RESUMEN
The efficacy and safety of aztreonam were evaluated in an open trial at King Khalid University Hospital, Riyadh, Saudi Arabia. A total of 45 critically-ill adult patients were enrolled in the study. All patients with documented Gram-negative infection were treated with aztreonam as monotherapy. Antibiotics active against only Gram-positive and/or anaerobic organisms were allowed. Twenty cases were clinically evaluable. Eleven had lower respiratory tract infections (pneumonia), 3 had urinary tract infections, and 6 had septicemia. Clinical signs and symptoms, cultures and other laboratory profiles were assessed prior to treatment, at 4-6 days during treatment and within 2-3 days of the end of therapy (usually 7-15 days). Nineteen out of 20 (95%) had a satisfactory clinical response. All cases with septicemia and urinary tract infections were microbiologically cured. The overall microbiological response rate was 90%. Fifty-five percent of all infections were caused by Pseudomonas aeruginosa. Two patients with Gram-negative pneumonia due to P. aeruginosa did not respond microbiologically to aztreonam therapy. No serious adverse events requiring discontinuation of aztreonam therapy were reported. No mortality occurred.
Asunto(s)
Aztreonam/uso terapéutico , Infección Hospitalaria/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Acinetobacter/efectos de los fármacos , Infecciones por Acinetobacter/tratamiento farmacológico , Adulto , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Citrobacter , Infección Hospitalaria/microbiología , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Escherichia coli/efectos de los fármacos , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Unidades de Cuidados Intensivos , Klebsiella/efectos de los fármacos , Infecciones por Klebsiella/tratamiento farmacológico , Neumonía/tratamiento farmacológico , Neumonía/microbiología , Infecciones por Proteus/tratamiento farmacológico , Infecciones por Proteus/microbiología , Proteus mirabilis/efectos de los fármacos , Pseudomonas/efectos de los fármacos , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/microbiologíaRESUMEN
Sera obtained during the Hajj seasons of 1985, 1986, 1987 and 1988 from 125 heat stroke patients were collected and subjected to chemical analysis which included determination of glucose, lactate, cholesterol, and triglycerides, as well as assay of T3, T4, TSH and cortisol. Hyperglycaemia and lactic acidaemia were found to be the most frequent metabolic abnormalities. The changes in cholesterol did not exhibit a specific pattern. Triglycerides were significantly elevated in only 6% of patients. Cortisol levels were very significantly elevated in precooled patients. Although the mean T3 levels remained within the normal range, the mean concentration on admission was significantly higher than the post-cooling mean. TSH and T4 levels did not show significant changes.
Asunto(s)
Agotamiento por Calor/sangre , Acidosis Láctica/sangre , Femenino , Agotamiento por Calor/epidemiología , Humanos , Hidrocortisona/sangre , Hiperglucemia/sangre , Islamismo , Lípidos/sangre , Masculino , Persona de Mediana Edad , Arabia Saudita/epidemiología , Hormonas Tiroideas/sangreRESUMEN
Dantrolene (2.45 mg/kg body weight, range 2 to 4) was administered iv in eight heat stroke (HS) patients and compared with a control group of 12 patients of similar age, weight, and temperature range (41.9 degrees to 44 degrees C). Body surface cooling was conducted in air conditioned rooms at temperatures of 18 degrees to 23 degrees C. Mean cooling time in the dantrolene group was 49.7 +/- 4.4 (SEM) min, whereas cooling time in the control group was 69.2 +/- 4.8 min. The decrease in temperature was significantly greater in the dantrolene group, for whom the cooling time was decreased by about 19.5 min (p less than .01). Although cooling time was significantly shorter in the dantrolene group, there was no difference in the recovery of both groups. Dantrolene is an expensive drug and justification for its routine use in HS remains to be evaluated.