one out cross-validation to the 12 patients to assess the performance of our approach. That is, out of the 12 patients, 11 are randomly selected and their sound samples are used to predict the sound samples in the remaining one patient. The results show that our automatic approach can classify the sputum condition at an accuracy rate of 83.5%. The matlab codes and examples of datasets explored in this work are available at Bioinformatics online. douglaszhang@umac.mo or yesoyou@gmail.com. Supplementary data are available at Bioinformatics online.

  11. Identification of bitter compounds in whole wheat bread crumb.

    Science.gov (United States)

    Bin, Qing; Peterson, Devin G

    2016-07-15

    Consumer acceptability of whole wheat foods is challenged by negative bitter flavour attributes. In this study, bitter compounds in whole wheat bread crumb were investigated. Utilising sensory-guided multi-dimensional fractionation techniques, the compounds with the highest bitterness intensity in the crumb were purified and identified by LC-MS-ToF and NMR techniques. The main bitter compounds were reported to be L-tryptophan, Wessely-Moser isomers apigenin-6-C-galactoside-8-C-arabinoside & apigenin-6-C-arabinoside-8-C-galactoside, and 9,12,13-trihydroxy-trans-10-octadecenoic acid (pinellic acid). Sensory recombination experiments of the bitter compounds formulated at the concentrations determined in expectorated saliva after bread mastication indicated pinellic acid had the greatest contribution to the bitterness perception of the crumb. Quantitative analysis of pinellic acid in the raw flour was reported to be inherently low compared to bread; the concentration increased more than 30-fold after flour hydration and baking. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. [Essential oils for the nutrition of poultry, swine and ruminants].

    Science.gov (United States)

    Westendarp, H

    2005-10-01

    Essential oils are very complex mixtures of volatile, lipophilic compounds originating from plants. Due to their lipophility they posses a good intestinale and percutane absorption. Under external application essential oils demonstrate antiphlogistic or rubefacient to pro-inflammatority activities. Orally intake they stimulate the secretion of digestive enzymes and increase gastric and intestinal motility. Moreover they show spasmolytic, expectorative and diuretic activities. Besides antimicrobial properties on bacteria and fungi have been observed in vitro and in vivo. Due to their various effects essential oils increasingly gain attention in animal nutrition and are discussed to be alternatives to antibiotic growth promoters. In some studies essential oils have been reported to reduce intestinal pathogens in broilers and piglets. When administered to ruminants essential oils decrease ruminal ammonia production by suppression the growth of deaminative microorganisms. However, the observed effects on growth performance are inconsistent among studies. In conclusion, there are still some unanswered questions concerning the mode of action, metabolic pathway and optimal dosage of essential oils in different animal species. Further scientific research is therefore needed to use essential oils effectivly in livestock feeding.

  13. Successful treatment of Reye's syndrome in a child (сase report

    Directory of Open Access Journals (Sweden)

    Tsymbalista O.L.

    2016-03-01

    Full Text Available A 6-year-old child with Reye's syndrome was successfully treated in the Department of Pediatric Anaesthesiology and Intensive Care of the Ivano-Frankivsk Regional Children's Clinical Hospital. At admission to the hospital the child's condition was critical due to cerebral vascular insufficiency (semicoma, psychomotor agitation, endogenous intoxication syndrome, severe anemic syndrome (Hb — 78g/l, and coagulopathy. Due to the progression of type II respiratory failure, hepatic failure, hemorrhagic and anemic syndromes, and cerebral deficit tracheal intubation for the purpose of controlled ventilation was performed. In order to correct anemia, hypoproteinemia and hemorrhagic syndrome washed erythrocytes, a 10% albumin solution and fresh frozen plasma were transfused. Therapeutic bronchoscopy was performed due to the progression of the expectorant component secondary to ventilator!associated pneumonia. Nonspecific detoxification therapy with discrete plasmapheresis was used. On the 3rd day of treatment tracheal extubation was performed, on the 10th day the child was transferred to the gastroenterology department. On the 13th day of hospital stay in the gastroenterology department and on the 24th day of admission the child was discharged home in satisfactory condition.

  14. The challenge of mastication: preparing a bolus suitable for deglutition.

    Science.gov (United States)

    Mishellany, Anne; Woda, Alain; Labas, Roland; Peyron, Marie-Agnès

    2006-04-01

    The main function of mastication is to transform a solid food into a bolus that can be swallowed safely. The bolus characteristics such as particles size or cohesiveness, are continuously sensed during mastication and they are important in initiating deglutition. This study examined the following question: What is the condition of the bolus just before swallowing? Ten subjects with normal dentition aged 37.5 +/- 3.7 years were asked to chew without swallowing six different foods (three nuts and three vegetables) while the number of cycles and the duration of the sequence were recorded. The particle size distribution shown by the expectorated food bolus just before swallowing was examined by image analysis. The results showed that, for a given food, the sizes of the bolus particles just before swallowing were comparable in all subjects. However, the number of cycles and duration of the sequence varied between subjects. Taken together these data strongly suggest that the granularity of the bolus before swallowing has to reach a predetermined state which is obtained by using an individual chewing strategy. This suggests that the bolus structure reflects a key factor for homeostasis and explains the large interindividual variability of the mastication physiologic parameters.

  15. Photoacoustic analysis of the solubilization kinetics of pulmonary secretions from cystic fibrosis patients - secretor and non-secretor phenotypes

    Energy Technology Data Exchange (ETDEWEB)

    Barja, P R; Coelho, C C; Paiva, R F [Research and Development Institute, UNIVAP, Av. Shishima Hifumi 2911, Sao Jose dos Campos, SP (Brazil); Barboza, M A; Matos, L C; Matos, C C B [Faculty of Medicine of Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, SP (Brazil); Oliveira, L V F, E-mail: barja@univap.b [Rehabilitation Sciences Master' s Program, Nove de Julho University (UNINOVE), Sao Paulo, SP (Brazil)

    2010-03-01

    Cystic fibrosis (CF) is an autosomal recessive inherited disease that increases viscoelasticity of pulmonary secretions. Affected patients are required to use therapeutic aerosols continuously. The expression of ABH glycoconjugates in exocrine secretions determines the nature of part of the carbohydrates present in these secretions, allowing the classification of individuals into the so-called 'secretor' and 'non secretor' phenotypes. The aim of this work was to employ photoacoustic (PA) measurements to monitor the solubilization kinetics of pulmonary secretions from CF patients, analyzing the influence of the secretor status in the solubilization kinetics of samples nebulized with different therapeutic aerosols. Sputum samples were obtained by spontaneous expectoration from positive and negative secretor CF patients. Each sample was nebulized with i) tobramycin, ii) alpha dornase, and iii) N-acetylcysteine in a PA cell; fitting of the data with the Boltzmann equation led to the determination of t{sub 0} (typical interaction time) and {Delta}t (solubilization interval) for each curve. Differences between the secretor and non-secretor phenotypes were statistically significant in the groups for tobramycin and alpha dornase, but not for N-acetylcysteine. Results show that the secretor status influences the solubilization of pulmonary mucus of CF patients nebulized with tobramycin and alpha dornase.

  16. Euphorbia neriifolia L.: Review on botany, ethnomedicinal uses, phytochemistry and biological activities.

    Science.gov (United States)

    Mali, Prashant Y; Panchal, Shital S

    2017-05-01

    The present review is intended to provide information on botany, ethnomedicinal uses, phytochemistry and biological activities of various parts of Euphorbia neriifolia (E. neriifolia). E. neriifolia has several ethnomedicinal uses. The latex of E. neriifolia is used as laxative, purgative, rubefacient, carminative and expectorant as well as in treatment of whooping cough, gonorrhoea, leprosy, asthma, dyspepsia, jaundice, enlargement of the spleen, tumours, stone in the bladder, abdominal troubles and leucoderma. Leaves are brittle, heating, carminative, and good for improving the appetite and treatment of tumours, pains, inflammations, abdominal swellings and bronchial infections. Roots are used as symptomatic treatment of snake bite, scorpion sting and antispasmodic. Various plant parts or whole E. neriifolia extract and its isolates have been reported scientifically using various in-vivo and in-vitro experimental methods for anaesthetic, analgesic, anti-anxiety, anti-convulsant, anti-psychotic, anti-arthritis, anti-carcinogenic, antidiabetic, anti-diarrhoeal, anti-inflammatory, anti-thrombotic, antimicrobial, antioxidant, antiulcer, cytotoxic, death-receptor expression enhancing, dermal irritation, diuretic, haemolytic, immunomodulatory, radioprotective, scorpion venom and wound healing properties. It is reported to have chemical constituents like, neriifolin-S, neriifolin, neriifoliene, euphol, neriifolione, cycloartenol, nerifoliol, lectin, euphonerins A-G, 3-O-acetyl-8-O-tigloylingol, taraxerol, antiquorin, etc. Identified chemical constituents are still required to be explored for their advanced isolation techniques and biological activities. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  17. Development of the ambroxol gels for enhanced transdermal delivery.

    Science.gov (United States)

    Cho, Cheong-Weon; Choi, Jun-Shik; Shin, Sang-Chul

    2008-03-01

    Ambroxol is an expectoration improver and mucolytic agent that has been used to treat acute and chronic disorders. However, ambroxol needs to be administered percutaneously in order to avoid systemic adverse effects, such as headache, drowsiness, dizziness, and insomnia, which can occur after oral administration. The aim of this study was to develop a gel preparation containing a permeation enhancer to enhance the delivery of ambroxol. The ambroxol gels were prepared using hydroxypropyl methylcellulose (HPMC) and poloxamer 407. The release characteristics of the drug from the gels were examined according to the receptor medium, drug concentration, and temperature. The rate of drug permeation into the skin was enhanced by incorporating various enhancers such as the ethylene glycols, the propylene glycols, the glycerides, the non-ionic surfactants, and the fatty acids into the gels. The permeation study through mouse skin was examined at 37 C. The rate of drug release increased with increasing drug concentration and temperature. Among the enhancers used, propylene glycol mono caprylate showed the best enhancing effects. The estimated activation energy of release (Ea), which was calculated from the slope of a log P versus 1000/T plot, was 14.80, 14.22, 13.91, and 12.46 kcal/mol for ambroxol loading doses of 2, 3, 4, and 5%, respectively. The results of this study show that the gel preparation of ambroxol containing a permeation enhancer could be developed for the enhanced transdermal delivery of ambroxol.

  18. Photoacoustic analysis of the solubilization kinetics of pulmonary secretions from cystic fibrosis patients - secretor and non-secretor phenotypes

    Science.gov (United States)

    Barja, P. R.; Coelho, C. C.; Paiva, R. F.; Barboza, M. A.; Matos, L. C.; Matos, C. C. B.; Oliveira, L. V. F.

    2010-03-01

    Cystic fibrosis (CF) is an autosomal recessive inherited disease that increases viscoelasticity of pulmonary secretions. Affected patients are required to use therapeutic aerosols continuously. The expression of ABH glycoconjugates in exocrine secretions determines the nature of part of the carbohydrates present in these secretions, allowing the classification of individuals into the so-called "secretor" and "non secretor" phenotypes. The aim of this work was to employ photoacoustic (PA) measurements to monitor the solubilization kinetics of pulmonary secretions from CF patients, analyzing the influence of the secretor status in the solubilization kinetics of samples nebulized with different therapeutic aerosols. Sputum samples were obtained by spontaneous expectoration from positive and negative secretor CF patients. Each sample was nebulized with i) tobramycin, ii) alpha dornase, and iii) N-acetylcysteine in a PA cell; fitting of the data with the Boltzmann equation led to the determination of t0 (typical interaction time) and Δt (solubilization interval) for each curve. Differences between the secretor and non-secretor phenotypes were statistically significant in the groups for tobramycin and alpha dornase, but not for N-acetylcysteine. Results show that the secretor status influences the solubilization of pulmonary mucus of CF patients nebulized with tobramycin and alpha dornase.

  19. Ambroxol chaperone therapy for neuronopathic Gaucher disease: A pilot study.

    Science.gov (United States)

    Narita, Aya; Shirai, Kentarou; Itamura, Shinji; Matsuda, Atsue; Ishihara, Akiko; Matsushita, Kumi; Fukuda, Chisako; Kubota, Norika; Takayama, Rumiko; Shigematsu, Hideo; Hayashi, Anri; Kumada, Tomohiro; Yuge, Kotaro; Watanabe, Yoriko; Kosugi, Saori; Nishida, Hiroshi; Kimura, Yukiko; Endo, Yusuke; Higaki, Katsumi; Nanba, Eiji; Nishimura, Yoko; Tamasaki, Akiko; Togawa, Masami; Saito, Yoshiaki; Maegaki, Yoshihiro; Ohno, Kousaku; Suzuki, Yoshiyuki

    2016-03-01

    Gaucher disease (GD) is a lysosomal storage disease characterized by a deficiency of glucocerebrosidase. Although enzyme-replacement and substrate-reduction therapies are available, their efficacies in treating the neurological manifestations of GD are negligible. Pharmacological chaperone therapy is hypothesized to offer a new strategy for treating the neurological manifestations of this disease. Specifically, ambroxol, a commonly used expectorant, has been proposed as a candidate pharmacological chaperone. The purpose of this study was to evaluate the safety, tolerability, and neurological efficacy of ambroxol in patients with neuronopathic GD. This open-label pilot study included five patients who received high-dose oral ambroxol in combination with enzyme replacement therapy. Safety was assessed by adverse event query, physical examination, electrocardiography, laboratory studies, and drug concentration. Biochemical efficacy was assessed through evidence of glucocerebrosidase activity in the lymphocytes and glucosylsphingosine levels in the cerebrospinal fluid. Neurological efficacy was evaluated using the Unified Myoclonus Rating Scale, Gross Motor Function Measure, Functional Independence Measure, seizure frequency, pupillary light reflex, horizontal saccadic latency, and electrophysiologic studies. High-dose oral ambroxol had good safety and tolerability, significantly increased lymphocyte glucocerebrosidase activity, permeated the blood-brain barrier, and decreased glucosylsphingosine levels in the cerebrospinal fluid. Myoclonus, seizures, and pupillary light reflex dysfunction markedly improved in all patients. Relief from myoclonus led to impressive recovery of gross motor function in two patients, allowing them to walk again. Pharmacological chaperone therapy with high-dose oral ambroxol shows promise in treating neuronopathic GD, necessitating further clinical trials.

  20. Changes in mastication after an immediate loading implantation with complete fixed rehabilitation.

    Science.gov (United States)

    Veyrune, J L; Opé, S; Nicolas, E; Woda, A; Hennequin, M

    2013-05-01

    This study aimed to measure modifications of mastication after immediate loading full-arch prosthesis (ILFAP) rehabilitation. Fourteen patients were observed before and 6 months after ILFAP rehabilitation when masticating two natural, standardized foods (peanut and carrot) and three model foods with increasing hardness. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were video recorded. A self-assessment questionnaire for oral health-related quality of life [Geriatric Oral Health Assessment Index (GOHAI)] was also used. After ILFAP rehabilitation, the mean D50 values for carrot and peanuts were smaller [Repeated Model Procedures (RMP), F = 41, p < 0.001]. Mean CT and CC values recorded with the three model foods decreased, while CF increased regardless of the model food hardness (RMP, F = 14, F = 10, and F = 11, respectively, p < 0.001). The GOHAI score increased from 43 ± 9 to 56 ± 3 (t test, p < 0.001). ILFAP rehabilitation improves the ability to reduce the bolus particle size and the ability to discriminate between different food hardnesses in the 6 months post-surgery period. This study encourages the clinical development of immediate loading implantation with a fixed full-arch prosthesis protocol.

  1. Influence of Polysaccharides from Aloe vera (Aloe barbadensis Miller, Liliaceae on Mechanically Induced Cough in Cats

    Directory of Open Access Journals (Sweden)

    Martina Šutovská

    2010-01-01

    Full Text Available Different plants have been reported to be a source of polysaccharides that possess a great variety of biological activities, including cough suppression. The experiments were aimed on the influence of two polysaccharides isolated from the gel (A, HF1-Z and one from the epidermis (SL-1 of Aloe vera leaves, characterized by chemical composition and structural properties, on the cough reflex. The method of mechanically induced cough was used in conscious cats. A nylon fibre directed individually into the mucous area of the laryngopharyngeal and tracheobronchial airways via endotracheal cannula elicited the cough reflex. Statistical evaluation registered cough reflex indicators (number of cough efforts - NE, cough frequency - NE min–1 intensity of cough attacks during expiration and inspiration - IA+ and IA-, intensity of maximal inspiratory and expiratory cough efforts - IME- and IME+ showed that gel polysaccharide HF1-Z possessed higher cough-suppressing activity than dropropizine, a nonnarcotic peripheral cough suppressant. Their antitussive activity was accompanied mainly with a decrease of NE, IA+ and IA- from both laryngopharyngeal and tracheobronchial mucous areas of the airways. Results of the presented study also showed minimal influence of polysaccharide HF1-Z on expectoration predictor, IME- and IME+. New pharmacodynamic property of polysaccharides isolated from Aloe vera was shown during experiments, which could be a base of their possible therapeutic use in this indication in future.

  2. South African herbal teas: Aspalathus linearis, Cyclopia spp. and Athrixia phylicoides--a review.

    Science.gov (United States)

    Joubert, E; Gelderblom, W C A; Louw, A; de Beer, D

    2008-10-28

    Rooibos (Aspalathus linearis (Brum.f) Dahlg.) and honeybush (Cyclopia Vent. species) are popular indigenous South African herbal teas enjoyed for their taste and aroma. Traditional medicinal uses of rooibos in South Africa include alleviation of infantile colic, allergies, asthma and dermatological problems, while a decoction of honeybush was used as a restorative and as an expectorant in chronic catarrh and pulmonary tuberculosis. Traditional medicinal uses of Athrixia phylicoides DC., or bush tea, another indigenous South African plant with very limited localised use as herbal tea, include treatment of boils, acne, infected wounds and infected throats. Currently rooibos and honeybush are produced for the herbal tea market, while bush tea has potential for commercialisation. A summary of the historical and modern uses, botany, distribution, industry and chemical composition of these herbal teas is presented. A comprehensive discussion of in vitro, ex vivo and in vivo biological properties, required to expand their applications as nutraceutical and cosmeceutical products, is included, with the main emphasis on rooibos. Future research needs include more comprehensive chemical characterisation of extracts, identification of marker compounds for extract standardisation and quality control, bioavailability and identification of bio-markers of dietary exposure, investigation of possible herb-drug interactions and plant improvement with regards to composition and bioactivity.

  3. MUCOLYTIC AGENTS IN PEDIATRICS: RATIONAL SELECTION, THERAPEUTIC EFFECTS AND SPECIFIC ASPECTS OF TREATMENT

    Directory of Open Access Journals (Sweden)

    O. I. Simonova

    2013-01-01

    Full Text Available The article deals with the cough treatment options with mucolytic agents administration at the first several days of acute respiratory tract infections in children. Efficacy of treatment with secretolytic and secretomotoric drugs significantly depends on certain factors. The article contains the criteria of therapeutic efficacy of expectorants. A special attention is given to N-acetylcysteine — a direct acting mucolytic agent, which effect is caused by presence of free sulfhydryl groups, disrupting disulfide bonds between molecules of acid mucopolysaccharides and glycoproteins therefore changing the structure of sputum. Acetylcysteine is active against every type of sputum (mucous, muco-purulent, purulent, that is especially important in treatment of bacterial infections, when it is necessary to quickly decrease sputum thickness, eliminate it from the respiratory tract and prevent dissemination of the infection. High efficacy of acetylcysteine is caused by its unique triple action: mucolytic, antioxidant and antitoxic. Mechanism of action of acetylcysteine is discussed in detail. Timely administered treatment will improve sputum discharge and therefore eliminate one of the main factors of bronchial obstruction and decrease the risk of microbial colonization of the respiratory tract. The article also includes indications, contraindications and dosage regimens of acetylcysteine in children. The most common mistakes and specific aspects of mucolytic drugs in pediatrics are listed in the conclusion. 

  4. A Rare Case of Idiopathic Plastic Bronchitis.

    Science.gov (United States)

    Raoufi, Mohammed; Achachi, Leila; Mrabet, Fatima Zahra; Herrak, Laila; Ftouh, Mustapha El; Bourhroum, Najoua; Ouazzani Taibi, Nezha

    2017-01-01

    Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

  5. A Rare Case of Idiopathic Plastic Bronchitis

    Directory of Open Access Journals (Sweden)

    Mohammed Raoufi

    2017-01-01

    Full Text Available Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

  6. A rare case of congenital bronchoesophageal fistula in an adult.

    Science.gov (United States)

    Taira, Naohiro; Kawasaki, Hidenori; Atsumi, Eriko; Furugen, Tomonori; Ichi, Takaharu; Kushi, Kazuaki; Yohena, Tomofumi; Baba, Motoo; Kawabata, Tsutomu

    2017-01-01

    When congenital bronchoesophageal fistulas exist without atresia of the esophagus, the diagnosis can be delayed, although symptoms may occur early following fistula development. Therefore, while they are usually found in infants, they can be extremely rarely found in adults. We herein report a rare case of bronchoesophageal fistula without atresia in an adult. An 69-year-old male presented to the outpatient clinic with a decades-long history of cough with expectoration immediately after taking food, especially liquids. Computed tomograph, esophagoscopy, and esophagography revealed the fistulous communication between the mid-esophagus and right lower lobe bronchus, with consolidation in the right lower lobe. We performed right lower lobectomy with the closure and excision of the fistula. The histopathology of the fistula revealed the mucosa to be lined by stratified squamous epithelium. There was no evidence of inflammation, granuloma, or carcinoma. In conclusion, despite the benign nature of this malformation, if left untreated, it can cause long-term debilitating respiratory symptoms associated with the fistula. Therefore, the diagnosis should be considered in the evaluation of recurrent lung infection. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  7. Paragonimiasis: first case reported in Brazil

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Moreira Lemos

    Full Text Available The authors present a case from a 59 years old white female Brazilian patient, based in Salvador-Bahia, Brazil's northeastern side area, who experienced irritative cough and progressive dyspnea, and, after 18 months, was admitted to a hospital with respiratory insufficiency. The physical exam showed diffuse rales in both hemithoraces. Initial leukogram showed 14,400 cells/mL with 14% of eosinophils and chest X-ray showed peribronchovascular infiltrate, predominating in the lower half of the lung fields, and small opaque nodules. The high-resolution computed tomography scan of the chest (HRCT presented compatible pattern with airways disease, especially from the small airways, with air trapping, tree sprouting images, central lobular nodules and bronchiectasis, making the results compatible with bronchiolitis and bronchiectasis. The transbroncho biopsy unveiled granulomatous lesion with necrosis, where was noticed a structure compatible to a parasitic case, and the research of the parasite eggs in the sputum was positive to paragonimus. After the praziquantel use, the patient presented a thick ferruginous expectoration and the result for BAAR examination was positive. The PCR exam and the sputum culture confirmed M. tuberculosis, and then the treatment for M. tuberculosis was initiated. The authors warn that this infection may have been a consequence of economics globalization process, where the importation of parasitized crustaceans might be the cause. However, there is the need of an accurate examination for the possibility of paragonimus specimens in this area of Brazil.

  8. Spectroscopic, structural and drug docking studies of carbocysteine

    Science.gov (United States)

    Manivannan, M.; Rajeshwaran, K.; Govindhan, R.; Karthikeyan, B.

    2017-09-01

    Carbocysteine or carbocisteine having the empirical formula C5H9NO4S,is one of the most therapeutically prescribed expectorant, sold under the brand name viz., Mucodyne (UK and India), Rhinathiol and Mucolite. In pediatric respiratory pathology, it can relieve the symptoms of obstructive pulmonary disease (COPD) and bronchiectasis. On the consideration of its extensive pharmaceutical usage and medicinal value, we have investigated its chemical structure and composition by employing various spectral techniques like 1H, 13C NMR, FT-IR,Raman, UV-Visible spectroscopy and powder X-ray diffraction method. Density Functional Theoretical (DFT) studies on its electronic structure is also carried out. Drug docking studies were carried out to ascertain the nature of molecular interaction with the biological protein system. Furthermore theoretical Raman spectrum of this molecule has been computed and compared with the experimental Raman spectrum. The forbidden energy gap between its frontier molecular orbitals, viz., HOMO-LUMO is calculated and correlated with its observed λmax value. Atomic orbitals which are mainly contributes to the frontier molecular orbitals were identified. Molecular electrostatic potential diagram has been mapped to explain its chemical activity. Based on the results, a suitable mechanism of its protein binding mode and drug action has been discussed.

  9. Medical image of the week: collapse of the trachea

    Directory of Open Access Journals (Sweden)

    Guruguri P

    2013-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A 61 year old man with a history of chronic obstructive pulmonary disease (COPD requiring multiple intubations over the past 2 years as well as obstructive sleep apnea (OSA presented with acute dyspnea, cough and difficulty expectorating sputum over the last 24 hours. His physical exam was notable for expiratory and inspiratory wheezing. ABG revealed a pH of 7.24, PaCO2 of 71, PaO2 of 103, and HCO3 of 29 mMol consistent with an acute on chronic respiratory acidosis. In the Emergency Department, the patient was given multiple bronchodilators and eventually placed on BiPAP with gradual improvement. CT of the chest revealed the caliber of the trachea was narrowed greater than 50% during expiration (Figure 1B consistent with dynamic airway collapse of tracheobronchomalacia. This often overlooked condition may be related to past intubations or COPD with chronic bronchitis and is often misdiagnosed as COPD or treatment resistant asthma. Stents are often …

  10. A retrievable nitinol endobronchial stent : an experimental study in dog

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sang Jin; Park, Sang Soo; Yoon, Hyun Ki; Sung, Kyu Bo; Song, Ho Young [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Kang, Sung Gwon [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    1999-06-01

    The purpose of this study was to evaluate the safety and the retrievability of a new covered retrievable nitinol tracheobronchial stent. Stents were knitted from 0.2mm nitinol wire, covered with polyurethane, and were 20-22mm in diameter and 2cm in length. Under fluoroscopic guidance, a stent was placed in the normal right bronchus intermedius of ten dogs. Using a retrieval hook, stent retrieval was attempted after 1 month(N=5) or 2 months(N=5). After removal, the dogs were sacrificed and their their tracheobronchial trees were examined grossly and histologically. Eleven stents were successfully placed in ten dogs. Migration and expectoration occurred in four of ten stents in nine dogs(40%). Five stents were successfully removed from six dogs(83%). Without significant difference between the two groups, mild to moderate mucosal hyperplasia was noted at the sites of stents as well as above and below them. On microscopy, three of five dogs showed pneumonia in the right middle lobes, but none of the stents was covered with epithelium. Temporary placement of a covered expandable nitinol stent in the tracheobronchial tree is feasible, but to establish its efficacy, further experimental studies are needed.

  11. Relationship between the amount of rice oil ingested by patients with Yusho and their subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, T.; Hayabuchi, H.

    1985-02-01

    The goal of this study was to clarify the subjective symptoms closely related to Yusho by examining the relationship between the amount of PCB-contaminated rice oil ingested by patients and the subjective symptoms recorded on their questionnaires. The amount of PCB-contaminated rice oil consumed by the patients was obtained by interviewing the housewife in each Yusho family. Individual consumption of the oil was estimated by taking into account age, sex and the number of meals at home. In 1970, 46 patients were available for analysis, and in 1971, 33 patients were available. Among 12 subjective symptoms studied, numbness of the limbs, coughing, expectoration, and the sensation of elevated teeth were considered to show a dose-response relationship, which suggests that these subjective symptoms are closely related to Yusho. Consistent high rates of complaints of general fatigue and eye discharge were considered possibly to be connected with Yusho, although no dose-response relationships have been determined. Other subjective symptoms, such as fever, headache, dizziness, abdominal pain, swelling in the joints, changes in menstruation, and loss of hair failed to show consistent dose-response relationships. It should be noted, however, that for these symptoms which failed to show dose-response relationships, it is impossible to deny a causal relationship.

  12. Human cysteine cathepsins are not reliable markers of infection by Pseudomonas aeruginosa in cystic fibrosis.

    Directory of Open Access Journals (Sweden)

    Clément Naudin

    Full Text Available Cysteine cathepsins have emerged as new players in inflammatory lung disorders. Their activities are dramatically increased in the sputum of cystic fibrosis (CF patients, suggesting that they are involved in the pathophysiology of CF. We have characterized the cathepsins in CF expectorations and evaluated their use as markers of colonization by Pseudomonas aeruginosa. The concentrations of active cathepsins B, H, K, L and S were the same in P. aeruginosa-positive (19 Ps+ and P. aeruginosa-negative (6 Ps- samples, unlike those of human neutrophil elastase. Also the cathepsin inhibitory potential and the cathepsins/cathepsin inhibitors imbalance remained unchanged and similar (∼2-fold in the Ps+ and Ps- groups (p<0.001, which correlated with the breakdown of their circulating cystatin-like inhibitors (kininogens. Procathepsins, which may be activated autocatalytically, are a potential proteolytic reservoir. Immunoblotting and active-site labeling identified the double-chain cathepsin B, the major cathepsin in CF sputum, as the main molecular form in both Ps+ and Ps- samples, despite the possible release of the ∼31 kDa single-chain form from procathepsin B by sputum elastase. Thus, the hydrolytic activity of cysteine cathepsins was not correlated with bacterial colonization, indicating that cathepsins, unlike human neutrophil elastase, are not suitable markers of P. aeruginosa infection.

  13. Specific cleavage of the lung surfactant protein A by human cathepsin S may impair its antibacterial properties.

    Science.gov (United States)

    Lecaille, Fabien; Naudin, Clément; Sage, Juliette; Joulin-Giet, Alix; Courty, Agnès; Andrault, Pierre-Marie; Veldhuizen, Ruud A W; Possmayer, Fred; Lalmanach, Gilles

    2013-08-01

    Human cysteine cathepsins (Cats) are implicated in lung injuries and tissue remodeling and have recently emerged as important players in pulmonary inflammations. The proteolytic activities of Cat B, L, K, S and H are dramatically increased in the sputum of patients with cystic fibrosis (CF), suggesting a possible involvement in the CF pathophysiology. We found that pulmonary surfactant protein A (SP-A) that participates to innate host defense is extensively degraded in CF expectorations. Breakdown of SP-A was markedly decreased in CF sputum by E-64 and Mu-Leu-Hph-VSPh, a Cat S inhibitor. Cat S cleaved efficiently and specifically SP-A within critical residues of the solvent-exposed loop of its carbohydrate recognition (C-type lectin) domain that allows binding to pathogens. Cat S decreased aggregation properties of SP-A (self-aggregation, aggregation of phospholipid vesicles and rough LPS). Moreover cleavage of SP-A by Cat S reduced binding to yeast mannan and impaired agglutination of Escherichia coli and Pseudomonas aeruginosa, a foremost detrimental pathogen colonizing the lungs of CF patients. Besides human neutrophil serine proteases and bacterial proteases, we propose that Cat S may participate in the pathophysiology of CF by weakening the antibacterial activity of SP-A. More broadly, present results provide further indication that Cat S, along with Cats B and L, could display immuno-modulatory functions by inactivating key proteins involved in the innate immunity defense. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Human cysteine cathepsins are not reliable markers of infection by Pseudomonas aeruginosa in cystic fibrosis.

    Science.gov (United States)

    Naudin, Clément; Joulin-Giet, Alix; Couetdic, Gérard; Plésiat, Patrick; Szymanska, Aneta; Gorna, Emilia; Gauthier, Francis; Kasprzykowski, Franciszek; Lecaille, Fabien; Lalmanach, Gilles

    2011-01-01

    Cysteine cathepsins have emerged as new players in inflammatory lung disorders. Their activities are dramatically increased in the sputum of cystic fibrosis (CF) patients, suggesting that they are involved in the pathophysiology of CF. We have characterized the cathepsins in CF expectorations and evaluated their use as markers of colonization by Pseudomonas aeruginosa. The concentrations of active cathepsins B, H, K, L and S were the same in P. aeruginosa-positive (19 Ps+) and P. aeruginosa-negative (6 Ps-) samples, unlike those of human neutrophil elastase. Also the cathepsin inhibitory potential and the cathepsins/cathepsin inhibitors imbalance remained unchanged and similar (∼2-fold) in the Ps+ and Ps- groups (p<0.001), which correlated with the breakdown of their circulating cystatin-like inhibitors (kininogens). Procathepsins, which may be activated autocatalytically, are a potential proteolytic reservoir. Immunoblotting and active-site labeling identified the double-chain cathepsin B, the major cathepsin in CF sputum, as the main molecular form in both Ps+ and Ps- samples, despite the possible release of the ∼31 kDa single-chain form from procathepsin B by sputum elastase. Thus, the hydrolytic activity of cysteine cathepsins was not correlated with bacterial colonization, indicating that cathepsins, unlike human neutrophil elastase, are not suitable markers of P. aeruginosa infection.

  15. [Pulmonary mucormycosis in a patient with kidney transplant and uncontrolled haemoptysis].

    Science.gov (United States)

    Navarro Vergara, Dulce Iliana; Barragán Pola, Gloria; Bonifaz, Alexandro; Núñez Pérez-Redondo, Carlos; Choreño García, Omar; Cicero Sabido, Raúl

    2017-07-27

    Pulmonary mucormycosis is a rare opportunistic infection with high mortality that is caused by species of Mucorales. The most common species involved are Rhizopus, Mucor, Lichtheimia, and Rhizomucor. A 56 year-old woman presented with a clinical history of diabetes mellitus type 2 and chronic renal disease. She underwent a cadaveric kidney transplantation two years before her admission, for which immunomodulating therapy with thymoglobulin, tacrolimus, mofetil-microphenolate and prednisone was established. The patient suffered a pneumonic process with cough, expectoration, and dyspnoea. The computed tomography scan showed a cavitation in the right upper lobe. With all these findings an invasive broncopulmonary aspergillosis was suspected and the patient began an antifungal treatment with voriconazole without improvement. Rhizomucor pusillus was isolated from a clinical specimen obtained by fine needle aspiration, and its identification was confirmed by PCR. After this finding amphotericin B was administered, but the patient had an uncontrolled haemoptysis and died. Pulmonary mucormycosis is a rare infection, usually fatal in kidney transplant recipients with anti-rejection therapy. Mucorales species usually produce thrombotic phenomena, associated with necrosis and parenchymal destruction that caused a fatal uncontrolled haemoptysis in our patient. Early diagnosis is important in order to perform any surgical treatment and to administer amphotericin B. Copyright © 2017 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Chinese medicine amygdalin and β-glucosidase combined with antibody enzymatic prodrug system as a feasible antitumor therapy.

    Science.gov (United States)

    Li, Yun-Long; Li, Qiao-Xing; Liu, Rui-Jiang; Shen, Xiang-Qian

    2015-08-14

    Amarogentin is an efficacious Chinese herbal medicine and a component of the bitter apricot kernel. It is commonly used as an expectorant and supplementary anti-cancer drug. β-Glucosidase is an enzyme that hydrolyzes the glycosidic bond between aryl and saccharide groups to release glucose. Upon their interaction, β-glucosidase catalyzes amarogentin to produce considerable amounts of hydrocyanic acid, which inhibits cytochrome C oxidase, the terminal enzyme in the mitochondrial respiration chain, and suspends adenosine triphosphate synthesis, resulting in cell death. Hydrocyanic acid is a cell-cycle-stage-nonspecific agent that kills cancer cells. Thus, β-glucosidase can be coupled with a tumor-specifific monoclonal antibody. β-Glucosidase can combine with cancer-cell-surface antigens and specifically convert amarogentin to an active drug that acts on cancer cells and the surrounding antibodies to achieve a killing effect. β-Glucosidase is injected intravenously and recognizes cancer-cell-surface antigens with the help of an antibody. The prodrug amarogentin is infused after β-glucosidase has reached the target position. Coupling of cell membrane peptides with β-glucosidase allows the enzyme to penetrate capillary endothelial cells and clear extracellular deep solid tumors to kill the cells therein. The Chinese medicine amarogentin and β-glucosidase will become an important treatment for various tumors when an appropriate monoclonal antibody is developed.

  17. Impact of removable partial denture prosthesis on chewing efficiency

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    Marion Bessadet

    2013-09-01

    Full Text Available Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. OBJECTIVES: The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. MATERIAL AND METHODS: Nineteen removable partial denture prosthesis (RPDP wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I. All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50, determined at the natural point of swallowing. Number of chewing cycles (CC, chewing time (CT and chewing frequency (CF=CC/CT were video recorded. RESULTS: With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP, F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01. With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI determined as 4,000 µm. CONCLUSION: RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. CLINICAL RELEVANCE: This study encourages the clinical improvement of oral rehabilitation procedure.

  18. Orange-Pigmented Sputum as a Manifestation of Smoke Grenade Inhalation Injury.

    Science.gov (United States)

    Chatzivasiloglou, Fotini; Katsenos, Stamatis; Psara, Anthoula; Tsintiris, Konstantinos

    2016-01-01

    A 34-year-old man presented with scanty hemoptysis, orange-colored expectoration, and mild dyspnea. He was in an enclosed building taking part in a military training exercise inhaling an orange-colored smoke from a smoke grenade ignition. His symptoms developed immediately after the initial exposure but he sought medical assistance 20 hours later because of their persistence. Fiberoptic bronchoscopy was performed revealing diffuse inflammatory tracheobronchial tree with streaky orange-pigmented secretions in the trachea and both main-stem bronchi. Acute tracheobronchitis was diagnosed and the patient was treated with nebulized bronchodilators and intravenous corticosteroids showing complete recovery. To our knowledge, this is the first well-documented report of inhalation injury induced by a smoke bomb explosion including potassium chlorate oxidizer and Sudan I and presenting with orange-pigmented sputum production. Smoke inhalation injury is associated with significant morbidity and mortality. The heterogeneity of the smoke and the large variety of the resulting symptoms may be the reason why a definition, specific diagnostic criteria, and therapeutic guidelines are still lacking.

  19. Mouth rinsing with a carbohydrate solution does not influence cycle time trial performance in the heat.

    Science.gov (United States)

    Watson, Phillip; Nichols, David; Cordery, Philip

    2014-09-01

    Ten endurance-trained males were recruited to examine the possible role of carbohydrate (CHO) receptors in the mouth influencing exercise performance in the heat. Volunteers completed an incremental test to exhaustion to determine peak oxygen uptake, a familiarisation trial, followed by 2 experimental trials. Trials consisted of a 1-h time trial undertaken in a climatic chamber maintained at 30 °C, 60% relative humidity. Immediately before, and at regular intervals throughout exercise, subjects ingested a bolus of water and then were provided with either a placebo (PLA) or a 6.4% glucose (CHO) solution to rinse in the mouth for 10 s before being expectorated. There was no difference in total work done between the PLA and CHO trials (758.8 ± 149.0 kJ; 762.6 ± 141.1 kJ; P = 0.951). Pacing was also similar, with no differences in power output apparent during the experimental trials (P = 0.546). Core temperature (P = 0.615), heart rate (P = 0.505), ratings of perceived exertion (P = 0.181), and perceived thermal stress (P = 0.416) were not influenced by the nature of the intervention. Blood glucose concentrations were similar during the CHO and PLA trials (P = 0.117). In contrast to the findings of several studies undertaken in temperate conditions, the present investigation failed to support role of oral sensing of CHO in influencing performance during prolonged exercise in warm conditions.

  20. Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation: A randomized controlled study.

    Science.gov (United States)

    Chuang, Ming-Lung; Chou, Yi-Ling; Lee, Chai-Yuan; Huang, Shih-Feng

    2017-03-01

    Endotracheal intubation and prolonged immobilization of patients receiving mechanical ventilation may reduce expectoration function. High-frequency chest wall oscillation (HFCWO) may ameliorate airway secretion movement; however, the instantaneous changes in patients' cardiopulmonary responses are unknown. Moreover, HFCWO may influence ventilator settings by the vigorous oscillation. The aim of this study was to investigate these issues. Seventy-three patients (52 men) aged 71.5 ± 13.4 years who were intubated with mechanical ventilation for pneumonic respiratory failure were recruited and randomly classified into 2 groups (HFCWO group, n = 36; and control group who received conventional chest physical therapy (CCPT, n = 37). HFCWO was applied with a fixed protocol, whereas CCPT was conducted using standard protocols. Both groups received sputum suction after the procedure. Changes in ventilator settings and the subjects' responses were measured at preset intervals and compared within groups and between groups. Oscillation did not affect the ventilator settings (all P > 0.05). The mean airway pressure, breathing frequency, and rapid shallow breathing index increased, and the tidal volume and SpO2 decreased (all P ventilation decreased (all P ventilator settings, whereas CCPT maintains a steadier condition. After sputum suction, HFCWO slightly improved Ppeak compared to CCPT, suggesting that the study extends the indications of HFCWO for these patients in intensive care unit. (ClinicalTrials.gov number NCT02758106, retrospectively registered.).

  1. Correlation of Dental Caries Experience with pH, Buffering Capacity and Flow Rate of Saliva among 15-year-old School Children in Mangalore

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    Vijay S Kumar

    2013-01-01

    Full Text Available Aim and Objectives: To correlate dental caries experience with pH, buffering capacity and flow rate of saliva among 15-year-old-children Materials & Method : Fifteen year old school children from adopted schools of a dental college in Mangalore were considered as study subjects. The study was carried out using a standardized proforma that consisted of questionnaire for recording demographic data. The caries experience was assessed by DMFT Index. Salivary pH was measured by using a pH meter and salivary buffering capacity was measured by using titration method. Unstimulated whole saliva was collected from all subjects by direct expectoration to calculate the flow rate. Results: The mean DMFT of the study population was 2.85 ± 2.5. The mean salivary pH was found to be 6.88 ± 0.69.About 74.1% were having medium salivary buffering capacities. The mean unstimulated salivary flow rate and mean total antioxidant capacity of the study population was 0.41 ± 0.14 ml/min and 94.15 ± 60.72 g/dL respectively. Conclusions: A marked association between the pH, buffering capacity and unstimulated flow rate with dental caries experience suggest that assessment of these salivary parameters can be used as predictors for future dental caries susceptibility in an individual.

  2. Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

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    Marcus B Conde

    1999-11-01

    Full Text Available In order to evaluate the predictive value of acid fast bacilii (AFB smear for the diagnosis of Mycobacterium tuberculosis in respiratory specimens in a setting with a high prevalence of Aids and an unknown prevalence of nontuberculous mycobacteria (NTM, we retrospectively examined specimens cultured for mycobacteria between 1 September 1993 and 30 September 1994 and medical records of patients with positive culture in a General Hospital, Aids reference in Rio de Janeiro, Brazil. Seventy three per cent (1517/2077 of samples were respiratory specimens and mycobacteria were recovered from 20.6% (313/1517 of these. M. tuberculosis was identified in 94.2% (295/313 and NTM in 5.8% (18/313. The yield of positive AFB smear and of positive culture was 6.1% (93/1517 and 20.6% (313/1517, respectively. The positive predictive value (PPV of AFB for M. tuberculosis was 98.4% in expectorated sputum and 96.4% in bronchoalveolar lavage. Forty four percent (130/295 of specimens with positive culture for M. tuberculosis and 66.7% (12/18 for NTM were from patients HIV positive. The conclusion was that in our study population, the PPV of AFB for M. tuberculosis in respiratory specimens was high and the prevalence of NTM was low despite the high prevalence of HIV positive.

  3. Comparative Metabolite Profiling of Triterpenoid Saponins and Flavonoids in Flower Color Mutations of Primula veris L.

    Science.gov (United States)

    Apel, Lysanne; Kammerer, Dietmar R.; Stintzing, Florian C.; Spring, Otmar

    2017-01-01

    Primula veris L. is an important medicinal plant with documented use for the treatment of gout, headache and migraine reaching back to the Middle Ages. Triterpenoid saponins from roots and flowers are used in up-to-date phytotherapeutic treatment of bronchitis and colds due to their expectorant and secretolytic effects. In addition to the wild type plants with yellow petals, a red variant and an intermediate orange form of Primula veris L. have recently been found in a natural habitat. The secondary metabolite profiles of roots, leaves and flowers of these rare variants were investigated and compared with the wild type metabolome. Two flavonoids, six flavonoid glycosides, four novel methylated flavonoid glycosides, five anthocyanins and three triterpenoid saponins were identified in alcoholic extracts from the petals, leaves and roots of the three variants by high performance liquid chromatography (HPLC)-diode array detection (DAD)/mass spectrometry (MSn) analyses. Anthocyanins were detected in the petals of the red and orange variety, but not in the wild type. No other effects on the metabolite profiles of the three varieties have been observed. The possibility is discussed that a regulatory step of the anthocyanin biosynthetic pathway may have been affected by mutation thus triggering color polymorphism in the petals. PMID:28098796

  4. Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis.

    Science.gov (United States)

    Fujita, Akira; Murata, Kengo; Takamori, Mikio

    2009-08-01

    The Lung Flute is a small self-powered audio device that generates sound waves, which vibrate in tracheobronchial secretions. This was a preliminary trial to evaluate the usefulness of the Lung Flute for sputum sampling in patients suspected of pulmonary tuberculosis (TB). Thirty-four patients who were not expectorating sputum, but for whom sputum examination was required for the differential diagnosis of TB or other diseases, were enrolled in the study. Patients were instructed to blow out fast and hard through the Lung Flute and to repeat this for a total 20 sets of two blows each. Using the Lung Flute, sputum samples were collected within 10 or 20 min from 30 of 34 patients (88%). The device permitted a rapid diagnosis of TB in seven of 15 confirmed TB cases. In three patients acid-fast bacillus smears were positive. In four patients acid-fast bacillus smears were negative, but PCR tests for TB were positive. Hyperventilation-related symptoms occurred in three patients. The application of the Lung Flute may represent a promising technique for the rapid diagnosis of pulmonary TB.

  5. Evaluation of lung flute in sputum samples for molecular analysis of lung cancer.

    Science.gov (United States)

    Anjuman, Nigar; Li, Ning; Guarnera, Maria; Stass, Sanford A; Jiang, Feng

    2013-09-22

    Molecular analysis of sputum provides a promising approach for lung cancer diagnosis, yet is limited by the difficulty in collecting the specimens from individuals who can't spontaneously expectorate sputum. Lung Flute is a small self-powered audio device that can induce sputum by generating sound waves and vibrating in the airways of the lungs. Here we propose to evaluate the usefulness of Lung Flute for sputum sampling to assist diagnosis of lung cancer. Forty-three stage I lung cancer patients and 47 cancer-free individuals who couldn't spontaneously cough sputum were instructed to use Lung Flute for sputum sampling. Expressions of two microRNAs, miRs-31 and 210, were determined in the specimens by qRT-PCR. The results were compared with sputum cytology. Sputum was easily collected from 39 of 43 (90.7%) lung cancer patients and 42 of 47 (89.4%) controls with volume ranges from 1 to 5 ml (median, 2.6 ml). The specimens had less than 4% oral squamous cells, indicating that sputum was obtained from low respiratory tract. Expressions of miRs-31 and 210 in sputum were considerably higher in cancer patients than cancer-free individuals (8.990 vs. 4.514; 0.6847 vs. 0.3317; all P Flute could potentially be useful in convenient and efficient collection of sputum for molecular diagnosis of lung cancer.

  6. Studies on Chromatographic Fingerprint and Fingerprinting Profile-Efficacy Relationship of Polygoni Perfoliati Herba

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    Li Tian

    2013-01-01

    Full Text Available Polygoni Perfoliati Herba is widely used in China with antibacterium, anti-inflammatory, expectorant, antitumor, and antivirus activities. To reveal the mechanisms of the activities of Polygoni Perfoliati Herba, the relationship between the fingerprinting profile and its bioactivities was investigated. In the present study, high-performance liquid chromatographic (HPLC fingerprinting method was developed. The established method was applied to analyze 51 batches of Polygoni Perfoliati Herba samples collected from different locations or in different harvesting times in China. Chemometrics, including similarity analysis, hierarchical clustering analysis, and principal component analysis, were used to express their similarities. It was found that similarity values of the samples were in the range of 0.432–0.998. The results of analgesic tests indicated that Polygoni Perfoliati Herba could significantly inhibit pain induced by hot plate and acetic acid in mice. The results of anti-inflammatory tests showed that Polygoni Perfoliati Herba had good anti-inflammatory effects (P < 0.01 in two models including dimethyl benzene-induced ear edema and acetic acid-induced peritoneal permeability in mice. Combining the results from chromatographic fingerprints with those from bioactivities, we found that seven peaks from Polygoni Perfoliati Herba were mainly responsible for analgesic and anti-inflammatory activities.

  7. Lung cancer, brucellosis and tuberculosis: remarkable togetherness

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    Muhammed Emin Akkoyunlu

    2013-08-01

    Full Text Available A 68 years old male farmer referred with cough, expectorating sputum, intermittant fever, night sweats, fatigue and anorexia persisting for two weeks. There was a history of 80 packs each year of smoking and he was still an active smoker. Pneumonectomy was performed because of pulmonary epidermoid cancer and he received chemotherapy. He was diagnosed lung tuberculosis and using anti-tuberculous treatment for 4 months. He had a weight loss of 8 kg in last month. His body tempereature was 38.5 °C. Heart rate was 100/min. ESR was 51mm/h and CRP was 5.6 mg/ dL. There was no proliferation in blood and sputum cultures. Three sputum specimens were examined and AFB wasn’t detected. Fibronodular infiltration was seen in right lower zone of chest X-ray. In thorax CT, fibronodular densities were seen in lower lobe anterior and posterior segments. Brucella melitensis was isolated in blood culture. Second bronchoscopy was performed with suspect of brucellosis pneumonia. Brucella tube agglutination test was positive at titer 1/320 in the bronchial lavage fluid and 1/640 in concurrent serum sample. In cases with chronic cough or pneumonia which is irresponsive to nonspecific antibiotherapy, respiratory brucellosis must be rememberred in endemic areas.

  8. Outcomes, infectiousness, and transmission dynamics of patients with extensively drug-resistant tuberculosis and home-discharged patients with programmatically incurable tuberculosis: a prospective cohort study

    KAUST Repository

    Dheda, Keertan

    2017-01-19

    Background: The emergence of programmatically incurable tuberculosis threatens to destabilise control efforts. The aim of this study was to collect prospective patient-level data to inform treatment and containment strategies. Methods: In a prospective cohort study, 273 South African patients with extensively drug-resistant tuberculosis, or resistance beyond extensively drug-resistant tuberculosis, were followed up over a period of 6 years. Transmission dynamics, infectiousness, and drug susceptibility were analysed in a subset of patients from the Western Cape using whole-genome sequencing (WGS; n=149), a cough aerosol sampling system (CASS; n=26), and phenotypic testing for 18 drugs (n=179). Findings: Between Oct 1, 2008, and Oct 31, 2012, we enrolled and followed up 273 patients for a median of 20·3 months (IQR 9·6-27·8). 203 (74%) had programmatically incurable tuberculosis and unfavourable outcomes (treatment failure, relapse, default, or death despite treatment with a regimen based on capreomycin, aminosalicylic acid, or both). 172 (63%) patients were discharged home, of whom 104 (60%) had an unfavourable outcome. 54 (31%) home-discharged patients had failed treatment, with a median time to death after discharge of 9·9 months (IQR 4·2-17·4). 35 (20%) home-discharged cases were smear-positive at discharge. Using CASS, six (23%) of 26 home-discharged cases with data available expectorated infectious culture-positive cough aerosols in the respirable range (<5 μm), and most reported inter-person contact with suboptimal protective mask usage. WGS identified 17 (19%) of the 90 patients (with available sequence data) that were discharged home before the diagnosis of 20 downstream cases of extensively drug-resistant tuberculosis with almost identical sequencing profiles suggestive of community-based transmission (five or fewer single nucleotide polymorphisms different and with identical resistance-encoding mutations for 14 drugs). 11 (55%) of these downstream

  9. Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência Clinical, radiological, and laboratory characteristics in pulmonary tuberculosis patients: comparative study of HIV-positive and HIV-negative inpatients at a referral hospital

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    Aline Besen

    2011-12-01

    sputum smear microscopy and culture for Mycobacterium tuberculosis, as well as hemoglobin levels and CD4+ T-cell counts, were obtained from medical records, and chest X-ray reports were consulted. RESULTS: We included 50 pulmonary tuberculosis patients, who were divided into two groups (HIV-positive and HIV-negative; n = 25 per group. The mean age of the participants was 38.4 ± 10.5 years; 46 (92% were males; and 27 (54% were White. Expectoration was presented by 21 (84% and 13 (52% of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016. Radiological findings of cavitation were present in 10 (43% and 2 (10% of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016, whereas an interstitial pattern was observed in 18 (78% and 8 (40%, respectively (p = 0.012. The mean hemoglobin level was 11.1 ± 2.9 g/dL and 9.3 ± 2.2 g/dL in the HIV-negative and HIV-positive groups, respectively (p = 0.015. CONCLUSIONS: In our sample of tuberculosis patients, expectoration was less prevalent, hemoglobin levels were lower, and cavitation was less common, as was an interstitial pattern, among those co-infected with HIV than among those without HIV co-infection.

  10. The wisdom of the deep south of Thailand: Case study on utilization of herbal medicine to treat domestic animal diseases by traditional doctors in Pattani, Yala and Narathiwat

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    Poh-etae A.

    2007-03-01

    Full Text Available This survey research was conducted to investigate the wisdom of the Deep South of Thailand: case study on utilization of herbal medicine to treat domestic animal diseases by traditional doctors in Pattani, Yala and Narathiwat. A purposive sampling method was applied in selecting 133 subjects from 33 districts of these provinces. The interview design was checked by experts for content validity index and adjusted after testing on 13 non-target men. Quantitative and qualitative data were analyzed using percentage and groups split by symptoms.The results showed that most traditional doctors (68.4% were males; 52.6% were 41-60 years old and 39.1% were more than 61 years of age. 60.2% of the subjects were Muslims; 73.7% of them were agri- culturalists; 63.2% of them had the income ranging from 3,001-6,000 baht/month. Most of the subjects (77.4% had only primary education, and 15.0% finished high school level. Only 6.0% practised traditional medicine as their main occupation and most of them (94.0% did not practise traditional medicine as their main occupation. Most traditional doctors (91.0% had experience in using medicinal herbs for animal treatment; 30.0% citing that herbal medicine was easy to find in local areas; 26.8% citing that it was cheap. For domestic animal utilization of herbal medicine, cats (54.1%, were first on the list of non-ruminants, chickens (62.9% came first among poultry, cattle (50.7% came first among ruminants and decorative fish e.g. goldfish (50.0% were commonest among aquatic animals. The single herbal medicine used to treat domestic animal diseases by traditional doctors were reported as follows: to chase away insects, citronella grass or tobacco (3.0% was used; to treat diarrhea, Tinospora crispa (2.3% was used; to treat antitussives, lemon grass or Andrographis paniculata (2.3% was used; as an expectorant, curcuma rhizomes (2.3% was used; to treat pus from worms, Phyllanthus reticularud or Cassytha filiformis (2.3% was

  11. DETECCIÓN DE ALTERACIÓN FUNCIONAL RESPIRATORIA EN UN GRUPO DE MINEROS DE CARBÓN DE PAIPA, BOYACÁ (2006-2008

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    Nubia Mercedes González Jiménez

    2011-04-01

    environment of 410 workers who were interviewed. On the other hand, we analyzed their parameters of respiratory function by means of spirometry and pulse oximetry. The abundant symptomatology detected (cough, expectoration, dyspnea and thoracic pain suggests an underlying presence of progressive chronic pulmonary disease. Marked prevalence of hypoxemia and of abnormal respiratory patterns related to an elapsed time of work in the mine equal or greater than three years, also shows that illness is work related. According to the findings of this study, we confirm that mining is a high-risk activity for the group analyzed. 

    Key words: Coal mines, respiratory function, dyspnea, cough, expectoration, arterial oxygen saturation.

  12. Comparative Evaluation for Assessing Oratest as a Diagnostic Tool for Evaluation of Plaque Levels & Gingivitis

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    Mahasweta Joshi

    2012-01-01

    Full Text Available Aims & Objectives: Periodontal disease comprises a group of inflammatory conditions of the supporting tissues of the teeth that are caused by bacteria. The present study was undertaken to evaluate whether Oratest could be used as a sensitive indicator of plaque levels and gingivitis. Material and Methods: Hundred caries free patients visiting the out-patient department of A.E.C.S. Maaruti College of Dental Sciences and Research Centre, Banglore were selected according to predetermined selection criteria. The study consisted of two clinical stages: Stage 1. Recording of Plaque Index (Loe, 1967 and Gingival Index (Loe & Silness 1963 in the subjects. Stage 2. Performance of the Oratest and recording the scores in the same subjects. The Oratest was performed by rinsing the mouth with sterilized UHT (Ultra high temperature milk. About 3 ml of expectorated milk was added to a test tube containing the 0.12 ml of 0.1% methylene blue. The time required for colour change from blue to white attained at the bottom of the tube was recorded. Plaque Index, Gingival Index and Oratest scores were compared using Student t test. Pearson correlation test was applied to assess correlation between the indices and Oratest scores. Results:The results of the study showed that as age increased plaque and Gingival Indexes also increased whereas Oratest scores decreased. No significant difference between males and females was found in mean values of Plaque Index, Gingival Index and Oratest scores. Negative correlation was seen between Plaque Index and Oratest scores (r = 0.724 and also between Gingival Index and Oratest scores (r = 0.728. Conclusions: The study showed high correlation between the plaque and gingival indices and Oratest scores. This study validates Oratest as a predictable & sensitive test to assess periodontal disease.

  13. Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms.

    Science.gov (United States)

    Klimek, Ludger; Schumacher, Helmut; Schütt, Tanja; Gräter, Heidemarie; Mueck, Tobias; Michel, Martin C

    2017-02-01

    The aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over-the-counter ibuprofen/pseudoephedrine combination product. Data from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post-hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non-specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%. After intake of first dose of medication, typically ibuprofen-sensitive, pseudoephedrine-responsive, non-specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen-sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective. Efficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose-dependent and greatest when treatment started within the first 2 days after onset of symptoms. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  14. Lubrication of chocolate during oral processing.

    Science.gov (United States)

    Rodrigues, S A; Selway, N; Morgenstern, M P; Motoi, L; Stokes, J R; James, B J

    2017-02-22

    The structure of chocolate is drastically transformed during oral processing from a composite solid to an oil/water fluid emulsion. Using two commercial dark chocolates varying in cocoa solids content, this study develops a method to identify the factors that govern lubrication in molten chocolate and saliva's contribution to lubrication following oral processing. In addition to chocolate and its individual components, simulated boluses (molten chocolate and phosphate buffered saline), in vitro boluses (molten chocolate and whole human saliva) and ex vivo boluses (chocolate expectorated after chewing till the point of swallow) were tested. The results reveal that the lubrication of molten chocolate is strongly influenced by the presence of solid sugar particles and cocoa solids. The entrainment of particles into the contact zone between the interacting surfaces reduces friction such that the maximum friction coefficient measured for chocolate boluses is much lower than those for single-phase Newtonian fluids. The addition of whole human saliva or a substitute aqueous phase (PBS) to molten chocolate dissolves sugar and decreases the viscosity of molten chocolate so that thinner films are achieved. However, saliva is more lubricating than PBS, which results in lower friction coefficients for chocolate-saliva mixtures when compared to chocolate-PBS mixtures. A comparison of ex vivo and in vitro boluses also suggests that the quantity of saliva added and uniformity of mixing during oral processing affect bolus structure, which leads to differences in measured friction. It is hypothesized that inhomogeneous mixing in the mouth introduces large air bubbles and regions of non-emulsified fat into the ex vivo boluses, which enhance wetting and lubrication.

  15. Characteristics of Chinese patients with cough in primary care centre

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    Bai Chunxue

    2011-09-01

    Full Text Available Abstract Background Cough is one of the most common respiratory symptoms and is well characterized in specialized cough clinics with high success rates of diagnosis and treatment. However, there is a paucity of data regarding cough in primary care settings. The present study aimed at investigating clinical epidemiology of cough through a national study of two questionnaire surveys sent to primary care physicians in China. Methods Approximately 18,000 subjects recruited were having daytime or night symptoms of cough and diagnoses of respiratory disease from February 2005 to April 2006 as Survey 1 and from June 2007 to December 2007 as Survey 2. Patients suffering from respiratory malignancy, hyperthyroidism, hypertension, heart disease, diabetes, severe hypohepatia or renal dysfunction, pregnancy, possible pregnancy or lactation, neutropenia were not eligible. Information regarding demography, history of allergies, symptomatic profile, treatment and curative effects for cough was elicited. Results 8216 questionnaires were collected in Survey 1 and 9711 in Survey 2. The mean values of ages were 25.7 and 22.3 years old, respectively. Symptoms included expectoration (74% and 76%, wheeze (59% and 74%, breathlessness (22% and 26%, chest pain (9% and 13% and fever (15% and 18%. About 15% and 23% patients had hypersusceptibility, of whom 6% to 17% had a family history. More than 50% of the cases had histories of allergic rhinitis, asthma, conjunctivitis or atopic dermatitis. Asthma, COPD, and bronchitis were dominant etiologies of cough. Procaterol or the combination of antibiotics and steroids were used as the treatment. Conclusion Causes and outcomes of cough differed with ages and time in this particular national study, while successful and precise diagnosis and management of cough in primary care settings need to be further improved in China.

  16. A new paradigm in respiratory hygiene: increasing the cohesivity of airway secretions to improve cough interaction and reduce aerosol dispersion

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    O'Brien Darryl

    2005-09-01

    Full Text Available Abstract Background Infectious respiratory diseases are transmitted to non-infected subjects when an infected person expels pathogenic microorganisms to the surrounding environment when coughing or sneezing. When the airway mucus layer interacts with high-speed airflow, droplets are expelled as aerosol; their concentration and size distribution may each play an important role in disease transmission. Our goal is to reduce the aerosolizability of respiratory secretions while interfering only minimally with normal mucus clearance using agents capable of increasing crosslinking in the mucin glycoprotein network. Methods We exposed mucus simulants (MS to airflow in a simulated cough machine (SCM. The MS ranged from non-viscous, non-elastic substances (water to MS of varying degrees of viscosity and elasticity. Mucociliary clearance of the MS was assessed on the frog palate, elasticity in the Filancemeter and the aerosol pattern in a "bulls-eye" target. The sample loaded was weighed before and after each cough maneuver. We tested two mucomodulators: sodium tetraborate (XL"B" and calcium chloride (XL "C". Results Mucociliary transport was close to normal speed in viscoelastic samples compared to non-elastic, non-viscous or viscous-only samples. Spinnability ranged from 2.5 ± 0.6 to 50.9 ± 6.9 cm, and the amount of MS expelled from the SCM increased from 47 % to 96 % adding 1.5 μL to 150 μL of XL "B". Concurrently, particles were inversely reduced to almost disappear from the aerosolization pattern. Conclusion The aerosolizability of MS was modified by increasing its cohesivity, thereby reducing the number of particles expelled from the SCM while interfering minimally with its clearance on the frog palate. An unexpected finding is that MS crosslinking increased "expectoration".

  17. Drug-resistant tuberculosis among HIV-infected patients starting antiretroviral therapy in Durban, South Africa.

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    Jeffrey K Hom

    Full Text Available To estimate the prevalence of drug-resistant tuberculosis (TB and describe the resistance patterns in patients commencing antiretroviral therapy (ART in an HIV clinic in Durban, South Africa.Cross-sectional cohort study.Consecutive HIV-infected adults (≥ 18y/o initiating HIV care were enrolled from May 2007-May 2008, regardless of signs or symptoms of active TB. Prior TB history and current TB treatment status were self-reported. Subjects expectorated sputum for culture (MGIT liquid and 7H11 solid medium. Positive cultures were tested for susceptibility to first- and second-line anti-tuberculous drugs. The prevalence of drug-resistant TB, stratified by prior TB history and current TB treatment status, was assessed.1,035 subjects had complete culture results. Median CD4 count was 92/µl (IQR 42-150/µl. 267 subjects (26% reported a prior history of TB and 210 (20% were receiving TB treatment at enrollment; 191 (18% subjects had positive sputum cultures, among whom the estimated prevalence of resistance to any antituberculous drug was 7.4% (95% CI 4.0-12.4. Among those with prior TB, the prevalence of resistance was 15.4% (95% CI 5.9-30.5 compared to 5.2% (95% CI 2.1-8.9 among those with no prior TB. 5.1% (95% CI 2.4-9.5 had rifampin or rifampin plus INH resistance.The prevalence of TB resistance to at least one drug was 7.4% among adults with positive TB cultures initiating ART in Durban, South Africa, with 5.1% having rifampin or rifampin plus INH resistance. Improved tools for diagnosing TB and drug resistance are urgently needed in areas of high HIV/TB prevalence.

  18. Plague: history and contemporary analysis.

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    Raoult, Didier; Mouffok, Nadjet; Bitam, Idir; Piarroux, Renaud; Drancourt, Michel

    2013-01-01

    Plague has caused ravaging outbreaks, including the Justinian plague and the "black death" in the Middle Ages. The causative agents of these outbreaks have been confirmed using modern molecular tests. The vector of plague during pandemics remains the subject of controversy. Nowadays, plague must be suspected in all areas where plague is endemic in rodents when patients present with adenitis or with pneumonia with a bloody expectorate. Diagnosis is more difficult in the situation of the reemergence of plague, as in Algeria for example, told by the first physician involved in that outbreak (NM). When in doubt, it is preferable to prescribe treatment with doxycycline while waiting for the test results because of the risk of fatality in individuals with plague. The typical bubo is a type of adenitis that is painful, red and nonfluctuating. The diagnosis is simple when microbiological analysis is conducted. Plague is a likely diagnosis when one sees gram-negative bacilli in lymph node aspirate or biopsy samples. Yersinia pestis grows very easily in blood cultures and is easy to identify by biochemical tests and MALDI-TOF mass spectrometry. Pneumonic plague and septicemic plague without adenitis are difficult to diagnose, and these diagnoses are often made by chance or retrospectively when cases are not part of an epidemic or related to another specific epidemiologic context. The treatment of plague must be based on gentamicin or doxycycline. Treatment with one of these antibiotics must be started as soon as plague is suspected. Analysis of past plague epidemics by using modern laboratory tools illustrated the value of epidemic buboes for the clinical diagnosis of plague; and brought new concepts regarding its transmission by human ectoparasites. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  19. Evaluation of the efficacy of pidotimod in the exacerbations in patients affected with chronic bronchitis.

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    Bisetti, A; Ciappi, G; Bariffi, F; Catena, E; Rocco, V; Vaccaro, L; Grassi, V; Scarpazza, G; Bertoli, L; Cardani, A

    1994-12-01

    The efficacy and safety of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl)carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new oral synthetic immunostimulating agent, were investigated in a multicentre study, performed in 10 university and hospital centres of pneumophthisiology and respiratory physiopathology, according to a double-blind vs. placebo experimental design. Primary objective of the investigation was to verify the efficacy of pidotimod against infectious exacerbations in patients affected with chronic bronchitis. 181 inpatients or outpatients (117 male, 64 female; mean age: 62.5 years), affected with chronic bronchitis, were enrolled in the study. Pidotimod 800 mg/die or placebo sachets were administered by oral route for 60 consecutive days, followed by a 60-day follow-up period. Clinical observations were performed at baseline (D 0), after 30 (D 30) and 60 (D 60) days of treatment, as well as at the end of the follow-up (D 120). Time and frequency of infectious relapses were considered as the target variable for the evaluation of the efficacy of the drug. Clinical picture, expectoration characteristics, spirometric parameters and laboratory tests were monitored to evaluate patients' conditions. The results indicate that pidotimod is significantly more effective than placebo against infectious relapses in patients suffering from chronic bronchitis. During the first month, 9% of patients treated with pidotimod were affected with an infectious relapse vs. 39.5% of patients treated with placebo (chi 2, p < 0.001). In the second month, infectious episodes were reported by 1.2% of patients treated with the drug vs. 46.1% of patients treated with placebo (chi 2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Tolerance and effect of an add-on treatment with a cough medicine containing ivy leaves dry extract on lung function in children with bronchial asthma.

    Science.gov (United States)

    Zeil, S; Schwanebeck, U; Vogelberg, C

    2014-09-15

    Ivy leaves dry extract is registered as an expectorant in patients with respiratory diseases associated with productive cough. Next to its secretolytical properties, bronchospasmolytical effects are described. However only limited data exist about a possible therapeutical effect in asthmatic patients. In this double blind, placebo-controlled, randomized cross-over study, 30 children (median age 9.07 years (min-max: 6-11)) suffering from partial or uncontrolled mild persistent allergic asthma despite long-term treatment with 400 μg budesonide equivalent were investigated. After a four week run-in period, patients either received ivy leaves dry extract for four weeks in addition to their inhaled corticosteroid therapy or placebo, followed by a wash-out phase before switching to the other treatment arm. Lung function, FeNO, exhaled breath condensate pH and life quality was analyzed after each treatment period. There was a significant improvement of MEF(75-25), MEF25 and VC after treatment with ivy leaves dry extract (MEF(75-25) change in the mean 0.115 l/s, p=0.044; MEF25 change in the mean 0.086 l/s, p=0.041; VC change in the mean 0.052 l, p=0.044), but not after treatment with placebo. For the primary outcome parameters (relative change of FEV1 and MEF(75-25) before bronchodilation) no treatment effect could be detected in the cross-over analysis (FEV1 p=0.6763 and MEF(75-25) p=0.6953). This proof-of-concept study indicates that children with mild uncontrolled asthma despite regular inhaled corticosteroid therapy might benefit from an additional therapy with ivy leaves dry extract. However, further studies are needed. Copyright © 2014 The Authors. Published by Elsevier GmbH.. All rights reserved.

  1. La tuberculose pulmonaire et le tabac: à propos de 100 cas

    Science.gov (United States)

    Janah, Hicham; Souhi, Hicham; Kouissmi, Hatim; Marc, Karima; Zahraoui, Rachida; Benamor, Jouda; Soualhi, Mona; Bourkadi, Jamal Eddine

    2014-01-01

    Le tabagisme et la tuberculose sont deux enjeux majeurs de santé publique au niveau mondial, en particulier dans les pays émergents. Pour déterminer les particularités cliniques, radiologiques, bactériologiques et thérapeutiques de la tuberculose pulmonaire chez les sujets tabagiques nous avons mené une étude prospective au service de phtisiologie de l'hôpital Moulay Youssef sur une période de 10 mois, portant sur 100 nouveaux cas de tuberculose pulmonaire, répartis en 2 groupes, 50 patients tabagiques: Groupe A et 50 patients non tabagiques: Groupe B. Tous nos patients étaient de sexe masculin, l’âge moyen était de 41 ans ± 12 chez le groupe A et de 36 ans ± 16 chez le groupe B. Le délai de consultation était plus long chez les tabagiques, la médiane était de 60j (30; 98) contre 40j (30; 60), la symptomatologie clinique était variable chez les deux groupes, dominée par les expectorations chez les tabagiques 96% contre 60%. Les lésions radiologiques étaient similaires chez les deux groupes ainsi que la charge bacillaire. Tous les patients ont été mis sous traitement antituberculeux. Après un mois du traitement, la Bacilloscopie était négative chez 50% du groupe A contre 66% chez le groupe B. la régression des lésions radiologiques était similaire chez les deux groupes. Le retard diagnostique et le retard de négativation des frottis sont les principales particularités de la tuberculose pulmonaire du sujet tabagique. Le sevrage tabagique doit faire partie intégrante de la prise en charge des patients atteints de tuberculose. PMID:25821545

  2. The hederagenin saponin SMG-1 is a natural FMLP receptor inhibitor that suppresses human neutrophil activation.

    Science.gov (United States)

    Hwang, Tsong-Long; Wang, Chien-Chiao; Kuo, Yao-Haur; Huang, Hui-Chi; Wu, Yang-Chang; Kuo, Liang-Mou; Wu, Yi-Hsiu

    2010-10-15

    The pericarp of Sapindus mukorossi Gaertn is traditionally used as an expectorant in Japan, China, and Taiwan. Activated neutrophils produce high concentrations of the superoxide anion (O(2)(-)) and elastase known to be involved in airway mucus hypersecretion. In the present study, the anti-inflammatory functions of hederagenin 3-O-(3,4-O-di-acetyl-alpha-L-arabinopyranoside)-(1-->3)-alpha-l-rhamnopyranosyl-(1-->2)-alpha-l-arabinopyranoside (SMG-1), a saponin isolated from S. mukorossi, and its underlying mechanisms were investigated in human neutrophils. SMG-1 potently and concentration-dependently inhibited O(2)(*-) generation and elastase release in N-Formyl-Met-Leu-Phe (FMLP)-activated human neutrophils. Furthermore, SMG-1 reduced membrane-associated p47(phox) expression in FMLP-induced intact neutrophils, but did not alter subcellular NADPH oxidase activity in reconstituted systems. SMG-1 attenuated FMLP-induced increase of cytosolic calcium concentration and phosphorylation of p38 MAPK, ERK, JNK, and AKT. However, SMG-1 displayed no effect on cellular cAMP levels and activity of adenylate cyclase and phosphodiesterase. Significantly, receptor-binding analysis showed that SMG-1 inhibited FMLP binding to its receptor in a concentration-dependent manner. In contrast, neither phorbol myristate acetate-induced O(2)(*-) generation and MAPKs activation nor thapsigargin-caused calcium mobilization was altered by SMG-1. Taken together, our results demonstrate that SMG-1 is a natural inhibitor of the FMLP receptor, which may have the potential to be developed into a useful new therapeutic agent for treating neutrophilic inflammatory diseases. Copyright 2010 Elsevier Inc. All rights reserved.

  3. Anti-snake venom activities of extracts and fractions from callus cultures of Sapindus saponaria.

    Science.gov (United States)

    da Silva, Marcos L; Marcussi, Silvana; Fernandes, Renata S; Pereira, Paulo S; Januário, Ana Helena; França, Suzelei C; Da Silva, Saulo L; Soares, Andreimar M; Lourenço, Miriam V

    2012-03-01

    Sapindus saponaria L. (Sapindaceae) bark, root, and fruits are used as sedatives and to treat gastric ulcer and also demonstrate diuretic and expectorant effects. The anti-snake venom properties of callus of S. saponaria are investigated here for the first time. In vitro cultivated callus of Sapindus saponaria were lyophilized, and the extracts were prepared with different solvents, before submitting to phytochemical studies and evaluation of the anti-ophidian activity. Crude extracts were fractionated by liquid-liquid partition and the fractions were monitored by thin layer chromatography (TLC). Subsequently, anti-ophidian activities were analyzed toward Bothrops jararacussu Lacerda (Viperidae), B. moojeni Hoge (Viperidae), B. alternates Duméril (Viperidea) and Crotalus durissus terrificus Lineu (Viperidae) venoms and isolated myotoxins and phospholipase A(2) (PLA(2)). Fractions A1, A2 and the extract in MeOH:H(2)O (9:1) significantly inhibited the toxic and pharmacological activities induced by snake venoms and toxins, when compared to other extracts and fractions. The lethal, clotting, phospholipase, edema-inducing, hemorrhagic and myotoxic activities were partially inhibited by the different extracts and fractions. TLC profiles of the crude extracts (B and C) and fractions (A1 and A2) showed β-sitosterol and stigmasterol as their main compounds. Stigmasterol exhibited inhibitory effects on enzymatic and myotoxic activities of PLA(2). Sapindus saponaria extracts and fractions presented anti-ophidian activity and could be used as an adjuvant to serum therapy or for its supplementation, and in addition, as a rich source of potential inhibitors of enzymes involved in several pathophysiological human and animal diseases.

  4. Inflammation and airway microbiota during cystic fibrosis pulmonary exacerbations.

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    Edith T Zemanick

    Full Text Available Pulmonary exacerbations (PEx, frequently associated with airway infection and inflammation, are the leading cause of morbidity in cystic fibrosis (CF. Molecular microbiologic approaches detect complex microbiota from CF airway samples taken during PEx. The relationship between airway microbiota, inflammation, and lung function during CF PEx is not well understood.To determine the relationships between airway microbiota, inflammation, and lung function in CF subjects treated for PEx.Expectorated sputum and blood were collected and lung function testing performed in CF subjects during early (0-3d. and late treatment (>7d. for PEx. Sputum was analyzed by culture, pyrosequencing of 16S rRNA amplicons, and quantitative PCR for total and specific bacteria. Sputum IL-8 and neutrophil elastase (NE; and circulating C-reactive protein (CRP were measured.Thirty-seven sputum samples were collected from 21 CF subjects. At early treatment, lower diversity was associated with high relative abundance (RA of Pseudomonas (r = -0.67, p<0.001, decreased FEV(1% predicted (r = 0.49, p = 0.03 and increased CRP (r = -0.58, p = 0.01. In contrast to Pseudomonas, obligate and facultative anaerobic genera were associated with less inflammation and higher FEV₁. With treatment, Pseudomonas RA and P. aeruginosa by qPCR decreased while anaerobic genera showed marked variability in response. Change in RA of Prevotella was associated with more variability in FEV₁ response to treatment than Pseudomonas or Staphylococcus.Anaerobes identified from sputum by sequencing are associated with less inflammation and higher lung function compared to Pseudomonas at early exacerbation. CF PEx treatment results in variable changes of anaerobic genera suggesting the need for larger studies particularly of patients without traditional CF pathogens.

  5. Muc5b is required for airway defence

    Science.gov (United States)

    Roy, Michelle G.; Livraghi-Butrico, Alessandra; Fletcher, Ashley A.; McElwee, Melissa M.; Evans, Scott E.; Boerner, Ryan M.; Alexander, Samantha N.; Bellinghausen, Lindsey K.; Song, Alfred S.; Petrova, Youlia M.; Tuvim, Michael J.; Adachi, Roberto; Romo, Irlanda; Bordt, Andrea S.; Bowden, M. Gabriela; Sisson, Joseph H.; Woodruff, Prescott G.; Thornton, David J.; Rousseau, Karine; de La Garza, Maria M.; Moghaddam, Seyed J.; Karmouty-Quintana, Harry; Blackburn, Michael R.; Drouin, Scott M.; Davis, C. William; Terrell, Kristy A.; Grubb, Barbara R.; O'Neal, Wanda K.; Flores, Sonia C.; Cota-Gomez, Adela; Lozupone, Catherine A.; Donnelly, Jody M.; Watson, Alan M.; Hennessy, Corinne E.; Keith, Rebecca C.; Yang, Ivana V.; Barthel, Lea; Henson, Peter M.; Janssen, William J.; Schwartz, David A.; Boucher, Richard C.; Dickey, Burton F.; Evans, Christopher M.

    2014-01-01

    Respiratory surfaces are exposed to billions of particulates and pathogens daily. A protective mucus barrier traps and eliminates them through mucociliary clearance (MCC). However, excessive mucus contributes to transient respiratory infections and to the pathogenesis of numerous respiratory diseases. MUC5AC and MUC5B are evolutionarily conserved genes that encode structurally related mucin glycoproteins, the principal macromolecules in airway mucus. Genetic variants are linked to diverse lung diseases, but specific roles for MUC5AC and MUC5B in MCC, and the lasting effects of their inhibition, are unknown. Here we show that mouse Muc5b (but not Muc5ac) is required for MCC, for controlling infections in the airways and middle ear, and for maintaining immune homeostasis in mouse lungs, whereas Muc5ac is dispensable. Muc5b deficiency caused materials to accumulate in upper and lower airways. This defect led to chronic infection by multiple bacterial species, including Staphylococcus aureus, and to inflammation that failed to resolve normally. Apoptotic macrophages accumulated, phagocytosis was impaired, and interleukin-23 (IL-23) production was reduced in Muc5b-/- mice. By contrast, in mice that transgenically overexpress Muc5b, macrophage functions improved. Existing dogma defines mucous phenotypes in asthma and chronic obstructive pulmonary disease (COPD) as driven by increased MUC5AC, with MUC5B levels either unaffected or increased in expectorated sputum. However, in many patients, MUC5B production at airway surfaces decreases by as much as 90%. By distinguishing a specific role for Muc5b in MCC, and by determining its impact on bacterial infections and inflammation in mice, our results provide a refined framework for designing targeted therapies to control mucin secretion and restore MCC.

  6. In Vivo Evaluation of Anti Diabetic, Hypolipidemic, Antioxidative Activities of Saudi Date Seed Extract on Streptozotocin Induced Diabetic Rats.

    Science.gov (United States)

    Hasan, Marghoob; Mohieldein, Abdelmarouf

    2016-03-01

    Phoenix dactylifera (date palm) is major fruit of gulf region. In folk medicine; dates have been traditionally use. The date seed is used as hypoglycaemic, expectorant, tonic, aphrodisiac, antidiarrheic and mouth hygiene. This study intended to evaluate the anti-diabetic, hypolipidaemic and antioxidative activities of date seed extract in diabetes-induced rats. Total of seven groups of rats, consisting of control rats and streptozotocin induced diabetic rats treated with aqueous seed extract in concentration of 100g/L in dosage of 10ml/day/rat. To evaluate the anti-diabetic property, glucose and weight was analysed weekly and at the end of eight week all rats were sacrificed. To evaluate the hypolipidaemic and antioxidative activities, serum cholesterol, triglyceride, malondialdehyde, superoxide dismutase, 8-hydroxy-2'-deoxyguanosine were estimated. Liver enzymes and kidney function tests were performed. Moreover to verify the glycaemic effect; glycated haemoglobin and serum insulin was performed. Aqueous seed extract in concentration of 100 gm/L in dosage of 10ml/day/rat brings a significant reduction of blood glucose levels in diabetic rats in comparison of control rats. There were significant differences in the investigated clinical chemistry and oxidative stress parameters between control and diabetic rats with both seed extract of Ajwa and Sukkari dates. Present study verifies the antidiabetic property, of aqueous seed extracts of two different varieties of dates namely Ajwa and Sukkari of Kingdom of Saudi on streptozotocin induced Diabetic rats. Prolong treatments with the extract restores the function of liver and kidney and balance the oxidative stress condition in diabetic treated rats.

  7. Impacto de la capacitación médica sobre el manejo de las infecciones respiratorias agudas en niños

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    Anai Medina Valdés

    2003-06-01

    Full Text Available Fue el propósito del trabajo el identificar el nivel de conocimiento médico sobre las infecciones respiratorias agudas, el uso de antibióticos, expectorantes y antitusígenos, además de la utilización del ingreso domiciliario. Para lograr lo antes expuesto se evaluó a los médicos antes de impartir un curso de capacitación y después de éste. Se contactó una mejoría en el nivel de conocimiento de los galenos, cuyos promedios evaluativos fueron de 70,7 a 81,58 antes del curso y después de él. Se disminuyó el uso de antitusígenos y expectorantes de 45,7 a 4,8 %. También se incrementó el ingreso domiciliario del 16 al 36 % y se logró mejorar la calidad de la atención del niño y reducir los costos.The objective of this paper was to identify the level of medical knowledge on the acute respiratory infections, the use of antibiotics, expectorants and antitussives in addition to the use of home care service. To this end, physicians were evaluated before and after receiving a training course. An improvement in the level of knowledge of physicians was observed, whose evaluation averages were 70,7 and 81,58 before and after the course, respectively. Home care service increased from 16 to 36 %, the quality of care to children improved and costs dropped.

  8. Pseudocisto pulmonar traumático Traumatic pulmonary pseudocyst

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    Andreia Salarini Monteiro

    2005-02-01

    Full Text Available O pseudocisto pulmonar traumático é uma lesão rara resultante de trauma torácico fechado. A infecção secundária é uma complicação incomum, mas com grande morbidade, devendo ser tratada precocemente. Um paciente do sexo masculino, de 28 anos, vítima de acidente de motocicleta, apresentou na internação hemoptóicos, dor torácica, dispnéia e hipoxemia. A tomografia computadorizada de tórax mostrou infiltrado pulmonar associado a imagens císticas em lobo inferior direito. Evoluiu com febre, expectoração purulenta e nível hidro-aéreo em pseudocistos de lobo inferior direito. Foi iniciado esquema antibiótico de amplo espectro após coleta de culturas, com melhora clínica e alta hospitalar após quinze dias.Traumatic pulmonary pseudocyst is a rare lesion and is typically seen after blunt chest trauma. Although secondary infection is an uncommon complication, it presents high morbidity and requires immediate treatment. A 28-year-old male motorcycle accident victim was admitted to the hospital with hemoptysis, chest pain, dyspnea and hypoxemia. Computed tomography of the chest revealed pulmonary infiltrate and pseudocysts in the lower lobe of the right lung. The patient developed fever, purulent expectoration and an air-fluid level within the pseudocysts. After culture collection, a course of broad-spectrum antibiotics was started. Clinical improvement was observed, and the patient was discharged 15 days after admission.

  9. Occupation, smoking, and chronic obstructive respiratory disorders: a cross sectional study in an industrial area of Catalonia, Spain

    Science.gov (United States)

    Jaén, Ángeles; Zock, Jan Paul; Kogevinas, Manolis; Ferrer, Antonio; Marín, Albert

    2006-01-01

    Background Few studies have investigated the independent effects of occupational exposures and smoking on chronic bronchitis and airflow obstruction. We assessed the association between lifetime occupational exposures and airflow obstruction in a cross-sectional survey in an urban-industrial area of Catalonia, Spain. Methods We interviewed 576 subjects of both sexes aged 20–70 years (response rate 80%) randomly selected from census rolls, using the ATS questionnaire. Forced spirometry was performed by 497 subjects according to ATS normative. Results Lifetime occupational exposure to dust, gases or fumes was reported by 52% of the subjects (63% in men, 41% in women). Textile industry was the most frequently reported job in relation to these exposures (39%). Chronic cough, expectoration and wheeze were more prevalent in exposed subjects with odds ratios ranging from 1.7 to 2.0 being highest among never-smokers (2.1 to 4.3). Lung function differences between exposed and unexposed subjects were dependent on duration of exposure, but not on smoking habits. Subjects exposed more than 15 years to dusts, gases or fumes had lower lung function values (FEV1 -80 ml, 95% confidence interval (CI) -186 to 26; MMEF -163 ml, CI -397 to 71; FEV1/FVC ratio -1.7%, CI -3.3 to -0.2) than non-exposed. Conclusion Chronic bronchitis symptoms and airflow obstruction are associated with occupational exposures in a population with a high employment in the textile industry. Lung function impairment was related to the duration of occupational exposure, being independent of the effect of smoking. PMID:16476167

  10. Clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease experiencing frequent acute exacerbations

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    Prem Parkash Gupta

    2018-01-01

    Full Text Available Purpose: The present study aimed at clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease (COPD to anticipate future exacerbations. Methods: The study included 80 COPD patients; 40 patients had ≥2 acute exacerbations during preceding 1 year (frequent exacerbation [FECOPD] group and 40 patients had <2 acute exacerbations during preceding 1 year (infrequent exacerbation [I-FECOPD] group. Clinical profile, sputum microbiology, blood gas analysis, spirometric indices, and diffusion capacity (transfer test variables were assessed. Groups' comparison was performed using an independent t-test for numeric scale parameters and Chi-square test for nominal parameters. Pearson's and Spearman's correlation coefficients were derived for numeric scale parameters and numeric nominal parameters, respectively. Multinomial logistic regression analysis was done using SPSS software. Results: FECOPD group contained younger patients than in I-FECOPD group although the difference was not statistically significant. There was no significant difference between two groups regarding smoking pack-years and duration of illness. FECOPD group had significantly more expectoration score and Modified Medical Research Council dyspnea scores. Cough score and wheeze score did not differ significantly between two groups. More patients in FECOPD group (12/40 vs. 4/40 had lower airway bacterial colonization. Arterial blood gas parameters were more deranged in FECOPD group. Spirometric indices (forced expiratory volume during 1st s as well as transfer test (both diffusing capacity for carbon monoxide and transfer coefficient of the lung values were significantly reduced in FECOPD group. Conclusions: The patients in FECOPD group had clinical, spirometric, and transfer test profiling suggestive of a severe COPD phenotype, the recognition will help in predicting future exacerbations and a better management.

  11. [Treatment of community-acquired pneumonia by pristinamycin (Pyostacine 500). Results of a non comparative open study].

    Science.gov (United States)

    Petitpretz, P; Guerin, J C; Nouvet, G; Poirier, R; Portier, F; Vergeret, J; Fraysse, P; Vercken, J B

    1994-01-01

    Activity of natural streptogramin (NSG) appears well adapted to pathogens responsible for CAP. The goal of this multicenter pilot study was to bring first data about efficacy of NSG in treatment of CAP. PATIENTS METHOD: Ten days of a NSG (1 gr b.i.d. or t.i.d.) regimen was administered to 46 hospitalized adult patients for CAP defined with fever > 38 degrees C, respiratory symptoms and X-ray opacity. Severely ill patients were excluded. A broncho-pulmonar sample (expectoration or trantracheal aspiration or protected distal sample) was performed in all patients. two patients were excluded because of pulmonary embolism (n = 1) or tuberculosis (n = 1) and 44 patients were analyzed. 50% of them had associated disease, 20% had failure of prior antibiotherapy. At inclusion, mean fever was 39.2 +/- 0.7 degrees C, respiratory rate was 22 +/- 5/mn, PaO2 was 74 +/- 10 mmHg, chest X-ray showed bilateral opacity in 16%, unilateral in 84% and pleural fluid level in 6 cases. Etiological diagnosis was determined in 70% of cases. Streptococcus pneumoniae (n = 14), Haemophilus influenzae (n = 5), Legionella pneumophila (n = 2), Mycoplasma pneumoniae (n = 2) and Chlamydia psittaci (n = 1) were the most frequent isolated pathogens. 40 patients (91%) were cured with NSG and delay to obtain apyrexia was 4.4 +/- 3.9 days. NSG was stopped in 4 patients: 1 clinical and bacteriological failure (Klebsiella pneumoniae), 2 clinical failures (1 pneumococcus with purulent pleurisy, 1 pneumococcus with worsening of respiratory status), 1 patient with resistant H. influenzae strain in spite of favourable clinical evolution. NSG was well tolerated in 86% of patients. these data invite to carry on evaluation of first line therapy of CAP with NSG.

  12. Benign emptying of the postpneumonectomy space.

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    Merritt, Robert E; Reznik, Scott I; DaSilva, Marcelo C; Sugarbaker, David J; Whyte, Richard I; Donahue, Dean M; Hoang, Chuong D; Smythe, W Roy; Shrager, Joseph B

    2011-09-01

    A fall in the postpneumonectomy fluid level is considered a sign of bronchopleural fistula (BPF) requiring surgical intervention. We have discovered however that in rare asymptomatic patients, this event may not require aggressive surgical treatment. After seeing a case of benign emptying of the postpneumonectomy space (BEPS), we surveyed 28 surgeons to determine its incidence and characteristics. Forty-four cases of BEPS were reported by 23 survey respondents. Among 7 fully documented cases from 4 institutions, we defined the following criteria: the patient must be asymptomatic (no fever, white cell count elevation, or fluid expectoration), negative culture results if fluid sampled (patient not receiving antibiotics), no BPF at bronchoscopy or ventilation scintigraphy scan (or both), and recovery without drainage, or retrospective assessment that the intervention was unnecessary. BEPS occurred between 5 days and 152 days after pneumonectomy (6 cases right pneumonectomy and 1 case left pneumonectomy). Four patients underwent no treatment, 1 patient underwent thoracoscopic exploration (sterile) and closure after antibiotic irrigation, 1 patient underwent thoracoscopic exploration alone, and 1 patient underwent open window thoracostomy (sterile) with eventual closure. In all 7 patients (except the patient who underwent the open window procedure) the space refilled within 8 weeks; no patient experienced a subsequent empyema/BPF. Four patients who met the initial criteria for BEPS went on to experience empyema. The incidence of BEPS appears related to pneumonectomy volume, particularly extrapleural pneumonectomy. Using surgeon volume assumptions, the incidence of BEPS is 0.65%. To our knowledge, BEPS is a previously unreported occurrence. We hypothesize that it results from postoperative intrapleural pressure shifts, with or without a microscopic BPF, that drive fluid out of the pleural space while failing to cause contamination. Awareness of BEPS' existence may allow

  13. Deaths due to abuse of dextromethorphan sold over-the-counter in Pakistan

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    Humera Shafi

    2016-09-01

    Full Text Available Dextromethorphan is the most commonly used over-the-counter anti-tussive and expectorant medicine at therapeutic doses. Due to easy availability, euphoric high and hallucinogenic effects at larger doses, dextromethorphan popularity amongst the drug abusers is growing day by day. It is often mixed with alcohol, opiates, cannabinoids or other drugs of abuse for recreational purposes despite their lethal synergistic effects. More than 50 deaths were reported the first time in Pakistan after consuming cough syrups containing dextromethorphan, manufactured by two local pharmaceutical industries. All deceased had the history of drug abuse. We report the deaths of nineteen males, ages ranged from 17 to 45 years, in two major cities of Pakistan who purposefully ingested large doses of dextromethorphan for recreational purposes and died as a result of direct toxic effects of the drug. Toxicological analysis revealed high levels of dextromethorphan ranging from 7.3 to 41.7 mg/L in the peripheral blood, 4.2–92.6 mg/kg in the liver and 9.9–349.6 mg/L in the gastric content by high performance liquid chromatography. The dextromethorphan concentrations in all subjects significantly exceeded the therapeutic range and were consistent with concentrations reported in other cases of dextromethorphan abuse and toxicity. Besides dextromethorphan other drugs of abuse like cannabinoids, opiates, benzodiazepines, ethanol and chlorpheniramine were also detected. The cause of death was determined to be acute dextromethorphan intoxication with lethal synergistic effect of other co-ingested drugs of abuse. The deaths resulted in the prosecution of all individuals involved in manufacturing, distribution or sale of the cough syrup.

  14. Candidate Genes Involved in the Biosynthesis of Triterpenoid Saponins in Platycodon grandiflorum Identified by Transcriptome Analysis.

    Science.gov (United States)

    Ma, Chun-Hua; Gao, Zheng-Jie; Zhang, Jia-Jin; Zhang, Wei; Shao, Jian-Hui; Hai, Mei-Rong; Chen, Jun-Wen; Yang, Sheng-Chao; Zhang, Guang-Hui

    2016-01-01

    Platycodon grandiflorum is the only species in the genus Platycodon of the family Campanulaceae, which has been traditionally used as a medicinal plant for its lung-heat-clearing, antitussive, and expectorant properties in China, Japanese, and Korean. Oleanane-type triterpenoid saponins were the main chemical components of P. grandiflorum and platycodin D was the abundant and main bioactive component, but little is known about their biosynthesis in plants. Hence, P. grandiflorum is an ideal medicinal plant for studying the biosynthesis of Oleanane-type saponins. In addition, the genomic information of this important herbal plant is unavailable. A total of 58,580,566 clean reads were obtained, which were assembled into 34,053 unigenes, with an average length of 936 bp and N50 of 1,661 bp by analyzing the transcriptome data of P. grandiflorum. Among these 34,053 unigenes, 22,409 unigenes (65.80%) were annotated based on the information available from public databases, including Nr, NCBI, Swiss-Prot, KOG, and KEGG. Furthermore, 21 candidate cytochrome P450 genes and 17 candidate UDP-glycosyltransferase genes most likely involved in triterpenoid saponins biosynthesis pathway were discovered from the transcriptome sequencing of P. grandiflorum. In addition, 10,626 SSRs were identified based on the transcriptome data, which would provide abundant candidates of molecular markers for genetic diversity and genetic map for this medicinal plant. The genomic data obtained from P. grandiflorum, especially the identification of putative genes involved in triterpenoid saponins biosynthesis pathway, will facilitate our understanding of the biosynthesis of triterpenoid saponins at molecular level.

  15. Candidate genes involved in the biosynthesis of triterpenoid saponins in Platycodon grandiflorum identified by transcriptome analysis

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    Chunhua eMa

    2016-05-01

    Full Text Available Background: Platycodon grandiflorum is the only species in the genus Platycodon of the family Campanulaceae, which has been traditionally used as a medicinal plant for its lung-heat-clearing, antitussive, and expectorant properties in China, Japanese and Korean. Oleanane-type triterpenoid saponins were the main chemical components of P. grandiflorum and platycodin D was the abundant and main bioactive component, but little is known about their biosynthesis in plants. Hence, P. grandiflorum is an ideal medicinal plant for studying the biosynthesis of Oleanane-type saponins. In addition, the genomic information of this important herbal plant is unavailable.Principal Findings:A total of 58,580,566 clean reads were obtained, which were assembled into 34,053 unigenes, with an average length of 936 bp and N50 of 1,661 bp by analyzing the transcriptome data of P. grandiflorum. Among these 34,053 unigenes, 22,409 unigenes (65.80% were annotated based on the information available from public databases, including Nr, NCBI, Swiss-Prot, KOG and KEGG. Furthermore, 21 candidate cytochrome P450 genes and 17 candidate UDP-glycosyltransferase genes most likely involved in triterpenoid saponins biosynthesis pathway were discovered from the transcriptome sequencing of P. grandiflorum. In addition, 10,626 SSRs were identified based on the transcriptome data, which would provide abundant candidates of molecular markers for genetic diversity and genetic map for this medicinal plant.Conclusion:The genomic data obtained from P. grandiflorum, especially the identification of putative genes involved in triterpenoid saponins biosynthesis pathway, will facilitate our understanding of the biosynthesis of triterpenoid saponins at molecular level.

  16. Molecular Identification of Staphylococcus aureus in Airway Samples from Children with Cystic Fibrosis.

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    Emily J Johnson

    Full Text Available Staphylococcus aureus is a common and significant pathogen in cystic fibrosis. We sought to determine if quantitative PCR (qPCR and 16S rRNA gene sequencing could provide a rapid, culture-independent approach to the identification of S. aureus airway infections.We examined the sensitivity and specificity of two qPCR assays, targeting the femA and 16S rRNA gene, using culture as the gold standard. In addition, 16S rRNA gene sequencing to identify S. aureus directly from airway samples was evaluated. DNA extraction was performed with and without prior enzymatic digestion.87 samples [42 oropharyngeal (OP and 45 expectorated sputum (ES] were analyzed. 59 samples (68% cultured positive for S. aureus. Using standard extraction techniques, sequencing had the highest sensitivity for S. aureus detection (85%, followed by FemA qPCR (52% and 16SrRNA qPCR (34%. For all assays, sensitivity was higher from ES samples compared to OP swabs. Specificity of the qPCR assays was 100%, but 21.4% for sequencing due to detection of S. aureus in low relative abundance from culture negative samples. Enzymatic digestion increased the sensitivity of qPCR assays, particularly for OP swabs.Sequencing had a high sensitivity for S. aureus, but low specificity. While femA qPCR had higher sensitivity than 16S qPCR for detection of S. aureus, neither assay was as sensitive as sequencing. The significance of S. aureus detection with low relative abundance by sequencing in culture-negative specimens is not clear.

  17. Molecular Identification of Staphylococcus aureus in Airway Samples from Children with Cystic Fibrosis.

    Science.gov (United States)

    Johnson, Emily J; Zemanick, Edith T; Accurso, Frank J; Wagner, Brandie D; Robertson, Charles E; Harris, J Kirk

    2016-01-01

    Staphylococcus aureus is a common and significant pathogen in cystic fibrosis. We sought to determine if quantitative PCR (qPCR) and 16S rRNA gene sequencing could provide a rapid, culture-independent approach to the identification of S. aureus airway infections. We examined the sensitivity and specificity of two qPCR assays, targeting the femA and 16S rRNA gene, using culture as the gold standard. In addition, 16S rRNA gene sequencing to identify S. aureus directly from airway samples was evaluated. DNA extraction was performed with and without prior enzymatic digestion. 87 samples [42 oropharyngeal (OP) and 45 expectorated sputum (ES)] were analyzed. 59 samples (68%) cultured positive for S. aureus. Using standard extraction techniques, sequencing had the highest sensitivity for S. aureus detection (85%), followed by FemA qPCR (52%) and 16SrRNA qPCR (34%). For all assays, sensitivity was higher from ES samples compared to OP swabs. Specificity of the qPCR assays was 100%, but 21.4% for sequencing due to detection of S. aureus in low relative abundance from culture negative samples. Enzymatic digestion increased the sensitivity of qPCR assays, particularly for OP swabs. Sequencing had a high sensitivity for S. aureus, but low specificity. While femA qPCR had higher sensitivity than 16S qPCR for detection of S. aureus, neither assay was as sensitive as sequencing. The significance of S. aureus detection with low relative abundance by sequencing in culture-negative specimens is not clear.

  18. STUDY OF 200 CASES OF PLEURAL FLUID

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    Ramakrishna R

    2016-09-01

    Full Text Available BACKGROUND We have studied 200 patients of pleural fluid presenting to our tertiary care centre. Presence of cases of pleural fluid is a common presentation both in pulmonary and extrapulmonary diseases. We analysed the patients having both exudates and transudates and studied the results. MATERIALS AND METHODS We selected patients above 20 years of age and classified the patients with pleural fluid as having transudates and exudates. We studied the causes of transudates and exudates. A total of 200 patients are studied in this prospective study. Diagnosis of pleural exudates is made on the basis of Light’s criteria, chest x-ray, pleural fluid analysis, CT scan in selected patients, sputum examination, bronchoscopy and bronchial washings. Moribund and non-cooperative patients and HIV positives were excluded from the study. RESULTS Among the 200 patients, 91% have exudates. 9% have transudates by Light’s criteria. Tuberculosis is the commonest cause of effusions (64.83% followed by malignancy (13.73% and sympneumonic or parapneumonic effusions (9.89%. Pleural effusions occurred predominantly in males. Prevalence of diabetes Mellitus among cases of tuberculous pleural effusions is 13.56%. Tuberculous effusions are predominantly right-sided. CONCLUSION Predominant cases of pleural fluid are exudates. Commonest cause of pleural effusion is Tuberculosis followed by malignancy both pulmonary and extrapulmonary and sym. and parapneumonic effusions. Prevalence of Diabetes among Tuberculous pleural effusion cases is more or less same as in general population. Cough, expectoration fever, chest pain and breathlessness are the common symptoms occurring in three fourths of the patients of tuberculous pleural effusion. Most of the cases of Tuberculous effusion are above 30 years of age. In the diagnosis of tuberculous pleural effusion, Pleural fluid ADA is very important. Pleural fluid cytology, pleural biopsy, bronchoscopy, bronchial washings and sputum

  19. Nitric oxide production by polymorphonuclear leucocytes in infected cystic fibrosis sputum consumes oxygen.

    Science.gov (United States)

    Kolpen, M; Bjarnsholt, T; Moser, C; Hansen, C R; Rickelt, L F; Kühl, M; Hempel, C; Pressler, T; Høiby, N; Jensen, P Ø

    2014-07-01

    Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients is characterized by persisting mucoid biofilms in hypoxic endobronchial mucus. These biofilms are surrounded by numerous polymorphonuclear leucocytes (PMNs), which consume a major part of present molecular oxygen (O(2)) due to production of superoxide (O(2)(-)). In this study, we show that the PMNs also consume O(2) for production of nitric oxide (NO) by the nitric oxide synthases (NOS) in the infected endobronchial mucus. Fresh expectorated sputum samples (n = 28) from chronically infected CF patients (n = 22) were analysed by quantifying and visualizing the NO production. NO production was detected by optode measurements combined with fluorescence microscopy, flow cytometry and spectrophotometry. Inhibition of nitric oxide synthases (NOS) with N(G) -monomethyl-L-arginine (L-NMMA) resulted in reduced O(2) consumption (P < 0·0008, n = 8) and a lower fraction of cells with fluorescence from the NO-indicator 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate (DAF-FM) (P < 0·002, n = 8). PMNs stained with DAF-FM and the superoxide indicator hydroethidine (HE) and host cells with inducible NOS (iNOS) were identified in the sputum. In addition, the production of the stable end-products of NO in CF sputum was correlated with the concentration of PMNs; NO(3)(-) (P < 0·04, r = 0·66, n = 10) and NO(2)(-) (P< 0·006, r = 0·78, n = 11). The present study suggests that besides consumption of O(2) for production of reactive oxygen species, the PMNs in CF sputum also consume O(2) for production of NO. © 2014 British Society for Immunology.

  20. Belamcanda chinensis (L.) DC-An ethnopharmacological, phytochemical and pharmacological review.

    Science.gov (United States)

    Zhang, Le; Wei, Kunhua; Xu, Jianping; Yang, Dawei; Zhang, Chunhong; Wang, Zhipeng; Li, Minhui

    2016-06-20

    Belamcanda chinensis (L.) DC is the sole species in the genus Belamcanda Adans. (Iridaceae), found mainly in Northeast Asia. Bombus chinensis has long been used in traditional Chinese medicine for its multiple therapeutic uses in the form of antipyretic agents, antidote, expectorant, antiphlogistic and analgesic. This manuscript comprehensively summarizes the various studies published in recent years on the botany, ethnopharmacology, phytochemistry, biological activity and toxicology of B. chinensis. We hope to provide a foundation for future studies on the mechanism of action and development of better therapeutic agents based on B. chinensis. All information available on B. chinensis was collected using electronic search engines, such as PubMed, SciFinder Scholar, CNKI, TPL (www.theplantlist.org), Google Scholar and Web of Science. The analysis shown that ethno-medical uses of B. chinensis have been recorded in China, Japan and Korea since a long time. Based on a phytochemical investigation, this plant contains flavonoids, terpenoids, quinones, phenolic compounds, ketones, organic acids, etc. Crude extracts and pure compounds isolated from B. chinensis exhibited various biological effects. In light of its long traditional use and the modern phytochemical and pharmacological studies summarized here, B. chinensis is known to be a promising medicinal plant with the isolated extracts and chemical components showing a wide range of biological activities. Thus, it is imperative that the necessary programs and value assessment of B. chinensis be established for further studies. It is also important that the synergistic or antagonistic effects of this traditional herbal medicine are investigated in depth to identify more bioactive components by bioactivity-guided isolation strategies, and to illustrate the mechanisms of action targeting on ethnomedical uses. Future clinical studies can also focus on the main therapeutic aspects, toxicity and adverse effects of B

  1. Examination of the potential association of stress with morbidity and mortality outcomes in patient with heart failure.

    Science.gov (United States)

    Alhurani, Abdullah S; Dekker, Rebecca; Tovar, Elizabeth; Bailey, Alison; Lennie, Terry A; Randall, David C; Moser, Debra K

    2014-12-01

    The high mortality and morbidity rates associated with heart failure are still not well explained. A few psychosocial factors have been studied and explain some of this risk, but other factors, like stress, remain largely unexplored in heart failure. This study aimed to (1) examine the association of stress with 6-month cardiac event-free survival, (2) examine the relationship of stress with salivary cortisol, and (3) examine the association of salivary cortisol level with 6-month cardiac event-free survival. A total of 81 heart failure patients participated. Stress was measured using the brief Perceived Stress Scale. Cortisol was measured from unstimulated whole expectorated saliva. Cox regression analyses were used to determine whether stress predicted event-free survival, and if salivary cortisol predicted event-free survival. Linear and multiple regressions were used to determine the association of stress with salivary cortisol. Stress was not a significant predictor of event-free survival in heart failure (heart rate = 1.06; 95% confidence interval = 0.95-1.81; p = 0.32). Salivary cortisol was a significant predictor of event-free survival in the unadjusted model (heart rate = 2.30; 95% confidence interval = 0.99-5.927; p = 0.05), but not in the adjusted model. Stress (β 1.06; 95% confidence interval = 0.95-1.18; p = 0.32) was not a significant predictor of salivary cortisol level. Stress is a complex phenomenon, and our measure of stress may not have captured it well. Alternatively, the physical stressors acting in heart failure produce levels of neurohormonal activation that mask the effects of psychosocial stressors or an indirect association of stress with outcomes that is mediated through another construct. Future studies are needed to investigate stress in patients with heart failure to provide definitive answers.

  2. Human cytomegalovirus prevalence and distribution of glycoprotein B, O genotypes among hospitalized children with respiratory infections in West China, 2009-2014.

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    Chen, Jia-Yi; Zheng, Tian-Li; Zhou, Tao; Hu, Peng-Wei; Huang, Meng-Jiao; Xu, Xin; Pei, Xiao-Fang

    2016-11-01

    Human cytomegalovirus (HCMV) is an important pathogen causing morbidity and mortality in children. HCMV prevalence in children with respiratory infections has not been investigated in West China. Previous studies have suggested that glycoproteins genotypes may be associated with different clinical presentations, but the associations were controversial. The aim of this study was to determine the prevalence of HCMV infection in children with respiratory infections, the distributions of gB, gO genotypes among these isolates and their potential predictive roles for the development of symptoms in children. A total of 1709 respiratory specimens were obtained from hospitalised children with respiratory symptoms from 2009 to 2014 for the confirmation of HCMV infection. Glycoprotein B,O genotyping was carried out by multiplex nested PCR and sequencing. The overall infection rate was 10.8%, and dominant genotypes were gB1 (74.2%) and gO1 (37.1%). Clinical characteristics differed between infants and children >1 year of age. Infants infected with HCMV had a higher frequency of fever (P < 0.001), cough (P < 0.001), rhinorrhea (P < 0.001), expectoration (P = 0.001) and diarrhoea (P = 0.005). Children <1 year age infected with gB1 had a higher rate of cough (P = 0.0192). Infants infected with HCMV had a severe clinical outcome. gB1 may negatively associate with clinical presentations and quality of life in these children. The prevalence of HCMV infection and genotype distribution emphasises the importance of HCMV screening, vaccination and control for transmission. © 2016 John Wiley & Sons Ltd.

  3. Hyperinfection by Strongyloides stercoralis probably associated with Rituximab in a patient with mantle cell lymphoma and hyper eosinophilia Hiperinfección por Strongyloides stercoralis probablemente asociada con Rituximab en una paciente con linfoma e hipereosinofilia

    Directory of Open Access Journals (Sweden)

    Renzo Nino Incani

    2010-08-01

    Full Text Available The first report to our knowledge, of hyperinfection by Strongyloides stercoralis (HS and hypereosinophilia, associated to immune suppression by Rituximab (the only drug received for the last one year and 10 months, in a patient with mantle-cell lymphoma (MCL, is presented. The patient has a 3-year history of MCL, and developed two accesses of HS during 2008, including meningitis, pneumonia and presence of larvae of S. stercoralis in the lungs. We had a unique chance to look at cytotoxicity of filariform larvae in the expectoration after Ivermectin treatment, showing immobilization and death of larvae, associated with eosinophils attached to the cuticle of the parasite.Se presenta el primer reporte, hasta donde tengamos información, de hiperinfección por Strongyloides stercoralis (HS e hipereosinofilia asociados a inmunosupresión por Rituximab (el único medicamento recibido durante 1 año y 10 meses, en un paciente con linfoma de células del manto (LCM. La paciente tuvo una historia de 3 años con LCM, y desarrolló 2 accesos de HS durante el 2008, incluyendo meningitis, neumonía y presencia de larvas de S. stercoralis en los pulmones. Se tuvo la oportunidad única de observar la citotoxicidad contra las larvas filariformes en la expectoración, luego del tratamiento con Ivermectina, mostrando la inmovilización y muerte de las larvas, asociada a la presencia de eosinófilos adheridos a la cutícula del parásito.

  4. Clinical efficacy of farcosolvin syrup (ambroxol–theophylline–guaiphenesin mixture) in the treatment of acute exacerbation of chronic bronchitis

    Science.gov (United States)

    Yakoot, Mostafa; Salem, Amel; Omar, Abdel-Mohsen

    2010-01-01

    Background: Acute exacerbations of chronic bronchitis (AECB) are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin® (Pharco Pharmaceuticals, Alexandria, Egypt) is a mixture of ambroxol (15 mg); theophylline (50 mg); and guaiphenesin (30 mg), per 5 mL syrup. Objective: To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design. Patients and methods: One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC). Results: There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05). There were highly statistically significant differences between groups in improvement in breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin treatment group (P < 0.001). Out of 50 patients, 48 (96%) in the Farcosolvin-treated group rated their improvement on the CGIC scale as “much” and “very much” improved, while only 41 patients (82%) reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05). Conclusion: We concluded from our study that Farcosolvin syrup might be safe and effective in improving symptoms in cases of acute exacerbation of chronic bronchitis. PMID:20714379

  5. Topical ambroxol for the treatment of neuropathic pain. An initial clinical observation.

    Science.gov (United States)

    Kern, K-U; Weiser, T

    2015-12-01

    Neuropathic pain is difficult to treat, and the available options are often inadequate. The expectorant ambroxol also acts as a strong local anaesthetic and blocks sodium channels about 40 times more potently than lidocaine. It preferentially inhibits the channel subtype Nav 1.8, which is expressed especially in nociceptive C-fibres. In view of the low toxicity of ambroxol, it seemed reasonable to try using it for the treatment of neuropathic pain that failed to respond to other standard options. The medical records of seven patients with severe neuropathic pain and pain reduction following topical ambroxol treatment are reported retrospectively. As standard therapies had not proved sufficient, a topical ambroxol 20% cream was repeatedly applied by the patients in the area of neuropathic pain. The reasons for neuropathic pain were postherpetic neuralgia (2 ×), mononeuropathy multiplex, phantom pain, deafferentation pain, postoperative neuralgia and foot neuropathy of unknown origin. The individual mean pain intensity reported was between 4 and 6/10 (NRS), maximum pain at 6-10/10 (NRS). The pain reduction achieved individually following ambroxol cream was 2-8 points (NRS) within 5-30 min and lasted for 3-8 h. Pain attacks were reduced in all five patients presenting with this problem. Four patients with no improvement after lidocaine 5% and one patient with no response to capsaicin 8% nevertheless experienced a pain reduction with topical ambroxol. No patient reported any side effects or skin changes during a treatment that has since been continued for up to 4 years. Ambroxol acts as a strong local anaesthetic and preferentially inhibits the nociceptively relevant sodium channel subtype Nav 1.8. For the first time, we report below on a relevant pain relief following topical ambroxol 20% cream in patients with neuropathic pain. In view of the positive side effect profile, the clinical benefit in patients with pain should be investigated further.

  6. Ambroxol inhalation ameliorates LPS-induced airway inflammation and mucus secretion through the extracellular signal-regulated kinase 1/2 signaling pathway.

    Science.gov (United States)

    Zhang, Shui-juan; Jiang, Juan-xia; Ren, Qian-qian; Jia, Yong-liang; Shen, Jian; Shen, Hui-juan; Lin, Xi-xi; Lu, Hong; Xie, Qiang-min

    2016-03-15

    Ambroxol, a metabolite of bromhexine, is shown to exert several pharmacological activities, including secretolytic, anti-inflammatory and antioxidant actions. Oral and intravenous administration of ambroxol is useful for the airway inflammatory diseases. However, little is known about its potential in inhalation therapy for lipopolysaccharide (LPS)-induced mucous hypersecretion and inflammatory response. In the present study, we compared the pharmacological effects of ambroxol by inhalation with intravenous administration and preliminarily explored its mechanism of action. Our results demonstrated that ambroxol administered by inhalation inhibited MUC5AC expression, reduced glycosaminoglycan levels, enhanced the function of mucociliary clearance and promoted sputum excretion, suggesting that ambroxol increases expectoration of sputum by reducing its viscosity. Moreover, ambroxol significantly alleviated LPS-induced the influx of inflammatory cells and the extracellular signal-regulated kinase 1/2 (Erk 1/2) expression in lung tissues, and inhibited increases in the mRNA expression of the pro-inflammatory cytokines tumor necrosis factor (TNF)-α, CCL-2 (monocyte chemotactic protein-1), KC (keratinocyte cell protein) and interleukin (IL)-1β in lung tissues. The secretolytic and anti-inflammatory effects of inhaled ambroxol at a dose of 7.5 mg/ml was comparable to that of ambroxol at 20 mg/ml i.v. and dexamethasone at 0.5 mg/kg i.p. In addition, we found that ambroxol dose-dependently inhibited LPS-induced increases in the mRNA expression of MUC5AC, TNF-α, and IL-1β in human bronchial epithelial cell (NCI-H292) by inhibiting the Erk signaling pathway. These results demonstrate the beneficial effects of ambroxol in inhalation therapy for the airway inflammatory diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. [Topical ambroxol for the treatment of neuropathic pain: A first clinical observation. German version].

    Science.gov (United States)

    Kern, K-U; Weiser, T

    2015-12-01

    Neuropathic pain is difficult to treat and available options are frequently not sufficient. The expectorant ambroxol also works as a strong local anesthetic and blocks sodium channels about 40 times more potently than lidocaine. Ambroxol preferentially inhibits the channel subtype Nav 1.8, which is expressed particularly in nociceptive C fibers. Due to the low toxicity, topical ambroxol seemed to represent a reasonable therapeutic attempt for treatment of neuropathic pain resistant to other standard options. Medical records of 7 patients with severe neuropathic pain, in whom many attempts at treatment with approved substances were not sufficient or possible, are reported retrospectively. Patients were then treated with topical ambroxol 20% cream applied in the area of neuropathic pain. Causes of neuropathic pain were postherpetic neuralgia (2-×), mononeuropathy multiplex, phantom pain, deafferentation pain, postoperative neuralgia and an unclear allodynia of the foot. Mean pain intensity was reported as 4-6/10 on a numeric rating scale (NRS) and maximum pain intensity as 6-10/10. Pain reduction following ambroxol cream was 2-8 points (NRS) within 15-30 min and lasted 3-8 h. Pain attacks were reduced in all 5 patients presenting this problem. Topical ambroxol achieved pain reduction in 4 patients with no improvement after lidocaine 5% and 1 patient with no response to capsaicin 8%. No adverse events or skin changes have been observed, and the longest treatment duration is currently 4 years. Ambroxol acts as a strong local anesthetic and preferentially inhibits the nociceptive-relevant sodium channel subtype Nav 1.8. For the first time, we report relevant pain reduction following topical Ambroxol 20% cream in patients with neuropathic pain. Regarding the advantageous profile with rare side effects, the clinical benefit for pain patients should be further investigated.

  8. Clinical efficacy of farcosolvin syrup (ambroxol-theophylline-guaiphenesin mixture) in the treatment of acute exacerbation of chronic bronchitis.

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    Yakoot, Mostafa; Salem, Amel; Omar, Abdel-Mohsen

    2010-08-09

    Acute exacerbations of chronic bronchitis (AECB) are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin (Pharco Pharmaceuticals, Alexandria, Egypt) is a mixture of ambroxol (15 mg); theophylline (50 mg); and guaiphenesin (30 mg), per 5 mL syrup. To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design. One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC). There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05). There were highly statistically significant differences between groups in improvement in breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin treatment group (P < 0.001). Out of 50 patients, 48 (96%) in the Farcosolvin-treated group rated their improvement on the CGIC scale as "much" and "very much" improved, while only 41 patients (82%) reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05). We concluded from our study that Farcosolvin syrup might be safe and effective in improving symptoms in cases of acute exacerbation of chronic bronchitis.

  9. Cavitary lung lesion suspicious for malignancy reveals Mycobacterium xenopi.

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    Fogla, Sumit; Pansare, Vaishali M; Camero, Luis G; Syeda, Uzma; Patil, Naveen; Chaudhury, Arun

    2018-01-01

    We report the case of a 68-year-old gentleman who presented with musculoskeletal chest pain which appeared suddenly when he bent over with his dog. The chest pain was localized to the left lower chest and increased with movement and deep breathing. The patient did not complain weight loss, night sweat, fever or chill. He complained of mild cough, with expectoration of whitish mucus. Imaging revealed cavitary chest lesion in the right upper lobe, which was initially suspected to be lung cancer. The patient had a 50-year-old history of smoking 2 packs per day. PET CT imaging did not reveal any specific activity. Needle biopsy and bronchoalveolar lavage, however, did not reveal any malignant cells. Rather, necrotic tissues were observed. A wedge resection of the lung mass was performed. No common organisms or fungi could be grown. However, acid fast bacilli were observed in clumps. The morphology hinted towards non-tuberculous mycobacterial organism(s). Molecular studies revealed infection with Mycobacterium xenopi. The patient was started on an anti-tuberculous regimen of INH, rifampicin, ethambutol and PZA, with pyridoxine. The patient is a Vietnam veteran and complained of exposure to dust from a bird's nest and asbestos exposure in childhood, but no specific exposure to tuberculosis. The patient had an uneventful recovery post-surgery. He complained of some nausea after initiation of the antituberculous medications, but his pain subsided with time. The patient had diabetes, though specific reasons of compromise of immune status could not be pinpointed as causative of his nontuberculous mycobacterial lung infection.

  10. Effectiveness of the BDProbeTec ET system for detection of Mycobacterium tuberculosis complex in sputum and bronchoalveolar lavage specimens

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    Hung-Chang Hung

    Full Text Available OBJECTIVE: The diagnostic efficacy of the BDProbeTEC ET Mycobacterium tuberculosis (MTB complex direct detection assay (DTB performed on bronchoalveolar lavage (BAL specimens and sputum smears was compared with acid-fast bacilli (AFB smear microscopy. METHOD: AFB smear microscopy, DTB and culture results of 286 patients with pulmonary tuberculosis were retrospectively reviewed. A total of 120 patients provided expectorated sputum samples, and 166 patients provided BAL specimens. Culture results and clinical diagnosis were used as gold standards. RESULTS: The sensitivity and specificity of the DTB assay in detecting MTB in sputum specimens was significantly higher compared to AFB smear microscopy (83.7% and 82.4%, vs. 75.6%, and 41.2%, respectively. The sensitivity and specificity of the DTB assay in detecting MTB in sputum samples was 77.2% and 100% compared to clinical diagnosis, while AFB smear had a sensitivity and specificity of 70.3% and 26.3%, respectively. Compared to culture, DTB had a sensitivity and specificity of 82.8% and 93.2%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 41.9% and 87.7%, respectively. Compared to clinical diagnosis, DTB had a sensitivity and specificity of 67.2% and 100%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 34.8% and 79.5%, respectively. CONCLUSIONS: The superior performance of the DTB assay relative to AFB smear microscopy makes it a valuable tool to enable early diagnosis of MTB, thereby improving patient care and reducing transmission.

  11. [Long-term therapeutic effects of whole lung lavage in the management of silicosis].

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    Zhang, Ying-ming; Zhang, Hai-tao; Wang, Cai-ying; Wang, Wei; Wu, Jing; Wang, Chun

    2012-09-01

    To investigate the long-term therapeutic effect of whole lung lavage (WLL) in the treatment of silicosis. A total of 70 patients with silicosis were randomly and equally divided into WLL group and control group based on chest X-ray, silicosis staging, age, and working age of dust exposure. Comparative analysis was performed to evaluate the long-term therapeutic effect of WLL. Moreover, 157 patients with silicosis treated by WLL were subject to long-term follow-up. Two years after treatment, the cough, expectoration, and asthma improvement rates of the WLL group were 62.5% , 75.0% , and 81.8%, respectively, significantly higher than those (24.0%, 23.8%, and 26.3%) of the control group (P 0.05), while the control group showed significant decrease in FVC and FEV1 after treatment (P 0.05). 22 cases of accelerated silicosis in the WLL group had significantly higher no change rate than the control group with respect to chest X-ray (75.0% vs. 30.0%; 58.3% vs. 20.0%). The WLL group had lower progression rate (2 years of treatment) and significant progression rate (4 years after treatment) than the control group (16.7% vs. 50.0%, P silicosis stage was, the less FVC decreased. Follow-up of 108 cases treated by WLL showed that the lower silicosis stage was, the higher no change rate was, according to the chest X-ray findings 2 ∼ 3, 4 ∼ 5, and 6 ∼ 7 years after treatment and that there were significant differences in no change rate between stages II and III silicosis groups and stages 0+ and I silicosis groups (P silicosis, especially for early silicosis and accelerated silicosis. However, WLL should be used cautiously in the treatment of advanced silicosis.

  12. Piperidine alkaloids from Piper retrofractum Vahl. protect against high-fat diet-induced obesity by regulating lipid metabolism and activating AMP-activated protein kinase.

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    Kim, Kyung Jin; Lee, Myoung-Su; Jo, Keunae; Hwang, Jae-Kwan

    2011-07-22

    The fruits of Piper retrofractum Vahl. have been used for their anti-flatulent, expectorant, antitussive, antifungal, and appetizing properties in traditional medicine, and they are reported to possess gastroprotective and cholesterol-lowering properties. However, their anti-obesity activity remains unexplored. The present study was conducted to isolate the anti-obesity constituents from P. retrofractum Vahl. and evaluate their effects in high-fat diet (HFD)-induced obese mice. Piperidine alkaloids from P. retrofractum Vahl. (PRPAs), including piperine, pipernonaline, and dehydropipernonaline, were isolated as the anti-obesity constituents through a peroxisome proliferator-activated receptor δ (PPARδ) transactivation assay. The molecular mechanism was investigated in 3T3-L1 adipocytes and L6 myocytes. PRPA treatment activated AMP-activated protein kinase (AMPK) signaling and PPARδ protein and also regulated the expression of lipid metabolism-related proteins. In the animal model, oral PRPA administration (50, 100, or 300mg/kg/day for 8weeks) significantly reduced HFD-induced body weight gain without altering the amount of food intake. Fat pad mass was reduced in the PRPA treatment groups, as evidenced by reduced adipocyte size. In addition, elevated serum levels of total cholesterol, low-density lipoprotein cholesterol, total lipid, leptin, and lipase were suppressed by PRPA treatment. PRPA also protected against the development of nonalcoholic fatty liver by decreasing hepatic triglyceride accumulation. Consistent with the in vitro results, PRPA activated AMPK signaling and altered the expression of lipid metabolism-related proteins in liver and skeletal muscle. Taken together, these findings demonstrate that PRPAs attenuate HFD-induced obesity by activating AMPK and PPARδ, and regulate lipid metabolism, suggesting their potential anti-obesity effects. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Muc5b Is Required for Airway Defense

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    Roy, Michelle G.; Livraghi-Butrico, Alessandra; Fletcher, Ashley A.; McElwee, Melissa M.; Evans, Scott E.; Boerner, Ryan M.; Alexander, Samantha N.; Bellinghausen, Lindsey K.; Song, Alfred S.; Petrova, Youlia M.; Tuvim, Michael J.; Adachi, Roberto; Romo, Irlanda; Bordt, Andrea S.; Gabriela Bowden, M.; Sisson, Joseph H.; Woodruff, Prescott G.; Thornton, David J.; Rousseau, Karine; De la Garza, Maria M.; Moghaddam, Seyed J.; Karmouty-Quintana, Harry; Blackburn, Michael R.; Drouin, Scott M.; William Davis, C.; Terrell, Kristy A.; Grubb, Barbara R.; O’Neal, Wanda K.; Flores, Sonia C.; Cota-Gomez, Adela; Lozupone, Catherine A.; Donnelly, Jody M.; Watson, Alan M.; Hennessy, Corinne E.; Keith, Rebecca C.; Yang, Ivana V.; Barthel, Lea; Henson, Peter M.; Janssen, William J.; Schwartz, David A.; Boucher, Richard C.; Dickey, Burton F.; Evans, Christopher M.

    2014-01-01

    Respiratory surfaces are exposed to billions of particulates and pathogens daily. A protective mucus barrier traps and eliminates them via mucociliary clearance (MCC)1,2. However, excessive mucus contributes to transient respiratory infections and to the pathogenesis of numerous respiratory diseases1. MUC5AC and MUC5B are evolutionarily conserved genes that encode structurally related mucin glycoproteins, the principal macromolecules in airway mucus1,3. Genetic variants are linked to diverse lung diseases4-6, but specific roles for MUC5AC and MUC5B in MCC, and the lasting effects of their inhibition, are unknown. Here we show that Muc5b (but not Muc5ac) is required for MCC, for controlling infections in the airways and middle ear, and for maintaining immune homeostasis in the lungs. Muc5b deficiency caused materials to accumulate in upper and lower airways. This defect led to chronic infection by multiple bacterial species, including Staphylococcus aureus, and to inflammation that failed to resolve normally7. Apoptotic macrophages accumulated, phagocytosis was impaired, and IL-23 production was reduced inMuc5b−/− mice. By contrast, in Muc5b transgenic (Tg) mice, macrophage functions improved. Existing dogma defines mucous phenotypes in asthma and chronic obstructive pulmonary disease (COPD) as driven by increased MUC5AC, with MUC5B levels either unaffected or increased in expectorated sputum1,8. However, in many patients, MUC5B production at airway surfaces decreases by as much as 90%9-11. By distinguishing a specific role for Muc5b in MCC, and by determining its impact on bacterial infections and inflammation in mice, our results provide a refined framework for designing targeted therapies to control mucin secretion and restore MCC. PMID:24317696

  14. EPs 7630-solution--an effective therapeutic option in acute and exacerbating bronchitis.

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    Matthys, H; Heger, M

    2007-01-01

    Acute bronchitis is one of the most common diagnoses in ambulatory care medicine. Although the benefit of antibiotics for acute bronchitis, which is mostly virally induced, is disputed, they are often prescribed. A therapeutic option for respiratory tract infections that do not fall within the strict indication range for antibiotic administration is the liquid herbal drug preparation from the roots of Pelargonium sidoides, EPs 7630 (Umckaloabo), which has been tested against placebo in double-blind clinical trials. EPs 7630 has both antibacterial and immuno-modulating properties. The efficacy and tolerability of EPs 7630 was investigated in a prospective, open, multicentric outcomes study with 205 patients suffering from acute bronchitis or acute exacerbation of chronic bronchitis. The main outcome measure was the change in the total score of five symptoms typical for bronchitis (cough, expectoration, wheezing/whistling on expiration, chest pain during coughing, and dyspnoea), which were each rated using a 5-point scale (from 0=not present to 4=extremely pronounced). Further symptoms (hoarseness, headache, aching limbs and fatigue) were assessed using a four-point scale (from 0=not present to 3=very pronounced). The total score of the typical bronchitis symptoms amounted to 6.1+/-2.8 points on average at the start of treatment and decreased by 3.3+/-3.8 points to 2.8+/-2.6 points by the final examination on day 7. About 60.5% of the patients assessed their health condition at the end of the study as much improved or free from symptoms. The onset of action appeared after two days on average. Adverse events occurred in a total of 16 patients. There were no serious adverse events. Altogether, 78% of the patients were satisfied or very satisfied with the treatment.

  15. Manual evaluation of the diaphragm muscle

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    Bordoni B

    2016-08-01

    Full Text Available Bruno Bordoni,1–3 F Marelli,2,3 B Morabito,2–4 B Sacconi5 1Department of Cardiology, Foundation Don Carlo Gnocchi IRCCS, Institute of Hospitalization and Care with Scientific Address, Milan, 2CRESO, School of Osteopathic Centre for Research and Studies, Castellanza, 3CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima, 4Foundation Polyclinic University A Gemelli, University Cattolica del Sacro Cuore, 5Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy Abstract: The respiratory diaphragm is the most important muscle for breathing. It contributes to various processes such as expectoration, vomiting, swallowing, urination, and defecation. It facilitates the venous and lymphatic return and helps viscera located above and below the diaphragm to work properly. Its activity is fundamental in the maintenance of posture and body position changes. It can affect the pain perception and emotional state. Many authors reported on diaphragmatic training by using special instruments, whereas only a few studies focused on manual therapy approaches. To the knowledge of the authors, the existing scientific literature does not exhaustively examines the manual evaluation of the diaphragm in its different portions. A complete evaluation of the diaphragm is mandatory for several professional subjects, such as physiotherapists, osteopaths, and chiropractors not only to elaborate a treatment strategy but also to obtain information on the validity of the training performed on the patient. This article aims to describe a strategy of manual evaluation of the diaphragm, with particular attention to anatomical fundamentals, in order to stimulate further research on this less explored field. Keywords: diaphragm, osteopathic evaluation, manual therapy, chiropractic, physiotherapy

  16. PNEUMONIA IN NURSING HOME RESIDENTS

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    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  17. A modified scoring system to describe gross pathology in the rabbit model of tuberculosis

    Science.gov (United States)

    2011-01-01

    Background The rabbit model is an ideal means to study the pathogenesis of tuberculosis due to its semblance to the disease in humans. We have previously described the results using a bronchoscopic route of infection with live bacilli as a reliable means of generating lung cavities in sensitized rabbits. The role of sensitization in the development of disease outcomes has been well established in several animal models. We have described here the varying gross pathology that result from lack of sensitization with heat-killed M. bovis prior to high-dose bronchoscopic infection with live bacilli. Results Rabbits lacking sensitization did not generate lung cavities, but instead formed solely a tuberculoid pneumonia that replaced the normal lung parenchyma in the area of infection. Extrapulmonary dissemination was seen in approximately equal frequency and distribution in both rabbit populations. Notable differences include the lack of intestinal lesions in non-sensitized rabbits likely due to the lack of ingestion of expectorated bacilli from cavitary lesions. The experiment also employed a modified scoring system developed initially in the primate model of tuberculosis to allow for the quantification of findings observed at necropsy. Conclusions To date, no such scoring system has been employed in the rabbit model to describe gross pathology. The quantitative methodology would allow for rapid comparative analyses and standardization of thoracic and extrapulmonary pathology that could be evaluated for statistical significance. The aim is to use such a scoring system as the foundation for all future rabbit studies describing gross pathology at all stages in TB pathogenesis. PMID:21375756

  18. A modified scoring system to describe gross pathology in the rabbit model of tuberculosis

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    Osborne Jonathan

    2011-03-01

    Full Text Available Abstract Background The rabbit model is an ideal means to study the pathogenesis of tuberculosis due to its semblance to the disease in humans. We have previously described the results using a bronchoscopic route of infection with live bacilli as a reliable means of generating lung cavities in sensitized rabbits. The role of sensitization in the development of disease outcomes has been well established in several animal models. We have described here the varying gross pathology that result from lack of sensitization with heat-killed M. bovis prior to high-dose bronchoscopic infection with live bacilli. Results Rabbits lacking sensitization did not generate lung cavities, but instead formed solely a tuberculoid pneumonia that replaced the normal lung parenchyma in the area of infection. Extrapulmonary dissemination was seen in approximately equal frequency and distribution in both rabbit populations. Notable differences include the lack of intestinal lesions in non-sensitized rabbits likely due to the lack of ingestion of expectorated bacilli from cavitary lesions. The experiment also employed a modified scoring system developed initially in the primate model of tuberculosis to allow for the quantification of findings observed at necropsy. Conclusions To date, no such scoring system has been employed in the rabbit model to describe gross pathology. The quantitative methodology would allow for rapid comparative analyses and standardization of thoracic and extrapulmonary pathology that could be evaluated for statistical significance. The aim is to use such a scoring system as the foundation for all future rabbit studies describing gross pathology at all stages in TB pathogenesis.

  19. USE OF FRESH PARTS OF MEDICINAL PLANTS FOR HEALTH AND PRODUCTION IN LIVESTOCK – A NEW CONCEPT OF FARMING

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    Shibabrata Pattanayak

    2013-06-01

    Full Text Available Farm animals are reared for production to meet up the demand for animal protein in human. Various modern medicines are extensively used for production as well as treatment and prevention of diseases of animals, which can ultimately reach us through food chain. Herbs are now considered as an important source of alternative medicines. The Ayurvedic medicines prepared by manufacturers contain processed plant parts and added with preservative and other chemicals in many cases. The present way of research on herbal medicine follows the path of identification of active principles from the extracts of preserved parts of medicinal plants after testing of their efficacy in laboratory. This concept of research have the limitation of loss of many aromatic and other phytochemicals present in the living plant, which may have very important role when used together. Animals maintained in modern farm may be given relief from modern medicines in minor and moderate ailments, cure of problems related with their production with the validated fresh plant medicine available from the plants cultivated adjacent to the farm area. Consulting the reports of ethno-botanical study, a preliminary list of medicinal plant is prepared which are having antipyretic, analgesic, wound healing, immunostimulant, hepato-protective, fertility enhancing, pregnancy assisting, lactation assisting, anthelmintic, astringent, expectorant, purgative and anti-flatulent, nutriceutical, antiseptic, anti-dermatitis, anti-dysenteric and anti-enteric, hematenic, stomachic, diuretic and kidney stone removing effects and insecticidal or insect repelling effects. This list may be enriched further and plants may be selected for a farm from these groups according to the agro-climatic condition of the area, disease prevalence, problems encountered during farming practice and other requirements of the farm. Validation of reported effects of the plants is to be performed in fresh condition, so that parts

  20. Oral fat exposure increases the first phase triacylglycerol concentration due to release of stored lipid in humans.

    Science.gov (United States)

    Mattes, Richard D

    2002-12-01

    Oral exposure to dietary fat (through modified sham feeding, which entails mastication and expectoration of foods) augments the postprandial triacylglycerol (TAG) concentration, in part, though augmented lipid absorption. This study was designed to characterize early events in this process. At 2200 h, 25 healthy adults (13 men, 12 women) consumed 80 g of almonds (high oleic acid content) and fasted until approximately 0700 h. After placement of a catheter in a hand vein and 4 blood draws at 10-min intervals, 50 1-g safflower oil (high linoleic acid content) capsules were consumed. After another blood draw, modified sham feeding was initiated with a cracker only or cracker with cream cheese in random order with 1 wk between trials. Oral exposures occurred at 5-min intervals for 60 min then at 15-min intervals from min 60 to 120. Additional blood draws occurred at 2, 4, 6, 8, 10, 12, 14, 30, 60, 120, 240, 360 and 480 min. Oral stimulation, especially by fat, prompted the rapid (mean approximately 23 min) release of lipid stored from the previous meal (almonds) in all participants. This resulted in multimodal postprandial triacylglycerol (TAG) peaks generally occurring at 0-30 min, 60-120 min and 240-480 min after loading and initiation of oral stimulation. TAG magnitudes during these times were correlated (r = 0.40-0.89, P absorption of meal lipid; this in turn supplements a later peak associated with release of endogenously synthesized TAG because lipid from all three sources competed for a common clearance mechanism. If substantiated, additional understanding of the behavioral factors (e.g., eating patterns) that initiate this cascade will be warranted.

  1. CLINICAL AND LABORATORY PROFILE OF SPUTUM POSITIVE PULMONARY TUBERCULOSIS AMONG HIV SEROPOSITIVE AND HIV SERONEGATIVE PATIENTS- A CROSS-SECTIONAL STUDY

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    Amit Govind Kamat

    2017-05-01

    Full Text Available BACKGROUND The global impact of the converging dual epidemics of TB and HIV is one of the major public health challenges. The increasing rate of HIV infection in many countries has had an impact on TB epidemiology. As the prevalence of pulmonary tuberculosis is increasing among HIV seropositive patients with a wide range of immune status and clinical presentations, the present study was undertaken to assess the clinical and laboratory profile of sputum positive pulmonary tuberculosis among HIV seropositive and HIV seronegative patients. MATERIALS AND METHODS The present one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 104 patients with sputum positive pulmonary tuberculosis patients during the period of January 2009 to December 2009. Routine investigations such as blood group, haemogram that is haemoglobin, total count, differential count, erythrocyte sedimentation rate, sputum smears for AFB and chest x-ray were done. RESULTS Seroprevalence of HIV among pulmonary tuberculosis patients was 23.08%. On examination anaemia, undernourishment, lymphadenopathy and the presence of opportunistic infections like oral candidiasis, herpes zoster stain and genital lesions were more predominant among HIV seropositives compared to HIV seronegatives. Mean Hb and TLC were significantly low among HIV seropositives compared to HIV seronegatives. Chest x-ray showed varied presentation. Upper zone infiltration, cavitation and fibrosis were more commonly involved among HIV seronegatives compared to HIV seropositives. CONCLUSION HIV seropositive PTB patients commonly present with fever, weight loss and loss of appetite, while cough with expectoration, haemoptysis, breathlessness were more common with HIV seronegative patients. Cavitation, fibrosis and fibrocavitary lesions were predominantly seen among HIV seronegatives, while infiltration and miliary mottling was

  2. Development of a new ultra-high performance liquid chromatography - tandem mass spectrometry method for determination of ambroxol hydrochloride in serum with pharmacokinetic application

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    Vujović Maja M.

    2016-01-01

    Full Text Available Ambroxol hydrochloride is an expectorant agent, successfully applied in mucolytic therapy for acute and chronic bronchopulmonary diseases. The drug regulates not only mucus secretion but also showed antioxidant, anti-inflammatory and local anesthetic properties. To supplement the pharmacokinetic and toxicological studies of ambroxol, a rapid ultra-high performance liquid chromatography-tandem mass spectrometry method for the quantitation of ambroxol in rabbit serum was developed. A validation of the method was performed as per the ICH guidelines for the validation of bioanalytical methods. The chromatographic separation was achieved in a submicron Kinetex RP - C18 - column (2.1 mm x 50 mm, 1.3μm using the no buffer mobile phase. The ESI mass spectrometry in the MRM mode was used with a typical transitions m/z 378.9→263.8 for ambroxol and m/z 455.2→165.0 for IS. Linearity was determined with an average coefficient of determination >0.999 over the dynamic range from 0.5 - 200 ng/mL with LOD and LOQ of 0.25 ng/mL and 0.5 ng/mL, respectively. The results of the intra- and inter-day precision and accuracy determined in different days were all found to be within the acceptable limits ±15%. The present method was successfully applied to pharmacokinetic study in the rabbits after a single oral dose administration. [Projekat Ministarstva nauke Republike Srbije, br. 175045

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

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    Diwan, J; Dhand, R; Jindal, S K; Malik, S K; Sharma, P L

    1982-08-01

    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.

  4. Rapid transport of muco-inert nanoparticles in cystic fibrosis sputum treated with N-acetyl cysteine.

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    Suk, Jung Soo; Lai, Samuel K; Boylan, Nicholas J; Dawson, Michelle R; Boyle, Michael P; Hanes, Justin

    2011-02-01

    Sputum poses a critical diffusional barrier that strongly limits the efficacy of drug and gene carriers in the airways of individuals with cystic fibrosis (CF). Previous attempts to enhance particle penetration of CF sputum have focused on either reducing its barrier properties via mucolytics, or decreasing particle adhesion to sputum constituents by coating the particle surface with non-mucoadhesive polymers, including polyethylene glycol (PEG). Neither approach has enabled particles to penetrate expectorated sputum at rates previously observed for non-mucoadhesive nanoparticles in human cervicovaginal mucus. Here, we sought to investigate whether a common mucolytic, N-acetyl cysteine (NAC), in combination with dense PEG coatings on particles, can synergistically enhance particle penetration across fresh undiluted CF sputum. We used high-resolution multiple particle tracking to measure the diffusion of uncoated and PEG-coated nanoparticles in native and NAC-treated CF sputum. We discovered that 200 nm particles, if densely coated with PEG, were able to penetrate CF sputum pretreated with NAC with average speeds approaching their theoretical speeds in water. Based on the rapid penetration of PEG-coated particles in NAC-treated sputum, we determined that the average spacing between sputum mesh elements was increased from 145 ± 50 nm to 230 ± 50 nm upon NAC treatment. Mathematical models based on particle transport rates suggest as much as 75 and 30% of 200 and 500 nm PEG-coated particles, respectively, may penetrate a physiologically thick NAC-treated CF sputum layer within 20 min. Uncoated particles were trapped in CF sputum pretreated with NAC nearly to the same extent as in native sputum, suggesting that NAC treatment alone offered little improvement to particle penetration. NAC facilitated rapid diffusion of PEG-coated, muco-inert nanoparticles in CF sputum. Our results provide a promising strategy to improve drug and gene carrier penetration in CF sputum

  5. Rhinoviruses as an underestimated cause of influenza-like illness in pregnancy during the 2009-2010 influenza pandemic.

    Science.gov (United States)

    Pilorgé, Léa; Chartier, Mélanie; Méritet, Jean-François; Cervantes, Minerva; Tsatsaris, Vassilis; Launay, Odile; Rozenberg, Flore; Krivine, Anne

    2013-08-01

    During the 2009-2010 influenza pandemic, pregnant women were identified at high risk for severe infection. In case of influenza-like illness they were systematically treated with oseltamivir. When performed, virological diagnosis showed that some of these women were not influenza-infected. The objectives of the study were to identify viruses which could induce an influenza-like illness in pregnant women during the 2009-2010 pandemic, then to establish possible links between detected viruses and symptoms, and then characterize human rhinoviruses (HRV) strains detected in some samples. Nasal swabs from 78 pregnant women presenting with influenza-like illness and previously tested for influenza virus by RT-PCR in 2009-2010 were further assayed by multiplex RespiFinder assay and bocavirus PCR to search for 13 other viruses. Genotyping of HRV strains was carried out using partial genomic sequencing in the VP4/VP2 region. Influenza A virus infection was confirmed in 33 women (42%). Non-influenza viruses were detected in 18 additional cases (23%). Rhinoviruses were the most numerous (13%) and belonged to 9 different genotypes distributed between the 3 genogroups. When comparing symptoms observed in influenza-infected women and women infected by other viruses, shivers were more frequent in the former group (P=0.02), and expectorations in the latter (P=0.03). During the influenza pandemic 2009-2010, non-influenza viruses and mostly rhinoviruses were an underestimated cause of influenza-like illness in pregnant women. Viral diagnosis should help to stop empiric oseltamivir therapy in influenza-negative patients and antibiotic treatment in patients infected with a non-influenza virus. Copyright © 2013 Wiley Periodicals, Inc.

  6. Lobar pneumonia caused by Ralstonia pickettii in a sixty-five-year-old Han Chinese man: a case report

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    Dong Mei

    2011-08-01

    Full Text Available Abstract Introduction Ralstonia pickettii is a gram-negative, oxidase-positive bacillus and is an emerging pathogen found in infections described in hospital settings. The cases reported in the literature mostly are nosocomial infections due to contaminated blood products, sterile water, saline, treatment fluids and venous catheters. Human infection unrelated to contaminated solutions is rare. We report a case of lobar pneumonia and pulmonary abscess caused by Ralstonia pickettii in an older patient. Case presentation A sixty-five-year old Han Chinese man presented having had cough, expectoration, chest pain and fever lasting for twenty days. His medical history was notable for hypertension over the previous ten years, and the habit of smoking for forty years. A thoracic computed tomography scan supported the diagnosis of right-sided lobar pneumonia. A lung biopsy was done and pathological analysis confirmed lobar pneumonia. Two lung biopsy specimens from separate sites grew Ralstonia pickettii. After six days, a repeat thoracic scan revealed a right-sided abscess. A thoracentesis was performed and the purulent fluid grew Ralstonia pickettii. The chest tube remained inserted to rinse the cavity with sterile sodium chloride. He received an antibiotic course of intravenous cefoperazone sodium-sulbactam sodium for eighteen days and imipenem-cilastatin for twelve days. A repeat chest X-ray revealed resolution of the pulmonary abscess and improvement of pneumonia. He remained afebrile and free of respiratory symptoms after treatments. Conclusion This case demonstrates a Ralstonia pickettii infection in the absence of an obvious nosocomial source. It is possible that such cases will become common in the future. Therefore, further studies are needed to evaluate its sensitivity to common antibiotics.

  7. MDGC-MS analysis of essential oils from Protium heptaphyllum (Aubl. and their antifungal activity against Candida specie

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    M. MOBIN

    Full Text Available ABSTRACT Protium heptaphyllum is found in the Amazon region, and in various Brazilian states and South American countries. Also Known as almecega, it produces an oil resin used in traditional medicine as analgesic, anti-inflammatory, cicatrizant and expectorant, it is rich in pentacyclic triterpenes and essential oil. The main objective of this study was to analyze the chemical composition of P. heptaphyllumresin (OEPh over different extraction times and to evaluate their antifungal activity against Candida species, obtained from gardeners with onychomycosis, using the disk diffusion method. The OEPh was obtained by hydrodistillation and analyzed by Multidimensional Gas Chromatography coupled with Mass Spectrometry (MDGC / MS. Candida species were obtained from lesions on the nails of horticulturist from a community garden in the city of Teresina, Piauí, Brazil. The antifungal activity in concentrations of 1000 µg/L, 500 µg/L and 250 µg/L, PROTOCOL M44-A2 (CLSI 2009 OEPh was tested. The main constituents identified were: l-limonene, α-terpineol, p-cineol, o-cymene and α-phellandrene, however, its composition varies significantly with extraction time. All species, except C. rugosa, were inhibited with halo (≥ 14 mm at 1000 μg / L. C. krusei is naturally resistant to the drug fluconazole, but when tested with OEPh the clinical species (case 9 demonstrated sensitivity in three dilutions (halo ≤ 10 ≥ 14 and the standard strain was inhibited at concentration of 1000 μg/Lg / L (halo 14mm. A similar situation also occurred with the standard strain of C. parapsilosis (halo ≥ 11mm. OEPh has considerable antifungal activity, which merits further investigation for alternative clinical applications, since this species is widely distributed in our community, and it presents good yields, and also has important therapeutic applications.

  8. Effects of Peanut Processing on Masticatory Performance during Variable Appetitive States

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    Fiona McKiernan

    2010-01-01

    Full Text Available Background. Current evidence indicates that peanut consumption reduces cardiovascular disease risk, while posing little threat to positive energy balance. However, questions have been raised as to whether inter- and intraindividual variability in mastication in response to peanut form and processing properties may influence these health effects, since mastication has the potential to alter the bioaccessibility of nutrients within the nut matrix. Objective. To explore the relationship between peanut form and processing and masticatory function. Subjects/Methods. Thirty nine adults (16 M, 23 F; BMI: 30.4±4.0 kg/m2; age: 27±8 y with healthy dentition chewed four different forms of peanuts until they would normally swallow and then expectorated the bolus. Surface electromyograms (EMGs were obtained from the masseter and temporalis muscles during chewing of the four test foods. The maximum and mean bite forces, duration of chewing sequence, number of chews, and total muscle work for the complete chewing cycle were measured on the integrated EMG in fasted and sated states. Results. While no significant differences were noted in response to appetitive state, peanut form and processing had a significant influence on masticatory efficiency, as measured by proportional particle size distributions. The processed peanuts (honey roasted, roasted salted, and roasted unsalted were chewed significantly fewer times compared to the unprocessed form (raw. Further, the proportional particle sizes within the swallowing bolus were significantly larger for the processed forms compared to the unprocessed form. Conclusion. These observations may have implications for bioaccessibility of energy and cardioprotective nutrients as well as endocrine responses, following peanut consumption.

  9. Effect of mastication on lipid bioaccessibility of almonds in a randomized human study and its implications for digestion kinetics, metabolizable energy, and postprandial lipemia1234

    Science.gov (United States)

    Grundy, Myriam ML; Grassby, Terri; Mandalari, Giuseppina; Waldron, Keith W; Butterworth, Peter J; Berry, Sarah EE

    2015-01-01

    Background: The particle size and structure of masticated almonds have a significant impact on nutrient release (bioaccessibility) and digestion kinetics. Objectives: The goals of this study were to quantify the effects of mastication on the bioaccessibility of intracellular lipid of almond tissue and examine microstructural characteristics of masticated almonds. Design: In a randomized, subject-blind, crossover trial, 17 healthy subjects chewed natural almonds (NAs) or roasted almonds (RAs) in 4 separate mastication sessions. Particle size distributions (PSDs) of the expectorated boluses were measured by using mechanical sieving and laser diffraction (primary outcome). The microstructure of masticated almonds, including the structural integrity of the cell walls (i.e., dietary fiber), was examined with microscopy. Lipid bioaccessibility was predicted by using a theoretical model, based on almond particle size and cell dimensions, and then compared with empirically derived release data. Results: Intersubject variations (n = 15; 2 subjects withdrew) in PSDs of both NA and RA samples were small (e.g., laser diffraction; CV: 12% and 9%, respectively). Significant differences in PSDs were found between these 2 almond forms (P masticated particles, as predicted by using the mathematical model (8.5% and 11.3% for NAs and RAs, respectively). This low percentage of lipid bioaccessibility is attributable to the high proportion (35–40%) of large particles (>500 μm) in masticated almonds. Microstructural examination of the almonds indicated that most intracellular lipid remained undisturbed in intact cells after mastication. No adverse events were recorded. Conclusions: Following mastication, most of the almond cells remained intact with lipid encapsulated by cell walls. Thus, most of the lipid in masticated almonds is not immediately bioaccessible and remains unavailable for early stages of digestion. The lipid encapsulation mechanism provides a convincing explanation for

  10. Effect of mastication on lipid bioaccessibility of almonds in a randomized human study and its implications for digestion kinetics, metabolizable energy, and postprandial lipemia.

    Science.gov (United States)

    Grundy, Myriam M L; Grassby, Terri; Mandalari, Giuseppina; Waldron, Keith W; Butterworth, Peter J; Berry, Sarah E E; Ellis, Peter R

    2015-01-01

    The particle size and structure of masticated almonds have a significant impact on nutrient release (bioaccessibility) and digestion kinetics. The goals of this study were to quantify the effects of mastication on the bioaccessibility of intracellular lipid of almond tissue and examine microstructural characteristics of masticated almonds. In a randomized, subject-blind, crossover trial, 17 healthy subjects chewed natural almonds (NAs) or roasted almonds (RAs) in 4 separate mastication sessions. Particle size distributions (PSDs) of the expectorated boluses were measured by using mechanical sieving and laser diffraction (primary outcome). The microstructure of masticated almonds, including the structural integrity of the cell walls (i.e., dietary fiber), was examined with microscopy. Lipid bioaccessibility was predicted by using a theoretical model, based on almond particle size and cell dimensions, and then compared with empirically derived release data. Intersubject variations (n = 15; 2 subjects withdrew) in PSDs of both NA and RA samples were small (e.g., laser diffraction; CV: 12% and 9%, respectively). Significant differences in PSDs were found between these 2 almond forms (P masticated particles, as predicted by using the mathematical model (8.5% and 11.3% for NAs and RAs, respectively). This low percentage of lipid bioaccessibility is attributable to the high proportion (35-40%) of large particles (>500 μm) in masticated almonds. Microstructural examination of the almonds indicated that most intracellular lipid remained undisturbed in intact cells after mastication. No adverse events were recorded. Following mastication, most of the almond cells remained intact with lipid encapsulated by cell walls. Thus, most of the lipid in masticated almonds is not immediately bioaccessible and remains unavailable for early stages of digestion. The lipid encapsulation mechanism provides a convincing explanation for why almonds have a low metabolizable energy content and

  11. Farmacobotânica, fitoquímica e farmacologia do Guaco: revisão considerando Mikania glomerata Sprengel e Mikania laevigata Schulyz Bip. ex Baker Morpho-anatomy, phytochemistry and pharmacology of Mikania glomerata Sprengel: a brief literature review

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    K.E. Czelusniak

    2012-01-01

    Full Text Available As plantas medicinais vêm sendo cada vez mais utilizadas devido às suas propriedades preventivas, paleativas e curativas, além de ser uma terapia alternativa que traz inúmeros benefícios aos usuários. As espécies Mikania glomerata e M. laevigata pertencem à família Asteraceae e são popularmente conhecidas como guaco sendo utilizadas no tratamento de enfermidades do trato respiratório. Além disso, as duas espécies são frequentemente confundidas ou citadas na literatura de forma errada. O presente trabalho teve por objetivo realizar uma revisão bibliográfica sobre a farmacologia, farmacobotânica e fitoquímica dos metabólitos secundários de Guaco, tendo destaque a cumarina, a biossíntese e as ações biológicas. As ações broncodilatadora, expectorante, anti-inflamatória e antialérgica, além de interações com alguns antibióticos e anticoagulantes, também foram descritas neste estudo.Medicinal plants have been increasingly used due to their preventive, palliative and curative properties, besides being an alternative therapy that brings a large number of benefits to their users. The species Mikania glomerata belongs to the Asteraceae family and is popularly known as guaco, being employed to treat diseases of the respiratory tract. This study aimed to carry out a literature review about the pharmacology, pharmacobotany and phytochemistry of the secondary metabolites of M. glomerata, particularly coumarin, its biosynthesis and biological actions. The bronchodilator, expectorant, anti-inflammatory and antiallergic actions, as well as the interactions with some antibiotics and anticoagulants, were also described in this study.

  12. [On the evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes (author's transl)].

    Science.gov (United States)

    Möse, J R; Fischer, G

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. These possibilities of interpretation regarding a biological ionic effect are supported, with reservations (e.g. effects produced by a change in climate), by positive medical effects during and after a stay in a well-ventilated mountain climate or also in a sea-climate. Owing to their lower mobility the large ions are inhaled as small ions to an increasing extent. The chemical and physical noxa are delivered and deposited in the respiratory tract. They "stick" the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements is reduced. Similar effects are known to be caused also by nicotine abuse. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases and to catarrh. The changed ionisation of air in urbanised areas (mainly large ions in high concentrations) definitely represents only one of the many risk factors. In addition to the attempt to characterize bioclimatically local weather conditions by means of the non-conventional parameter "air ionisation" our study has also been intended to establish biologically oriented criteria for the living in a high-rise building in a particularly unfavourable location. Under specific microclimatic conditions the uppermost storeys were at times bioclimatically favoured over the lowermost, especially when shallow air inversion is present. In such cases, small ions exclusively were registered in the upper storeys and large ions in the lower floors.

  13. Evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes

    Energy Technology Data Exchange (ETDEWEB)

    Moese, J.R.; Fischer, G.

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. These possibilities of interpretation regarding a biological ionic effect are supported, with reservations by positive medical effects during and after a stay in a well-ventilated mountain climate or also in a sea-climate. Owing to their lower mobility the large ions are inhaled as small ions to an increasing extent. The chemical and physical noxa are delivered and deposited in the respiratory tract. They stick the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements is reduced. Similar effects are known to be caused also by nicotine abuse. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases and to catarrh. The changed ionisation of air in urbanised areas definitely represents only one of the many risk factors. In addition to the attempt to characterize bioclimatically local weather conditions by means of the non-conventional parameter air ionisation our study has also been intended to establish biologically oriented criteria for the living in a high-rise building in a particularly unfavourable location. Under specific microclimatic conditions the uppermost storeys were at times bioclimatically favoured over the lowermost, especially when shallow air inversion is present. In such cases, small ions exclusively were registered in the upper storeys and large ions in the lower floors.

  14. Real-Life Clinical Practice of Using the Xpert MTB/RIF Assay in Thailand.

    Science.gov (United States)

    Kawkitinarong, Kamon; Suwanpimolkul, Gompol; Kateruttanakul, Pairaj; Manosuthi, Weerawat; Ubolyam, Sasiwimol; Sophonphan, Jiratchaya; Avihingsanon, Anchalee; Ruxrungtham, Kiat

    2017-05-15

    Delayed diagnosis of tuberculosis (TB) and drug-resistant TB are major challenges of TB control in Thailand. This study assessed the practicality of the Xpert MTB/RIF assay in a real-life setting with high prevalence of human immunodeficiency virus (HIV) infection and pulmonary tuberculosis (PTB). This prospective study was conducted at 3 large tertiary care hospitals. Patients who had suspected PTB were enrolled into the study. Expectorated sputum samples were sent for staining, mycobacterial culture, and Xpert MTB/RIF. Four hundred ninety-four patients were enrolled. From 355 cases with final diagnosis of PTB, 263 (71.8%) had definite diagnosis and 92 cases had probable diagnosis. Among TB culture-positive cases, Xpert MTB/RIF had 100% and 81% sensitivity in sputum smear-positive and smear-negative groups, respectively. The specificity was 95.7%. The sensitivity and positive predictive value of Xpert MTB/RIF in culture-negative but clinically diagnosed PTB was 37.8% and 83.8%, respectively. Centrifugation was required in 59% cases with scanty sputum. Five cases were false-positive by Xpert MTB/RIF in patients with nontuberculous mycobacteria, old PTB scar, and immune reconstitution syndrome. Discordant rifampicin susceptibility results of Xpert MTB/RIF and mycobacteria growth indicator tube (MGIT) were confirmed by using rpoB gene sequencing, which raised the sensitivity of Xpert MTB/RIF in detecting rifampicin resistance to 93.8%. Xpert MTB/RIF is an effective tool in diagnosing PTB but will be more cost-effective for sputum-negative patients and in settings with high prevalence of rifampicin resistance. Early diagnosis of TB results in early treatment and implementation of strategies to limit spreading of TB. Sputum centrifugation may increase the yield of Xpert MTB/RIF.

  15. Investigating the altitude effect on the quantity and quality of the essential oil in Tanacetum polycephalum Sch.-Bip. polycephalum in the Baladeh region of Nour, Iran.

    Science.gov (United States)

    Mahdavi, M; Jouri, M H; Mahmoudi, J; Rezazadeh, F; Mahzooni-Kachapi, S S

    2013-09-01

    Medicinal plant are grown and produced in different ecosystems and sites under the influence of different potential factors, including the altitude as one of the vital determinants in the quantity and quality of the plants. One of the species that grows in the highlands is Tanacetum polycephalum, an aromatic perennial of the Asteraceae. This species is characterized to be antiseptic, analgesic, anesthetic, disinfective, expectorant, anti-cancer, anti-allergic, and conducive to low blood pressure. The purpose of this study is to investigate the essential compositions in the aerial parts of T. polycephalum at the time of flowering, and in three different altitudes of the Baladeh region of Nour. Thus, the essential oil was extracted from the aerial parts in the flowering stage of the plant at three altitudes of 1 600, 2 400 and 3 200 m using a water distillation method, and the essential oil compositions were identified using GC and GC/MS instruments. One-way ANOVA method was conducted to analyze the obtained data using SPSS, and a Duncan test was administered to compare the means. The results indicated that the essential output obtained from the altitudes of 1 600, 2 400 and 3 200 m was (0.74 ± 0.01)%, (1.09 ± 0.02)%, and (1.32 ± 1.2)%, respectively, so that the altitude of 3 200 m revealed the greatest quantity, and the altitude of 1 600 m represented the smallest quantity. Moreover, the essential oil compositions showed the highest percentage in the altitude of 3 200 m and the lowest percentage at the altitude of 1 600 m. The results showed that as the altitude increases, the essential oil compositions revealed the greater quantity and percentage in the aerial parts of T. polycephalum. Copyright © 2013 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

  16. Prevalence of acute respiratory symptoms in breath-hold divers.

    Science.gov (United States)

    Cialoni, Danilo; Sponsiello, Nicola; Marabotti, Claudio; Marroni, Alessandro; Pieri, Massimo; Maggiorelli, Fabrizio; Tonerini, Michele; Frammartino, Brunella

    2012-01-01

    After repetitive deep dives, breath-hold divers are often affected by a syndrome characterized by typical symptoms such as cough, sensation of chest constriction, blood-striated expectorate (hemoptysis) and, rarely, an overt acute pulmonary edema syndrome, often together with various degrees of dyspnea. The aim of this work is an epidemiological investigation to evaluate the prevalence of acute respiratory symptoms (ARS) in breath-hold divers (BHDs) in practicing breath-hold diving. A retrospective investigation has been performed using specific questionnaires completed by a selected sample of free-divers (212 breath-hold diving instructors--194 male, 18 female; mean age 34 +/- 6.91 years); affiliated with Apnea Academy, (International School for Education and Research of Free-Diving). We also investigated possible risk factors for post-dive acute respiratory symptoms. Furthermore, the authors report that a severe case of acute pulmonary edema occurred to a healthy and experienced breath-hold diving instructor. We reported detailed CT scan and follow-up CT scans three days later, with another scan reported 10 days later as well. A total of 56 subjects (26.4%) reported previous events such as cough, thoracic constraint, hemoptysis, associated with various degrees of dyspnea as confirmation of pulmonary involvement. Forty-five of them (82%) reported signs of true hemoptysis and a high degrees of dyspnea. A CT scan revealed the presence of patchy bilateral lung opacities at the level of superior and parahilar zones; follow-up CT scans three days later and 10 days later are also reported. Our data show that this is a common condition among experienced BHDs. In our opinion, this is particularly interesting for the free-diving community.

  17. Chest physiotherapy in paediatric patients hospitalised with community-acquired pneumonia: a randomised clinical trial.

    Science.gov (United States)

    Lukrafka, Janice Luisa; Fuchs, Sandra C; Fischer, Gilberto Bueno; Flores, José A; Fachel, Jandira M; Castro-Rodriguez, Jose A

    2012-11-01

    Chest physiotherapy has been used to treat children hospitalised with pneumonia with no clear scientific evidence to support a beneficial effect. The objective of the current study was to evaluate the efficacy of chest physiotherapy as an adjuvant treatment in children hospitalised with acute community-acquired pneumonia. Children (aged 1-12 years) with a clinical and confirmed radiological diagnosis of pneumonia sequentially admitted to a tertiary children hospital were eligible for this study. Participants were randomly selected to receive a standardised respiratory physiotherapy (positioning, thoracic vibration, thoracic compression, positive expiratory pressure, breathing exercises and forced exhalation with the glottis open or 'huffing') three times daily in the 'intervention group' or a non-mandatory request to breathe deeply, expectorate the sputum and maintain a lateral body position once a day in the 'control group'. The primary outcomes were reduction in respiratory rate and severity score (respiratory rate, recession, fever, oxygen saturation and chest x-ray) from baseline to discharge. Secondary outcome was duration of hospitalisation. In all, 72 patients were randomly allocated to the intervention (n=35) or control (n=37) groups. There were no differences at admission on severity of pneumonia between groups. Respiratory rate and severity score significant decreased between admission to discharge within each group; however, there were no differences when comparing groups. Also, there was no significant difference in duration of hospitalisation between the control and intervention groups (6 vs 8 days, p=0.11, respectively). This clinical trial suggests that, in children hospitalised with moderate community-acquired pneumonia, chest physiotherapy did not have clinical benefits in comparison to control group.

  18. BACTERIAL COLONISATION IN NON-CYSTIC FIBROSIS BRONCHIECTASIS IN A TERTIARY CARE CENTER IN CENTRAL KERALA

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    Kiran Vishnu Narayan

    2017-07-01

    Full Text Available BACKGROUND Bronchiectasis is an abnormal dilatation of the bronchi resulting in permanent damage to the pulmonary architecture and function. This disease expresses itself as chronic cough and expectoration, haemoptysis and with recurrent exacerbations of symptoms. The aim of the study is to study the prevalence of chronic bacterial colonisation in the lower respiratory tract of patients with non-cystic fibrosis bronchiectasis in the Pulmonary Medicine Department of Government Medical College, Kottayam, Kerala, India. MATERIALS AND METHODS A longitudinal observational study was conducted during a period of 1 year from April 2015 to March 2016 in patients with highresolution CT thorax evidence of bronchiectasis. The sputum was collected for bacterial cultures during exacerbations. Those with coexisting pulmonary diseases and diabetes mellitus were excluded from the study. The patients were treated with empirical antibiotics and bronchial toileting, chest physiotherapy and postural drainage. All patients were kept under follow up and a repeat sputum culture was sent 6 weeks after the episode of exacerbation to determine initial colonisation of the respiratory tract. In stable patients, induced spot sputum samples were sent for culture and when exacerbations occurred during the follow up period, new sputum samples were given. RESULTS Among 46 patients enrolled into the study, 10 gave a positive culture isolate during exacerbations, while 78% culture samples yielded normal pharyngeal flora. The organisms during exacerbations were namely Pseudomonas aeruginosa, Klebsiella pneumonia, Haemophilus influenzae, E. coli and one was Burkholderia mallei in a person with Kartagener’s syndrome. 10.8% showed evidence of colonisation and 4 among them showed chronic colonisation with Pseudomonas aeruginosa on repeated cultures taken a month apart when not on any antibiotics. CONCLUSION The prevalence of colonisation of the lower respiratory tract is 10.8% in the

  19. Frankincense--therapeutic properties.

    Science.gov (United States)

    Al-Yasiry, Ali Ridha Mustafa; Kiczorowska, Bożena

    2016-01-04

    Recently, increasing interest in natural dietary and therapeutic preparations used as dietary supplements has been observed. One of them is frankincense. This traditional medicine of the East is believed to have anti-inflammatory, expectorant, antiseptic, and even anxiolytic and anti-neurotic effects. The present study aims to verify the reported therapeutic properties of Boswellia resin and describe its chemical composition based on available scientific studies. The main component of frankincense is oil (60%). It contains mono- (13%) and diterpenes (40%) as well as ethyl acetate (21.4%), octyl acetate (13.4%) and methylanisole (7.6%). The highest biological activity among terpenes is characteristic of 11-keto-ß-acetyl-beta-boswellic acid, acetyl-11-keto-ß-boswellic acid and acetyl-α-boswellic acid. Contemporary studies have shown that resin indeed has an analgesic, tranquilising and anti-bacterial effects. From the point of view of therapeutic properties, extracts from Boswellia serrata and Boswellia carterii are reported to be particularly useful. They reduce inflammatory conditions in the course of rheumatism by inhibiting leukocyte elastase and degrading glycosaminoglycans. Boswellia preparations inhibit 5-lipoxygenase and prevent the release of leukotrienes, thus having an anti-inflammatory effect in ulcerative colitis, irritable bowel syndrome, bronchitis and sinusitis. Inhalation and consumption of Boswellia olibanum reduces the risk of asthma. In addition, boswellic acids have an antiproliferative effect on tumours. They inhibit proliferation of tumour cells of the leukaemia and glioblastoma subset. They have an anti-tumour effect since they inhibit topoisomerase I and II-alpha and stimulate programmed cell death (apoptosis).

  20. Frankincense – therapeutic properties

    Directory of Open Access Journals (Sweden)

    Ali Ridha Mustafa Al-Yasiry

    2016-01-01

    Full Text Available Recently, increasing interest in natural dietary and therapeutic preparations used as dietary supplements has been observed. One of them is frankincense. This traditional medicine of the East is believed to have anti-inflammatory, expectorant, antiseptic, and even anxiolytic and anti-neurotic effects. The present study aims to verify the reported therapeutic properties of Boswellia resin and describe its chemical composition based on available scientific studies. The main component of frankincense is oil (60%. It contains mono- (13% and diterpenes (40% as well as ethyl acetate (21.4%, octyl acetate (13.4% and methylanisole (7.6%. The highest biological activity among terpenes is characteristic of 11-keto-ß-acetyl-beta-boswellic acid, acetyl-11-keto-ß-boswellic acid and acetyl-α-boswellic acid. Contemporary studies have shown that resin indeed has an analgesic, tranquilising and anti-bacterial effects. From the point of view of therapeutic properties, extracts from Boswellia serrata and Boswellia carterii are reported to be particularly useful. They reduce inflammatory conditions in the course of rheumatism by inhibiting leukocyte elastase and degrading glycosaminoglycans. Boswellia preparations inhibit 5-lipoxygenase and prevent the release of leukotrienes, thus having an anti-inflammatory effect in ulcerative colitis, irritable bowel syndrome, bronchitis and sinusitis. Inhalation and consumption of Boswellia olibanum reduces the risk of asthma. In addition, boswellic acids have an antiproliferative effect on tumours. They inhibit proliferation of tumour cells of the leukaemia and glioblastoma subset. They have an anti-tumour effect since they inhibit topoisomerase I and II-alpha and stimulate programmed cell death (apoptosis.

  1. Bacteria isolated from the airways of paediatric patients with bronchiectasis according to HIV status

    Directory of Open Access Journals (Sweden)

    Charl Verwey

    2017-05-01

    Full Text Available Background. Knowledge of which bacteria are found in the airways of paediatric patients with bronchiectasis unrelated to cystic fibrosis (CF is important in defining empirical antibiotic guidelines for the treatment of acute infective exacerbations. Objective. To describe the bacteria isolated from the airways of children with non-CF bronchiectasis according to their HIV status. Methods. Records of children with non-CF bronchiectasis who attended the paediatric pulmonology clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from April 2011 to March 2013, or were admitted to the hospital during that period, were reviewed. Data collected included patient demographics, HIV status, and characteristics of the airway samples and types of bacteria isolated. Results. There were 66 patients with non-CF bronchiectasis over the 2-year study period. The median age was 9.1 years (interquartile range 7.2 - 12.1. The majority of patients (78.8% were HIV-infected. A total of 134 samples was collected (median 1.5 per patient, range 1 - 7, of which 81.3% were expectorated or induced sputum samples. Most bacteria were Gram negatives (72.1%. Haemophilus influenzae was the most common bacterium identified (36.0%, followed by Streptococcus pneumoniae (12.6%, Moraxella catarrhalis (11.1% and Staphylococcus aureus (10.6%. There were no differences between HIV-infected and uninfected patients in prevalence or type of pathogens isolated. Conclusion. Bacterial isolates from the airways of children with non-CF bronchiectasis were similar to those in other paediatric populations and were not affected by HIV status.

  2. A CLINICORADIOLOGICAL STUDY OF MIDDLE LOBE SYNDROME DUE TO TUBERCULOSIS

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    Saurabh Karmakar

    2016-09-01

    Full Text Available BACKGROUND Although pulmonary tuberculosis is a common disease in India, tuberculosis of right middle lobe is infrequent. Tuberculosis of the right middle lobe leading to chronic collapse is a cause of Right Middle Lobe syndrome. METHODS The patients attended Pulmonary Medicine Outdoor at Era’s Lucknow Medical College, Lucknow from April 2015 to March 2016. The purpose of this study is to describe the clinicoradiological features of patients of middle lobe syndrome due to tuberculosis. All patients presented with cough with or without expectoration, fever, chest pain, haemoptysis and constitutional symptoms like loss of appetite and weight. Chest X-ray PA view revealed ill-defined opacity abutting the right cardiac border. HRCT thorax was done in each case. The diagnosis of tuberculous aetiology was based on (1 History of chronic cough and fever, not responding to antibiotic therapy and constitutional symptoms, (2 A positive tuberculin test using 2 TU of PPD RT 23 and (3 Detection of acid fast bacilli by direct smear or Mycobacterium tuberculosis by polymerase chain reaction in bronchoalveolar lavage. RESULTS Out of 10 patients, 4 (40% were males and 6 (60% were females. The mean ages of the males were 55.8 years and females were 60.8 years and overall mean age was 59 years. Most of the patients were females and belonged to the middle age and old age group. ATT was started in all the patients. CONCLUSIONS Right middle lobe syndrome predominantly affects the older population and the female gender. Although tuberculosis is a common disease in India, Middle Lobe Syndrome is a very rare presentation of the disease. Due to non-specific symptoms and usually normal chest X-ray PA view in Right Middle Lobe Syndrome, we should keep a high index of suspicion to diagnose the condition.

  3. Use of the Lung Flute for sputum induction in children with cystic fibrosis: a pilot study.

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    Doumit, Michael; Jaffé, Adam

    2015-04-01

    This study aimed to assess the effectiveness of the Lung Flute in obtaining a sputum sample from children with cystic fibrosis (CF) that were not productive of sputum with coughing alone. Children attending an outpatient CF clinic who were not able to provide a sample with coughing alone were eligible. Each child used the Lung Flute on two occasions at least one month apart. The primary outcome was expectoration of a sputum sample. Secondary outcomes were sputum microbiology, time taken for the procedure, and ease of use of the device as assessed by the patient using a visual analogue scale (VAS), with 0/10 representing very easy and 10/10 representing very hard. Twenty-five children participated (15 males, mean age 12.7 range 6.5-17.9). Overall, a sputum sample was obtained on 26/50 (52%) uses of the device. In children that presented with a moist cough, a sample was obtained on 17/17 (100%) occasions, compared to 9/33 (27%) occasions when a child presented with a dry cough. A positive culture result for at least one known CF pathogen was found in 24/26 samples. Culture results from obtained samples resulted in management changes in 12 cases. Mean time taken to obtain a sample was 9.8 min (SD 2.2). Mean ease of use on the VAS was 1.5 (SD 1.6). The lung flute appears to be a clinically useful and easy device for sputum induction in children with CF. Further research comparing its effectiveness to other sputum induction methods is warranted. © 2014 Wiley Periodicals, Inc.

  4. Rapid emergence of a ceftazidime-resistant Burkholderia multivorans strain in a cystic fibrosis patient.

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    Stokell, Joshua R; Gharaibeh, Raad Z; Steck, Todd R

    2013-12-01

    Burkholderia multivorans poses a serious health threat to cystic fibrosis patients due to innate resistance to multiple antibiotics and acquisition of resistance to a range of antibiotics due to the frequent use of antibiotics to treat chronic infections. Monitoring antibiotic susceptibility is crucial to managing patient care. We identified the rapid emergence of a ceftazidime-resistant strain in a single patient within four days during a hospitalization for treatment of an exacerbation. B. multivorans was isolated from expectorated sputum samples using Burkholderia cepacia selective agar. A macrodilution assay was performed on all isolates to determine the minimum inhibitory concentration of ceftazidime. Approximately 4000 colonies were scored to identify the percent of ceftazidime-resistant colonies. Extracted DNA was used to determine the total bacterial counts and abundance of B. multivorans using quantitative PCR. An increase from no detectable B. multivorans ceftazidime-resistant colonies to over 75% of all colonies tested occurred within a four-day period. The resistant population remained dominant in 6 of the 8 samples in the following 17 months of the study. qPCR revealed an association between change in the percent of resistant colonies and abundance of B. multivorans, but not of total bacteria. No association was found between the acquisition of resistance to ceftazidime and other antibiotics commonly used to treat B. multivorans infections. The rapid emergence of a ceftazidime-resistant by B. multivorans strain occurred during a hospitalization while under selective pressure of antibiotics. The resistant strain maintained dominance in the B. multivorans population which resulted in an overall decline in a patient health and treatment efficacy. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  5. Airway clearance techniques for bronchiectasis.

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    Lee, Annemarie L; Burge, Angela T; Holland, Anne E

    2015-11-23

    People with non-cystic fibrosis bronchiectasis commonly experience chronic cough and sputum production, features that may be associated with progressive decline in clinical and functional status. Airway clearance techniques (ACTs) are often prescribed to facilitate expectoration of sputum from the lungs, but the efficacy of these techniques in a stable clinical state or during an acute exacerbation of bronchiectasis is unclear. Primary: to determine effects of ACTs on rates of acute exacerbation, incidence of hospitalisation and health-related quality of life (HRQoL) in individuals with acute and stable bronchiectasis. Secondary: to determine whether:• ACTs are safe for individuals with acute and stable bronchiectasis; and• ACTs have beneficial effects on physiology and symptoms in individuals with acute and stable bronchiectasis. We searched the Cochrane Airways Group Specialised Register of trials from inception to November 2015 and PEDro in March 2015, and we handsearched relevant journals. Randomised controlled parallel and cross-over trials that compared an ACT versus no treatment, sham ACT or directed coughing in participants with bronchiectasis. We used standard methodological procedures as expected by The Cochrane Collaboration. Seven studies involving 105 participants met the inclusion criteria of this review, six of which were cross-over in design. Six studies included adults with stable bronchiectasis; the other study examined clinically stable children with bronchiectasis. Three studies provided single treatment sessions, two lasted 15 to 21 days and two were longer-term studies. Interventions varied; some control groups received a sham intervention and others were inactive. The methodological quality of these studies was variable, with most studies failing to use concealed allocation for group assignment and with absence of blinding of participants and personnel for outcome measure assessment. Heterogeneity between studies precluded inclusion of

  6. Mutagenicity of Chinese traditional medicine Semen Armeniacae amarum by two modified Ames tests.

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    Jin, Jianling; Liu, Bo; Zhang, Hui; Tian, Xiao; Cai, Yupin; Gao, Peiji

    2009-11-15

    Semen armeniacae amarum (SAA) is a Chinese traditional medicine and has long been used to control acute lower respiratory tract infection and asthma, as a result of its expectorant and antiasthmatic activities. However, its mutagenicity in vitro and in vivo has not yet been reported. The Ames test for mutagenicity is used worldwide. The histidine contained in biological samples can induce histidine-deficient cells to replicate, which results in more his+ colonies than in negative control cells, therefore false-positive results may be obtained. So, it becomes a prerequisite to exclude the effects of any residual histidine from samples when they are assayed for their mutagenicity. Chinese traditional herbs, such as SAA, are histidine-containing biological sample, need modified Ames tests to assay their in vitro mutagenicity. The mutagenicity of SAA was evaluated by the standard and two modified Ames tests. The first modification used the plate incorporation test same as standard Ames teat, but with new negative control systems, in which different amounts of histidine corresponding to different concentrations of SAA was incorporated. When the number of his+ revertants in SAA experiments was compared with that in new negative control, the effect of histidine contained in SAA could be eliminated. The second modification used a liquid suspension test similar to the standard Ames test, except with histidine-rich instead of histidine-limited medium. The aim of this change was to conceal the effect of histidine contained in SAA on the final counting of his+ revertants, and therefore to exclude false-positive results of SAA in the Ames test. Furthermore, the effect of SAA on chromosomal aberration in mammalian bone marrow cells was tested. The standard Ames test showed a positive result for mutagenicity of SAA. In contrast, a negative response was obtained with the modified plate incorporation and modified suspension Ames tests. Moreover, no apparent chromosomal aberrations

  7. Cyclospora cayetanensis in sputum and stool samples Cyclospora cayetanensis em amostra de escarro

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    Angela Beatriz DI GLIULLO

    2000-04-01

    Full Text Available We report the observation of acid-fast Cyclospora cayetanensis oocysts in a sputum sample. The patient, a 60 year-old, HIV negative man, was successfully treated for pulmonary tuberculosis during 1997. On February 1998, he was admitted to our center due to loss of weight, cough with purulent expectoration, dysphonia and a radiological picture of pulmonary fibrosis. Bacilloscopic study of sputum (negative for acid-fast bacilli stained with Ziehl-Neelsen technique showed large (8-10 µm spherical, acid-fast Cyclospora cayetanensis oocysts. No other pathogens were isolated on cultures from this sample or from laryngeal biopsy. Serial parasitologic studies showed C. cayetanensis and also eggs of Trichuris trichiura, Ascaris lumbricoides and Hymenolepis nana and of Entamoeba coli cysts. The patient lives in the outskirts of Buenos Aires in a brick-made house with potable water and works as builder of sewers. He travelled in several occasions to the rural area of province of Tucumán which has poor sanitary conditions. C. cayetanensis is an emergent agent of diarrhea and as far as we know this is the first time the parasite is observed in respiratory samples.Comunicamos a observação de grandes oocistos (8-10 µm de diâmetro esféricos, ácido-álcool-resistentes de Cyclospora cayetanensis em amostra de escarro corada com a técnica de Ziehl-Neelsen. Na amostra não foram observados nem cultivados outros agentes patogênicos. Trata-se de um paciente do sexo masculino, 60 anos de idade, HIV (-, tratado previamente para tuberculose pulmonar (1997. Em fevereiro de 1998 apresentou-se em nosso hospital com perda de peso, tosse com expectoração purulenta, disfonia e imagens radiológicas de fibrose pulmonar. As culturas das amostras de escarro e da biopsia de laringe foram negativas. O exame parasitológico seriado de fezes mostrou ovos de Ascaris lumbricoides, Hymenolepis nana e Trichuris trichiura e cistos de Entamoeba coli. O paciente mora nos

  8. Prevalence of cutipositivity in a sample of homeless shelter population in Rome in the course of Latent Tuberculosis Infection surveillance plan. Preliminary results

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    Patrizia Laurenti

    2010-03-01

    Full Text Available

    Background: in Europe homelessness is a known risk factor both for active and latent tuberculosis (TB. In Rome 409 cases of TB were notified in 2004, but the real occurrence among homeless people is unknown. Tuberculosis surveillance has been organized with the aim to develop an integrated model for the risk evaluation and management of both Latent Tuberculosis infections (LTBI and TB in Rome homeless people.

    Methods: the eligible individuals have been recruited in the homeless’ refuges. The Tuberculin Mantoux test has been used to evaluate the infection prevalence; in case of a positive result, the individual’s expectorate has been collected and the chest X-ray has been performed. A collecting data form has been filled in for evaluating some risk factors. Multiple logistic regression models have been carried out to find statistically significant determinants of infection.

    Results: out of 120 subjects recruited, 108 came back for the evaluation of the skin test; the prevalence of LTBI was 43.5% (47/108 subjects; no active TB cases were found. According to the multivariate analysis, factors significantly associated to LTBI are gender (for males OR = 4.94; 95% CI: 1.46 – 16.67, 1st model; OR 5.84; 95% CI: 1.26 – 21.10, 2nd model, birth place (for Europe: OR 3.05; 95% CI: 1.02 – 9.13, 1st model; OR 3.12; 95% CI: 1.10 – 8.88, 2nd model; for East Mediterranean native Region OR = 4.34; 95%CI: 1.15-16.39; Body Mass Index class (for obesity OR = 3.34; 95% CI:1.31-8.51.

    Conclusions: these preliminary results have demonstrated a high prevalence of LTBI among homeless people. Male gender, birth place (Europe and East Mediterranean native Region and obesity were found to be significant risk factors. The surveillance system allowed positive patients for LTBI to be rapidly directed to a specialized centre for the clinical evaluation and the appropriate therapy

  9. Respiratory metabolism of salivary glands during the late larval and prepupal development of Drosophila melanogaster.

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    Farkaš, Robert; Sláma, Karel

    2015-10-01

    During the late larval period, the salivary glands (SG) of Drosophila show a cascade of cytological changes associated with exocytosis and the expectoration of the proteinaceous glue that is used to affix the pupariating larva to a substrate. After puparium formation (APF), SG undergo extensive cytoplasmic vacuolation due to endocytosis, vacuole consolidation and massive apocrine secretion. Here we investigated possible correlations between cytological changes, the puffing pattern in polytene chromosomes and respiratory metabolism of the SG. The carefully staged SG were explanted into small amounts (1 or 2μl) of tissue culture medium. The respiratory metabolism of single or up to 3 pairs of glands was evaluated by recording the rate of O2 consumption using a scanning microrespirographic technique sensitive to subnanoliter volumes of the respiratory O2 or CO2. The recordings were carried out at times between 8h before pupariation (BPF), until 16h APF, at which point the SG completely disintegrate. At the early wandering larval stage (8h BPF), the glands consume 2nl of O2/gland/min (=2500μl O2/g/h). This relatively high metabolic rate decreases down to 1.2-1.3nl of O2 during the endogenous peak in ecdysteroid concentration that culminates around pupariation. The metabolic decline coincides with the exocytosis of the proteinaceous glue. During and shortly after puparium formation, which is accompanied cytologically by intense vacuolation, O2 consumption in the SG temporarily increases to 1.6nl O2/gland/min. After this time, the metabolic rate of the SG decreases downward steadily until 16h APF, when the glands disintegrate and cease to consume oxygen. The SG we analyzed from Drosophila larvae were composed of 134 intrinsic cells, with the average volume of one lobe being 37nl. Therefore, a single SG cell of the wandering larva (with O2 consumption of 2nl/gland/min), consumes each about 16pl of O2/cell/min. A simultaneous analysis of the rate of protein and RNA

  10. [Effect of chest physiotherapy in patients undergoing mechanical ventilation: a prospective randomized controlled trial].

    Science.gov (United States)

    Zeng, Hui; Zhang, Zhen; Gong, Yuan; Chen, Miao

    2017-05-01

    To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table. The patients in control group received routine physical therapy; while those in the CPT group received comprehensive CPT including manual lung inflation, vibration expectoration and early functional exercise etc. on the basis of the treatment in control group. Acute physiology and chronic health evaluation II (APACHE II) score and oxygenation index (PaO2/FiO2) before and after the treatment in both two groups were observed as well as the respiratory function and vital signs before and after CPT. The laboratory indicators after treatment, incidence of complications, duration of MV and the length of ICU stay in the two groups were recorded. The incidence of ventilator associated pneumonia (VAP) in the CPT group was significantly lower than that of control group (5.4% vs. 25.8%, P respiratory function parameters including tidal volume (VT), respiratory rate (RR), peak airway pressure (Ppeak) and mean airway pressure (Pmean) before and after treatment in CPT group excepting pulse oxygen saturation (SpO2) was significantly higher than that before treatment (0.985±0.016 vs. 0.978±0.018, P 2 0.05), indicating that CPT treatment did not cause fluctuations in respiratory function and vital signs. Blood lactate in CPT group was significantly lower than that of control group (mmol/L: 1.10±0.79 vs. 1.32±1.09, P < 0.05), indicating that CPT treatment, especially early functional exercise, could improve the oxygen supply and limb circulation. CPT treatment has some effect on prevention of VAP and other complications

  11. Ziziphora tenuior L. essential oil from Dana Biosphere Reserve (Southern Jordan); Chemical characterization and assessment of biological activities.

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    Abu-Darwish, M S; Cabral, C; Gonçalves, M J; Cavaleiro, C; Cruz, M T; Paoli, M; Tomi, F; Efferth, T; Salgueiro, L

    2016-12-24

    Ziziphora tenuior L. (Lamiaceae) is a medicinal plant in Jordan, which is included in various antimicrobial, antiseptic, expectorant and wound healing preparations. It is used for the treatment of cough, stomach ache, dysentery, fever, uterus infection, gut inflammation and painful menstruation. The aim of this study was to assess, for the first time, the chemical composition of the essential oil of Z. tenuior originated from southern Jordan and its antifungal effects against several yeasts. Concomitantly, the mechanisms behind the anti-fungal activity against Candida albicans were also disclosed. Since the Z. tenuior traditional uses are related with inflammatory-associated conditions, the putative anti-inflammatory activity of the oil was also unveiled. Importantly, the potential toxicity of pharmacologically active concentrations was screened in different types of mammalian cells. Z. tenuior essential oil, isolated by hydrodistillation, was analyzed by gas chromatography, gas chromatography-mass spectrometry and (13)C nuclear magnetic resonance spectroscopy. Antifungal activity was evaluated against yeasts, dermatophytes and Aspergillus strains. Germ tube inhibition and biofilm formation assays were evaluated using C. albicans. Assessment of cell viability was made by the MTT assay using different types of mammalian cells, including hepatocytes, keratinocytes and macrophages. The in vitro anti-inflammatory potential of the oil was evaluated by measuring nitric oxide production using lipopolysaccharide-stimulated mouse macrophages. Oxygen-containing monoterpenes are the main oil compounds: pulegone (46.8%), p-menth-3-en-8-ol (12.5%), isomenthone (6.6%) and 8-hydroxymenthone (6.2%). The highest antifungal activity was against Cryptococcus neoformans, with a MIC value of 0.16µL/mL. The oil revealed an important inhibitory effect on germ tube formation with a filamentation inhibition rate higher than 80% at 0.16µL/mL. The amount of the attached biomass was reduced

  12. Correlates of COPD and chronic bronchitis in nonsmokers: data from a cross-sectional study

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    Khayat G

    2012-09-01

    Full Text Available Mirna Waked,1 Joseph Salame,2 Georges Khayat,3 Pascale Salameh41Faculty of Medicine, Balamand University, and St George Hospital, Beirut, Lebanon; 2Lebanese University, Faculty of Medicine, Beirut, Lebanon; 3Faculty of Medicine, St Joseph University and Hôtel Dieu de France Hospital, Beirut, Lebanon; 4Lebanese University, Faculties of Pharmacy and Public Health, Beirut, LebanonPurpose: Our objective was to assess the prevalence of chronic bronchitis and chronic obstructive pulmonary disease (COPD and their correlates among a Lebanese nonsmoker group.Material and methods: A cross-sectional study was conducted between October 2009 and September 2010, using a multistage cluster sample throughout Lebanon including Lebanese residents aged 40 years and above with no exclusion criteria. Pre- and postbronchodilator spirometry measurements were performed and carbon monoxide level was measured in exhaled air. COPD was defined and classified according to the Global Initiative for Chronic Obstructive Lung Disease guidelines or according to the lower limit of normal (forced expiratory volume in 1 second/forced vital capacity postbronchodilator < 5th percentile of the healthy population having the same age and sex. Chronic bronchitis was defined by the declaration of morning cough and expectorations for more than 3 months a year over more than 2 years in individuals with normal spirometry.Results: Out of 2201 individuals, 732 were never-smokers: 25 (3.4% of them had COPD, and 86 (11.75% fulfilled the definition of chronic bronchitis. Correlates of COPD included a childhood respiratory disease, house heated by diesel, and older age. On the other hand, correlates of chronic bronchitis included childhood respiratory diseases, living in southern Lebanon versus other regions, heating home by gas, older age, number of smokers at work, and lower height.Conclusion: A substantial percentage of the nonsmoking population may exhibit chronic bronchitis or COPD. The

  13. Facteurs prédictifs de l’échec de traitement antituberculeux en Guinée Conakry

    Science.gov (United States)

    Nimagan, Souleymane; Bopaka, Regis Gothard; Diallo, Mamadou Mouctar; Diallo, Boubacar Djelo; Diallo, Mamadou Bailo; Sow, Oumou Younoussa

    2015-01-01

    La tuberculose est un véritable problème de santé publique. C'est une maladie guérissable et cette guérison passe par une bonne prise en charge thérapeutique. Il arrive parfois on assiste à l’échec thérapeutique, d'où l'intérêt de notre étude portant sur les facteurs prédictifs de ses échecs. Dans l'espace d'une année sur 1300 cas de tuberculose toute forme confondue, 700 cas de tuberculose pulmonaire à microscopie positive ont été répertorié dont 100 cas transférés. La tranche d’âge de 15-25 ans a été la plus touchée avec un sexe-ratio de 2 en faveur des hommes et 41,66% de nos malades ont été les ouvriers suivis de 20,83% des commerçants. La majorité de nos patients provenait de Conakry soit 99, 5%. Sur 600 patients suivis les nouveaux cas représentaient 83,33% et l’échec thérapeutique représentait 12 cas soit 2%. L'interruption du traitement représente le principal facteur de l’échec. Les facteurs qui ont influencé la régularité des malades au traitement ont été multiples. Des facteurs liés à l'organisation du système de santé, la rupture des médicaments antituberculeux, l’éducation sanitaire insuffisante, les contraintes de la supervision du traitement, l'implication insuffisante et la vente des médicaments par le personnel de santé. Des facteurs liés aux patients eux-mêmes, la crainte de perte d'emploi, les contraintes financières. Les renforcements de l'organisation du système sanitaire et l’éducation thérapeutiques pourront réduire le taux d’échec du traitement antituberculeux. L'amélioration de la qualité de la prise en charge des malades en situation d’échec devrait passer par une culture systématique des expectorations avec antibiogramme. PMID:26889327

  14. Forme pseudotumorale de la tuberculose pulmonaire et les difficultés diagnostic: à propos d’un cas

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    Ouarssani, Aziz; Atoini, Fouad; Reda, Rafik; Lhou, Fatima Ait; Rguibi, Mustapha Idrissi

    2013-01-01

    La tuberculose pulmonaire est un problème majeur de santé publique. Dans sa forme commune, le diagnostic est habituellement aisé, mais elle peut se présenter sous une forme trompeuse et entrainer un retard diagnostic et thérapeutique. Nous rapportons le cas d’un patient âgé de 25ans, étudiant, sans antécédents pathologiques particuliers, hospitalisé dans notre formation pour un syndrome bronchique trainant avec altération de l’état général. L’examen clinique pleuropulmonaire est normal, l’examen des aires ganglionnaires trouve une adénopathie sus claviculaire droite, la radiographie thoracique de face objective une opacité hilaire droite hétérogène à contours irréguliers, la TDM thoracique retrouve un processus lésionnel tissulaire du lobe supérieur droit qui s’étend vers le médiastin et englobe partiellement la veine cave supérieure avec une adénopathie latérotracheale droite nécrosée. La fibroscopie bronchique objective un élargissement des éperons intersegmentaires du lobe supérieur droit, les biopsies réalisées avec étude histologique sont non concluantes. Les recherches de BK dans les expectorations et dans le liquide d’aspiration bronchique sont negatives. L’IDR à la tuberculine est à 15mm. C’est la ponction transparietale scannoguidée avec étude anatomopathologique qui confirme le diagnostic de tuberculose caseofolliculaire. La sérologie VIH est négative. Le diagnostic de tuberculose pulmonaire pseudotumorale chez un immunocompétent a été retenu et le patient a été mis sous traitement antibacillaire (régime standard national Marocain) par rifampicine, isoniazide, pyrazinamide et éthambutol pendant 6 mois avec évolution clinique et radiologique favorable. La tuberculose pulmonaire ne cesse de tromper le clinicien par son polymorphisme clinique et radiologique, elle doit être évoquée devant toute atteinte pulmonaire d’allure tumorale pour permettre une prise en charge précoce de la

  15. [Study of the clinical phenotype of symptomatic chronic airways disease by hierarchical cluster analysis and two-step cluster analyses].

    Science.gov (United States)

    Ning, P; Guo, Y F; Sun, T Y; Zhang, H S; Chai, D; Li, X M

    2016-09-01

    To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis. A population sample of adult patients in Donghuamen community, Dongcheng district and Qinghe community, Haidian district, Beijing from April 2012 to January 2015, who had wheeze within the last 12 months, underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, total serum IgE levels, blood eosinophil level and a peak flow diary. Nine variables were chosen as evaluating parameters, including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity(FVC) ratio, pre-salbutamol FEV1, percentage of post-salbutamol change in FEV1, residual capacity, diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level, peak expiratory flow(PEF) variability, serum IgE level, cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration). Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified. (1) Four clusters were identified by hierarchical cluster analysis. Cluster 1 was chronic bronchitis in smokers with normal pulmonary function. Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation. Cluster 3 included COPD patients with heavy smoking, poor quality of life and severe airflow limitation. Cluster 4 recognized atopic patients with mild airflow limitation, elevated serum IgE and clinical features of asthma. Significant differences were revealed regarding pre-salbutamol FEV1/FVC%, pre-salbutamol FEV1% pred, post-salbutamol change in FEV1%, maximal mid-expiratory flow curve(MMEF)% pred, carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)% pred, residual volume(RV)% pred, total serum IgE level, smoking history (pack-years), St.George's respiratory questionnaire

  16. Procalcitonin and C-reactive protein cannot differentiate bacterial or viral infection in COPD exacerbation requiring emergency department visits

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    Chang CH

    2015-04-01

    Full Text Available Chih-Hao Chang,1 Kuo-Chien Tsao,2,3 Han-Chung Hu,1,4 Chung-Chi Huang,1,4 Kuo-Chin Kao,1,4 Ning-Hung Chen,1,4 Cheng-Ta Yang,1,4 Ying-Huang Tsai,4,5 Meng-Jer Hsieh4,51Department of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan; 2Department of Laboratory Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation; 3Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; 4Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan; 5Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Puzi City, TaiwanBackground: Viral and bacterial infections are the most common causes of chronic obstructive pulmonary disease (COPD exacerbations. Whether serum inflammatory markers can differentiate bacterial from virus infection in patients with COPD exacerbation requiring emergency department (ED visits remains controversial.Methods: Viral culture and polymerase chain reaction (PCR were used to identify the viruses in the oropharynx of patients with COPD exacerbations. The bacteria were identified by the semiquantitative culture of the expectorated sputum. The peripheral blood white blood cell (WBC counts, serum C-reactive protein (CRP, procalcitonin (PCT, and clinical symptoms were compared among patients with different types of infections.Results: Viruses were isolated from 16 (22.2% of the 72 patients enrolled. The most commonly identified viruses were parainfluenza type 3, influenza A, and rhinovirus. A total of 30 (41.7% patients had positive bacterial cultures, with the most commonly found bacteria being Haemophilus influenzae and Haemophilus parainfluenzae. Five patients (6.9% had both positive sputum cultures and virus identification. The WBC, CRP, and PCT levels of the bacteria-positive and bacteria

  17. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype - a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial.

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    Beeh, Kai-Michael; Beier, Jutta; Candler, Henning; Wittig, Thomas

    2016-01-01

    Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg) in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period) and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29). Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, P=0.031) and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, P=0.012) during the winter season. The percentage of asymptomatic or mildly symptomatic patients (sputum/expectoration and cough) was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment (2 months: ELOM-080 25%, placebo

  18. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

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    Akashdeep Singh

    2016-01-01

    Full Text Available Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009-2014 review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16-76 and majority of them (75% were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%, chronic lung disease (52.8%, diabetes (27.8%, and solid-organ transplantation (22.2%. All the patients were symptomatic, and the most common symptoms were cough (91.7%, fever (78%, and expectoration (72%. Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7, community-acquired pneumonia (n = 5, lung abscess (n = 4, invasive fungal infection (n = 3, lung cancer (n = 2, and Wegener′s granulomatosis (n = 2. The most common radiographic features were consolidation (77.8% and nodules (56%. The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%, HIV positivity (100%, need for mechanical ventilation (87.5%, solid-organ transplantation (50%, and elderly (age > 60 years patients (43%. Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis, and

  19. Impact of carbohydrate mouth rinsing on time to exhaustion during Ramadan: A randomized controlled trial in Jordanian men.

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    Bataineh, Mo'ath F; Al-Nawaiseh, Ali M; Abu Altaieb, Mohammad H; Bellar, David M; Hindawi, Omar S; Judge, Lawrence W

    2018-01-24

    Mouth rinsing using a carbohydrate (CHO) solution has been suggested to improve physical performance in fasting participants. This study examined the effects of CHO mouth rinsing during Ramadan fasting on running time to exhaustion and on peak treadmill speed (V peak ). In a counterbalanced crossover design, 18 sub-elite male runners (Age: 21 ± 2 years, Weight: 68.1 ± 5.7 kg, VO 2max : 55.4 ± 4.8 ml/kg/min) who observed Ramadan completed a familiarization trial and three experimental trials. The three trials included rinsing and expectorating a 25 mL bolus of either a 7.5% sucrose solution (CHO), a flavour and taste matched placebo solution (PLA) for 10 s, or no rinse (CON). The treatments were performed prior to an incremental treadmill test to exhaustion. Three-day dietary and exercise records were obtained on two occasions and analysed. Anthropometric characteristics were obtained and recorded for all participants. A main effect for mouth rinse on peak velocity (V peak ) (CHO: 17.6 ± 1.5 km/h; PLA: 17.1 ± 1.4 km/h; CON: 16.7 ± 1.2 km/h; P exhaustion (CHO: 1282.0 ± 121.3 s; PLA: 1258.1 ± 113.4 s; CON: 1228.7 ± 98.5 s; P = .002, η p 2  = 0.41) was detected, with CHO significantly higher than PLA (P  .05). Energy availability from dietary analysis, body weight, and fat-free mass did not change during the last two weeks of Ramadan (P > .05). This study concludes that carbohydrate mouth rinsing improves running time to exhaustion and peak treadmill speed under Ramadan fasting conditions.

  20. Use of the Xpert® MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug-resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia

    Science.gov (United States)

    Bates, Matthew; Ahmed, Yusuf; Chilukutu, Lophina; Tembo, John; Cheelo, Busiku; Sinyangwe, Sylvester; Kapata, Nathan; Maeurer, Markus; O'Grady, Justin; Mwaba, Peter; Zumla, Alimuddin

    2013-01-01

    OBJECTIVES In high-tuberculosis (TB)-endemic countries, comorbidity of pulmonary TB in hospitalised patients with non-communicable diseases is well documented. In this study, we evaluated the use of the Xpert® MTB/RIF assay for the detection of concomitant pulmonary TB in patients admitted to the University Teaching Hospital, Lusaka, Zambia, with a primary obstetric or gynaecological condition. METHODS The Study population were inpatients admitted with a primary obstetric or gynaecological problem who had a concomitant cough and were able to expectorate a sputum sample. Sputum samples from 94 patients were analysed for the presence of Mycobacterium tuberculosis (M.tb) by standard smear microscopy, MGIT culture, MGIT drug-susceptibility testing (DST) and the Xpert® MTB/RIF assay. The sensitivity and specificity of the Xpert® MTB/RIF assay were evaluated against the culture gold standard. RESULTS Twenty-six of 94 (27.7%) patients had culture-confirmed pulmonary TB. The Xpert® MTB/RIF assay had a sensitivity of 80.8% [95% CI: 60.0–92.7%]) compared against MGIT culture. The Xpert® MTB/RIF assay was more sensitive than sputum smear microscopy (21/26 (80.8%) vs. 13/26 (50.0%), P = 0.02) and detected an additional eight culture-confirmed cases. Culture DST analysis identified two monoresistant M.tb strains: one resistant to rifampicin (rifampicin sensitive by the Xpert® MTB/RIF assay) and one to ethambutol. HIV infection was linked with a 3-fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non-communicable diseases (NCDs). CONCLUSIONS As an alternative to sputum microscopy, the Xpert® MTB/RIF assay provides a sensitive, specific and rapid method for the diagnosis of pulmonary TB in obstetric or gynaecological inpatients. Pulmonary TB is an important cause of concomitant comorbidity to the obstetric or gynaecological condition necessitating admission. TB and

  1. A thioredoxin reductase and/or thioredoxin system-based mechanism for antioxidant effects of ambroxol.

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    Huang, Jin; Xu, Jianying; Tian, Lin; Zhong, Liangwei

    2014-02-01

    Long-term treatment with ambroxol (ABX), a bronchial expectorant, was found to prevent acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The underlying mechanism remains unclear. To address this, we have investigated the effect of ABX on critical antioxidant proteins thioredoxin (Trx) and thioredoxin reductase (TrxR) that are decreased in patients with AECOPD. Trx, TrxR and NADP(H) form Trx system, which is involved in regulating numerous oxidative stress-related events. In human bronchial epithelial cells, treatment with ABX from 0 to 200 μM gradually increased mRNA and protein levels of TrxR/Trx. At these ABX concentrations, TrxR activity was elevated progressively, whereas Trx activity exhibited a dose-dependent biphasic response, increasing at 50 and 75 μM, but decreasing at ABX over 150 μM. Pre-treatment with 75 μM ABX enhanced the capacity of the cells to eliminate reactive oxygen species, which was largely prevented by knockdown of cytosolic Trx (hTrx1). In a purified system, ABX shortened the initial lag phase during the reduction of insulin disulfide by Trx system. Pre-treatment of NADPH-reduced TrxR with ABX caused a dose- and time-dependent increase in thiolate/selenolate species, i.e. the catalytically active form of TrxR. Kinetic analysis demonstrated that the reduction of H2O2 by TrxR or Trx system were enhanced by 100 or 200 μM ABX. When hTrx1 was mixed with ABX in a molar ratio of 1:1 to 1:100 (which could occur in human plasma), changes in intrinsic Trp fluorescence occurred, and the response of reduced hTrx1 was especially remarkable. These data reveal an ABX-sensing mechanism of TrxR/Trx. We therefore conclude that the antioxidant actions of ABX at physiological concentrations are, at least partially, mediated by TrxR and/or Trx system. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  2. Burden of pneumocystis pneumonia in HIV-infected adults in sub-Saharan Africa: a systematic review and meta-analysis.

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    Wasserman, Sean; Engel, Mark E; Griesel, Rulan; Mendelson, Marc

    2016-09-09

    Seroprevalence data and clinical studies in children suggest that the burden of pneumocystis pneumonia (PCP) in Africa may be underestimated. We performed a systematic review to determine the prevalence and attributable mortality of PCP amongst HIV-infected adults in sub-Saharan Africa. We searched Pubmed, Web of Science, Africa-Wide: NiPAD and CINAHL, from Jan 1 1995 to June 1 2015, for studies that reported the prevalence, mortality or case fatality of PCP in HIV-infected adults living in sub-Saharan African countries. Prevalence data from individual studies were combined by random-effects meta-analysis according to the Mantel-Haenszel method. Data were stratified by clinical setting, diagnostic method, and study year. We included 48 unique study populations comprising 6884 individuals from 18 countries in sub-Saharan Africa. The pooled prevalence of PCP among 6018 patients from all clinical settings was 15 · 4 % (95 % CI 12 · 9-18 · 0), and was highest amongst inpatients, 22 · 4 % (95 % CI 17 · 2-27 · 7). More cases were identified by bronchoalveolar lavage, 21 · 0 % (15 · 0-27 · 0), compared with expectorated, 7 · 7 % (4 · 4-11 · 1), or induced sputum, 11 · 7 % (4 · 9-18 · 4). Polymerase chain reaction (PCR) was used in 14 studies (n = 1686). There was a trend of decreasing PCP prevalence amongst inpatients over time, from 28 % (21-34) in the 1990s to 9 % (8-10) after 2005. The case fatality rate was 18 · 8 % (11 · 0-26 · 5), and PCP accounted for 6 · 5 % (3 · 7-9 · 3) of study deaths. PCP is an important opportunistic infection amongst HIV-infected adults in sub-Saharan Africa, particularly amongst patients admitted to hospital. Although prevalence appears to be decreasing, improved access to antiretroviral therapy and non-invasive diagnostics, such as PCR, are needed.

  3. Wolbachia Reduces the Transmission Potential of Dengue-Infected Aedes aegypti.

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    Yixin H Ye

    Full Text Available Dengue viruses (DENV are the causative agents of dengue, the world's most prevalent arthropod-borne disease with around 40% of the world's population at risk of infection annually. Wolbachia pipientis, an obligate intracellular bacterium, is being developed as a biocontrol strategy against dengue because it limits replication of the virus in the mosquito. The Wolbachia strain wMel, which has been introduced into the mosquito vector, Aedes aegypti, has been shown to invade and spread to near fixation in field releases. Standard measures of Wolbachia's efficacy for blocking virus replication focus on the detection and quantification of virus in mosquito tissues. Examining the saliva provides a more accurate measure of transmission potential and can reveal the extrinsic incubation period (EIP, that is, the time it takes virus to arrive in the saliva following the consumption of DENV viremic blood. EIP is a key determinant of a mosquito's ability to transmit DENVs, as the earlier the virus appears in the saliva the more opportunities the mosquito will have to infect humans on subsequent bites.We used a non-destructive assay to repeatedly quantify DENV in saliva from wMel-infected and Wolbachia-free wild-type control mosquitoes following the consumption of a DENV-infected blood meal. We show that wMel lengthens the EIP, reduces the frequency at which the virus is expectorated and decreases the dengue copy number in mosquito saliva as compared to wild-type mosquitoes. These observations can at least be partially explained by an overall reduction in saliva produced by wMel mosquitoes. More generally, we found that the concentration of DENV in a blood meal is a determinant of the length of EIP, saliva virus titer and mosquito survival.The saliva-based traits reported here offer more disease-relevant measures of Wolbachia's effects on the vector and the virus. The lengthening of EIP highlights another means, in addition to the reduction of infection

  4. Glucose-dependent insulinotropic polypeptide and insulin-like immunoreactivity in saliva following sham-fed and swallowed meals.

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    Messenger, B; Clifford, M N; Morgan, L M

    2003-06-01

    Gastrointestinal peptides, including insulin, glucagon and glucose-dependent insulinotropic polypeptide (GIP) have previously been reported in salivary glands. Recent evidence has suggested they might influence postprandial macronutrient metabolism. This study therefore investigated and compared postprandial hormone concentrations in saliva and plasma to determine whether their secretion was influenced by oral food stimuli. In a within-subject randomised cross-over comparison of hormone concentrations in plasma and saliva following a mixed meal, 12 subjects were given two 1708 kJ mixed meals. On one occasion the meal was chewed and swallowed (swallowed meal), on the other it was chewed and expectorated (sham-fed meal). Salivary and plasma levels of immunoreactive insulin, GIP and glucagon-like peptide-1 (GLP-1), total protein, alpha-amylase, glucose and non-esterified fatty acid were measured before and for 90 min following the meals. Saliva total protein and alpha-amylase rose following both meals, indicating that the stimulus for salivary protein release is related to the presence of food in the mouth. GLP-1 was not detected in saliva. Fasting salivary insulin levels were lower in saliva than plasma (28+/-6 vs 40+/-25 pmol/l respectively). Both increased following the swallowed meal but the rise in saliva was slower and less marked than in plasma (peak levels 96+/-18 and 270+/-66 pmol/l for saliva and plasma respectively, Psaliva. Fasting GIP levels were significantly higher in saliva than plasma (183+/-23 compared with 20+/-7 pmol/l, Psaliva following both swallowed and sham-fed meals to nadirs of 117+/-17 and 71+/-12 pmol/l respectively, but rose following the swallowed meal to peak levels of 268+/-66 pmol/l. These findings are consistent with insulin in saliva being an ultrafiltrate of that circulating in blood, but GIP in saliva being the product of local salivary gland synthesis, whose secretion is influenced, directly or indirectly, by oral stimuli. The

  5. [Diagnostic value of serum procalcitonin in identifying the etiology of non-responding community-acquired pneumonia after initial antibiotic therapy].

    Science.gov (United States)

    Wang, Zheng; Zhang, Xiaoju; Wu, Jizhen; Zhang, Wenping; Kuang, Hongyan; Li, Xiao; Xuan, Weixia; Wang, Kai; Ma, Lijun

    2014-11-01

    This study was to investigate the diagnostic value of serum procalcitonin(PCT) in identifying the etiology of non-responding community-acquired pneumonia (CAP) after initial antibiotic therapy. A retrospective analysis was performed for 232 hospitalized CAP patients admitted to the People's Hospital of Zhengzhou University during June 2013 and January 2014. Early treatment failure was defined as the presence of persistent fever (>38 °C) and/or clinical symptoms (malaise, cough, expectoration, dyspnea) or deterioration after at least 72 h of initial antimicrobial treatment, or development of respiratory failure requiring mechanical ventilation, or septic shock. Bronchoscopy or transthoracic lung biopsy was performed in case of early treatment failure when indicated. Serum level of PCT was detected by double antibody sandwich method. The differences between 2 or more groups were compared using 2-independent student t test, one-way ANOVA; Mann-Whitney U test, Kruskal-Wallis rank sum test, or χ(2) test. Risk factors and odds ratios for nonresponsiveness were analyzed by setting up a Logistic regression model. The diagnostic values of PCT were determined by receiver operating characteristic curves (ROC curves). Of the 232 CAP patients enrolled, 124 were male and 108 were female, with an average age of (46 ± 20) years. Thirty-six patients failed to respond to the initial antibiotic therapy. As shown by Logistic regression analysis, the risk factors for treatment failure included hypoalbuminemia, type 2 diabetes, previous history of splenectomy , PSI 4-5 grade, and lung infiltration ≥ 3 lobes. The most common causes of non-responsiveness were antimicrobial insufficiency (n = 23), and misdiagnosis of noninfectious mimics of pneumonia (n = 11), with 2 cases of unidentified etiology. The serum PCT level in admission was 0.19 (0.07-0.66) µg/L in the antimicrobial insufficiency subgroup, which was significantly higher than that in the misdiagnosis subgroup [0

  6. COMPLEX CLINICAL AND INSTRUMENTAL EVALUATION OF LUNG INJURY IN PATIENTS WITH RHEUMATOID ARTHRITIS

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    I. I. Nesterovich

    2016-01-01

    Full Text Available The damage of the respiratory system is a quite common  extra-articular manifestation  of rheumatoid  arthritis (RA. It is important  to note that its clinical symptoms occur in only 20–30% of patients; however, subclinical forms identified by active screening are observed in 70–80% of patients.Objective: to compare the significance of pulmonary complaints,  the results of physical examination, and the data of instrumental  studies for the detection  of lung injury in patients with RA.Subjects and methods. The study enrolled 70 RA patients (63 women and 7 men aged 24 to 83 years. Only 10% of them had clinically evident lung injury associated with RA. Patients with other pulmonary diseases, such as asthma, chronic obstructive pulmonary disease, etc., were excluded. Physical examination, radiography/fluoroscopy, high-resolution computed  tomography (HRCT, single-photon emission computed  tomography (SPECT of the lung, and lung function testing (LFT with the determination of lung diffusion capacity.Results and discussion. The data of physical examination  were nonspecific and unconvincing.  Pulmonary  complaints (dyspnea, cough, expectoration were seen in 65% of the patients; an objective assessment revealed changes (vesiculotympanitic resonance,  harsh breathing, and pleural friction rub in 40%. The X-ray films/fluorograms  displayed abnormalities (pulmonary fibrosis, focal changes in only 10% of cases. 92% of the patients had lung HRCT  changes including moderate (bronchial  obstruction (40%, rheumatoid  nodules (10%, ground glass opacities (60%, bronchial thickening (20%, pleural effusion (10%, tree-in-bud opacities (3% and severe (pulmonary hypertension  (10%, bronchiectasis (10%, emphysema (5% and lung tissue fibrotic changes as the honeycomb lung (2% ones. SPECT showed local hypoperfusion in the mantle and mediastinal parts of the lungs in 80% of cases. LFT analysis demonstrated reduced lung diffusion capacity in 41% of

  7. Uso de jarabes antitusivos y otros medicamentos en las infecciones respiratorias agudas

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    María Eulalia Prieto Herrera

    2000-01-01

    Full Text Available Se realizó un estudio de intervención para la aplicación del protocolo de tratamiento estándar de casos de infecciones respiratorias agudas y el uso de jarabes antitusivos y otros medicamentos, propuesto por la Organización Panamericana de la Salud/Organización Mundial de la Salud, en el Policlínico Comunitario Este de Camagüey durante el año 1998. El universo de estudio fueron los 252 niños menores de 5 años con diagnóstico de infección respiratoria aguda. El registro de pacientes atendidos y la historia clínica individual constituyeron la fuente primaria de datos. Los resultados más relevantes fueron que después de la intervención disminuyó el uso de jarabes antitusivos (44,04 %, así como los casos tratados ambulatoriamente (37,6 %. Se concluyó que existió predominio del sexo masculino y del grupo de edades de 1 a 2 años; los medicamentos más utilizados fueron los expectorantes y mucolíticos en el catarro común, observándose una disminución después de la intervención.An intervention study for the application of the standard treatment protocol for acute respiratory infections and the use of antitussive syrups and other medication was made after being proposed by the Pan-American Health Organization/World Health Organization, at the Eastern Community Hospital of Camagüey in the year 1998. The study material was constituted by the 252 children under 5 years of age with diagnosis of acute respiratory infection. The record of patients treated and their individual medical history were the primary data sources. The most relevant outcomes being that after intervention the use of antitussive syrups decreased (44.04%, as well as the ambulatory cases (37.6 %. It was concluded that there was a prevalence of male sex and the age group of 1-2 years old. The most frequently used medication were expectorants and mucolytic medication in common catarrh, a decrease being noticed after intervention.

  8. Spatial analysis of avoidable hospitalizations due to tuberculosis in Ribeirao Preto, SP, Brazil (2006-2012

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    Mellina Yamamura

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe the spatial distribution of avoidable hospitalizations due to tuberculosis in the municipality of Ribeirao Preto, SP, Brazil, and to identify spatial and space-time clusters for the risk of occurrence of these events. METHODS This is a descriptive, ecological study that considered the hospitalizations records of the Hospital Information System of residents of Ribeirao Preto, SP, Southeastern Brazil, from 2006 to 2012. Only the cases with recorded addresses were considered for the spatial analyses, and they were also geocoded. We resorted to Kernel density estimation to identify the densest areas, local empirical Bayes rate as the method for smoothing the incidence rates of hospital admissions, and scan statistic for identifying clusters of risk. Softwares ArcGis 10.2, TerraView 4.2.2, and SaTScanTM were used in the analysis. RESULTS We identified 169 hospitalizations due to tuberculosis. Most were of men (n = 134; 79.2%, averagely aged 48 years (SD = 16.2. The predominant clinical form was the pulmonary one, which was confirmed through a microscopic examination of expectorated sputum (n = 66; 39.0%. We geocoded 159 cases (94.0%. We observed a non-random spatial distribution of avoidable hospitalizations due to tuberculosis concentrated in the northern and western regions of the municipality. Through the scan statistic, three spatial clusters for risk of hospitalizations due to tuberculosis were identified, one of them in the northern region of the municipality (relative risk [RR] = 3.4; 95%CI 2.7–4,4; the second in the central region, where there is a prison unit (RR = 28.6; 95%CI 22.4–36.6; and the last one in the southern region, and area of protection for hospitalizations (RR = 0.2; 95%CI 0.2–0.3. We did not identify any space-time clusters. CONCLUSIONS The investigation showed priority areas for the control and surveillance of tuberculosis, as well as the profile of the affected population, which shows

  9. A possible anti-inflammatory mechanism of ethyl acetate extracts of Teucrium stocksianum Bioss.

    Science.gov (United States)

    Mukarram Shah, Syed Muhammad

    2015-08-29

    Teucrium stocksianum (T. stocksianum) is one of the important members of the genus Teucrium which contains numerous biologically active compounds. Traditionally, it is used for the treatment of fever, pain, as expectorant and blood purifier. Researchers are trying to discover plants origin, novel and safe remedies for the management of various ailments. The present study was aimed to determine the possible anti-inflammatory mechanism of ethyl acetate extract of T. stocksianum. Preliminary, the ethanolic extract and sub-fractions were screened for anti-inflammatory potential at doses of 100, 200 and 300 mg/kg (i.p) body weight, using carrageenan induced paw edema test in mice. In-order to determine the possible mechanism of anti-inflammatory effect, the ethyl acetate fraction was ascertained with different phlogistic agents like histamine, bradykinin, prostaglandins E2 and arachedonic acid via paw edema test in mice. The ethanolic extract and sub-fractions of T. stocksianum displayed marked to moderate anti-inflammatory activity in a carrageenan induced paw edema test in mice. Among the sub-fractions, ethyl acetate fraction (EAF) demonstrated excellent (66%) anti-inflammatory action at the highest tested dose (300 mg/kg) that reached to the maximum value at 3rd hour after carrageenan injection and remained significant (***P<0.001) till 5th hour of test sample administration. EAF revealed moderate effect against the paw edema induced by histamine (31.048%) while non-significant results (18.148%) were observed against the edema induced by bradykinin. The extract demonstrated significant (66.23-73.076%) anti-inflammatory potential against the edematogenic effect of prostaglandin E2. Moreover, the extract also significantly inhibited (51.33%) the paw edema induced by arachedonic acid. Our results suggest that the EAF has dual action and produced the anti-inflammatory effect by blocking both pathways of arachedonic acid metabolites (cyclooxygenase and lipoxygenase). Thus

  10. Compounds isolated from Eriobotrya deflexa leaves protect against ultraviolet radiation B-induced photoaging in human fibroblasts.

    Science.gov (United States)

    Huang, Chung-Yu; Lin, Yi-Tzu; Kuo, Hsiang-Chun; Chiou, Wen-Fei; Lee, Mei-Hsien

    2017-10-01

    Ultraviolet (UV) irradiation leads to skin photoaging because of the upregulation of matrix metalloproteinase (MMP)-1 and downregulation of type I collagen and tissue inhibitor of metalloproteinase (TIMP)-1. Eriobotrya deflexa (Hemsl.) Nakai (Rosaceae) is a flowering plant endemic to Taiwan, and its leaves have been used as an expectorant and in antitussive folk remedy. Our previous studies have demonstrated that an E. deflexa leaf extract functions as a free radical scavenger. The current evaluated the antiphotoaging effect of partitioned fractions and specific compounds from the leaves of E. deflexa by using bioguided isolation, compound identification, and biological activity testing with UVB-irradiated human fibroblasts (WS-1 cells). E. deflexa leaves were extracted with 95% ethanol and then partitioned using a sequential treatment of n-hexane, ethyl acetate, and n-butanol (n-BuOH). The bioactive n-BuOH fraction was used for isolation and purification through chromatography. The compounds were identified by analyzing their physical and spectroscopic properties. We identified eight compounds from this fraction; of these compounds, 3-O-α-l-rhamnopyranosyl-(1‴→6″)-β-d-galactopyranoside (1), hyperin (2), afzelin (5), and cryptochlorogenic acid methyl ester (7) were isolated from E. deflexa for the first time, and they exhibited MMP-1 inhibition activity. The IC50 values were 96.5, 89.5, 93.4, and 92.8μM for 1, 2, 5, and 7, respectively. These compounds also enhanced the expression of procollagen type I, and TIMP-1 and hyperin (2) were found to be most effective with IC50 values of 56.7 and 70.3μM, respectively. Hyperin (2) could reduce intracellular reactive oxygen species production in UVB-irradiated WS-1 cells, with the corresponding IC50 value being 80.7μM. Liquid chromatography triple-quadrupole mass spectrometry was used for the quantitative and chemical fingerprint analysis of active compounds. Quercetin 3-O-α-l-rhamnopyranosyl-(1‴→6

  11. Non-antibiotic treatments for upper-respiratory tract infections (common cold).

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    Arroll, B

    2005-12-01

    To review the seven Cochrane reviews of non-antibiotic treatment for the common cold. Each Cochrane review was read and summarized, and results presented as relative risks and, where possible, numbers needed to treat. The main theme that runs through these Cochrane reviews is the variable quality of the primary studies. In general, the reviewers are fairly cautious about the benefits of any of the treatments other than first-dose decongestants and antihistamine-decongestant combinations. For antihistamines alone, the reviewers were clear about the lack of efficacy except in the high-quality studies in which a global improvement in symptoms was noted. Some studies were statistically significant, but the Cochrane reviewers were guarded about how clinically significant they were. For Echinacea, problems were found with the quality of the studies and the wide range of different forms of this substance. Heated humidified air seemed to be effective in the UK and Israel, but not the USA, making definitive statements about efficacy difficult. Over-the-counter medication for cough seemed to have no documented benefit in children under the age of 5 years. Letosteine (a mucolytic) may be effective in children but is not available in the UK. Bisolvon (a mucolytic) was found to be effective for cough in only one study. For older children and adults, dextromethorphan may be effective (two out of three studies showed benefit), and guiafenesin (an expectorant) showed mixed benefit in two trials. Dexbrompheniramine (a sedating antihistamine)/pseudoephedrine (6 mg/120 mg twice daily for 1 week) was significantly more effective than placebo for severity of cough, whereas, in another study, loratadine (a non-sedating antihistamine)/pseudoephedrine (5 mg/120 mg twice daily for 4 days) did not show any difference between the study groups. Vitamin C may have a small role in preventing the common cold, with possibly a greater role in high-intensity physical activity and sub

  12. Morbilidad y manejo de infecciones respiratorias agudas en menores de 5 años

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    Gloria Robaina Suárez

    2003-09-01

    infections. Infants were the ones mostly admitted to home care as the best follow-up and control method, and to the hospital. A high percentage of symptomatic drugs mainly nasal drops and expectorants was used whereas the administration of antibiotics was excessive in 62,4 % of cases. Only 12,7 % of prescribed antibiotics was correct.

  13. Use of the Xpert(®) MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug-resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia.

    Science.gov (United States)

    Bates, Matthew; Ahmed, Yusuf; Chilukutu, Lophina; Tembo, John; Cheelo, Busiku; Sinyangwe, Sylvester; Kapata, Nathan; Maeurer, Markus; O'Grady, Justin; Mwaba, Peter; Zumla, Alimuddin

    2013-09-01

    In high-tuberculosis (TB)-endemic countries, comorbidity of pulmonary TB in hospitalised patients with non-communicable diseases is well documented. In this study, we evaluated the use of the Xpert(®) MTB/RIF assay for the detection of concomitant pulmonary TB in patients admitted to the University Teaching Hospital, Lusaka, Zambia, with a primary obstetric or gynaecological condition. The Study population were inpatients admitted with a primary obstetric or gynaecological problem who had a concomitant cough and were able to expectorate a sputum sample. Sputum samples from 94 patients were analysed for the presence of Mycobacterium tuberculosis (M.tb) by standard smear microscopy, MGIT culture, MGIT drug-susceptibility testing (DST) and the Xpert(®) MTB/RIF assay. The sensitivity and specificity of the Xpert(®) MTB/RIF assay were evaluated against the culture gold standard. Twenty-six of 94 (27.7%) patients had culture-confirmed pulmonary TB. The Xpert(®) MTB/RIF assay had a sensitivity of 80.8% [95% CI: 60.0-92.7%]) compared against MGIT culture. The Xpert(®) MTB/RIF assay was more sensitive than sputum smear microscopy (21/26 (80.8%) vs. 13/26 (50.0%), P = 0.02) and detected an additional eight culture-confirmed cases. Culture DST analysis identified two monoresistant M.tb strains: one resistant to rifampicin (rifampicin sensitive by the Xpert(®) MTB/RIF assay) and one to ethambutol. HIV infection was linked with a 3-fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non-communicable diseases (NCDs). As an alternative to sputum microscopy, the Xpert(®) MTB/RIF assay provides a sensitive, specific and rapid method for the diagnosis of pulmonary TB in obstetric or gynaecological inpatients. Pulmonary TB is an important cause of concomitant comorbidity to the obstetric or gynaecological condition necessitating admission. TB and HIV comorbidities with other

  14. Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in sputum specimens in remote health care facility.

    Science.gov (United States)

    Geleta, Dereje Assefa; Megerssa, Yoseph Cherinet; Gudeta, Adugna Negussie; Akalu, Gizachew Taddesse; Debele, Melaku Tesfaye; Tulu, Kassu Desta

    2015-10-19

    Xpert MTB/RIF assay is considered as a great advance over conventional smear and culture in the diagnosis of TB and MDR-TB by simultaneously detecting M.tuberculosis and rifampicin resistance bacilli. However, very little information regarding the performance characteristics of Xpert MTB/RIF assay is available in Ethiopia. Therefore, the purpose of this study was to evaluate the performance of Xpert MTB/RIF assay compared to conventional sputum smear and culture methods for the diagnosis of pulmonary tuberculosis in remote health care facility. A paired expectorated sputum samples were obtained from 227 consecutively recruited patients with signs and symptoms suggestive of tuberculosis at Karamara hospital during December 2013 to May 2014. One of the sputum specimen was tested directly by Ziehl-Neelsen staining and Xpert MTB/RIF assay without NALC-NaOH decontamination. The other of pair of sputa specimen was cultured for isolation of TB bacilli by conventional methods. Diagnostic performance of Xpert MTB/RIF assay and AFB smear microscopy were calculated against culture as the gold standard. Overall 25.5% (58/227) samples were positive for Mycobacterium tuberculosis complex (MTBC) by MGIT and/or LJ media of which 36.2% (21/58) and 65.5% (35/58) were positive by AFB smear microscopy and Xpert MTB/RIF respectively. The sensitivity, specificity, as well as the positive and negative predictive value of Xpert MTB/RIF assay were 65.5% (95% CI: 53.3-77.7%), 96.3% (95% CI: 93.4-99.2%), 86.4% (95% CI: 76.2-96.5%), and 88.6% (95% CI: 83.9-93.3%) respectively. Eighteen of 58 (31%) cases that were smear microscopy negative, were positive by Xpert MTB/RIF assay. Although Xpert MTB/RIF assay demonstrated high sensitivity in detecting MTBC in sputum specimens compared with conventional AFB smear microscopy, it demonstrated suboptimal sensitivity in smear negative patients compared to conventional culture.

  15. Valor del estudio celular del esputo en el seguimiento de las enfermedades inflamatorias de la vía aérea Value of sputum analysis in the management of inflammatory airway diseases

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    Juan Antonio Mazzei

    2012-08-01

    Full Text Available El análisis celular del esputo, espontáneo u obtenido mediante la técnica de esputo inducido, se ha transformado en una herramienta ampliamente difundida para la evaluación y orientación del tratamiento de las enfermedades inflamatorias de la vía aérea, principalmente asma, enfermedad pulmonar obstructiva crónica y bronquitis eosinofílica. Se han aportado evidencias sobre la utilidad de la técnica del esputo inducido, validada y estandarizada, para ser empleada en pacientes con dificultades para expectorar. Numerosas investigaciones dieron cuenta de la efectividad de basar las decisiones terapéuticas en el componente inflamatorio de la vía aérea mediante el recuento de células en el esputo. Varios estudios mostraron que, en pacientes con asma el análisis celular de esputo guía en la determinación de estrategias para disminuir las exacerbaciones y para mejorar la función pulmonar, aun en pacientes con asma grave, para disminuir el remodelamiento; también se ha descrito su utilidad en pacientes con EPOC, para la disminución de las exacerbaciones.Cellular analysis of sputum either spontaneous or by induced sputum technique, has become a widespread tool for the evaluation and guidance of treatment of inflammatory diseases of the airway, primarily asthma, COPD and eosinophilic bronchitis. Induced sputum method is a validated, standardized and non-invasive technique, useful in patients with difficulties to expectorate. Its implementation is simple and cost effective. Numerous investigations have shown the effectiveness of basing treatment decisions on the inflammatory component of the airway by counting cells in sputum. Several studies have demonstrated that in patients with asthma, results of this analysis can guide in defining strategies to reduce exacerbations and to improve lung function even in patients with severe asthma, as well as to decrease the remodeling; in addition, a reduction in exacerbations in COPD patients

  16. A (polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer)-dispersed sustained-release tablet for imperialine to simultaneously prolong the drug release and improve the oral bioavailability.

    Science.gov (United States)

    Lin, Qing; Fu, Yu; Li, Jia; Qu, Mengke; Deng, Li; Gong, Tao; Zhang, Zhirong

    2015-11-15

    Imperialine, extracted from Bulbus Fritillariae Cirrhosae, is an efficient antitussive and expectorant medicine. However, its short half-life and stomach degradation limited imperialine from further clinical use. The current study was conducted to develop a sustained-release tablet for imperialine both to prolong absorption time and to improve the oral bioavailability of the drug. The tablets were prepared by a direct compression method formulated on optimized solid dispersion (SD) for imperialine based on polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer (Soluplus(®)) with imperialine/Soluplus(®) ratio of 1:8 (w/w). In order to obtain the optimized formulation, factors that affected the drug release were investigated by in vitro dissolution studies in the media of pH1.2, 5.8, 7.0 and 7.4. Powder X-ray diffraction and scanning electron microscope confirmed that the imperialine in SD was amorphous instead of crystalline, and still stayed amorphous even after the direct compression. And besides, pharmacokinetic study in Beagle dogs was performed to inspect the in vivo sustained release. Plasma concentration-time curves and pharmacokinetic parameters were gained. As a result, the Cmax of imperialine was one-fold reduced and Tmax was two-fold prolonged, and the mean AUC0-24 was expressed as 89.581±21.243μgh/L, which showed that the oral bioavailability of imperialine was 2.46-fold improved. Moreover, the in vitro-in vivo correlation was recommended to carry out, demonstrating the percentages of drug release in vitro were well-correlated with the absorptive fraction in vivo with the correlation coefficients above 0.9900. By mathematically modeling and moment imaging of the drug release, Peppas equation was selected as the most fitted model for the sustained-release tablets with the diffusional coefficient in the range of 0.59-0.62, indicating the release of imperialine from the sustained-release tablets was an anomalous process involving

  17. Technological Evaluation of Emulsions Containing The Volatile Oil from Leaves of Plectranthus Amboinicus Lour

    Science.gov (United States)

    Lopes, Pablo Queiroz; Carneiro, Fabíola Bernardo; de Sousa, Ana Letícia Braz; Santos, Sócrates Golziodo; Oliveira, Elquio Eleamen; Soares, Luiz Alberto Lira

    2017-01-01

    Background: Plectranthus amboinicus Lour is a species which is widespread throughout tropical countries where it is widely used against respiratory tract disorders such as bronchodilator, antitussive, and expectorant conditions. Objective: This study aims to characterize the essential oil of P. amboinicus (PaEO) and produce and evaluate emulsions containing PaEO. Materials and Methods: The essential oil was characterized by physical-chemical analyses for density, refractive index, 90% ethanol solubility, color, appearance, and identification by gas chromatography coupled to mass spectrometry detection. The emulsions were prepared following a hydrophile-lipophile balance [HLB] spreadsheet design from two nonionic surfactants (Span 80® and Tween 20®) producing HLB values ranging from 4.3 to 16.7. The products were stored at room temperature at 5°C. The emulsion stabilities were tested both in the long and short-term. Results: The PaEO was obtained by steam distillation and the total extraction was reached after 3 hours yielding of 0.2% (w/w). This essential oil was characterized by physicochemical analyses for density [1.5 g.ml-1], refraction index [0.9167], ethanol 90% solubility [1:2], color, and appearance (yellow/clear). Nineteen components were identified in the oil, among them the sesquiterpenes: carvacrol [33.50%], p-cymene [28.20%] and γ-terpinene [14.77%]. The emulsions obtained successfully showed, for the first time, HLB values for essential oils from Plectranthus amboinicus [15.7]. Conclusion: The experimental data shows a relationship between HLB values of the surfactant mixtures contributing to the emulsified systems production containing phytopharmaceuticals. Such an approach is of great importance to the development of lipid carriers for therapeutic drugs. SUMMARY The essential oil from leaves of Plectranthus amboinicus was extracted by steam distillation and characterized.The emulsions containing essential oil were produced and the stability was

  18. Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodeficiency due to autoantibodies against interferon gamma: a case report

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    Poulin Sébastien

    2013-01-01

    Full Text Available Abstract Background Reports of acquired immunodeficiency due to autoantibodies against interferon gamma in the adult population are increasing. The interleukin-12-dependent interferon-gamma axis is a major regulatory pathway of cell-mediated immunity and is critical for protection against a few intracellular organisms, including non-tuberculous mycobacteria and Salmonella spp. We report the first case of a fatal disseminated Mycobacterium colombiense/cytomegalovirus coinfection in an adult woman associated with the acquisition of autoantibodies against interferon-gamma. Case presentation A 49-year-old woman, born to nonconsanguineous parents in Laos, but who had lived in Canada for the past 30 years, presented with a 1-month history of weight loss, fatigue, cough, and intermittent low-grade fever. A thoracic computed tomography scan revealed an 8 × 7 cm irregular mass impacting the right superior lobar bronchus along with multiple mediastinal and hilar adenopathies. On the fourth day of admission, the patient developed fever with purulent expectorations. Treatment for a post-obstructive bacterial pneumonia was initiated while other investigations were being pursued. Almost every culture performed during the patient’s hospitalization was positive for M. colombiense. Given the late presentation of symptoms - at the age of 49 years - and the absence of significant family or personal medical history, we suspected an acquired immunodeficiency due to the presence of anti-interferon-gamma autoantibodies. This was confirmed by their detection at high levels in the plasma and a STAT1 phosphorylation assay on human monocytes. The final diagnosis was immunodeficiency secondary to the production of autoantibodies against interferon-gamma, which resulted in a post-obstructive pneumonia and disseminated infection of M. colombiense. The clinical course was complicated by the presence of a multiresistant Pseudomonas aeruginosa post-endobronchial ultrasound

  19. Clinical characteristics and gene mutation analysis of riboflavin-responsive lipid storage myopathy: report of 3 cases in 2 families and review of literature

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    Ji-qing CAO

    2014-06-01

    Full Text Available Objective The clinical manifestation and electron transfer flavoprotein dehydrogenase (ETFDH gene mutation of riboflavin-responsive lipid storage myopathy were analyzed for early diagnosis and treatment.mutation of riboflavin-responsive lipid storage myopathy were analyzed for early diagnosis and treatment. Methods Clinical material, ETFDH gene mutation and the motor function before and after vitamin B2 treatment in 3 patients from 2 predigrees were collected from August 2012 to March 2013 in our hospital. Results Case 1 was 16-year-old female. The chief complaint was difficulty of breathing and expectorating for over 3 years. Clinical symptoms included progressive respiratory muscle and proximal limb muscle weakness and worsen by fever, cardiac involvement, myopathic electromyography (EMG changes and deposition of lipid droplets in muscle fiber by oil red O staining. Case 2 and Case 3 were brothers, the chief complaint of whom was fatigue after exercise for more than 1 year and 1 month, respectively. Clinical symptoms included significantly weakness of lower limbs and neck muscles after exercise and myopathic EMG changes. All 3 patients from two predigrees presented ETFDH gene mutation [c.250G > A (Ala84Thr homozygous mutations and c.250G > A (Ala84Thr and c.524G > A (Arg175His compound heterozygous mutations, respectively]. They all had a dramatic response to vitamin B2 treatment with muscle strength and motor function recovering to normal. The symptoms of Case 1 were completely disappeared with vitamin B2 treatment for over 10 months, including respiratory muscle and proximal limb muscle weakness, and the motor function of her limbs returned to normal, characterized by completing over 10 squat-stand in 1 min. Case 2 could walk and run as ordinary people, raise his head without difficulty and play basketball about 2 h without fatigue after vitamin B2 treatment for over 2 months. Case 3 could participate in any kind of strenuous exercise

  20. Evaluation of subacute toxicity of methanolic/aqueous preparation of aerial parts of O. sanctum in Wistar rats: Clinical, haematological, biochemical and histopathological studies.

    Science.gov (United States)

    Raina, P; Chandrasekaran, C V; Deepak, M; Agarwal, A; Ruchika, K-G

    2015-12-04

    Ocimum sanctum, commonly known as Holy Basil or Tulsi has been used in Ayurveda as a demulcent, stimulant, expectorant; in the treatment of bronchitis, skin infections, malaria, diarrhoea, dysentery, arthritis, gastric and inflammatory disorders. We have previously shown that methanolic/aqueous extract of O. sanctum did not induce genotoxicity and other toxic effects in acute oral toxicity study. In the present report, we have performed sub-acute toxicity of methanolic/aqueous preparation of O. sanctum in Wistar rats to evaluate whether it induced any chronic toxic effects. In subacute toxicity study, animals received O. sanctum extract (OSE) by oral gavage at the doses of 250, 500 and 1000 mg/kg/day (n=5/group/sex) for 28 days. At the end of the study, the animals were sacrificed and evaluated for the effect of OSE on clinical, haematological, biochemical and histopathological parameters. The rats treated with OSE did not show any change in body weight, food and water consumption, motor activity, sensory reactivity and foot splay measurements. There were no significant changes in haematological, pathological and biochemical parameters; and histopathology of tissues (liver, kidney, spleen, heart, and testis/ovary) among rats of either sex. OSE at a dose of 1000 mg/kg showed significant increase of Mean corpuscular hemoglobin (MCH) (19.8 ± 0.8; 18.7 ± 0.5) and mean corpuscular hemoglobin concentration (MCHC) (41.8 ± 1.1; 39.3 ± 0.7) in male and female rats in comparison to their respective controls (MCH: 17.7 ± 0.3; 17.4 ± 0.3; MCHC: 37.8 ± 0.5; 36.1 ± 0.2). Urine parameters (appearance, blood, nitrate, leucocyte, glucose, ketone, pH, protein and specific gravity) in both the male and female rats were comparable to their respective controls. In addition, no changes were observed in the vital organs of rats at macroscopic and microscopic levels. Our results showed that oral administration of OSE was not toxic to male and female Wistar rats upto the highest

  1. Codeine consumption from over-the-counter anti-cough syrup in Taiwan: A useful indicator for opioid abuse.

    Science.gov (United States)

    Lo, Ming-Yu; Ong, Ming Wei; Lin, Jaung-Geng; Sun, Wei-Zen

    2015-12-01

    Over-the-counter (OTC) anti-cough preparations, many of which contain codeine (an opioid) or dextromethorphan (an opioid-like), are widely available in Taiwan and thus susceptible to overuse or abuse. We aimed to investigate whether opioids in the form of OTC antitussives play a significant role in medication abuse in Taiwan. Data on the consumption of codeine and dextromethorphan in antitussives and expectorants from 2011 through 2014 in Taiwan were provided by IMS Health (Intercontinental Marketing Services). These data were then analyzed for trends and variance according to availability, as prescription or OTC, and according to drug type, as codeine or dextromethorphan, in order to form four primary sectors under opioid-containing anti-cough syrup consumption. From 2011 to 2014, use of opioid-containing cough syrup fluctuated between 6% and 9% from year to year for all cough syrup consumption, with an overall declining trend (11.3% per year relative to 2011). Within the underlying sectors, mean consumption for prescription dextromethorphan (61.4%) outstripped the other three sectors, followed in decreasing order by OTC codeine (20.2%), OTC dextromethorphan (10.5%), and prescription codeine (8.0%). However, movement in consumption corresponded mainly with OTC codeine, whose variance greatly exceeded that of the other sectors, which follow in order of decreasing variance as OTC dextromethorphan, prescription dextromethorphan, and prescription codeine. The fairly low and stable consumption of prescription codeine suggested that physicians in Taiwan were careful in prescribing codeine, and that the medical demand for codeine was stable. The large variance in OTC codeine consumption suggested that a minority of consumers purchased significant quantities of codeine for non-medical purposes. Although opioids in cough syrup were not a large part of overall consumption and thus not widely abused, the data revealed that OTC codeine-containing cough syrup may serve as an

  2. The effect of ice slushy ingestion and mouthwash on thermoregulation and endurance performance in the heat.

    Science.gov (United States)

    Burdon, Catriona A; Hoon, Matthew W; Johnson, Nathan A; Chapman, Phillip G; O'Connor, Helen T

    2013-10-01

    The purpose of this study was to establish whether sensory factors associated with cold-beverage ingestion exert an ergogenic effect on endurance performance independent of thermoregulatory or cardiovascular factors. Ten males performed three trials involving 90 min of steady state cycling (SS; 62% VO2max) in the heat (32.1 ± 0.9 °C, 40 ± 2.4% relative humidity) followed by a 4 kJ/kg body mass time trial (TT). During SS, participants consumed an identical volume (260 ± 38 g) of sports beverage (7.4% carbohydrate) every 15 min as either ice slushy (-1 °C; ICE), thermoneutral liquid (37 °C; CON), or thermoneutral liquid consumption with expectorated ice slushy mouthwash (WASH). Rectal temperature, hydration status, heart rate, and skin blood flow were not different between trials. Gastrointestinal (pill) temperature was lower in ICE (35.6 ± 2.7 °C) versus CON (37.4 ± 0.7 °C, p = .05). Heat storage tended to be lower with ICE during SS (14.7 ± 8.4 W.m(-2), p = .08) and higher during TT (68.9 ± 38.6 W.m(-2), p = .03) compared with CON (22.1 ± 6.6 and 31.4 ± 27.6 W.m(-2)). ICE tended to lower the rating of perceived exertion (RPE, 12.9 ± 0.6, p = .05) and improve thermal comfort (TC, 4.5 ± 0.2; p = .01) vs. CON (13.8 ± 1.0 and 5.2 ± 0.2 respectively). WASH RPE (13.0 ± 0.8) and TC (4.8 ± 0.2) tended to be lower versus CON (p = .07 and p = .09 respectively). ICE improved performance (18:28 ± 1:03) compared with CON (20:24 ± 1:46) but not WASH (19:45 ± 1:43). Improved performance with ICE ingestion likely resulted from the creation of a gastrointestinal heat sink, reducing SS heat storage. Although the benefits of cold-beverage consumption are more potent when there is ingestion, improved RPE, TC, and meaningful performance improvement with WASH supports an independent sensory effect of presenting a cold stimulus to the mouth.

  3. Clinical efficacy of farcosolvin syrup (ambroxol–theophylline–guaiphenesin mixture in the treatment of acute exacerbation of chronic bronchitis

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    Mostafa Yakoot

    2010-07-01

    Full Text Available Mostafa Yakoot1, Amel Salem2, Abdel-Mohsen Omar31Green Clinics and Research Center, Alexandria, Egypt; 2Al-Mabarah Hospital, 3Faculty of Pharmacy, Alexandria University, Alexandria, EgyptBackground: Acute exacerbations of chronic bronchitis (AECB are defined as recurrent attacks of worsening bronchial inflammation that are marked by an increase in the volume of daily sputum produced, a change in color of the expectorated sputum, and worsening dyspnea. Farcosolvin® (Pharco Pharmaceuticals, Alexandria, Egypt is a mixture of ambroxol (15 mg; theophylline (50 mg; and guaiphenesin (30 mg, per 5 mL syrup.Objective: To test the clinical efficacy of Farcosolvin in the treatment of AECB in a randomized, single-blinded, controlled study design.Patients and methods: One hundred patients with AECB were randomized to either Farcosolvin or guaiphenesin treatment groups, in addition to the standard medical treatment for their cases. Baseline clinical symptomatolgy of breathlessness, cough, and sputum severity scoring were compared before and after 3 and 7 days of treatment in both groups and the differences compared between groups. Changes in perceived improvement were also compared between groups using the Clinical Global Impression of Improvement or Change Scale (CGIC.Results: There were statistically significant improvements in breathlessness and cough scores in both groups (pretreatment versus posttreatment at day 3 and at day 7; P < 0.05. There were highly statistically significant differences between groups in improvement in ­breathlessness and cough scores, after 3 and 7 days treatment, in favor of the Farcosolvin ­treatment group (P < 0.001. Out of 50 patients, 48 (96% in the Farcosolvin-treated group rated their ­improvement on the CGIC scale as “much” and “very much” improved, while only 41 patients (82% reported such a degree of improvement in the control group. The difference was statistically significant (P < 0.05.Conclusion: We

  4. Piperidine alkaloids from Piperretrofractum Vahl. protect against high-fat diet-induced obesity by regulating lipid metabolism and activating AMP-activated protein kinase

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Jin [Department of Biomaterials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of); Lee, Myoung-Su; Jo, Keunae [Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 120-749 (Korea, Republic of); Hwang, Jae-Kwan, E-mail: jkhwang@yonsei.ac.kr [Department of Biomaterials Science and Engineering, Yonsei University, Seoul 120-749 (Korea, Republic of); Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 120-749 (Korea, Republic of); Translational Research Center for Protein Functional Control, Yonsei University, Seoul 120-749 (Korea, Republic of)

    2011-07-22

    Highlights: {yields} Piperidine alkaloids from Piperretrofractum Vahl. (PRPAs), including piperine, pipernonaline, and dehydropipernonaline, are isolated as the anti-obesity constituents. {yields} PRPA administration significantly reduces body weight gain without altering food intake and fat pad mass. {yields} PRPA reduces high-fat diet-induced triglyceride accumulation in liver. {yields} PRPAs attenuate HFD-induced obesity by activating AMPK and PPAR{delta}, and regulate lipid metabolism, suggesting their potential anti-obesity effects. -- Abstract: The fruits of Piperretrofractum Vahl. have been used for their anti-flatulent, expectorant, antitussive, antifungal, and appetizing properties in traditional medicine, and they are reported to possess gastroprotective and cholesterol-lowering properties. However, their anti-obesity activity remains unexplored. The present study was conducted to isolate the anti-obesity constituents from P. retrofractum Vahl. and evaluate their effects in high-fat diet (HFD)-induced obese mice. Piperidine alkaloids from P. retrofractum Vahl. (PRPAs), including piperine, pipernonaline, and dehydropipernonaline, were isolated as the anti-obesity constituents through a peroxisome proliferator-activated receptor {delta} (PPAR{delta}) transactivation assay. The molecular mechanism was investigated in 3T3-L1 adipocytes and L6 myocytes. PRPA treatment activated AMP-activated protein kinase (AMPK) signaling and PPAR{delta} protein and also regulated the expression of lipid metabolism-related proteins. In the animal model, oral PRPA administration (50, 100, or 300 mg/kg/day for 8 weeks) significantly reduced HFD-induced body weight gain without altering the amount of food intake. Fat pad mass was reduced in the PRPA treatment groups, as evidenced by reduced adipocyte size. In addition, elevated serum levels of total cholesterol, low-density lipoprotein cholesterol, total lipid, leptin, and lipase were suppressed by PRPA treatment. PRPA also

  5. Non-invasive ventilation for cystic fibrosis.

    Science.gov (United States)

    Moran, Fidelma; Bradley, Judy M; Piper, Amanda J

    2017-02-20

    other domains. One single intervention trial had a low risk of bias for the randomisation procedure with the remaining trials judged to have an unclear risk of bias. Most trials had a low risk of bias with regard to incomplete outcome data and selective reporting.Six trials (151 participants) evaluated non-invasive ventilation for airway clearance compared with an alternative chest physiotherapy method such as the active cycle of breathing techniques or positive expiratory pressure. Three trials used nasal masks, one used a nasal mask or mouthpiece and one trial used a face mask and in one trial it is unclear. Three of the trials reported on one of the review's primary outcome measures (quality of life). Results for the reviews secondary outcomes showed that airway clearance may be easier with non-invasive ventilation and people with cystic fibrosis may prefer it. We were unable to find any evidence that non-invasive ventilation increases sputum expectoration, but it did improve some lung function parameters.Three trials (27 participants) evaluated non-invasive ventilation for overnight ventilatory support compared to oxygen or room air using nasal masks (two trials) and nasal masks or full face masks (one trial). Trials reported on two of the review's primary outcomes (quality of life and symptoms of sleep-disordered breathing). Results for the reviews secondary outcome measures showed that they measured lung function, gas exchange, adherence to treatment and preference, and nocturnal transcutaneous carbon dioxide. Due to the small numbers of participants and statistical issues, there were discrepancies in the results between the RevMan and the original trial analyses. No clear differences were found between non-invasive ventilation compared with oxygen or room air except for exercise performance, which significantly improved with non-invasive ventilation compared to room air over six weeks.One trial (13 participants) evaluated non-invasive ventilation on exercise

  6. Positive expiratory pressure therapy versus other airway clearance techniques for bronchiectasis.

    Science.gov (United States)

    Lee, Annemarie L; Burge, Angela T; Holland, Anne E

    2017-09-27

    participants, therapists or personnel for outcome measure assessment in most studies. Clinical heterogeneity between studies limited meta-analysis.Daily use of oscillatory PEP therapy for four weeks was associated with improved general health according to the Short-Form 36 questionnaire compared to the active cycle of breathing technique (ACBT). When applied for three sessions over one week, minimal PEP therapy resulted in similar improvement in cough-related quality of life as autogenic drainage (AD) and L'expiration Lente Totale Glotte Ouverte en Decubitus Lateral (ELTGOL). Oscillatory PEP therapy twice daily for four weeks had similar effects on disease-specific HRQOL (MD -0.09, 95% CI -0.37 to 0.19; low-quality evidence). Data were not available to determine the incidence of hospitalisation or rate of exacerbation in clinically stable participants.Two studies of a single session comparison of oscillatory PEP therapy and gravity-assisted drainage (GAD) with ACBT had contrasting findings. One study found a similar sputum weight produced with both techniques (SMD 0.54g (-0.38 to 1.46; 20 participants); the other found greater sputum expectoration with GAD and ACBT (SMD 5.6 g (95% CI 2.91 to 8.29: 36 participants). There was no difference in sputum weight yielded between oscillatory PEP therapy and ACBT with GAD when applied daily for four weeks or during an acute exacerbation. Although a single session of oscillatory PEP therapy was associated with less sputum compared to AD (median difference 3.1 g (95% CI 1.5 to 4.8 g; one study, 31 participants), no difference between oscillatory PEP therapy and seated ACBT was evident. PEP therapy had a similar effect on dynamic and static measures of lung volumes and gas exchange as all other ACTs. A single session of oscillatory PEP therapy (Flutter) generated a similar level of fatigue as ACBT with GAD, but greater fatigue was noted with oscillatory PEP therapy compared to ACBT alone. The degree of breathlessness experienced with PEP

  7. Automedicação em crianças de zero a cinco anos: fármacos administrados, conhecimentos, motivos e justificativas La automedicación en niños de cero a cinco años: fármacos administrados, conocimientos, declaraciones y justificativas Self-medication in children from zero to five years: farmacos managed, knowledge, statement and background

    Directory of Open Access Journals (Sweden)

    Paulo Celso Prado Telles Filho

    2013-06-01

    automedicación.We carried out the analysis of drugs administered, knowledge, motives and justifications of parents and/or guardians in relation to self-medication in children. It is a descriptive study, developed in Estratégia de Saúde da Família in a city in the interior of Minas Gerais, which includes parents and/or guardians of children aged zero to five years, in the period one month, reaching the amount of 50 individuals. The highlights were the self administration of drugs Dipyrone, Paracetamol and syrups expectorants, erroneous knowledge 32 (64%, followed by partial 11 (22% and correct 7 (14%, respectively, the symptoms of fever with 29 (58% of the reasons and justification that they are accustomed to administer such drugs and they already have them at home. It is necessary to implement strategies focused in educate parents and/or guardians about the problems arising from self-medication.

  8. Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon

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    Layoun N

    2017-02-01

    the textual warnings effects. A higher motivation to quit cigarette smoking was seen among the following groups of smokers: males (odds ratio [OR] =1.8, P=0.02, who had stopped smoking for at least 1 month during the last year due to textual warning (OR =2.79, P<0.001, who considered it very important to report health warning on cigarette packs (OR =1.92, P=0.01, who had chronic expectoration (OR =1.81, P=0.06 and who would change their favorite cigarette pack if they found shocking images on the pack (OR =1.95, P=0.004. Conclusion: Low-dependent smokers and highly motivated to quit smokers appeared to be more hypothetically susceptible to shocking pictorial warnings. Motivation to quit was associated with sensitivity to warnings, but not with the presence of all chronic respiratory symptoms. Keywords: cigarette tobacco smoking, adult smokers, health warnings, cigarette packaging, graphic warning labels, textual warning labels

  9. Evaluation of a combined polymer system for use in relieving the symptoms of xerostomia.

    Science.gov (United States)

    Corcoran, Ruth A; Stovell, Alex G; Urquhart, David; Chui, Ted; Richardson, Marie

    2006-01-01

    The aim of this series of studies on rheological, sensory, and mucoadhesive properties was to evaluate the potential of using a combined polymer system to more closely represent the adaptive nature of saliva, while providing long lasting relief from the symptoms of xerostomia. The rheological investigations were conducted on 1% polymer solutions 24 hours after preparation, during which time they were stored in sealed glass containers at room temperature. The rheometer was controlled via peltier to 35 degrees C +/- 0.1 degrees C, and a shear rate range of 0.1 to 300 s(-1) was applied; thirty measurements were taken during each run. Eight panelists were recruited from the in-house sensory panel at GlaxoSmithKline (GSK) Weybridge to take part in the sensory evaluation. A brief training session was conducted at the start of the study in order to standardize the panelists' responses to the sensory term "tacky." For each test, panelists were given 10 ml of the respective polymer solution and instructed to swirl this solution around their mouths for 20 seconds before expectorating. The panelists were then asked to evaluate the solution in terms of "tack," measured by tapping the tongue on the roof of the mouth. A new formulation, based upon the rheology and sensory testing, was evaluated versus other commercially available sprays for the relief of xerostomia. The new formulation, named OASIS, contains a combination of Xanthan gum, carboxymethyl cellulose and a polyvinyl pyrollidone backboned polymer. To evaluate mucoadhesion of this final product, a 16 mm diameter cylindrical aluminium probe was selected. The probe and the base platform were both coated with a thin layer of artificial polyurethane membrane to more closely mimic the oral mucosal surface. The probe was set to travel downward at 2.0 mm/sec until it made contact with the base platform with a force of 1000 g. The two surfaces were then left in contact for 30 seconds before the probe receded from the base

  10. Intoxicações medicamentosas em crianças menores de cinco anos Drug intoxication among children under five years old

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    Guacira Corrêa de Matos

    2002-08-01

    circumstances. RESULTS: in Brazil, there were 151.000 intoxication cases in the focused period. Almost one third was associated to medication, and about forty thousand occurred among children less than five years old. Analgesics, the decongestants, the bronchodilators, the antiepileptics and oral contraceptives were the therapeutic classes involved, and the decongestants, the antiepileptics, the antihistamines and the expectorants were associated to cause of death. The surveillance system pointed out that individual accidents, medication errors and therapeutic misuse were the main circumstances involved. CONCLUSIONS: drug intoxication is a major public health problem, for which intervention measures are necessary. Educational and regulatory actions could decrease the number of accidents and injuries. The main inadequacies of SINITOX are under-registration, lack of integration with health services and poor data uniformity.

  11. Facteurs de risque de mortalité par tuberculose pulmonaire

    Science.gov (United States)

    Janah, Hicham; Souhi, Hicham; Kouismi, Hatim; Mark, Karima; Zahraoui, Rachida; Benamor, Jouda; Soualhi, Mona; Bourkadi, Jamal Eddine

    2014-01-01

    La tuberculose est une maladie infectieuse transmissible provoquée par myco-bacterium tuberculosis (bacille de Koch ou BK). Elle représente, selon les estimations del'Organisation Mondiale de la Santé (OMS), l'une des pathologies infectieuses causant le plus de décès au niveau mondial avec plus de 1 million de décès par an. Pour déterminer les facteurs de risque de mortalité au cours de la tuberculose pulmonaire à microscopie positive nous avons mené une étude rétrospective portant sur tous les cas de tuberculose pulmonaire à microscopie positive et qui étaient décédés au cours de leur hospitalisation. Cette étude a colligé 1803 cas de tuberculose sur une période de 2 ans et demi dont 46 sont décédés. La prévalence de décès est de 2,55%. La population se répartit en 32 hommes et 14 femmes. L’âge moyen était de 53ans ± 17 ans. Le tabagisme était retrouvé chez la moitié des cas. Une comorbidité était retrouvée dans 43%, avec 17% de diabète. Le délai de diagnostic avait une médiane de 60 jours avec percentile (30j; 105j). La symptomatologie clinique était dominée par la toux, la dyspnée et les expectorations soit respectivement: 97,8%, 69,6% et 67,4% des cas. Sur le plan radiologique les lésions étaient diffuses et bilatérales dans 76,1% des cas. Tous les patients étaient mis sous SRHZ. 11% avaient présenté une toxicité aux antibacillaires (de type hépatiques dans 3 cas et neurologiques dans 2 cas). Le délai médian de décès était de 8,5 jours (5j; 17j). Les causes de décès retrouvées étaient: Une hépatite fulminante (3 cas), une décompensation acido-cétosique (3 cas), un SDRA (2 cas), des hémoptysies foudroyantes (2 cas), et respectivement un cas secondaire à une décompensation de BPCO, une décompensation cardiaque, une hypoglycémie et un tableau d'anasarque. Cette étude suggère que le terrain, le retard diagnostique et les effets secondaires du traitement sont les principaux facteurs de risque de

  12. Pneumonia tuberculosa: um estudo de 59 casos confirmados microbiologicamente Tuberculous pneumonia: a study of 59 microbiologically confirmed cases

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    Jose Moreira

    2011-04-01

    consistent with fistula between a lymph node and a bronchus. RESULTS: Of the 59 patients studied, 43 (73% were between 20 and 50 years of age, 31 (53% were male, and 28 (47% were Black. The most common symptoms were cough (in 100%, fever (in 88%, expectoration (in 81%, and weight loss (in 40%. Comorbidities were reported in 35 cases (59%, the most common being HIV infection (in 20% and diabetes (in 15%. On chest X-rays, consolidation was observed, predominantly in the upper lobes (in 68%. The diagnostic confirmation (identification of AFB was made through the sputum smear microscopy in the majority of the cases and by bronchoscopy (BAL examination or bronchial biopsy in the remainder. Bronchial lesions were clearly indicative or suggestive of fistula in three cases and five cases, respectively. CONCLUSIONS: Tuberculous pneumonia presents as acute respiratory infection, initiating with a dry cough that is followed by fever. Chest X-rays show alveolar consolidation. In most cases, tuberculous pneumonia was accompanied by at least one comorbid condition, the most common being HIV infection, and the etiological diagnosis was made through sputum smear microscopy for AFB. Bronchoscopy findings were indicative of bronchial fistula in eight cases (13%.

  13. Subdiagnóstico de DPOC na atenção primária em Aparecida de Goiânia, Goiás Underdiagnosis of COPD at primary health care clinics in the city of Aparecida de Goiânia, Brazil

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    Maria Conceição de Castro Antonelli Monteiro de Queiroz

    2012-12-01

    seeking medical attention at one of the selected PHCCs. All subjects included in the study underwent spirometry for the diagnosis of COPD. RESULTS: We successfully evaluated 200 individuals, mostly males. The mean age was 65.9 ± 10.5 years. The diagnosis of COPD was confirmed in 63 individuals, only 18 of whom had been previously diagnosed with COPD (underdiagnosis rate, 71.4%. There were no significant differences between the subgroups with and without a previous diagnosis of COPD in relation to demographics and risk factors. However, there were significant differences between these subgroups for the presence of expectoration, wheezing, and dyspnea (p = 0.047; p = 0.005; and p = 0.047, respectively. The FEV1 and FEV1/FVC ratio, expressed as percentages of the predicted values, were significantly lower in the subjects with a previous diagnosis of COPD, which was predominantly mild or moderate in both subgroups. CONCLUSIONS: The rate of underdiagnosis of COPD was high at the PHCCs studied. One third of the patients with risk factors for COPD met the clinical and functional criteria for the disease. It seems that spirometry is underutilized at such facilities.

  14. Directory of Open Access Journals (Sweden)

    Vikas Goyal

    2013-03-01

    .02. The mean change in daytime cough diary scores from baseline was also better in the placebo group compared to those on nebulized rhDNase, but the difference between groups was not statistically significant (MD 0.70; 95% CI -0.19 to 1.59. Other outcomes (dyspnoea, and difficulty in expectorating sputum scores, and lung function tests at two weeks also favoured placebo over nebulized rhDNase but did not reach levels of significance.AUTHORS' CONCLUSIONSThere is currently an absence of evidence to support any of the therapies currently utilised for management of intrinsic tracheomalacia. It remains inconclusive whether the use of nebulized rhDNase in children with airway malacia and a respiratory tract infection worsens recovery. It is unlikely that any RCT on surgically based management will ever be available for children with severe life-threatening illness associated with tracheomalacia. For those with less severe disease, RCTs on interventions such as antibiotics and chest physiotherapy are clearly needed. Outcomes of these RCTs should include measurements of the trachea and physiological outcomes in addition to clinical outcomes.

  15. Interventions for primary (intrinsic tracheomalacia in children

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    Vikas Goyal

    .02. The mean change in daytime cough diary scores from baseline was also better in the placebo group compared to those on nebulized rhDNase, but the difference between groups was not statistically significant (MD 0.70; 95% CI -0.19 to 1.59. Other outcomes (dyspnoea, and difficulty in expectorating sputum scores, and lung function tests at two weeks also favoured placebo over nebulized rhDNase but did not reach levels of significance.AUTHORS' CONCLUSIONSThere is currently an absence of evidence to support any of the therapies currently utilised for management of intrinsic tracheomalacia. It remains inconclusive whether the use of nebulized rhDNase in children with airway malacia and a respiratory tract infection worsens recovery. It is unlikely that any RCT on surgically based management will ever be available for children with severe life-threatening illness associated with tracheomalacia. For those with less severe disease, RCTs on interventions such as antibiotics and chest physiotherapy are clearly needed. Outcomes of these RCTs should include measurements of the trachea and physiological outcomes in addition to clinical outcomes.

  16. Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label, randomised controlled trial.

    Science.gov (United States)

    Peter, Jonny G; Zijenah, Lynn S; Chanda, Duncan; Clowes, Petra; Lesosky, Maia; Gina, Phindile; Mehta, Nirja; Calligaro, Greg; Lombard, Carl J; Kadzirange, Gerard; Bandason, Tsitsi; Chansa, Abidan; Liusha, Namakando; Mangu, Chacha; Mtafya, Bariki; Msila, Henry; Rachow, Andrea; Hoelscher, Michael; Mwaba, Peter; Theron, Grant; Dheda, Keertan

    2016-03-19

    Trials.gov, number NCT01770730. Between Jan 1, 2013, and Oct 2, 2014, we screened 8728 patients and randomly assigned 2659 to treatment (1336 to LAM, 1323 to no LAM). 108 patients did not receive their allocated treatment, mainly because they did not meet the inclusion criteria, and 23 were excluded from analysis, leaving 2528 in the final modified intention-to-treat analysis (1257 in the LAM group, 1271 in the no LAM group). Overall all-cause 8-week mortality occurred in 578 (23%) patients, 261 (21%) in LAM and 317 (25%) in no LAM, an absolute reduction of 4% (95% CI 1-7). The risk ratio adjusted for country was 0·83 (95% CI 0·73-0·96), p=0·012, with a relative risk reduction of 17% (95% CI 4-28). With the time-to-event analysis, there were 159 deaths per 100 person-years in LAM and 196 per 100 person-years in no LAM (hazard ratio adjusted for country 0·82 [95% CI 0·70-0·96], p=0·015). No adverse events were associated with LAM testing. Bedside LAM-guided initiation of anti-tuberculosis treatment in HIV-positive hospital inpatients with suspected tuberculosis was associated with reduced 8-week mortality. The implementation of LAM testing is likely to offer the greatest benefit in hospitals where diagnostic resources are most scarce and where patients present with severe illness, advanced immunosuppression, and an inability to self-expectorate sputum. European Developing Clinical Trials Partnership, the South African Medical Research Council, and the South African National Research Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Avaliação biológica de Foeniculum vulgare (Mill. (Umbelliferae/Apiaceae Biological evaluation of Foeniculum vulgare (Mill. (Umbelliferae/Apiaceae

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    O. Araujo R

    2013-01-01

    territory. It is commonly known as fennel or "erva-doce" and has been used in medicine as analgesic, digestive, carminative, diuretic, expectorant, lactigenous, anti-inflammatory, and antispasmodic agent. Crude ethanolic extract for the verification of biological activities was prepared from seeds bought in the market. For the phytochemical profile, analytical thin-layer chromatography was used; the antimicrobial activity was determined by the paper disc diffusion test and minimum inhibitory concentration (MIC; the antinociceptive activity was verified by the method of abdominal writhings in the animals. The tested microorganisms were multiresistant clinical isolates obtained from the Bacteriology Sector of the Clinical Hospital of Pernambuco. The phytochemical study identified the majority of secondary compounds present in the methanolic fraction of seeds, as follows: triterpenes, flavanoid glycosides, smaller terpenes (monoterpenoids, sesquiterpenoids and diterpenoids and reducing sugars. The obtained results showed that the ethanolic extract had greater activity against Micrococcus spp. (MIC=250µg/mL. Results of the evaluation of the antinociceptive activity demonstrated that only the dosage of 298 mg/Kg, compared to the indomethacin pattern, led to a significant reduction in the number of abdominal writhings in the animals. Further studies will be carried out for the identification and isolation of some secondary compounds, as well as other analgesic protocols.

  18. Eficácia antitussígena de duas formulações fitoterápicas Antitussive efficacy of two phytotherapics formulations

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    F.B. Mello

    2007-06-01

    Full Text Available Avaliaram-se os efeitos antitussígenos-expectorantes de duas formulações fitoterápicas utilizando-se três modelos biológicos diferentes. Foram utilizados ratos Wistar no modelo da secreção das vias aéreas, cobaias no modelo de tosse induzido por ácido cítrico e codornas japonesas na determinação da velocidade de transporte mucociliar. Os animais foram distribuídos em grupos e tratados por via oral com as formulações, com doses equivalentes a 10 vezes a terapêutica recomendada, 9ml.kg-1. O grupo-controle negativo de cada espécie foi tratado com solução fisiológica, 10ml.kg-1. O grupo-controle positivo no modelo de tosse induzida pelo ácido cítrico foi tratado com morfina, 1mg.kg-1, por via subcutânea. No modelo em que foram utilizados ratos e codornas, o grupo-controle positivo recebeu erdosteína por via oral, 600mg.kg-1. Os resultados mostraram que as duas formulações fitoterápicas foram eficazes no reflexo da tosse em cobaias, causando 36,4% e 27,3%, respectivamente, de redução. Nos modelos de secreção das vias aéreas e determinação da velocidade de transporte mucociliar, ambas as formulações não apresentaram eficácia significativa.The antitussive-expectorant effects of two phytotherapic formulations available in the Brazilian market were evaluated using three different biological models. Each phytotherapic formulation, with different composition, had the same batch number and fabrication date. The trade names of the phytotherapics were: Gripalplus Solução® and Melagrião®. Wistar rats were used in the airway secretion model, guinea pigs in the citric acid-induced cough model and japanese quails in the mucociliary transport rate determination. The animals (one group/formulation were divided in the two phytotherapic groups and orally treated with the equivalent to ten told the therapeutic recommended dose, which was 9ml.kg-1. Animals of negative control group of each specie were orally treated with 10ml

  19. Chemical composition and antioxidative activity of essential oil of Thymus serpyllum L.

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    Petrović Slobodan S.

    2014-01-01

    Full Text Available Wild thyme (Thymus serpyllum L. is a popular remedy regarding both traditional and conventional medicine. It is used as the antiseptic, aromatic, expectorant, stomachic, antispasmodic, carminative and preservative substance. For the purpose of this paper, wild thyme essential oil was isolated from the dried herb T. serpyllum by hydrodistillation. Original semi-industrial distillation device SP-130 performing distillation by water and steam was used for the hydrodistillation of T. serpyllum essential oils. The temperature during the hydrodistillation in the device SP-130 ranged from 100°C - 102°C at atmospheric pressure, and the whole process lasted 5 hours. The isolated essential oil is a liquid of light yellow colour and the odour characteristic of the genus Thymus. Obtained yield of essential oil was 0.08 %, with 65 components identified in the tested essential oil. The most represented chemical groups are sesquiturpene hydrocarbons with 35.1%, and oxygenated sesquiturpenes with 34.8%. The main components of essential oil of T. serpyllum were: trans-nerolidol (24.2%, germacrene D (16.0%, thymol (7.3%, δ-cadinene (3.7% and β-bisabolene (3.3%. The essential oil showed significantly better ability to neutralize DPPH free radicals (IC50 = 0.503 μL / mL compared with synthetic antioxidants BHA and BHT. Synthetic chemical compounds such as BHA and BHT are used in food industry as antioxidants due to their ability to prolong the shelf-life of foodstuffs by protecting them against deterioration caused by oxidation, such as fat rancidity, colour changes, degradation of the flavor and loss of nutrient value. In recent years, there is a considerable interest in finding natural compounds that could replace sinthetic antioxidants because of adverse toxicological reports on many synthetic compounds. Lamiaceae herbs and their essential oils or extracts application has proven to be the effective preservation agents for the extension shelf-life of

  20. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines.

    Science.gov (United States)

    Braman, Sidney S

    2006-01-01

    therapy for short-term symptomatic relief of coughing, but there is no role for inhaled bronchodilator or expectorant therapy. Children and adult patients with confirmed and probable whooping cough should receive a macrolide antibiotic and should be isolated for 5 days from the start of treatment; early treatment within the first few weeks will diminish the coughing paroxysms and prevent spread of the disease; the patient is unlikely to respond to treatment beyond this period. Acute bronchitis is an acute respiratory infection that is manifested by cough and, at times, sputum production that lasts for no more than 3 weeks. This syndrome should be distinguished from the common cold, an acute exacerbation of chronic bronchitis, and acute asthma as the cause of acute cough. The widespread use of antibiotics for the treatment of acute bronchitis is not justified, and vigorous efforts to curtail their use should be encouraged.

  1. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype – a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial

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    Beeh KM

    2016-11-01

    mildly symptomatic patients (sputum/expectoration and cough was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment (2 months: ELOM-080 25%, placebo 11%, P<0.005; 3 months: ELOM-080 26%, placebo 14%, P<0.05. Likewise the subjective rating of general health status was better in the ELOM-080 group with statistically significant superiority after 2 and 3 months of treatment (2-month treatment: P=0.015; 3-month treatment: P=0.024. Tolerability results were comparable between ELOM-080 and placebo. Conclusion: ELOM-080 is efficacious in patients with COPD and a chronic bronchitis phenotype. Prophylactic use reduces the rate of exacerbations and improves the key symptoms of sputum and cough with a favorable long-term tolerability profile. Keywords: COPD, exacerbations, winter, phytotherapy, myrtol, chronic bronchitis, sputum

  2. Medicinal plants from the genus Acalypha (Euphorbiaceae)--a review of their ethnopharmacology and phytochemistry.

    Science.gov (United States)

    Seebaluck, R; Gurib-Fakim, A; Mahomoodally, F

    2015-01-15

    , Acalypha alnifolia and Acalypha fruticosa are used as insecticides and sand fly repellent respectively. Only 2 species (Acalypha fruticosa and Acalypha indica) are used in ethnoveterinary practice and have similar human and veterinary applications. In zoopharmacognosy, only Acalypha ornata has been mentioned. Natives from Africa, Central America, North America, Southern China, India, Bangladesh, Papua New Guinea and Mascarenes islands utilize Acalypha species as ethnomedicine. Traditionally used Acalypha species have been reported to possess at least one of the following biological activities: antimicrobial, anti-diabetic, antioxidant, anti-inflammatory, larvidal, pupicidal, hepatoprotective, anticancer, leishmanicidal, antihyperglycemic, antihypertensive, anti-venom, analgesic, anthelmintic, antiemetic, laxative, expectorant, diuretic, post-coital antifertility effects and wound healing. A total of 167 compounds have been identified from 19 species, with 16 from eight species were reported to be bioactive. The present review represents 32.3% of species from the Acalypha genus and can be considered as the first compilation of ethnopharmacologically useful plants from this genus. There is a great potential to discover new biologically active phytochemicals from the Acalypha genus because only few species have been studied comprehensively. Therefore, the clinical evaluation of species from this genus is warranted in future studies to confirm the ethnomedicinal claims and for the safety approval of therapeutic applications. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Formulation development of ambroxol hydrochloride soft gel with application of statistical experimental design and response surface methodology.

    Science.gov (United States)

    Dabhi, Mahesh; Gohel, Mukesh; Parikh, Rajesh; Sheth, Navin; Nagori, Stavan

    2011-01-01

    The purpose of present work was to develop ambroxol hydrochloride soft gel formulation with the application of statistical experimental design and response surface methodology (RSM). A two-factor, three-level (3(2)) full factorial design of experiment with RSM was run to evaluate the main and interaction effect of two independent formulation variables that included the amount of low-acetylated gellan gum and sodium citrate. The dependent variables included viscosity (Y(1)), amount of drug release at 10 min (Y(2)) and 30 min (Y(3)), and gelation time (Y(4)). In order to obtain a formulation having the maximum amount of drug release at 10 min and minimum gelation time, RSM optimization was used. The prepared formulations were evaluated for pH, viscosity, rheological properties, gelation time, drug content, in vitro drug release, appearance, and taste. All the formulations showed a gelation time in the range of 6 to 48 min. The drug content in all the formulations was within limit (99.6 ± 1.56%). The viscosity of all the formulations was found in the range of 1872-12,182 cP. Dissolution studies of the formulations showed drug release in the range of 40.56-72.46% within 10 min and 80.2-100.5% within 30 min. Human evaluation tests revealed that all the gels possessed acceptable characteristics. This study showed that the soft gel formulation GA5, containing 0.3% of gellan gum and 0.4% of sodium citrate, has potential use as an immediate release soft gel for oral drug delivery. The objective of this investigation was to develop a new, immediate-release, soft gel dosage form for ambroxol hydrochloride, an oral expectorant and mucolytic agent. This novel soft gel dosage form needs to be suitable for pediatric and geriatric patients as well as patients with dysphagia. A statistical technique was used for optimization of the gel formulation. The methodology, called a design of experiment with response surface methodology, evaluated several independent formulation variables

  4. ADJUNCTIVE THERAPY OF COMMUNITY-ACKUIRED PNEUMONIA: NECESSITY AND SUFFICIENCY

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    L. V. Savchenkova

    2016-01-01

    Full Text Available Objective: analysis of pathogenetic and  symptomatic therapy of community-acquired pneumonia in the prehospital and at the stage  of hospital treatment of disease in hospitals of city Khujand of the Republic of Tajikistan.Materials and  methods: A retrospective analysis of 393 case  histories of  patients treated for  community-acquired pneumonia in  the  hospital Khujand from  2011  to  2015  is conducted. The estimation of the scope  and efficiency of the additional medical support for the treatment of communityacquired pneumonia was conducted, take  into  account the drugs  that  given  to patients in an outpatient setting and  in a hospital. Analyzed purpose rationale, adequacy of dose, duration of treatment and  compliance of the  activities with existing international and  national guidelines for the treatment  of community-acquired pneumonia.Results:  the  study found that  in  clinical  practice, 57% of  patients with  community-acquired pneumonia received funds pathogenetic and  symptomatic therapy. It  is  found that  quite  often  prescribed drugs  with  unproven efficiency. Thus,  75%  of patients received expectorants and  mucolytic drugs,   42.2% of  patients  received anti-allergic medicals. Non-steroidal anti-inflammatory medicals received 37.9% of patients with  community-acquired pneumonia, almost  30% of patients receiving infusion therapy. Quite often  (15.7% patients with   community-acquired  pneumonia  prescribed antifungal drugs  and  antiprotozoal drug  – metronidazole (59%  of cases.  Furthermore, in complex treatment of community-acquired pneumonia include vitamin C (23.1% and vitamin B (65.9%.Conclusion: the  analysis of pharmacotherapy community-acquired pneumonia showed that  in the treatment of this disease occurs  unjustified polypharmacy. Quite often  prescribe drugs with unproven efficacy and, as a consequence of a significant frequency of clinical

  5. The genus Inula and their metabolites: from ethnopharmacological to medicinal uses.

    Science.gov (United States)

    Seca, Ana M L; Grigore, Alice; Pinto, Diana C G A; Silva, Artur M S

    2014-06-11

    The genus Inula comprises more than one hundred species widespread in temperate regions of Europe and Asia. Uses of this genus as herbal medicines have been first recorded by the Greek and Roman ancient physicians. In the Chinese Pharmacopoeia, from the 20 Inula spp. distributed in China, three are used as Traditional Chinese medicines, named Tumuxiang, Xuanfuhua and Jinfeicao. These medicines are used as expectorants, antitussives, diaphoretics, antiemetics, and bactericides. Moreover, Inula helenium L. which is mentioned in Minoan, Mycenaean, Egyptian/Assyrian pharmacotherapy and Chilandar Medical Codex, is good to treat neoplasm, wound, freckles and dandruff. Many other Inula spp. are used in Ayurvedic and Tibetan traditional medicinal systems for the treatment of diseases such as bronchitis, diabetes, fever, hypertension and several types of inflammation. This review is a critical evaluation of the published data on the more relevant ethnopharmacological and medicinal uses of Inula spp. and on their metabolites biological activities. This study allows the identification of the ethnopharmacological knowledge of this genus and will provide insight into the emerging pharmacological applications of Inula spp. facilitating the prioritirization of future investigations. The corroboration of the ethnopharmacological applications described in the literature with proved biological activities of Inula spp. secondary metabolites will also be explored. The major scientific databases including ScienceDirect, Medline, Scopus and Web of Science were queried for information on the genus Inula using various keyword combinations, more than 180 papers and patents related to the genus Inula were consulted. The International Plant Name Index was also used to confirm the species names. Although the benefits of Inula spp. are known for centuries, there are insufficient scientific studies to certify it. Most of the patents are registered by Chinese researchers, proving the traditional

  6. SUBCLINICAL INTERSTITIAL PULMONARY INJURY IN RHEUMATOID ARTHRITIS

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    D. V. Bestaev

    2015-01-01

    Full Text Available Subjects and methods. The study enrolled 61 inpatients diagnosed with RA (according to the 1987 American College of Rheumatology criteria who were treated at the V.A. Nasonova Research Institute of Rheumatology; in so doing, high-resolution computed tomography revealed lung changes as a ground glass pattern in 15 patients, reticular striation, traction bronchoectases, and lung tissue changes as honeycomb ones in 25 patients; no lung abnormalities were found in 21 patients. DAS28 was applied to determine the inflammatory activity of RA. The RA patients underwent X-ray studies of the hand, foot, and chest, by using accordingly X-Ray unit and spiral computed tomography scanner (section thickness, 0.65 mm. External respiration function (ERF indicators were studied with plethysmograph. IgM rheumatoid factor was measured using an immune nephelometer. Serum anti-cyclic citrullinated peptide antibodies were assayed by immunochemiluminescence technique on a Cobas e411 analyzer. The xMAP technology using a BioPlex200 analyzer was employed to determine the serum concentrations of 27 cytokines in 15 patients with subclinical IPI and in 25 with clinical IPI. Results and discussion. The major respiratory signs in patients with IPI proved to be cough (24 %, expectoration (20 %, dyspnea (16 %, and crepitation (64 % on auscultation. Three patients with subclinical IPI were found to have crepitation on auscultation. Respiratory symptoms were absent in the RA patients without IPI. It should be noted that there are a larger number of RA patients with a high smoking index among the RA patients with IPI than among those without IPI (p < 0.05. Investigation of ERF indicators revealed a statistically significantly lower lung diffusing capacity (LDC in the RA patients with subclinical IPI than in those without IPI (p < 0.05. Other ERF indicators showed no significant deviations of the reference values. LDC and total lung capacity appeared to be statistically

  7. Bronquiectasia e fisioterapia desobstrutiva: ênfase em drenagem postural e percussão Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion

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    Neuseli Marino Lamari

    2006-06-01

    Full Text Available Bronquiectasia consiste em dilatação anormal, permanente e irreversível de brônquios e bronquíolos, com infecções recorrentes, inflamações, hipersecreção e redução da limpeza mucociliar. Acomete predominantemente o sexo feminino, entre 28 e 48 anos de idade e afeta com maior freqüência os lobos inferiores bilateralmente. Manifestações clínicas da doença são a tosse crônica, febre e expectoração volumosa, purulenta, com odor fétido. Etiologia é inespecífica e representada pelo estádio final de diversos processos patológicos. Pode ser classificada em cilíndrica, varicosa e sacular, e ainda, em localizada e multissegmentar. Drenagem postural e percussão são técnicas desobstrutivas usuais na prática clínica diária, no entanto, há escassez de estudos comparativos enfatizando-as com amostras populacionais e recursos metodológicos. Tomando por base as considerações, teve-se como objetivo verificar a eficácia da drenagem postural e da percussão na higiene brônquica de pacientes bronquiectásicos, bem como seus efeitos e associação com outras técnicas apontadas pela literatura atual. Os principais achados comprovaram que a drenagem postural e a percussão são efetivas na mobilização da secreção pulmonar, uma vez que aumentam a velocidade do muco transportado, melhoram a função pulmonar e as trocas gasosas. A efetividade requer ajuda de um profissional, o que pode dificultar a prática clínica diária. Por esta razão, fisioterapeutas têm selecionado técnicas que propiciem independência ao paciente.Bronchiectasis consists of abnormal, permanent and irreversible dilation of bronchi and bronchia, with recurrent infections, inflammation, hypersecretion and reduction of mucus clearance. It predominantly affects women of between 28 and 48 years old and more frequently affects the inferior lobes. Clinical manifestations are chronic cough, fever and voluminous expectoration, with a fetid odor. The etiology

  8. Clinical Experience of the Treatment of Solitary Pulmonary Nodules with Da Vinci Surgical System

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    Xiangdong TONG

    2014-07-01

    Full Text Available Background and objective A solitary pulmonary nodule (SPN is defined as a round intraparenchimal lung lesion less than 3 cm in size, not associated with atelectasis or adenopathy. The aim of this study is to learn clinical experience of the treatment of SPN with Da Vinci Surgical System. Methods A total of 9 patients with solitary pulmonary nodules (SPN less than 3 cm in diameter was treated with Da Vinci Surgical System (Intuitive Surgical, California in thoracic surgery department from General Hospital of Shenyang Militrary Region from November 2011 to March 2014. This group of patients included 3 males and 6 females, and the mean age was 51±9.9 yr (range: 41-74 yr. Most of the patients were no obvious clinical symptoms (7 cases were found by physical examination, others were with cough and expectoration. Their median medical history was 12 mo (range: 4 d-3 yr. All the lesions of patients were peripheral pulmonary nodules and the mean diameter of those was (1.4±0.6 cm(range: 0.8-2.8 cm. Wedge-shaped resection or lobectomy was performed depending on the result of rapid pathology and systemic lymph node dissection was done for malignant leision. We used general anesthesis with double lumens trachea cannula. We set the patients in lateral decubitus position with jackknife. The patient cart enter from top of the patient. The position of trocars would be set according to the position of lesion. A 12 mm incision was positioned at the 8th intercostal space in the posterior axillary line as vision port, and two 8 mm incisions were positioned at the 5th intercostal space between the anterior axillary line and midclavicular line, and the 8th infrascapular line as robotic instrument ports about 10 cm apart from the vision port. One additional auxiliary small incision for instrument without retracting ribs was set at the 7th intercostal space in the middle axillary line. Results There were 4 benign leisions and 5 malignancies identified. Wedge

  9. Content of amino acids in dense extracts from raw material of Echium vulgare L.

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    V. V. Mashtaler

    2013-08-01

    Full Text Available Echium vulgare L. of Boraginaceae family is a biennial rigidly pubescent plant with a spindle-shaped root, which is rather widespread in Ukraine. Above-ground and underground part of the plant is used in folk medicine as a blood purifying agent and anticonvulsant, herb decoctions – as expectorant and calming agent for cough of various etiology. Owing to shikonin and its ethers presence, extracts from Echium vulgare L. have high antibacterial activity and stable fungistatic effect against yeast fungi. In addition, these substances also exibit anti-inflammatory, antioxidant, and regenerative activity. Echium vulgare L., as most representatives of Boraginaceae, is not sufficiently studied. Continuing to study this species, we have determined amino acid composition of its aqueous extracts. This group of biologically active substances is present in easy-to-digest complexes and in biologically available concentrations; it demonstrates a number of biological actions, such as hepatoprotective, lipotropic, cardiotropic, regenerative, wound-healing, calming, etc. The objective of our work was to study qualitative composition and quantitative content of amino acids in dense extracts obtained from roots and herb of Echium vulgare L. Objects of our study were dense extracts obtained from roots and herb of Echium vulgare L. Roots were harvested in autumn, at the end of vegetation period (October – November 2009; herb was collected during the phase of mass flowering (June 2009 in Kharkov region. Well-known methods were used to obtain dense extracts (extraction agent: purified water. Output of root dense extract was 22,7%, and herb dense extract was 23,5%. Amino acid composition of dense extracts was studied with amino acid analyzer AAA-339 (Czech Republic after hydrolysis with hydrochloric acid. There have been identified 16 amino acids, 7 of which are essential, 3 semiessential ones and the rest – nonessential amino acids. Qualitative composition and

  10. Utilização de medicamentos e fatores associados entre crianças residentes em áreas pobres Utilización de medicamentos y factores asociados entre niños residentes en áreas pobres Drug use and associated factors in children living in poor areas

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    Djanilson Barbosa Santos

    2009-10-01

    medicamentos superior al sexo masculino, 50,9% y 45,4%, respectivamente (p=0,004. La prevalencia de uso de medicamentos disminuyó significativamente con la edad (OBJECTIVE: To describe drug use profile in children living in poor areas and associated factors. METHODS: Population-based, cross-sectional study, including 1,382 children aged between four and 11 years. These children were selected by random sampling of 24 micro-areas, representative of the poorest segments of the population living in the city of Salvador, Northeastern Brazil, in 2006. The dependent variable was drug use in the 15 days preceding the surveys. A total of three groups of explanatory variables were considered: socioeconomic variables, child health status, and use of health services. Adjusted analysis used Poisson regression, following a hierarchical conceptual model. RESULTS: Drug use prevalence in children was 48%. Female children showed higher drug use prevalence than males, 50.9% and 45.4%, respectively (p=0.004. Drug use prevalence decreased significantly with age (p<0.001 in both sexes. Most used pharmacological groups were: analgesics/antipyretics (25.5%, systemic antibiotics (6.5%, and anti-cough /expectorant drugs (6.2%. In the multivariate analysis, factors determining greater drug use were: age (four to five, six, seven to eight years; female sex; white mother; poorer health perception; interruption of activities due to health problems and health care, whether ill or not, in the last 15 days; drug spending in the last month; and medical visits in the last three months. CONCLUSIONS: Drug use prevalence in the poor children studied was below that observed in other population-based studies in Brazil, yet similar to that of adults. The identification of groups most subject to excessive drug use may serve as the basis for strategies to promote their rational use.

  11. UTILIDAD DE LAS TÉCNICAS DE ESPIROMETRÍA Y OXIMETRÍA EN LA PREDICCIÓN DE ALTERACIÓN PULMONAR EN TRABAJADORES DE LA MINERÍA DEL CARBÓN EN PAIPA- BOYACÁ Utility of spirometry and oximetry in the prediction of pulmonary alterations among coal miners from Paipa, Colombia

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    González Jiménez Nubia Mercedes

    2009-01-01

    among coal miners from Paipa, Colombia and to establish possible factors associated with such dysfunction; like age and duration of exposure, in order to propose occupational health preventive measures. Materials and methods. Cross-sectional study. Using a previously designed instrument we surveyed 410 workers from the coal mines. We also evaluated general working conditions, health history and respiratory function parameters using spirometry and oximetry. Results. The average age of the study group was 35,1 years (SD=11,7, and the average exposure time was 12.8 years (SD=11,8. There was a high prevalence of respiratory symptoms: cough (42,7%, expectoration (31,5%; dyspnea (48,8% and thoracic pain (19,7%. In 26,1 percent of the study participants there was some functional respiratory alteration and in 4 percent, hypoxemia. An exposure time greater than five years was associated with respiratory alterations (OR=1,75 and with hypoxemia (OR=9,30. Also, being older than 40 years was associated with spirometric alterations (OR=1,91 and hypoxemia (OR=3,17. Conclusions. Coal mining is a high-risk activity: there was a high prevalence of symptoms associated with pneumoconiosis and progressing chronic respiratory disease. We also found a high prevalence of alterations of the respiratory pattern and hypoxemia, which suggests that these measurements could be predictors of the development of chronic pulmonary disease of occupational origin.

  12. Phytotherapy of Acute Respiratory Viral Diseases

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    I.B. Ershova

    2016-11-01

    of acute respiratory viral infections the medicinal plants of several pharmacological groups mainly used are: plants with a tonic effect (plants containing vitamins and minerals — rose hips, black currant, sea buckthorn, citrus fruits, adaptogens and immune modulators should be used in pediatric practice with caution (Ginseng, Rhodiola Rosea, Aralia Manchurian, plants containing biogenic stimulators — the aloe latex, kalanchoe, plant with bactericidal and bacteriostatic effect (sage leaves drug, eucalyptus switchgrass, plants with anti-inflammatory effect, containing tannins — oak bark, Potentilla rhizome, rhizome of Polygonum snake, burnet, alder cones, etc; plants containing essential oils, azulene derivatives — Chamomile flowers; plants containing mucus — Farfara leaves, Plantain; Linden flowers; plants with antipyretic and diaphoretic action — plants containing vitamins (fruits of raspberry, black currant fruit, cranberry; plants containing salicylic acid derivatives — Viola tricolor, raspberry fruit; plants with protective, emollient, expectorant action containing mucus — Farfara leaves; Linden flowers, plantain leaves are large; containing alkaloids, with antitussive effect —codeine phosphate; glaucine hydrochloride grass of Thermopsis lancet; bronchodilators plants; plants with anti-allergic effect, containing flavonoids — herb of Viola tricolor, the roots of Licorice. The article presents the re­commendation of professor O.D. Barnaulov, a pediatric phytotherapist O.A. Daniluk on herbal medicine using in children, the rules of the certain medicinal plants use by Y.I. Korshikova, dosage regimen for herbal remedies for children, proposed by N.P. Menshikova, as well as practical advice on drafting phytospecies for the treatment and prophylaxis of acute respiratory viral infections and prescribing proposed by phytotherapist O.V. Kostareva.

  13. Complicações cardiovasculares em usuário de cocaína: relato de caso Cardiovascular complications related to cocaine use: case report

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    Fernanda Martins Gazoni

    2006-12-01

    : Cocaine is the most commonly used illicit drug and its acute and chronic effects are related to a variety of physiological changes, mainly in the cardiovascular system. This study is a case report of a patient with cardiomyopathy related to cocaine use. CASE REPORT: A 19 year old men, who has been using cocaine and crack since 15 years old, was admitted to the emergency department (ED in February 2006 with progressive dyspnea during minimal efforts and bloody expectoration. During the physical exam it was observed legs edema, jugular stasis and dyspnea at rest. The echocardiogram demonstrated left ventricular hypocinesia, a 17 mm ventricular thrombus and a 12% ejection fraction. A bleeding from the left upper lobe was identified during a pulmonary bronchoscopy which was treated with arterial embolization. After 48h of the procedure, the patient was asymptomatic and an antithrombotic treatment with warfarin and enoxaparin was started. No obstruction was found at the cineangiography and the patient was discharged after clinical improvement. The patient was admitted again to the intensive care unit in July with intense chest pain and dyspnea at rest. A new cineangiography was performed and it was observed occlusion in the anterior descendent coronary artery. CONCLUSIONS: The cocaine acute effects are commonly seen at the ED but the chronic effects, as the cardiovascular manifestations, can take longer to be correlated as a side effect of cocaine use. Its prolonged use is related to left ventricular systolic dysfunction due to hypertrophy or myocardial dilation, atherosclerosis, arrhythmias, myocyte apoptosis and sympathetic damage.

  14. Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004 Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004

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    José da Silva Moreira

    2006-04-01

    and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004. RESULTS: Of the 252 patients, 209 were male, and 43 were female. The mean age was 41.4 years, and 70.2% were alcoholic. Cough, expectoration, fever and overall poor health were seen over 97% of patients. Chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. In 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. Concomitant pleural empyema was seen in 24 (9.5% of the patients. Mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%. All patients were initially treated with antibiotics (mainly penicillin or clindamycin, and postural drainage was performed in 98.4% of cases. Surgical procedures were performed in 52 (20.6% of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6. Cure was obtained in 242 patients (96.0%, and 10 (4.0% died. CONCLUSION: Lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse. Most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.

  15. Comparação entre a azitromicina e a amoxicilina no tratamento da exacerbação infecciosa da doença pulmonar obstrutiva crônica Comparison between azithromycin and amoxicillin in the treatment of infectious exacerbation of chronic obstructive pulmonary disease

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    Mara Rúbia Andre-Alves

    2007-02-01

    years of age. Of those, 102 were randomized to receive either azithromycin (500 mg/day for three days, n = 49 or amoxicillin (500 mg every eight hours for ten days, n = 53. The patients were evaluated at the study outset, on day ten, and at one month. Based on the clinical evaluation of the signs and symptoms present on day ten and at one month, the outcomes were classified as cure, improvement, or treatment failure. The microbiological evaluation was made through the culture of sputum samples that were considered appropriate samples only after leukocyte counts and Gram staining. Secondary efficacy evaluations were made in order to analyze symptoms (cough, dyspnea, and expectoration and pulmonary function. RESULTS: There were no differences between the groups treated with azithromycin or amoxicillin in terms of the percentages of cases in which the outcomes were classified as cure or improvement: 85% vs. 78% (p = 0.368 on day ten; and 83% vs. 78% (p = 0.571 at one month. Similarly, there were no significant differences between the two groups in the secondary efficacy variables or the incidence of adverse effects. CONCLUSION: Azithromycin and amoxicillin present similar efficacy and tolerability in the treatment of acute exacerbation of chronic obstructive pulmonary disease.

  16. Prevalência de TB ativa e TB latente em internos de um hospital penal na Bahia Prevalence of active and latent TB among inmates in a prison hospital in Bahia, Brazil

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    Antônio Carlos Moreira Lemos

    2009-01-01

    questionnaire was applied and completed by medical students. The detainees were systematically submitted to the following tests: tuberculin skin test, chest X-ray (anteroposterior, sputum smear microscopy and culture for mycobacteria. The events of interest were active TB and latent TB. RESULTS: The mean age of the participants was 36.6 years, and 89.9% were male. Smoking and alcohol consumption were reported by 70.0% and 43.9% of the inmates, respectively. A history of treatment for TB was reported by 11.3% of the inmates. Of the inmates evaluated, 36.3% reported cough and 31.4% reported expectoration. Other less common symptoms were asthenia (in 26.2%, weight loss (in 23.1%, loss of appetite (in 17.7%, fever (in 11.3% and hemoptysis (in 6.7%. Of the 86 inmates tested, none presented positive HIV serology. The prevalence of latent TB was 61.5% (96 of the 156 inmates submitted to tuberculin skin tests, whereas that of active TB was 2.5% (6 of the 237 inmates evaluated. The presence of cough was a determinant of active TB (prevalence ratio = 8.8; 95% CI: 1.04-73.9; p = 0.025. CONCLUSIONS: Active and latent TB are highly prevalent among inmates hospitalized in the Bahia State Prison Hospital. Our findings justify the need to implement public policies specifically directed towards the control of TB in this population.

  17. Tuberculosis and latent tuberculosis in prison inmates Tuberculosis y tuberculosis latente en la población carcelaria Tuberculose e tuberculose latente na população prisional

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    Péricles Alves Nogueira

    2012-02-01

    Full Text Available OBJECTIVE: To estimate the prevalences of tuberculosis and latent tuberculosis in inmates. METHODS: Observational study was carried out with inmates of a prison and a jail in the State of São Paulo, Southeastern Brazil, between March and December of 2008. Questionnaires were used to collect sociodemographic and epidemiological data. Tuberculin skin testing was administered (PPD-RT23-2TU/0.1 mL, and the following laboratory tests were also performed: sputum smear examination, sputum culture, identification of strains isolated and drug susceptibility testing. The variables were compared using Pearson's chi-square (Χ2 association test, Fisher's exact test and the proportion test. RESULTS: Of the 2,435 inmates interviewed, 2,237 (91.9% agreed to submit to tuberculin skin testing and of these, 73.0% had positive reactions. The prevalence of tuberculosis was 830.6 per 100,000 inmates. The coefficients of prevalence were 1,029.5/100,000 for inmates of the prison and 525.7/100,000 for inmates of the jail. The sociodemographic characteristics of the inmates in the two groups studied were similar; most of the inmates were young and single with little schooling. The epidemiological characteristics differed between the prison units, with the number of cases of previous tuberculosis and of previous contact with the disease greater in the prison and coughing, expectoration and smoking more common in the jail. Among the 20 Mycobacterium tuberculosis strains identified, 95.0% were sensitive to anti-tuberculosis drugs, and 5.0% were resistant to streptomycin. CONCLUSIONS: The prevalences of tuberculosis and latent tuberculosis were higher in the incarcerated population than in the general population, and they were also higher in the prison than in the jail.OBJETIVO: Estimar la prevalencia de la tuberculosis y tuberculosis latente en detenidos. MÉTODOS: Estudio observacional realizado de marzo a diciembre de 200 con 4.435 detenidos de una penitenciaria y de un

  18. Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients

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    Fleming, M. F.; Krupitsky, E.; Tsoy, M.; Zvartau, E.; Brazhenko, N.; Jakubowiak, W.; E. McCaul, M.

    2006-01-01

    emploi d’une combinaison du cliché thoracique, de la bacilloscopie et des cultures d’expectoration. Chez 62% des patients, les critères DSM-IV pour utilisation courante d’alcool ou pour dépendance étaient présents. L’utilisation de drogues est inhabituelle: deux patients seulement ont signalé une utilisation récente de l’héroïne par voie intraveineuse. Il n’y avait qu’un seul cas d’infection VIH. Le score total moyen de la batterie d’évaluation des risques a été de 3,4. Il y avait de la dépression chez 60% de 1’échantillon, dont 17% étaient en dépression sévère. L’utilisation ou la dépendance à l’égard de l’alcool étaient associées avec une multiplication par huit de la résistance aux médicaments (OR 8,58 ; IC95% 2,09-35,32). Les patients atteints de rechute de TB ou de TB chronique sont plus susceptibles de répondre aux critérés d’abus ou de dépendance de l’alcool (OR 2,56; IC95% 1,0-6,54). CONCLUSION: Les maladies liées à l’utilisation d’alcool sont fréquentes chez les patients traités pour TB active et sont associées à une morbidité significative. Des enquêtes complémentaires sont nécessaires pour examiner les relations entre les maladies liées à l’utilisation d’alcool et la résistance à l’égard des médicaments antituberculeux. MARCO DE REFERENCIA: El consumo de alcohol, la tuberculosis (TB) farmacorresistente y los comportamientos de riesgo para la infección por el virus de la inmunodeficiencia humana (VIH) constituyen una preocupación creciente en los pacientes con TB en la Fedéración de Rusia. MÉTODOS: Se llevó a cabo un estudio de prevalencia del consumo de alcohol y del comportamiento de riesgo para la infección por el VIH en una muestra de 200 adultos, hombres y mujeres, ingresados por TB en dos hospitales de San Petersburgo e Ivanovo en la Federación de Rusia. RESULTADOS: El 72% de los individuos fueron de sexo masculino. La media de la edad fue 41 años. El diagn