Infection
-
Chest physiotherapy is a treatment program that attempts to compensate for impaired mucociliary clearance. By removing mucopurulent secretions, it reduces airway obstruction and its consequences, such as atelectasis and hyperinflation; furthermore, physiotherapy can decrease the rate of proteolytic tissue damage by removing infected secretions. Conventional physiotherapy (clapping, vibration and compression, together with postural drainage and assisted coughing) is the most efficient physiotherapy for sick infants and young children. ⋯ Autogenic drainage, a special breathing technique, aims at avoiding airway compression by reducing positive expiratory transthoracic pressure. PEP-mask-physiotherapy achieves the same goal by expiring against an external airflow obstruction. Last but not least, physical exercise can clear the lungs of some CF patients and thus offers an attractive adjunct to physiotherapy.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Factors indicative of outcome in a comparative trial of acyclovir and vidarabine for biopsy-proven herpes simplex encephalitis.
A total of 208 patients underwent brain biopsy for presumptive herpes simplex encephalitis and were randomized to receive either vidarabine, vira-A, at 15 mg/kg/day, or acyclovir, at 30 mg/kg/day for ten days. 69 patients (33%) had biopsy-proven disease; 37 received vira-A and 32 acyclovir. With the exception of age, patient populations were balanced for demographic characteristics. Overall survival for acyclovir recipients was 72% compared with 46% for vira-A-treated patients 18 months after therapy (p = 0.008). ⋯ Age and Glasgow coma scale greater than 10 predicted the best outcome following acyclovir treatment. Disoriented patients who flex and respond by eye to pain had no mortality and 50% returned to normal. These data indicate that acyclovir is the treatment of choice for biopsy-proven herpes simplex encephalitis.
-
Randomized Controlled Trial Clinical Trial
[Pseudomonas immunoglobulin prophylaxis in patients with burn injuries].
Pseudomonas aeruginosa belongs to the most frequent pathogens isolated from patients with burns. In a mouse model for artificial burns it was found that prophylactic administration of a hyperimmune globulin with antibody titres against P. aeruginosa (Fisher immunotypes 1, 2, 4 and 6) reduced mortality. Therefore, the prophylactic administration of Pseudomonas immunoglobulin was examined in a prospective randomized study in two groups of 13 patients each. ⋯ However, only two of the six infected patients, developed septicaemia, whereas in the control group, local Pseudomonas infection led to septicaemia in five out of seven patients. The number of septicaemic Staphylococcus aureus infections was also lower in patients on immunoglobulin prophylaxis, with two cases compared to four cases in the control group. Due to the limited number of cases studied, statistically significant results could not be obtained, however, there was a positive trend in favour of Pseudomonas immunoglobulin treatment.
-
Randomized Controlled Trial Clinical Trial
[Prevention using a Pseudomonas immunoglobulin in burn patients].
Pseudomonas aeruginosa belongs to the most frequent pathogens isolated from patients with burns. In a mouse model for artificial burns it was found that prophylactic administration of a hyperimmune globulin with antibody titres against P. aeruginosa (Fisher immunotypes 1, 2, 4 and 6) reduced mortality. Therefore, the prophylactic administration of Pseudomonas immunoglobulin was examined in a prospective randomized study in two groups of 13 patients each. ⋯ However, only two of the six infected patients, developed septicaemia, whereas in the control group, local Pseudomonas infection led to septicaemia in five out of seven patients. The number of septicaemic Staphylococcus aureus infections was also lower in patients on immunoglobulin prophylaxis, with two cases compared to four cases in the control group. Due to the limited number of cases studied, statistically significant results could not be obtained, however, there was a positive trend in favour of Pseudomonas immunoglobulin treatment.
-
Clinical Trial Controlled Clinical Trial
[Immunoglobulins in the treatment of bacterial meningitis in childhood].
In a prospective, clinical study forty-four children with bacterial meningitis were treated with antibiotics and underwent a special intravenous treatment with 7-S-immunoglobulins. The children's age ranged between two days and thirteen years. ⋯ The apparently improved prognosis, due to the immunoglobulin therapy, was confirmed by a retrospective study of thirty-six patients, that had an unfavorable prognosis of pneumococcal meningitis. All fourteen patients that had acquired pneumococcal meningitis, and had been treated with immunoglobulins, were clinically cured, whereas in comparison, the sixteen patients of the other group exhibited severe sequelae, and two of them died.