Expert opinion on pharmacotherapy
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Surfactant administration has proven remarkably effective in the prevention and treatment of infantile respiratory distress syndrome (IRDS) and may also be beneficial in other forms of acute lung injury. Several surfactant products are available commercially along with others in various phases of development and clinical trials. ⋯ At present, the 'modified natural' surfactants containing the hydrophobic surfactant proteins SP-B and SP-C appear most effective. Calfactant may have a particular advantage because of its relatively high content of SP-B and its lack of contamination with non-surfactant lipids and proteins.
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Expert Opin Pharmacother · Aug 2001
ReviewFluoroquinolones in the treatment of acute uncomplicated urinary tract infections in adult women.
Urinary tract infections (UTIs) are among the most commonly encountered bacterial infections. Acute uncomplicated UTIs in adults include episodes of cystitis and pyelonephritis. The main uropathogens causing uncomplicated UTIs have, in the past, been fairly predictable and they have generally been susceptible to several commonly used oral antimicrobials. ⋯ Treatment of acute pyelonephritis is less controversial and fluoroquinolones are recommended as first-line agents in the empiric treatment of community-acquired pyelonephritis. Of concern, the increased use of fluoroquinolones for the treatment of UTIs and other infectious processes has resulted in an increasing prevalence of fluoroquinolone-resistant uropathogens worldwide. In light of these changing resistance patterns, prudent use of fluoroquinolones for the treatment of UTIs is warranted.
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The availability of rituximab and the possible imminent availability of two new radiolabelled monoclonal anti-CD20 antibodies (Yttrium-90 (90Y)-ibritumomab and Iodine-131(131I)-tositumomab) have captured much attention in the treatment of lymphoma. The chimeric monoclonal anti-CD20 antibody, rituximab has truly heralded a new era for the treatment of lymphoma and human malignancies. ⋯ New advances in antibody therapy, driven by new technologies and defining novel antigen targets, offer the promise of more effective tumour specific therapies. Combinations of antibodies, either conjugated with radioisotopes or unlabelled, used with chemotherapy are likely to provide definitive advances in the treatment of lymphoma in the immediate future.
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Lyme borreliosis, a tick-transmitted spirochetal disease, may begin with a characteristic expanding skin lesion at the site of the tick bite. Within several days to weeks, the infection can spread haematogenously to involve the heart, nervous system or the joints. After months to years, the spirochete may persist in these organs causing a chronic form of illness. All stages of this disease can be treatable with antimicrobial agents.
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Expert Opin Pharmacother · Dec 2000
ReviewRole of aprotinin in the management of patients during and after cardiac surgery.
Management of patients undergoing cardiac surgery has evolved in recent years as more is understood about the physiological changes and responses that occur during and after cardiopulmonary bypass (CPB). In particular, our understanding of the mechanisms involved in haemostasis and in the inflammatory response to bypass surgery, has allowed significant refinements in patient management. ⋯ However, in view of its cost, making an appropriate selection of patients most at risk of serious blood loss is a major consideration in the use of aprotinin. While its mechanisms of action are not well understood, the use of aprotinin also appears to reduce inflammatory response to CPB.