Macrolides for the Treatment of Chronic Sinusitis

April 13th, 2015 Posted in Treatment
Apr, 13 2015
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The efficacy of macrolide therapy in patients with asthma may not be based exclusively on their antiinflammatory effects. Atypical intracellular pathogens (Chlamydia pneumoniae and Mycoplasma pneumoniae) may play a role in the pathogenesis of reactive airway diseases, and macrolides possess antimicrobial activity against these pathogens. In one study, M pneumoniae or C pneumoniae was present in the airways (detected by polymerase chain reaction [PCR]) in more than half of stable patients with chronic asthma. Thus, it is difficult to distinguish between the anti-inflammatory and antimicrobial effects of macrolides compared with the beneficial responses in some patients with asthma. Chronic Sinusitis

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Table 1—Effect of Clarithromycin in Asthma

Pretreatment Posttreatment p Value
FEVj 1.6 ± 0.58 1.85 ± 0.76 0.07
FVC 2.7 ± 0.9L 3.0 ± 1L 0.0038
Chest discomfort 0.7 ± 0.8 0.5 ± 0.7 0.02
Nighttime SOB 3.20 ± 2.15 2.51 ± 2.16 0.051
Social concerns 3.6 ± 2.6 3.0 ± 2.6 0.048

Values given as mean ± SD, unless otherwise indicated. SOB = shortness of breath. Table used with permission of Gotfried.

Macrolide therapy improves lung function in patients with asthma associated with the presence of atypical pathogens. Hahn and Golubjatnikov treated 46 asthmatic patients with doxycycline (Vi-bramycin; Pfizer Pharmaceuticals; New York, NY), 100 mg twice daily, azithromycin, 1 g once weekly, or erythromycin, 1 g daily for a median of 4 weeks. The mean FEV1 (67.8% of predicted at baseline) increased by 12.5% after treatment (p = 0.003). Subsequently, Kraft and associates conducted a double-blind study in which 52 stable patients with chronic asthma were randomized to therapy with clarithromycin, 500 mg, or placebo twice daily for 6 weeks. Macrolide therapy resulted in significantly increased mean (± SD) FEV1 levels in asthmatic patients who were PCR-positive for Chlamydia or Mycoplasma (baseline, 2.50 ± 0.16 L; posttreatment, 2.69 ± 0.19 L; p = 0.05). In contrast, there was no improvement in FEV1 in patients who were PCR-negative (baseline, 2.59 ± 0.24 L; posttreatment, 2.54 ± 0.18 L; p = 0.85). A statistically significant reduction in inflammatory mediators (ie, IL-5, IL-12, and TNF-a), and in eosinophil and neutrophil levels in bronchoalveolar lavage fluid also was observed with clarithromycin, suggesting immunomodulatory activity.

Black randomized 232 asthmatic patients who were antibody-positive for C pneumoniae to roxithromycin, 150 mg, or placebo twice daily. After 6 weeks of therapy, patients treated with the macro-lide had significantly increased nighttime peak expiratory flow (increase from baseline: roxithromycin, 15 L/min; placebo, 3 L/min; p = 0.02), but a nonsignificant change in the daytime peak expiratory flow (increase from baseline: roxithromycin, 14 L/min; placebo, 8 L/min).

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About lung

October 7th, 2014 Posted in Treatment
Oct, 07 2014
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At the end of the second month of this treatment, bone pain had improved but he developed a slight fever (38°C) and exertional dyspnea. On admission, his general condition was good. Crepitations were heard in both lungs. A chest roentgenogram showed metastases on fifth and sixth right ribs and small opacities of an interstitial type spread throughout both lungs. A few days after admission this patients respiratory assessment was suddenly interrupted by the occurrence of thromboembolic disease with diffuse chest pain, increased dyspnea, signs of right ventricular failure and left lower limb phlebitis. Systemic blood pressure was normal. Chest roentgenogram displayed a blunted right costo-phrenic angle, an elevated right diaphragm; Pa02 was 45 mm Hg and PaC02, 25 mm Hg on room air. The thromboembolism was confirmed by pulmonary angiography which showed multiple pulmonary emboli; deep vein thrombosis of the left leg was obvious on phlebography film. Treatment ED by Viagra Australia Pharmacy was commenced with heparin and a filter was placed in the inferior vena cava
through the right femoral vein.

Fifteen days later, all thromboembolic signs had subsided. Clinically, and while still on nilutamide, he remained breathless with crepitations audible in both lungs. A chest x-ray film showed an interstitial process throughout both lungs, a similar appearance to that seen prior to thromboembolism. Peripheral blood cell count was 9,250 with 70.4 percent neutrophils, 2.3 percent eosinophils, 20.9 percent lymphocytes and 6.4 percent monocytes; ESR was increased to 60 mm at first hour. Pulmonary function tests showed results consistent with a restrictive syndrome (vital capacity: 76 percent predicted) with Pa0 of 60 mm Hg on room air and an alveolo-arterial oxygen gradient greatly increased to 54 mm Hg. Gas-diffusing capacity was decreased to 0.8 mmol/minAPa/L (normal value: 1.9 to 2.4). All tests of sputum and serum for bacterial, viral or fungal infection were negative. Tuberculin skin test was negative. Serum IgE level was normal as were serum levels of C3 and C4 complement fractions and circulating immune complexes. A search for rheumatoid factor, cryoglobulin and antinuclear antibodies was negative. A migration inhibition test on peripheral blood leukocytes in the presence of different concentrations of nilutamide showed an inhibition of 31.3 percent at the 72nd hour of a cell culture containing 10 p.g nilutamide/ml; with the same concentration, no significant inhibition (10 percent) was observed in a healthy control.

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Health Care and Cocaine

September 22nd, 2014 Posted in Health, Treatment
Sep, 22 2014
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Cocaine is a white flaky powder made from the leaves of the coca plant, which grows in South America and South East Asia. ‘Coke’, ‘white lady’, ‘snow’ and ‘gold dust’ are just some of the street names for cocaine. In Ireland cocaine comes in two forms: cocaine powder and crack cocaine. Cocaine powder is usually used by snorting it through the nose. It is sometimes injected and can also be eaten. Crack cocaine is a more addictive form of cocaine and is usually smoked.

Cocaine used to be seen as an upper-class drug. However, since the Celtic Tiger years it has become much more widely available and for many people has become the illegal drug of choice. Regular and even daily use of cocaine is increasing. It is thought that about 7 per cent of Irish men have taken coke. In many ways the increase in cocaine usage has been a good analogy for the excesses of the Celtic Tiger and the ‘I want it all and I’ll have it all now’ mentality. Attitudes to cocaine have accordingly changed with increased prosperity and the desire for instant gratification. Unfortunately, cocaine can have devastating effects on both physical and mental health and leave a trail of destruction in its wake.

What Are the Effects of Cocaine?

Cocaine is a powerful stimulant drug and is highly addictive. The initial effects can include increased energy, confidence and alertness, and an increase in sex drive. The user may also feel less hungry, more aggressive, more excited and more prone to taking risks. Cocaine can also give you headaches, nausea and stomach or chest pains. Some users feel paranoid or suffer from hallucinations. As cocaine is used more often, tolerance develops, which means larger amounts of the drug are needed to achieve the same ‘high’ and the good feelings experienced tend to lessen. This can lead to serious adverse health effects. Cocaine is highly addictive and dependence (both physical and psychological) can develop rapidly, with strong cravings for cocaine.

Withdrawal effects can include sleep disturbance, exhaustion, irritability, restlessness and feelings of depression. Some people can experience severe seizures. ‘Snow bugs’ is an unpleasant crawling sensation that can be felt under the skin during cocaine withdrawal.

What Are the Medical Complications of Cocaine Abuse?

Cocaine is usually snorted into the nostrils. This causes the blood vessels in the nose to narrow, damaging the lining (septum) between both sides of the nose. Eventually a hole can appear in the septum. A tell-tale sign of regular cocaine use is a red, runny stuffed-up nose. Cocaine can also cause loss of smell, hoarseness and nosebleeds.

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Alternative method Treatment of ED: Herbal Supplements

September 11th, 2014 Posted in Erectile Dysfunction, Treatment
Sep, 11 2014
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They come in numerous delivery methods and names. There is an important point I’d like to make:
just because a product claims to be herbal or natural doesn’t mean it’s safe. Many herbal remedies can cause side effects and dangerous interactions when taken with certain medications. Hence the importance of testing and talking to your Doctor before you try any herbal treatment for ED — especially if you’re taking medications or you have a health problem such as heart disease or diabetes.

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Various myths have also been built up over the ages based on herbal substances such as Henbane, Jimson-Weed, Spanish Fly etc and results are claimed for natural tonics ranging from ginseng to oysters. Some of them may have some blood vessel widening properties (vasodilation) but with no scientific proof. If they did actually deliver what is promised I am sure the pharmaceutical corporations would have been onto it in a flash.

Some of the offered supplements can be are sourced from the recommended diet that promote Nitric Oxide production and antioxidants in our Nutrition recommendations in Step 6. They may also promote testosterone and general well being. For example, oysters are found in our shellfish recommendations. How many times have you heard that oysters are an aphrodisiac based on their high zinc content? The implication is that zinc has some kind of Viagra in Canada online effect. Zinc supplementation is only relevant when there’s a deficiency of the mineral in our bodies and this affects normal testosterone levels.

Pomegranate juice is another recently claimed ED superfood. A famous producer of pomegranate juice has recently been forced by the US to stop claiming it treats ED. It is a good antioxidant and antioxidants help to keep cells healthy. It is also included in my recommended diet.

Likewise, Korean red ginseng is claimed to stimulate male sexual function, but not proven and again, it is probably a useful antioxidant. Ginkgo Biloba may also have other health benefits but, for sexual function, studies are inconclusive. Horny goat weed and related herbs have purportedly been treatments for sexual dysfunction for years. Not proven, but may have blood vessel dilation properties.

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