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Orv Hetil. 2000 Dec 3;141(49):2639-47.
[Importance of professional proposals in the era of broadening antibiotic resistance]

[Article in Hungarian]

Katona Z, Molnar I.

Kalocsai Korhaz, Csecsemo- es Gyermekosztaly, Budapest.

A great degree of neglection has been portrayed on the consideration in two most important professional proposals in 6906 patients of 44 praxis in the basic health care in 1996: 1. the obviously viral respiratory diseases (including acute bronchitis, ordinarily) was treated in 56% of cases with antibacterial drugs (in 83% of all treatments with broad spectrum antibiotics), and 2. for patients with Streptococcal infections too broadened spectrum antibiotics for this purpose were undesirably prescribed (in 75.5% of treatments) by physicians. Taking into consideration the suitable efficient ("evidence based") anticausal therapy and professional proposals, as well, in 63.6% of all antibiotic therapy could be avoided by physicians. By all means, these prescribed legion of the aimless, unnecessary and simultaneously too broadened spectrum antibacterial drugs served for the spreading of antibiotic resistance only, and all of them were the results of the neglection of the most important professional proposals. These unnecessary treatments--excluding the increase of resistance or the improper, unsubstantiated raise in hopes of patients--cost too much: the sum of expenses were 49.5% of the cost for antibiotics in Hungary in 1996 (in our estimation). To measure and examine periodically the quality level of primary infectological care, new quality indicators were appointed by the authors: the attained quality levels of each medical praxis would have to be compared and approached to the desirable level of quality indicators (reflecting the "evidence based" infections care) for the abolition of the unreasonable, expensive and dangerous practice for patients, as well. It appears, that the wide application of the appropriate, "evidence based" anticausal therapy would be reached with control of offered quality (the offered values of the quality indicators) of physicians in primary care, only. The introduction of quality assurance in basic health care needs urgent comprehensive official action.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11138473&dopt=Abstract

Infection. 2000 Nov-Dec;28(6):351-4.
Haemophilus influenzae infections among hospitalized adult patients.

Furrer M, Cottagnoud P, Muhlemann K.

Institute of Medical Microbiology, University of Berne, Switzerland.

BACKGROUND: Relatively few data are available about Haemophilus influenzae (Hi) infection among adults. MATERIALS AND METHODS: We studied all adult patients with Hi infection hospitalized between 1988 and 1997 at the University Hospital of Berne. Data were abstracted retrospectively from clinical charts and microbiology records using a standardized questionnaire. RESULTS: 12 invasive and 19 noninvasive Hi infections were observed during the study period.The main clinical manifestations were pneumonia (38.7%), bronchitis (29.0%) and meningitis (12.9%). Most patients (71.8%) had an underlying condition. Lethality was high (22.6%), especially in pneumonia patients (50%). The frequency of meningitis caused by Hi serotype b (Hib) seemed to decrease after 1990 when conjugated vaccines against Hib were introduced. CONCLUSION: Hi remains an important cause of lower respiratory and invasive disease associated with high lethality among polymorbid adult patients. The frequency of Hib infections may also decrease in adults due to herd immunity induced by universal vaccination of children.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11139153&dopt=Abstract

Biol Pharm Bull. 2000 Dec;23(12):1441-4.
YM-40461 improves airway clearance in guinea pigs with induced subacute bronchitis.

Kimoto A, Hirano Y, Iwai T, Saitou M, Tomioka K, Miyata K, Yamada T.

Institute for Drug Discovery Research, Yamanouchi Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan. kimotamanouchi.co.jp

The effects of the surfactant secretagogue YM-40461 on the mucociliary transport (MCT) velocity were examined in guinea pigs with induced bronchitis. Guinea pigs were exposed to SO2 gas (900 ppm, 3 h/d) for 5 d. MCT velocity was measured by the movement of a 30% gelatin solution containing Evans blue dye placed on the tracheal mucosal surface. Repeated doses of YM-40461 improved the MCT guinea pigs with bronchitis within 5 d after the completion of SO2 exposure, with an ED50 value of 3.1 mg/kg p.o. At a dose of 10 mg/kg p.o., YM-40461 restored MCT to the control level (98.0% recovery). Ambroxol, bromhexine and salbutamol also improved MCT, but were far less effective than YM-40461. Airway fluid collected from bronchitic animals revealed increased disaturated phosphatidylcholine (DSPC, a major component of surfactants)-to-protein ratio and decreased surface tension produced by YM-40461 treatment (10 mg/kg). These results suggest that YM-40461 ameliorates MCT dysfunction in animals with SO2 gas-induced bronchitis by increasing the DSPC-to-protein ratio in the airway.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11145174&dopt=Abstract

Trop Anim Health Prod. 2000 Dec;32(6):381-90.
A serological survey for avian infectious bronchitis virus and Newcastle disease virus antibodies in backyard (free-range) village chickens in Mexico.

Gutierrez-Ruiz EJ, Ramirez-Cruz GT, Camara Gamboa EI, Alexander DJ, Gough RE.

Departamento de Virologia, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autonoma de Yucatan, Merida Yucatan, Mexico.

The commercial flocks in Yucatan, Mexico are free of Newcastle disease virus (NDV) in its velogenic viscerotropic form, but little is known about the disease status of backyard poultry. A seroprevalence survey in 30 villages using haemagglutination inhibition (HI) tests for infectious bronchitis virus (IBV) and NDV antibodies was carried out from December 1997 to June 1998. The seroprevalences were 56.5% (95% CI 50-63%) for IBV and 2.2% (95% CI 0.5-3.8%) for NDV. All the villages had chickens that were positive for antibodies to IBV and nine of the villages had chickens that were positive for antibodies to NDV. This suggests that IBV may be responsible for a large proportion of the respiratory disease observed in backyard chickens in Yucatan. The implications of these findings are discussed, including the highly susceptible status of the backyard chickens in Yucatan to NDV and the possibility of this virus being one cause of the syndrome known as mortandad by the local people.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11147278&dopt=Abstract

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