Efficacy of arbidol in prophylaxis and treatment of acute respiratory viral infections in servicemen

The authors present the results of study of arbidolum therapeutic-and-prophylactic effectiveness in acute respiratory viral infections (ARVI) under conditions of military staff with determination of economic expediency. Coefficient of effectiveness of arbidolum prophylactic use was 25% and efficiency index--1.33. In experimental group the ARVI complicated forms were noted in 3% of the patients and in control group--in 5%. Due to decreased expenses on the treatment of non-complicated and complicated ARVI forms the cost of therapy of one servicemen in the first group was 290.6 rubles, in the second group--323 rubles, in the third group--336 rubles and in the fourth group--368 rubles. The results of investigation have shown the significant advantage of arbidolum therapeutic-and-prophylactic use compared with other variants. Its use permitted to decrease the febrile period, to reduce the manifestation of symptoms of intoxication and affection of upper respiratory tract.     

Antibiotic combination with photodynamic inactivation for the treatment of bacterial infections

The growing number of antibiotic-resistant bacteria motivates the search for strategies that recover the use of antimicrobials, such as the combination of therapies to combat or delay resistance [1]. Since photodynamic inactivation (PDI) is a technique with antimicrobial efficiency widely reported in the literature, in addition to the advantages of low side effect and mainly because its mechanism of action is based on bacterial death through oxidative stress, which has a probability of developing resistance until then unreported, makes it an excellent role adjunct to antibiotic therapy [2]. In this work, the objective was to evaluate the protocols for combining PDI with antibiotics in order to potentiate the antimicrobial action of the treatment.PDI protocols were applied to Staphylococcus aureus, using curcumin as photosensitizer (10 μM) and light dose of 10 to 20 J/cm² using the Biotable® (lighting device containing 24 uniformly distributed LEDs) at wavelength of 450 nm. The minimum inhibitory concentration (MIC) for the antibiotics amoxicillin, erythromycin and gentamicin were determined with according to the recommendation of the Clinical and Laboratory Standards Institute (CLSI). For synergy analysis, the Bliss independence model was applied to the results [3].We have demonstrated that the application of PDI reduces the dosage required of antibiotic for bacterial cell elimination, proving to be an efficient strategy for application in resistant strains. In addition, we verified that the interaction of photosensitizer with the antibiotics promotes changes in metabolism and bacteria biomolecule. These results are fundamental to transfer in vitro studies to the clinical implementation of PDI as an adjunct to antibiotic therapy.     

细菌生物膜的形成及其耐药性研究进展

细菌生物膜是由许多细菌附着于物体表面构成,表面包被多聚糖基质,由特定的基因调控,不同于浮游状态细菌的一种存在形式.现在已有许多技术可用来检测生物膜的成分.形成的生物膜具有极强的耐药性,其机制主要通过(1)延长抗菌剂渗透生物膜的时间;(2)改变生物膜中微生物生长率;(3)生物膜生长模式的其他生理变化.     

Arbidol used in the prophylaxis of acute respiratory viral infections and their complications in servicemen

The prophylactic action of arbidol to prevent the acute respiratory viral infections and their complications (extra-hospital pneumonia) was studied under conditions of two military collectives during winter and summer time. The data obtained confirm the prophylactic activity of the drug in respect of ARVI. Regardless of the degree of disease epidemic rise among the servicemen who didn't take arbitol the minimal threshold of grippe and other ARVI incidence (10-15%) remained in the experimental group. The incidence of pneumonia decreased. It was connected with decrease in viral-and-bacterial pneumonia. The number of patients with bacterial (generally pneumococcal) pneumonia didn't change.     

Epidemiology and prophylaxis of influenza and other acute respiratory infections occurred in the military collectives

The long complex study of epidemiology of influenza and other acute respiratory infections (ARI) was conducted by the specialists from General and Military Epidemiology Department of the Military Medical Academy collaboration with specialists of Civilian and Military Health Service. The study has revealed the causes of ARI high incidence in the Army and Fleet, allowed to establish the risk groups, the reservoirs of circulating infectious agents, the criteria of premorbid diagnosis of servicemen' susceptibility to often diseases and formation of chronic virus carriage. Besides the different vaccines against influenza, adenovirus and mycoplasma, immunostimulators, other measures of urgent prophylaxis including their various combinations were studied. Many of them as an inactivated influenza vaccine are used according the epidemiological situation. The experience gained and cooperative practice of military and civilian epidemiologists are realized in the interests of sanitary-and epidemiologic inspection and prophylaxis of influenza and other ARI, aerosolic anthroponosis in the Armed Forces as well as among the civilian population. It can be used in creation of global system for infection control.     

法罗培南钠片和头孢呋辛酯片治疗呼吸道细菌性感染成本-效果分析

 目的 评价2种药物治疗呼吸道细菌性感染的成本-效果.方法 根据文献资料,运用药物经济学的成本-效果分析方法,对法罗培南片和头孢呋辛酯片治疗呼吸道细菌性感染进行药物经济学评价.结果 2组有效率分别为98.51%和97.06%,不良反应发生率分别为7.35%与5.80%,均无显著差异.成本-效果分析显示2种方案成本效果比(C/E)分别为3.12,0.48元.结论 头孢呋辛酯片治疗呼吸道细菌性感染是更经济的选择.     

CT and radiography of bacterial respiratory infections in AIDS patients

OBJECTIVE: Acute vertebral collapse is common, and it is sometimes difficult to determine whether the cause is benign or malignant. Recently, diffusion-weighted imaging has been reported to be useful for differentiating the two types. The purpose of this study was to evaluate diffusion abnormalities quantitatively in benign and malignant compression fractures using line scan diffusion-weighted imaging. SUBJECTS AND METHODS. Line scan diffusion-weighted imaging was prospectively performed in 17 patients with 20 acute vertebral compression fractures caused by osteoporosis or trauma, in 12 patients with 16 vertebral compression fractures caused by malignant tumors, and in 35 patients with 47 metastatic vertebrae without collapse. Images were obtained at b values of 5 and 1,000 sec/mm(2). The apparent diffusion coefficient (ADC) was measured in vertebral compression fractures and metastatic vertebrae without collapse. RESULTS: The ADC (mean +/- SD) was 1.21 +/- 0.17 x 10(-3) mm(2)/sec in benign compression fractures, 0.92 +/- 0.20 x 10(-3) mm(2)/sec in malignant compression fractures, and 0.83 +/- 0.17 x 10(-3) mm(2)/sec in metastatic vertebral lesions without collapse. The ADC was significantly higher in benign compression fractures than in malignant compression fractures (p < 0.01), although the two types showed considerable overlap. CONCLUSION: Although the quantitative assessment of vertebral diffusion provides additional information concerning compressed vertebrae, the benign and malignant compression fracture ADC values overlap considerably. Therefore, even a quantitative vertebral diffusion assessment may not always permit a clear distinction between benign and malignant compression fractures.     

Review of antibiotic prophylaxis for bacterial endocarditis in relation to radiological procedures

Although the risk of endocarditis from radiological instrumentation is low, it is recommended that antibiotic cover is used for certain invasive procedures in patients at high risk. The barium enema is, in this context, included in procedures requiring cover. Prosthetic heart valves are particularly liable to infection.     

The prophylaxis and treatment of urination disorders in the early postoperative period

The article is devoted to the main principles of prophylaxis of urination disorders and infective-and-inflammatory complications after the serious operations and trauma. The authors consider that surgeons, urologists and reanimators should take into account the risk of urinary bladder long catheterization. To prevent such complications it is recommended to use the selective alpha1A/D-adrenoblocker tamsulosin. It will allow the prevention of ischuria development, restoration of adequate urination in the early postoperative period with evident economical profit of such measure.     

血清降钙素原对危重病人细菌感染的诊断价值

目的 评价血清降钙素原（PCT）对危重病人感染诊断和鉴别诊断的临床价值。方法 53例危重病人按细菌感染、非细菌感染分为两组,采用微量双夹心免疫发光法测定血清PCT水平。结果 细菌感染组PCT水平明显高于非细菌感染组（χ^2=10．05,P〈0．05）。随血清PCT浓度升高,其对危重病人感染诊断的敏感度降低、特异度增高;以1．5ng／ml为阳性诊断标准时,Youden指数和诊断符合率分别为0．65和83．0％,明显高于以1ng／ml和2ng／ml为阳性诊断标准时。结论 血清PCT检测对危重病人细菌感染的早期诊断、鉴别诊断及指导临床治疗具有重要意义。     

沐舒坦预防和治疗ARDS研究进展

沐舒坦（Ambroxol)是一种较新的粘液溶解剂，近年来其对呼吸系统的保护作用倍受关注，已较多学者将其应用于ARDS的预防和治疗，取得了较好的临床效果，并对其机制进行了深入的研究。其预防和治疗ARDS的机制可能是：（1）减少TNFα和IL－1及相关炎性介质的释放，减轻SIRS在肺部的表现；（2）抗氧化作用，阻止氧自由基对肺组织的损伤；（3）刺激肺泡Ⅱ型上皮细胞合成、分泌内源性肺表面活性物质，同时抑制磷脂酶A对肺表面活性物质的降解，增加肺的顺应性；（4）减轻ARDS时气管壁离子转运和电位差的破坏。临床应用大剂量沐舒坦对ARDS的预防、治疗和转归可能具有一定疗效。     

12家部队医院细菌分布及耐药监测分析

目的调查不同地区部队医院患者血液、尿液等标本中的细菌分布及耐药情况,为合理使用抗菌药物提供实验室依据。方法收集12家部队医院2006年1-12月临床分离的1099株不重复细菌,采用琼脂稀释法测定抗菌药物对细菌的最低抑菌浓度(MIC),计算MIC50、MIC90,并按美国临床实验室标准化协会(CLSI)2007年标准判断敏感率(S%)、中介率(I%)、耐药率(R%),利用WHONET5.4软件进行分析。纸片法检测超广谱β-内酰胺酶(ESBLs),3-氨基苯酚硼酸(APB)纸片增强法检测AmpC酶。结果共获得革兰阳性菌436株(39.7%),革兰阴性菌663株(60.3%)。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)检出率分别为62%和92%,未发现万古霉素耐药的肠球菌和葡萄球菌。大肠埃希菌(E.coli)、肺炎克雷伯菌产ES-BLs的比率分别为51.1%和45.1%,二者产AmpC酶的比率分别为11.3%和16.2%。血液中E.coli和肺炎克雷伯菌对头孢他啶、阿米卡星、头孢噻肟、头孢西丁和左氧氟沙星的耐药率普遍低于尿液中的相应细菌,而血液中铜绿假单胞菌和不动杆菌对美罗培南、头孢他啶、多黏菌素、米诺环素的耐药率均显著高于尿液中的相应细菌。结论MRSA、MRSCN以及产ESBLs、AmpC酶的耐药细菌在部队医院的发生率较高;自血液和尿液分离的细菌对抗菌药物的耐药性差异较大。