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Ann Acad Med Singapore. 2000 Jul;29(4):531-3.
Pseudomembranous tracheobronchitis caused by Aspergillus in a patient after peripheral blood stem cell transplantation.

Koh LP, Goh YT, Linn YC, Hwang J, Tan P.

Department of Haematology, Singapore General Hospital, Singapore.

INTRODUCTION: We report a case of pseudomembranous tracheobronchitis caused by Aspergillus fumigatus 2 years after matched unrelated stem cell transplant. CLINICAL PICTURE: The patient presented with dyspnoea and obstructive airway disease coinciding with the onset of chronic graft-versus-host disease (GVHD). Following treatment with higher immunosuppressive therapy for presumptive diagnosis of bronchiolitis obliterans, he subsequently developed recurrent spontaneous pneumomediastinum and progressive respiratory failure. TREATMENT AND OUTCOME: Tracheobronchial biopsy and culture of bronchoalveolar lavage (BAL) fluid revealed Aspergillus tracheobronchitis. Despite mechanical ventilation and antifungal therapy, he succumbed to progressive respiratory failure. CONCLUSIONS AND CLINICAL IMPLICATIONS: Aspergillus tracheobronchitis should be suspected in heavily immunosuppressed stem cell transplant recipients presenting with recurrent pneumomediastinum and progressive respiratory failure.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11056787&dopt=Abstract

Acta Ophthalmol Scand Suppl. 2000;(230):52-5.
Comparative study of clinical efficacy and tolerance in seasonal allergic conjunctivitis management with 0.1% olopatadine hydrochloride versus 0.05% ketotifen fumarate.

Aguilar AJ.

OBJECTIVE: To compare the clinical efficacy and tolerance of 0.1% olopatadine hydrochloride (OHC) versus 0.05% ketotifen fumarate (KF) in the management of allergic conjunctivitis. MATERIALS AND METHODS: Eighty adult patients with a history of allergy (allergic conjunctivitis, hay fever, asthmatic bronchitis and dermatitis) that were showing allergic conjunctivitis signs and symptoms (itching, hyperemia, mucous discharge and tearing) at the time of inclusion in this study were evaluated. Patients were divided in two groups, A and B. Group A patients were treated with OHC and group B patients were treated with KF. Both groups received one drop in the affected eye every 12 hrs. The start time of this study was the first patient visit, in which the medication was instilled for the first time. Both groups of patients were evaluated 30 min, 48 hr., 7 days and 14 days later. Local tolerance of each medication was evaluated. RESULTS: Clinical improvement of the signs and symptoms of allergic conjunctivitis occurred in 42.5% to 62.5% of the patients in Group A when assessed 30 min following the first topical ocular dose of olopatadine. However, mucous discharge was not affected. Forty-eight (48) hrs. after the first instillation, improvements in 57.5% to 75% of the patients were shown in every evaluated parameter. After 7 days of treatment, positive clinical results were observed in 80% to 87.5% of the treated patients. Except for the patients that were dismissed from the study before the seventh day of treatment due to the absence of therapeutic response (4/40), all patients satisfactorily completed the therapeutic plan by the seventh day. No intolerance reactions were observed in patients of this group. In Group B patients (KF), clinical improvement of the signs and symptoms measured in the study was shown in 20.0% to 47.5% 30 min after instillation. As observed with olopatadine, no improvement in the number of patients showing mucous discharge was noted at the 30-min time point. At 48 hr. after the first instillation, 27.5% to 48% of patients showed improvement in every evaluated parameter. After 7 days of treatment, improvement was observed in 60% to 75% of patients. On Day 14, positive responses were observed in 67.5% to 75% of patients. Seventeen and one-half percent of the patients were dismissed from the study before the seventh day of treatment due to the absence of a therapeutic response. Approximately 23% of the patients had mild reactions of intolerance (stinging) which was not a cause to discontinue the treatment. CONCLUSION: Olopatadine hydrochloride controlled allergic conjunctivitis symptoms and signs more rapidly and to a greater extent than ketotifen fumarate. Fewer cases of treatment failure were noted with OHC, and no local intolerance reactions were observed, while KF triggered mild reactions (stinging) in 23% of patients.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11057352&dopt=Abstract

Antibiot Khimioter. 2000;45(9):13-9.
[Spectrum of pneumotropic pathogens in pediatric patients with acute bronchitis and pneumonia]

[Article in Russian]

Lykova EA, Bokovoi AG, Bondarenko VM, Karazhas NV, Evseeva LF, Rybalkina TN, Dzis NB, Vorob'ev AA.

Central Clinical Hospital, Medical Centre of the Managing Department of the President of the Russian Federation, Moscow.

One hundred eighty nine children with acute bronchopulmonary infectious pathological processes were examined bacteriologically and serologically for typical pneumotropic pathogens, 47 of them being as well examined for atypical organisms. Microbial associations mainly with Mycoplasma and Pneumocystis and to a lesser extent with Chlamydia were isolated from the majority of the children. Reactivation of the cytomegalovirus infection was observed in 25 per cent of the children. Pneumonia and bronchitis due to Mycoplasma pneumoniae either as a monoagent or in associations were mainly stated in children over 7 years of age. No significant changes between the indices of the infection due to a definite organism and the active progression of the infectious process of the same etiology were revealed, though in the cases of chlamydiosis the changes reached almost 10 per cent. In cases of acute bronchitis and pneumonia the chlamydial or cytomegalovirus infection could be assumed to be of the persisting nature, mainly acute in cases of pneumococcal infection, mixed in cases of hemophilic or pneumocystic infection, primary contamination with a tendency to prolonged in cases of mycoplasmic infection. The findings of the examination and the clinical and anamnestic data showed that the clinical picture of acute pneumonia had specific features associated with the supposed etiological agents, still it could change under the action of associations of pneumotropic pathogens.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11057368&dopt=Abstract

Respir Med. 2000 Oct;94(10):954-63.
Risk factors for community-acquired pneumonia diagnosed upon hospital admission. British Thoracic Society Pneumonia Study Group.

Farr BM, Bartlett CL, Wadsworth J, Miller DL.

Department of Epidemiology and Public Health, St Mary's Hospital Medical School, University of London, UK.

A case-control study of risk factors for community-acquired pneumonia in adults admitted to hospital is reported. Cases were surviving patients (n = 178) admitted to 14 hospitals in England. Controls were individuals (n = 385) randomly selected from the electoral registers of the areas served by the hospitals. The two groups were compared with regard to risk factors for pneumonia using a standardized postal questionnaire. Independent risk factors associated with cases in log-linear regression analysis were age, heart disease (as indicated by congestive heart failure and/or digitalis treatment), lifetime smoking history, chronic airway disease (chronic bronchitis and/or asthma), occupational dust exposure, pneumonia as a child, single marital status and unemployment. Corticosteroid and bronchodilator therapy were also independent risk factors in the log-linear regression analysis, but may reflect the severity of underlying lung disease for which these drugs were prescribed. These data suggest that cigarette smoking is the major avoidable risk factor for acute pneumonia in adults.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11059948&dopt=Abstract

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