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Aten Primaria. 2002 Nov 15;30(8):490-5.
[Antibiotics prescription in ambulatory patient]

[Article in Spanish]

Alvarez Carrera A, Martinez Cantarero C, Vidal Oliveras A, Saavedra Vilchez MD, Iglesias Niubo A, Forga Visa X; Grupo de Estudio de las Infecciones del Bages-Bergueda.

Direccion de Atencion Primaria (DAP) Bages-Bergueda-Solsones. Institut Catala de la Salut. Espana. asun.alvareanresa.scs.es

OBJECTIVE: To find what antibiotics are prescibed for common infections in adult and paediatric primary care patients. DESIGN: Drug utilization (DU) study: cross-sectional and observational design. SETTING: Primary care centres and hospital casualty departments in Bages and Bergueda counties (total population: 198 129 inhabitants). PARTICIPANTS: Adults and children with acute respiratory infection, acute otitis media, acute pharyngitis, acute tonsillitis, or acute bronchitis and flu syndrome; adults only with acute sinusitis, attacks of chronic obstructive pulmonary disease (COPD) or urinary infections. MAIN MEASUREMENTS AND RESULTS: 1596 episodes from November 1999 to February 2000 were collected. 975 (61%) of these were in adults, and 621 (3996) in children. Of the infections of mainly viral aetilogy, those most commonly treated with antibiotics were acute Bronchitis, in both adults (76.096 [95% CI, 67.6%-84.2%]) and children (60296 [95% CI, 50.0%-70.5%]). The most common antibiotics were: amoxycillin/clavulanic acid for otitis (34%), sinusitis (37%) and tonsillitis (44%) in adults macrolides in attacks of COPD (4096) and tonsillitis (33%) in children; quinolones for urinary infections (56%), and cefalor for otitis in children (2096). CONCLUSIONS: Local policy measures need to be taken to improve use of antibiotics for primary care patients. DU studies are extremely useful, as their description of the pattern of prescription enables concrete problems to be detected.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12506924&dopt=Abstract



Thorax. 2003 Jan;58(1):14-8.
Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?

Fujimura M, Ogawa H, Nishizawa Y, Nishi K.

Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan. fujimured3.m.kanazawa-u.ac.jp

BACKGROUND: We have described a group of patients who present with isolated chronic bronchodilator resistant non-productive cough with an atopic constitution, eosinophilic tracheobronchitis, and airway cough receptor hypersensitivity without bronchial hyperresponsiveness, which we have termed "atopic cough". Although cough variant asthma (in which the cough responds to bronchodilators) is recognised as a precursor of typical asthma, it is not known whether atopic cough is also a precursor of asthma. METHODS: Eighty two patients with atopic cough were retrospectively examined for onset of typical asthma and compared with 55 patients with cough variant asthma (20 untreated patients and 35 treated with long term inhaled beclomethasone dipropionate (BDP), 218-467 micro g/day). The median follow up period for patients with atopic cough and cough variant asthma was 4.8 (1-11.5) years and 3.7 (1-12.4) years, respectively. RESULTS: Onset of typical asthma occurred in only one of the patients with atopic cough. In patients with cough variant asthma, typical asthma developed in two of 35 patients taking BDP and six of 20 untreated patients (difference 24.3%, 95% CI 2.8 to 45.8, p<0.02). CONCLUSIONS: These findings suggest that cough variant asthma is a precursor of typical asthma but that atopic cough is not. Treatment with inhaled steroids may prevent the transformation of cough variant asthma into typical asthma.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12511712&dopt=Abstract



Transplantation. 1999 Mar 27;67(6):890-6.
Allogeneic bronchoalveolar lavage cells induce the histology and immunology of lung allograft rejection in recipient murine lungs: role of intercellular adhesion molecule-1 on donor cells.

Wilkes DS, Bowman D, Cummings OW, Heidler KM.

Department of Medicine, Indiana University School of Medicine, Indianapolis 46202, USA. dwilkeupui.edu

BACKGROUND: Intercellular adhesion molecule (ICAM)-1 expressed on accessory cells has a key role in antigen presentation. The histology and immunology of lung allograft rejection is postulated to result from donor lung accessory cells presenting alloantigens to recipient lymphocytes, and, therefore, ICAM-1 may have a crucial role in the rejection process. We have previously reported that the instillation of allogeneic (C57BL/6, I-a(b)) bronchoalveolar lavage (BAL) cells (96% macrophages, 2% dendritic cells) into the lungs of recipient BALB/c mice (I-a(d)) induced the histology and immunology of acute lung allograft rejection. Using this model, the purpose of the current study was to determine the role of ICAM-1 on donor lung cells in lung allograft rejection. METHODS: BALB/c mice received allogeneic BAL cells from wild-type or ICAM-1 mutant (lacking ICAM-1 expression) C57BL/6 mice by nasal insufflation weekly for 4 weeks. Recipient mice underwent BAL and serum collection for the determination of T helper 1/T helper 2 cytokines and IgG subtypes. Lung histology was graded using standard criteria for allograft rejection. RESULTS: Although wild-type cells induced a lymphocytic vasculitis and bronchitis, ICAM-1 mutant allogeneic BAL cells only induced a lymphocytic vasculitis in recipient lungs. Both wild-type and ICAM-1 mutant cells induced up-regulated local interferon-gamma and IgG2a production, and deposition of IgG2a in recipient lungs. CONCLUSIONS: These data show that ICAM-1 on donor lung accessory cells mediates differential effects on the histology and immunology of acute lung allograft rejection.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10199739&dopt=Abstract



Int J Biochem Cell Biol. 2003 Mar;35(3):272-6.
Airway smooth muscle: contraction and beyond.

Amrani Y, Panettieri RA.

Department of Medicine, University of Pennsylvania Medical Center, Pulmonary, Allergy and Critical Care Division, 848 BRB II/III 421 Curie Boulevard, 19104, Philadelphia PA, USA

Airway smooth muscle (ASM), an important tissue involved in the regulation of bronchomotor tone, exists in the trachea and in the bronchial tree up to the terminal bronchioles. The physiological relevance of ASM in healthy airways remains unclear. Evidence, however, suggests that ASM undergoes marked phenotypic modulation in lung development and in disease states such as asthma, chronic bronchitis and emphysema. The shortening of ASM regulates airway luminal diameter and modulates airway resistance, which can be augmented by cytokines as well as extracellular matrix alterations. ASM may also serve immunomodulatory functions, which are mediated by the secretion of pro-inflammatory mediators such as cytokines and chemokines. In addition, ASM mass increases in chronic airway diseases and may represent either a pathologic or an injury-repair response due to chronic inflammation. This review will present evidence that ASM, a "passive" contractile tissue, may become an "active participant" in modulating inflammation in chronic lung diseases.Cell factsFound in the trachea and along the bronchial tree.Critically important in regulating bronchomotor tone of the airways.Differentiation state is associated with the expression of various "contractile proteins."Displays phenotypic modulation of mechanical, synthetic and proliferative responses.Secretes cytokines, chemokines and extracellular matrix proteins.May serve as a potential new target for the treatment of chronic lung diseases.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12531237&dopt=Abstract [PubMed - in process]







Natural Herbal Supplement: Hair Million


Hair loss alone does not pose significant health problems. In fact, there are people who opt for baldness as an alternative hair style. However, in general, however, hair loss is not considered desirable.

The most ostensive feature that distinguishes us human from chimps and other primates is the lack of bodily hair. During evolutionary process, we have lost the majority of hair. Hair is no longer a biologically essential part of our body, just like appendix. The hair we still have on our scalp and a few other bodily parts is still regarded as significant for reasons other than biological necessity. Hair loss is naturally accompanied by aging process, although the extent of hair loss and the timing of onset vary widely among individuals. Thus, loss of hair and baldness is considered as a symbol of maturity or old age. Like winkles and other signs of aging, hair loss is not welcome by most people, because we don't welcome aging, and being perceived as an aging person. However, it is alopecia, or premature hair loss that especially concerns certain people.

While the hair loss and resulting baldness in general have not been proven to be related to underlying health problems, there are certain correlations between hair loss and health problems. For instance, premature hair loss could suggest premature aging or nutritional and hormonal imbalance, stressful life, use of drugs that cause hair loss as a side effect, skin disease, or heart disease. The balding appearance could also impart a subdued impression of integrity in bodily health and youthfulness.












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