摘要:

Traveler’s diarrhea is usually a short, self-limiting illness lasting on average 3-5 days. The illness may present either as (1) acute watery diarrhea, (2) diarrhea with blood (dysentery) or (3) chronic diarrhea, often with clinical evidence of fat or carbohydrate malabsorption. The majority of cases of traveler’s diarrhea are due to intestinal infection and resolve without specific treatment. Antibiotics can reduce the severity and duration of the illness and are always indicated for dysenteric shigellosis and amoebiasis. Oral rehydration therapy is the mainstay for managing water and electrolyte depletion.

ISSN:0009-3157    

DOI:10.1159/000239396

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Phagocytosis and intracellular killing of invading pathogens by host cells play the major role in resistance to bacterial infections. In vitro, antibiotics improve the susceptibility of microorganisms to antimicrobial activity of leukocytes, suggesting that this effect may contribute to determine the antimicrobial therapy and safe dosing intervals. The susceptibility of Staphylococcus aureus to phagocytosis and killing by human polymorphonuclear leukocytes (PMNL) in the presence of normal human serum in the postantibiotic phase of fosfomycin were compared with ciprofloxacin, cefotaxime and pristinamycin. Pretreatment of S. aureus for 10 min with 4 × MIC of fosfomycin and ciprofloxacin clearly sensitized the bacteria to leukocytic killing in the presence of normal human serum (10% v/v); cefotaxime and pristinamycin failed to enhance the phagocytic killing

ISSN:0009-3157    

DOI:10.1159/000239323

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Diarrhea represents a major health problem for travelers to developing countries. Although the syndrome is usually self-limited and recovery occurs in the majority of cases without any specific form of therapy, there is a need for safe and effective ways of preventing and treating it. Since the syndrome is most often caused by an infection acquired by ingesting fecally contaminated food or beverages, precautions regarding dietary habits remain the cornerstone of prophylaxis, but dietary self-restrictions do not always translate to reduced rates of diarrheal illness. Administration of probiotics (e.g. lactobacilli or Saccharomyces boulardii)and immunoprophylaxis with the newer oral cholera vaccines have been tried with promising results. Antimicrobials remain, however, the most successful form of prophylaxis, being effective in up to 90% of travelers. For those with impaired health who will take prophylaxis, systemic agents with proved efficacy should be recommended. For other otherwise healthy persons, poorly absorbed agents are preferable in order to avoid the serious, albeit rare, toxicity of systemic drugs. The key factor in the management of acute watery traveler’s diarrhea, particularly in infants and young children, is the restoration of water and electrolyte balance. This does not reduce the duration of the illness but will limit dehydration and prevent acidosis. Many patients will require no additional therapy, whereas some will need pharmacologic treatment to shorten the duration of diarrhea or to relieve the accompanying symptoms, like abdominal discomfort, nausea and vomiting. A typical 3- to 5-day illness can be reduced to approximately 1 day by trimethoprim-sulfamethoxazole (TMP-SMX) combination. Some other systemic antimicrobials have been successfully used but, during the last few years, the 4-fluoroquinolone drugs have received considerable attention and have been shown to be highly effective in reducing the duration of traveler’s diarrhea. These antimicrobials may become the best option for adults. The safest choice remains the use of poorly absorbed antimicrobials. Unfortunately, however, only a few compounds (i.e. bicozamycin and furazolidone) have been specifically tested in the therapy of traveler’s diarrhea. Others (e.g. nifuroxazide or rifaximin), which have been found effective in various homeland forms of infective diarrhea deserve to be evaluated in specifically designed clinical trials. Persons visiting developing countries where the risk of traveler’s diarrhea is high should be recommended to bring an antidiarrheal compound or bismuth subsalycilate, if available, and an antibacterial agent. For infants, children and the elderly, in whom dehydration may occur rapidly and be particularly dangerous, oral rehydration solutions are indicated. With these drugs at hand, the traveler can face a trip with more confidence and fully enjoy the stay abroad.

ISSN:0009-3157    

DOI:10.1159/000239397

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

In the present study the ability of subinhibitory concentrations (sub-MICs) of brodimoprim (a new 2,4-dimethoxybenzylpyrimidine) to interfere with some important aspects of bacterial cell function, such as surface hydrophobicity, fimbriation, motility and adhesiveness to mucosal cells, was investigated in comparison with those of trimethoprim. The inhibitory behavior of both diaminopyrimidines concerning hydrophobicity and hemagglutination (fimbriation) were essentially the same, while for adhesiveness and motility brodimoprim was more effective than trimethoprim. Diaminopyrimidines have high affinity for the bacterial enzyme dihydrofolate reductase, and this reduces the synthesis of essential purines and as a consequence of DNA and proteins. Our findings indicate that the synthesis and/or the expression of surface adhesins, which are proteins, was also affected by both brodimoprim and trimethoprim, the former being more active.

ISSN:0009-3157    

DOI:10.1159/000239324

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Oral administration of erythromycin in the dose range of 1-10 mg/kg increased the survival times of tumor-bearing mice in both allogeneic and syngeneic mouse systems by two- to threefold as compared with those of vehicle control mice, with the maximum effect at a dose of 5 mg/kg/day. During the early phase of tumor transplantation, tumoricidal macrophages and natural killer cells were active in the antitumor resistance of erythromycin-treated mice. Thereafter, the tumoricidal activity of macrophages became stronger as serum levels of interleukin-4 (IL-4) rose. Furthermore, treatment of mice with anti-IL-4 monoclonal antibody abolished the antitumor resistance conferred by erythromycin. These results indicate that erythromycin exhibits an indirect antineoplastic activity by enhancing the production of IL-4 which augments the tumoricidal activity of macrophages.

ISSN:0009-3157    

DOI:10.1159/000239325

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Diarrhea represents a major health problem for travelers to developing countries. Although the syndrome is usually self-limited and recovery occurs in the majority of cases without any specific form of therapy, there is a need for safe and effective ways of preventing and treating it. Since the syndrome is most often caused by an infection acquired by ingesting fecally contaminated food or beverages, precautions regarding dietary habits remain the cornerstone of prophylaxis, but dietary self-restrictions do not always translate to reduced rates of diarrheal illness. Administration of probiotics (e.g. lactobacilli or Saccharomyces boulardii)and immunoprophylaxis with the newer oral cholera vaccines have been tried with promising results. Antimicrobials remain, however, the most successful form of prophylaxis, being effective in up to 90% of travelers. For those with impaired health who will take prophylaxis, systemic agents with proved efficacy should be recommended. For other otherwise healthy persons, poorly absorbed agents are preferable in order to avoid the serious, albeit rare, toxicity of systemic drugs. The key factor in the management of acute watery traveler’s diarrhea, particularly in infants and young children, is the restoration of water and electrolyte balance. This does not reduce the duration of the illness but will limit dehydration and prevent acidosis. Many patients will require no additional therapy, whereas some will need pharmacologic treatment to shorten the duration of diarrhea or to relieve the accompanying symptoms, like abdominal discomfort, nausea and vomiting. A typical 3- to 5-day illness can be reduced to approximately 1 day by trimethoprim-sulfamethoxazole (TMP-SMX) combination. Some other systemic antimicrobials have been successfully used but, during the last few years, the 4-fluoroquinolone drugs have received considerable attention and have been shown to be highly effective in reducing the duration of traveler’s diarrhea. These antimicrobials may become the best option for adults. The safest choice remains the use of poorly absorbed antimicrobials. Unfortunately, however, only a few compounds (i.e. bicozamycin and furazolidone) have been specifically tested in the therapy of traveler’s diarrhea. Others (e.g. nifuroxazide or rifaximin), which have been found effective in various homeland forms of infective diarrhea deserve to be evaluated in specifically designed clinical trials. Persons visiting developing countries where the risk of traveler’s diarrhea is high should be recommended to bring an antidiarrheal compound or bismuth subsalycilate, if available, and an antibacterial agent. For infants, children and the elderly, in whom dehydration may occur rapidly and be particularly dangerous, oral rehydration solutions are indicated. With these drugs at hand, the traveler can face a trip with more confidence and fully enjoy the stay abroad.

ISSN:0009-3157    

DOI:10.1159/000316313

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The purpose of our study was to evaluate different schedules of ondansetron administration in cisplatin-induced emesis. All patients had previously received 2 cycles of CDDP-based chemotherapy in a dose of 100 mg/m2. Ondansetron was given by two schedules. Group A (45 patients) received a dose of 1 ampoule of 8 mg in 100 ml normal saline in a 10-min intravenous infusion before the infusion of CDDP; this was continued by 1 tablet of 8 mg in the afternoon and 1 before sleeping on the first day. For the next 3 days, the patients received 3 tablets of 8 mg daily. In group B (45 patients) the same doses were used at the same time and by the same route as in group A, except on the first day when all the dosages were intravenous. Nausea persisted for a longer time (A = 177 ± 271 min, B = 78 ± 83 min, p < 0.022), and it was intenser in group A (grade 0, p < 0.036, grade 1, p < 0.050) in comparison with group B. More patients of group B achieved complete (p < 0.015) and minor (p < 0.050) control of emesis, on the other hand group A presented an increased number with major (p < 0.015) and failure (p < 0.069) of control of emesis. There was no difference in nausea and vomiting for the next 3 days nor any difference in secondary side effects. We conclude that the intravenous administration schedule has shown superior antiemetic efficacy in patients who received cisplatin during the first 24

ISSN:0009-3157    

DOI:10.1159/000239326

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:0009-3157    

DOI:10.1159/000239398

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:0009-3157    

DOI:10.1159/000239392

出版商:S. Karger AG    

年代:1995

数据来源: Karger