Experience of X-ray control of the effectiveness of antibiotic therapy for post-infectious colitis

Community-acquired pneumonia is one of the most common infections in children with an annual incidence of 34 to 40 cases per 1000 children in Europe and North America. Pneumonia is a common cause of death in children under five years of age worldwide. Thus, about 1,8 million children die from pneumonia annually. According to the statistics of the Ministry of Health of Ukraine, about 80,000 children every year suffer from community-acquired pneumonia in Ukraine. Material and methods: Retrospective analysis of 100 case histories of children aged 3-9 years old with outpatient segmental/polisegmental pneumonia who were in inpatient treatment in the pulmonology department of regional hospital from January 2017 to December 2018. The representativeness of the comparison groups is represented by age and sex. Methods of examination: clinical-anamnestic, laboratory and instrumental (pulse oximetry, chest X-ray). Results: Most of the children (58%) were admitted to the hospital on the first day of the illness. In 33% of children, comorbidity was noted. All children had fever, an unproductive cough, while symptoms of intoxication (76 ± 4.27%) and dyspnea (52 ± 4.49%) were more pronounced in children 3-6 years old. In the general analysis of blood in children of the first age group, in most cases, leukocytosis was more than 12 G / L (56 ± 4.96%), neutrophilic shift of the leukocyte formula to the left of 88 ± 3.25% and elevated ESR (84 ± 3.66%). X-ray in children of the first age group was dominated by polysegmental pneumonia at 54 ± 4.44%, while in children of the second age group segmental pneumonia was more common (64 ± 4.66%). Half of the children of both age groups prescribed antibiotics of the first line - a group of penicillins and cephalosporins. When starting antibiotic therapy with penicillins, the symptoms of pneumonia decreased already in the 2nd day in 16% ± 3.67% in the group of children 3-6 years old and in 18% ± 3.84% of children 7-9 years. Conclusion. Pneumonia is one of the most common diseases in children, and one of those that can cause many complications and even death. Accordingly, the treatment of this disease should be maximally effective and short-lived. The best choice for treating pneumonia is a group of oral aminopenicillins, which were administered in the first days of the disease and showed significantly better results than patients treated with cephalosporins.

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Cefuroxime-tobramycin Therapy in Cancer Patients with Bacterial Infections

Tumori Journal ◽

10.1177/030089168006600612 ◽

1980 ◽

Vol 66 (6) ◽

pp. 765-773

Author(s):

Paolo Azzoni

Keyword(s):

Antibiotic Therapy ◽

Cancer Patients ◽

Clinical Picture ◽

Bacterial Infections ◽

Laboratory Tests ◽

Positive Culture ◽

X Ray ◽

Urinary Infections ◽

Small Rise ◽

Probable Infection

Twenty-five patients with different metastatic tumors, and often with other diseases which may have further compromised their organic defenses (such as diabetes, anemia and neutropenia), had a simultaneous bacterial complication. This was regarded as documented (i.e., proved by positive culture) in 12 of 25 patients, and probable if subjective and objective symptoms, X-ray, laboratory tests and the clinical picture agreed with bacterial infection in progress, even though the culture was negative, in 13 of 25 patients. Antibiotic therapy with cefuroxime-tobramycin gave good results in 19 of 25 patients, i.e., in 10 of 12 with a documented infection and in 9 of 13 with a probable infection. Fever of unknow origin and urinary infections were the most responsive to the therapy. Three of 25 patients had nephrotoxicity, with a very small rise in BUN and creatinine, which was easily reversible. According to our experience, antibiotic therapy with cefuroxime-tobramycin would be useful in cancer patients with bacterial complications because of its effectiveness and tolerability.

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A Successful Medical Treatment of Necrotizing Pneumonia in a Pediatric Patient

Case Reports in Pediatrics ◽

10.1155/2020/8875119 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Herlina Uinarni ◽

Felicia Nike ◽

Andi Dwi Bahagia

Keyword(s):

Antibiotic Therapy ◽

Respiratory Distress ◽

Medical Treatment ◽

Chest Ct ◽

Lung Ultrasonography ◽

Necrotizing Pneumonia ◽

Intravenous Antibiotic ◽

X Ray ◽

Chest X Ray

Necrotizing pneumonia is a rare, serious complication of pneumonia in children. We present a case of a 20-month-old girl presenting with respiratory distress which later be diagnosed with necrotizing pneumonia. In this paper, we highlight the role of imaging such as chest X-ray, chest CT, and lung ultrasonography for diagnosis and the importance of intravenous antibiotic therapy for better outcome.

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073 Alemtuzumab induced allergic inflammatory syndrome (ALIAS) with eosinophilic acalculous cholecystitis: a report of two cases

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-anzan.72 ◽

2018 ◽

Vol 89 (6) ◽

pp. A30.1-A30 ◽

Cited By ~ 1

Author(s):

Ariadna Fontes-Villalba ◽

John DE Parratt

Keyword(s):

Antibiotic Therapy ◽

Clinical Signs ◽

Young Patients ◽

Lower Lobe ◽

Acalculous Cholecystitis ◽

X Ray ◽

Blood Tests ◽

Chest X Ray ◽

The Right ◽

Inflammatory Syndrome

IntroductionAlemtuzumab, a humanised monoclonal antibody directed at CD52, is a highly active treatment for multiple sclerosis (MS) that induces rapid depetion of circulating lymphocytes. Infusion-associated reactions and autoimmune disorders are established adverse effects. We describe two cases of alemtuzumab associated allergic inflammatory syndrome involving the lungs and gallbladder in two young patients after their first course of Alemtuzumab.Case 1 A 26 year old female with relapsing-remitting MS (RRMS) received her first course of alemtuzumab. On the fourth day of treatment, she developed bronchospasm, chest pain and an interstitial infiltrate in the right lower lobe on chest X-ray. She had right upper quadrant pain and a positive Murphy’s sign and ‘gallbladder sludge’ on ultrasound. Blood tests showed lymphopenia and eosinophilia. The patient was diagnosed with acalculous cholecystitis. Antibiotic therapy was initiated but laparoscopic cholecystectomy was required. The pathology demonstrated eosinophilic cholecystitis.Case 2 A 29 year old man with RRMS was switched to alemtuzumab due to positive JCV antibody status. He had an episode of hemoptysis on the fifth day of the infusion. Two days later, haemoptysis was accompanied by chest tightness. Physical examination revealed a palpable liver and positive Murphy sign. Blood tests were remarkable for abnormal liver enzymes. Signs of interstitial changes in the right lower lobe were observed on a chest X-ray. The patient was diagnosed with acalculous cholecystitis and antibiotic therapy was initiated. The infiltrate resolved and the clinical signs quickly improved.ConclusionThe characteristics of this condition are acute onset (within days of alemtuzumab) and non-infective inflammation of the lung (right lower lobe in these cases) and gallbladder. The pathology in one case indicates this is likely to be a drug related, allergic phenomenon with extensive eosinophilic infiltration of the gallbladder.

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731. Investigating Clinical Factors Contributing to Continued Antibiotic Therapy in Patients with Viral Upper Respiratory Tract Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.738 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S263-S263

Author(s):

Alexander Lawandi ◽

Charles Frenette

Keyword(s):

Respiratory Tract ◽

Antibiotic Therapy ◽

Emergency Departments ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Upper Respiratory Tract ◽

X Ray ◽

Chest X Ray ◽

Upper Respiratory ◽

Tract Infections

Abstract Background It has previously been demonstrated that upwards of 50% of patients presenting to Emergency Departments with symptoms of an upper respiratory tract infection receive empirical antibiotics, and that even with a demonstrated viral infection, 70% of these patients are continued on antibiotics. However, the clinical and biochemical factors contributing to this continued therapy is unclear. This study assessed parameters that may impact antibiotic prescriptions in patients with a confirmed viral respiratory infection. Methods. Positive respiratory virus PCRs (RVPs) from nasopharyngeal aspirates performed on adult patients presenting to the McGill University Health Centre Emergency Departments and outpatient clinics over a period of 10 days during the peak of influenza season were included. For each patient, antibiotic administration pre- and post-PCR result were determined, as were the presence of leukocytosis, neutrophilia, an abnormal chest X-ray, and sepsis. Each parameter’s effect on antibiotic use was then determined. Results. During the study period, there were 123 positive RVPs included. These consisted of 34% Flu A, 43% Flu B, and 23% were a mixture of other common respiratory viruses. Antibiotics were administered in 38% of patients before the test was resulted and continued in 79% of these patients afterwards. There was no correlation between the presence of leukocytosis, neutrophilia, signs of sepsis or abnormalities on chest X-ray and continued antibiotic therapy. Conclusion. Despite identification of a respiratory virus infection, patients are routinely treated with antibiotics even without significant evidence of a bacterial process. The impact of testing for respiratory viruses in limiting antibiotic therapy could be improved by education and direct antibiotic stewardship interventions in this population. Disclosures All authors: No reported disclosures.

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Pneumonia in patients with chronic kidney disease V D stage: pathogenetic aspects of complex therapy and outcomes

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.1(61).2019.03 ◽

2019 ◽

pp. 20-28

Author(s):

I. Shifris ◽

L. Korol ◽

O. Magas ◽

E. Krasiuk ◽

I. Dudar

Keyword(s):

Antibiotic Therapy ◽

Complex Method ◽

Traditional Therapy ◽

X Ray ◽

Ckd Stage ◽

Significant Difference ◽

Complex Therapy ◽

Duration Of Hospitalization ◽

Group 2 ◽

Group 1

Abstract.The aim of our study was to increase the effectiveness of treatment of comorbid pneumonia in patients with CKD VD stage. Materials and Methods. 73 patients with CKD VD st. (59 on HD and 14 on PD) with mild to moderate comorbid pneumonia who received renal replacement therapy (RRT) during 2013-2016 were included in the observational prospective open-label randomized trial. Patients were randomized into two groups: group 1 (n = 42) included patients who in addition to the conventional therapy of pneumonia received medication «Lipin» as a complex therapy; group 2 included patients (n = 31) who received only basic (traditional) therapy. The groups were representative by the main demographic, social and clinical-laboratory findings, severity of pneumonia, duration and modality of RRT. The primary endpoints were death from any cause and episodes of rehospitalization. The overall assessment of the clinical efficacy of the therapy was based on a comparison of the duration of hospitalization, antibiotic therapy, intoxication syndrome, and regression of X-ray changes. Survival in observation groups was determined by the Kaplan-Meier method. Analyzed cases were included to October 31, 2018. The markers of oxidative stress (OS) were determined in 29 patients of group 1 and 14 patients of group 2 before treatment and after 14 days while treatment of pneumonia was started. Results. The analysis demonstrated that during a 1-year period a 17 (25,76%) episodes of rehospitalization were recorded: 11 causes (35.5%) in group 1 and 6 (14.3%) in group 2 (χ² = 4.486, p = 0.035). In total, 29 deaths were recorded during the study period: 10 (23.8%) cases in group 1, and 19 (61.3%) - in group 2 (χ² = 8.957, p = 0.003, RR - 2.574, 95% CI: 1.400-4.733). The three- and five-year cumulative survival rates were 83% vs. 21% and 59% vs. 21%, in the group 1 and group 2, respectively (p = 0.00003). It was stated that the duration of hospitalization, antibiotic therapy, intoxication syndrome and X-ray regression were significantly lower in group 1 compared with group 2 (p <0.05). The comparative analysis of dynamics in the groups shows that increasing the treatment effectiveness at complex therapy background accompanied by a significant positive dynamics of OS markers (p <0,05). Conclusions Thus, the results of this study demonstrated the effectiveness of complex method of pneumonia treatment in patients with CKD stage 5D including Lipin medication compared traditional therapy. There is a significant difference in patient survival depending on the proposed and generally accepted treatment.

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Space and Time Distribution of Hard X-Ray Emission in a Loop at the Beginning of a Flare

International Astronomical Union Colloquium ◽

10.1017/s0252921100025446 ◽

1994 ◽

Vol 144 ◽

pp. 275-277

Author(s):

M. Karlický ◽

J. C. Hénoux

Keyword(s):

Time Distribution ◽

Electron Bombardment ◽

Spatial Evolution ◽

Superthermal Electrons ◽

Flare Loop ◽

X Ray ◽

Superthermal Electron ◽

Flare Loops ◽

Chromospheric Evaporation ◽

Temporal And Spatial

AbstractUsing a new ID hybrid model of the electron bombardment in flare loops, we study not only the evolution of densities, plasma velocities and temperatures in the loop, but also the temporal and spatial evolution of hard X-ray emission. In the present paper a continuous bombardment by electrons isotropically accelerated at the top of flare loop with a power-law injection distribution function is considered. The computations include the effects of the return-current that reduces significantly the depth of the chromospheric layer which is evaporated. The present modelling is made with superthermal electron parameters corresponding to the classical resistivity regime for an input energy flux of superthermal electrons of 109erg cm−2s−1. It was found that due to the electron bombardment the two chromospheric evaporation waves are generated at both feet of the loop and they propagate up to the top, where they collide and cause temporary density and hard X-ray enhancements.

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Some Problems in Understanding the Solar Corona

International Astronomical Union Colloquium ◽

10.1017/s025292110002491x ◽

1994 ◽

Vol 144 ◽

pp. 1-9

Author(s):

A. H. Gabriel

Keyword(s):

Solar Corona ◽

Solar Atmosphere ◽

Theoretical Modelling ◽

Total System ◽

Major Advance ◽

X Ray ◽

Proper Perspective ◽

Space Observations

The development of the physics of the solar atmosphere during the last 50 years has been greatly influenced by the increasing capability of observations made from space. Access to images and spectra of the hotter plasma in the UV, XUV and X-ray regions provided a major advance over the few coronal forbidden lines seen in the visible and enabled the cooler chromospheric and photospheric plasma to be seen in its proper perspective, as part of a total system. In this way space observations have stimulated new and important advances, not only in space but also in ground-based observations and theoretical modelling, so that today we find a well-balanced harmony between the three techniques.

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White-Light Coronal Structures: Streamers and CMEs

International Astronomical Union Colloquium ◽

10.1017/s0252921100025045 ◽

1994 ◽

Vol 144 ◽

pp. 82

Author(s):

E. Hildner

Keyword(s):

Emission Line ◽

Electron Density ◽

White Light ◽

Coronal Mass Ejections ◽

X Rays ◽

Solar Cycles ◽

Temperature Function ◽

X Ray ◽

Eclipse Observations ◽

Coronal Structures

AbstractOver the last twenty years, orbiting coronagraphs have vastly increased the amount of observational material for the whitelight corona. Spanning almost two solar cycles, and augmented by ground-based K-coronameter, emission-line, and eclipse observations, these data allow us to assess,inter alia: the typical and atypical behavior of the corona; how the corona evolves on time scales from minutes to a decade; and (in some respects) the relation between photospheric, coronal, and interplanetary features. This talk will review recent results on these three topics. A remark or two will attempt to relate the whitelight corona between 1.5 and 6 R⊙to the corona seen at lower altitudes in soft X-rays (e.g., with Yohkoh). The whitelight emission depends only on integrated electron density independent of temperature, whereas the soft X-ray emission depends upon the integral of electron density squared times a temperature function. The properties of coronal mass ejections (CMEs) will be reviewed briefly and their relationships to other solar and interplanetary phenomena will be noted.

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Iron K-Line Emission from X-Ray Binaries

International Astronomical Union Colloquium ◽

10.1017/s0252921100107389 ◽

1988 ◽

Vol 102 ◽

pp. 47-50

Author(s):

K. Masai ◽

S. Hayakawa ◽

F. Nagase

Keyword(s):

Accretion Disk ◽

Radiative Recombination ◽

Characteristic Temperature ◽

Line Emission ◽

Ionization Front ◽

Continuum Radiation ◽

X Ray ◽

Low Mass ◽

X Ray Binaries

AbstractEmission mechanisms of the iron Kα-lines in X-ray binaries are discussed in relation with the characteristic temperature Txof continuum radiation thereof. The 6.7 keV line is ascribed to radiative recombination followed by cascades in a corona of ∼ 100 eV formed above the accretion disk. This mechanism is attained for Tx≲ 10 keV as observed for low mass X-ray binaries. The 6.4 keV line observed for binary X-ray pulsars with Tx> 10 keV is likely due to fluorescence outside the He II ionization front.

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