Adverse Drug Reaction Reporting Systems ; Anti-Infective Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Humans ; Safety

Acetamides ; adverse effects ; therapeutic use ; Anti-Infective Agents ; Female ; Humans ; Infant, Newborn ; Linezolid ; Male ; Oxazolidinones ; adverse effects ; therapeutic use ; Sepsis ; drug therapy

OBJECTIVETo evaluate the effects of local-delivery of 25% metronidazol gel and mechanical cleaning using ultrasonic carbon fiber tip on dental implants with peri-implantitis.

METHODS27 implants with peri-implantitis were randomly assigned to receiving either 25% metronidazol gel treatment or carbon fiber tip ultrasonic scaling. All parameters including plaque index (PLI), probing depth (PD) of pocket, sulcular bleeding index (SBI), and BANA enzyme analysis were measured at baseline, 1, 2, 6 and 12 weeks after treatment.

RESULTSStatistically significant decrease (P < 0.05) in SBI, BANA test and PLI occurred in both treatment groups at all time intervals compared to baseline. PD had a decreasing tendency in both groups, but only metronidazole group reached statistically significant level (P < 0.05) at 2 and 6 week intervals compared to baseline. None of the treatment modalities produced any side effects on the implant and peri-implant tissues.

CONCLUSIONSBoth 25% metronidazol gel and mechanical cleaning using ultrasonic carbon fiber tip can be safely and effectively used in the treatment of peri-implant diseases.

Adult ; Anti-Infective Agents ; therapeutic use ; Carbon ; Dental Implants ; adverse effects ; microbiology ; Female ; Humans ; Male ; Metronidazole ; therapeutic use ; Middle Aged ; Periodontitis ; etiology ; therapy ; Time Factors ; Treatment Outcome ; Ultrasonics

OBJECTIVETo assess the efficacy and safety of bifid triple viable bacterial tablet in treatment of infantile diarrhea.

METHODSAccording to the requirements of Cochrane systematic review, a thorough literature search was performed among Chinese Digital Hospital Library (www.chkd.cnki.net) and Chinese Biomedical Literature Disk Database (CBMdisk). A meta analysis was performed on a total of 1326 patients involved in 12 papers which met the inclusion criteria.

RESULTSPublication bias analysis showed that the funnel plot was symmetrical. Test for heterogeneity showed that the groups treated with bifid triple viable bacterial tablet and antibiotics or anti-viral agents or placebo control had clinical homogeneity and statistical homogeneity (P = 0.66, 0.67, 0.85, respectively, I(2) = 0%), which allowed to use fixed effect model analysis. The bifid triple viable bacterial tablet and Smecta did not have statistical homogeneity (P = 0.02, I(2) = 70.9%), therefore random effect model analysis was applied. Incorporation analysis showed that in comparison of the bifid triple viable bacterial tablet versus antibiotics or anti-viral agents or placebo control, the odds ratios were 5.34, 4.74 and 6.43, respectively, and 95% CIs were [2.81, 10.16], [2.47, 9.09], and [2.61, 15.83], on test for overall effect, Z = 5.11, 4.67 and 4.04, P < 0.00001. In the forest plot the 95% CI horizontal line of incorporation odds ratio droped to the right side of the vertical line indicating the border of effectiveness. However, no statistically significant difference was found between bifid triple viable bacterial tablet and Smecta.

CONCLUSIONThe clinical evidences available so far indicated that treatment of infantile diarrhea with bifid triple viable bacterial tablet is safe and effective although rigorously designed large sample size randomized double blind clinical trials are required to further demonstrate and support the conclusion.

Administration, Oral ; Anti-Bacterial Agents ; therapeutic use ; Anti-Infective Agents ; administration & dosage ; adverse effects ; therapeutic use ; Antiviral Agents ; therapeutic use ; Child, Preschool ; China ; Controlled Clinical Trials as Topic ; Diarrhea, Infantile ; drug therapy ; Humans ; Infant ; Odds Ratio ; Tablets ; Treatment Outcome

Adrenal Cortex Hormones ; therapeutic use ; Aged ; Anti-Infective Agents ; therapeutic use ; Anti-Inflammatory Agents ; therapeutic use ; Atropine ; therapeutic use ; Dexamethasone ; therapeutic use ; Eye Infections ; complications ; drug therapy ; Female ; Fluoroquinolones ; therapeutic use ; Glucocorticoids ; therapeutic use ; Humans ; Mydriatics ; therapeutic use ; Ophthalmia, Sympathetic ; drug therapy ; etiology ; Prednisolone ; therapeutic use ; Scleral Buckling ; adverse effects ; Triamcinolone ; therapeutic use

TNF-alpha mediated apoptosis of the hematopoietic cells has been thought to contribute to the ineffective hematopoiesis observed in myelodysplastic syndrome (MDS). The combination of pentoxifylline (P) and ciprofloxacin (C) has been shown to reduce the serum levels of TNF-alpha, and an earlier trial of P and C with dexamethasone (D) provided good palliation for patients with MDS. The purpose of this study is to assess the hematologic response to PCD therapy for patients suffering with MDS. 21 of 25 patients who completed at least of 12 weeks of treatment were evaluable for the treatment efficacy. At baseline, the patient's median age was 60 yr (range: 18-75 yr). The diagnoses according to WHO classification included: RA (n=5), RCMD (n=10), RARS (n=1), RCMD/RS (n=1), RAEB (3), and CMML (n=1). 11 patients (52%) had at least single lineage response. 3 patients (11%) showed improvement of triple lineage cytopenia. There were no differences in the response rates between the FAB subtypes. The median time to response was 4 weeks (range: 2-12 weeks), and it is interesting that 9 of 11 patients who had a response remained without relapse for a median of 177 days (range: 78-634 days). These preliminary results indicate that anti-cytokine therapy with PCD is an effective and well tolerated palliative treatment for patients with MDS.
Adolescent ; Adult ; Aged ; Anti-Infective Agents/adverse effects/therapeutic use ; Anti-Inflammatory Agents/adverse effects/therapeutic use ; Apoptosis/*drug effects ; Ciprofloxacin/adverse effects/therapeutic use ; Comparative Study ; Dexamethasone/adverse effects/therapeutic use ; Drug Therapy, Combination ; Erythrocyte Count ; Female ; Hematologic Agents/adverse effects/therapeutic use ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes/*blood/drug therapy ; Nausea/chemically induced ; Pentoxifylline/adverse effects/therapeutic use ; Platelet Count ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha/*metabolism

Encephalopathy is a disorder characterized by altered brain function, which can be attributed to various causes. Encephalopathy associated with metronidazole administration occurs rarely and depends on the cumulative metronidazole dose, and most patients with this condition recover rapidly after discontinuation of therapy. Because metronidazole is metabolized in the liver and can be transported by the cerebrospinal fluid and cross the blood-brain barrier, it may induce encephalopathy even at a low cumulative dose in patients with hepatic dysfunction. We experienced a patient who showed ataxic gait and dysarthric speech after receiving metronidazole for the treatment of hepatic encephalopathy that was not controlled by the administration of lactulose. The patient was diagnosed as metronidazole-induced encephalopathy, and stopping drug administration resulted in a complete recovery from encephalopathy. This case shows that caution should be exercised when administering metronidazole because even a low dose can induce encephalopathy in patients with liver cirrhosis.
Anti-Infective Agents/*adverse effects/therapeutic use ; Brain Diseases/*chemically induced/diagnosis ; Hepatic Encephalopathy/*drug therapy/etiology ; Humans ; Liver Cirrhosis/*complications ; Magnetic Resonance Imaging ; Male ; Metronidazole/*adverse effects/therapeutic use ; Middle Aged ; Tomography, X-Ray Computed

Antibiotics-associated pseudomembranous colitis is well documented and caused by abnormal overgrowth of toxin producing Clostridium difficile colonizing the large bowel of patients undergoing antibiotic therapy. Administration of chemotherapeutic agents is frequently complicated by diarrhea and enterocolitis. However, pseudomembranous colitis related to chemotherapeutic agent usage is very rare. We experienced a 67 old-years male patient diagnosed of non-small cell lung carcinoma who complained of watery diarrhea and abdominal pain after treated with paclitaxel and carboplatin. Sigmoidoscopic examination revealed diffusely scattered, whitish to yellowish pseudo-membrane with background edematous hyperemic mucosa from sigmoid colon to rectum. Histopathologic findings were consistent with pseudomembranous colitis as typical volcano-like exudate. The symptoms improved after stopping chemotherapy and treatment with metronidazole. In patients with persistent diarrhea and abdominal pain after receiving chemotherapy agents, although rare, pseudomembranous colitis should be considered as a differential diagnosis.
Aged ; Anti-Infective Agents/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/*adverse effects/therapeutic use ; Carboplatin/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Diagnosis, Differential ; Enterocolitis, Pseudomembranous/*diagnosis/etiology/pathology ; Humans ; Lung Neoplasms/drug therapy ; Male ; Metronidazole/therapeutic use ; Paclitaxel/*adverse effects/therapeutic use ; Sigmoidoscopy ; Tomography, X-Ray Computed

OBJECTIVETo identify the risk factors which will indicate the Pneumocystis carinii (Pc) infection in children with systemic lupus erythematosus (SLE) and investigate the clinical features and to elevate the level to find out the high-risk patients and make early diagnosis and treatment.

METHODThe characteristics, clinical features, laboratory examinations, treatment and prognosis of Pneumocystis carinii pneumonia (PCP) in children with SLE under 18 years of age treated in our hospital between January 2000 and January 2013 were prospectively reviewed. A comparison was made with the 26 cases of SLE children without PCP who were matched for gender, age and course, and a literature review was made.

RESULTS(1) Five cases were enrolled, 3 were male and 2 female. Their age range was 13-17 (14.0 ± 1.6) years. All the children had kidney involvement. The courses were from 3 months to 4.5 years. All patients were receiving daily glucocorticoid therapy and immunosuppressive drugs before the diagnosis of PCP.Four patients were in the inactive phase of SLE (SLEDAI 2-4 points), and the fifth case was in active phase (SLEDAI 8, low complement 2 points, anti-dsDNA antibody positive 2 points, urine-protein 4 points). (2) Besides the clinical manifestations of SLE, most patients had progressive dyspnea, fever and dry cough at onset of PCP. Two children accepted mechanical ventilation because of respiratory failure. The mean duration of the symptoms to diagnosis was 10-30 (17.6 ± 7.8) days. Lactose dehydrogenase (LDH) was elevated more or less, median was (700 ± 263) U/L. Lymphocyte count were (0.3-1.4)×10(9)/L (median 0.5×10(9)/L), and three children had CD4 T lymphocyte count <0.3×10(9)/L. Arterial blood gas analyses showed severe hypoxemia. Chest radiographs showed in all cases diffuse interstitial infiltration. Pc was positive in the sputum. All patients were treated with trimethoprim-sulfamethoxazole and corticosteroids.

CONCLUSIONWhen SLE children are treated with corticosteroids and immunosuppressive drugs, low lymphocyte count is the risk factor for Pc infection.It is essential to monitor lymphocyte count.We should pay more attention to fever, dry cough and hypoxemia. Chest radiologic examination may help diagnose the PCP in SLE children.It may be helpful for SLE children whose CD4T lymphocyte was below 0.3×10(9)/L to take trimethoprim-sulfamethoxazole for PCP prophylaxis.

Adolescent ; Anti-Infective Agents ; adverse effects ; therapeutic use ; Case-Control Studies ; Child ; Female ; Glucocorticoids ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Kidney Diseases ; etiology ; Lung ; pathology ; Lupus Erythematosus, Systemic ; complications ; drug therapy ; Lymphocyte Count ; Male ; Opportunistic Infections ; drug therapy ; epidemiology ; Pneumonia, Pneumocystis ; drug therapy ; epidemiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use

OBJECTIVE: We wanted to evaluate the safety and feasibility of ethanol sclerotherapy for treating craniofacial venous malformations (CVMs). MATERIALS AND METHODS: From May 1998 to April 2007, 87 patients (40 men and 47 women; age range, 2-68 years) with CVMs underwent staged ethanol sclerotherapy (range, 1-21 sessions; median number of sessions, 2) by the direct puncture technique. Clinical follow up (range, 0-120 months; mean follow up, 35 months; median follow up, 28 months) was performed for all the patients. Therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms in all patients, as well as the degree of devascularization, which was determined on the follow-up imaging, in 71 patients. RESULTS: A total of 305 procedures with the use of ethanol were performed in 87 patients. Follow-up imaging studies were performed for 71 of 87 patients. Twenty-three (32%) of the 71 patients showed excellent outcomes, 37 patients (52%) showed good outcomes and 11 patients (16%) showed poor outcomes. Ethanol sclerotherapy was considered effective for 60 patients. All the minor complications such as bulla (n = 5) healed with only wound dressing and observation. Any major complication such as skin necrosis did not develop. CONCLUSION: Percutaneous ethanol sclerotherapy is an effective, safe treatment for CVMs.
Adolescent ; Adult ; Aged ; Analgesics/administration & dosage ; Anti-Infective Agents, Local/adverse effects/*therapeutic use ; Child ; Child, Preschool ; Craniofacial Abnormalities/*therapy ; Ethanol/adverse effects/*therapeutic use ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain/drug therapy/etiology ; Retrospective Studies ; Sclerosing Solutions/adverse effects/therapeutic use ; Sclerotherapy/adverse effects/*methods ; Treatment Outcome ; Vascular Malformations/*therapy ; Young Adult