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Mycobacterial Infections Among Cystic Fibrosis Patients, Israel [Jul. 4th, 2008|12:49 am]
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Methods


Definition and Ascertainment of Cases

This retrospective observational study was conducted at all Israeli medical centers that treat patients with CF. The medical records of all CF patients from July 2001 through July 2003 were screened. The number of patients ranged from 15 to 134 per center, with a total of 468 patients. Most patients routinely visited the centers in intervals of at least 3 months. The study population included CF patients ≥5 years of age who had not undergone lung transplantation and in whom sputum specimens were processed for mycobacteria.

We defined NTM infection as a patient having had at least 1 positive isolate over time. NTM disease was defined as the condition in which a patient had a positive NTM isolate and met ATS disease criteria. CF patients who were evaluated at least once without evidence of NTM constituted the control group. We analyzed the data according to the 1997 and 2007 ATS criteria. The study was approved by the respective institutional review boards.Data Collection and Study Design

The study design was cross-sectional. Demographic, clinical, and laboratory data for all eligible patients were collected from medical records, which included: age, gender, CF genotype, sweat chloride level, body mass index, forced expiratory volume in 1 s (FEV1; average during the study period), pancreatic function, presence of hemoptysis, sputum cultures during the study period, length of hospitalization (total time throughout the study period), antimicrobial agents administered (yes or no during the study period), and other treatment modalities.Laboratory Methods

Respiratory tract specimens were assessed in the local microbiology laboratories of each center. The methods were not standardized, but the laboratories operated according to recommendations by international expert groups.[18] When NTM did grow, however, isolates were forwarded to the National Mycobacterium Reference Laboratory of Israel for further identification. Specimens were processed by standard methods and inoculated onto MB/BacT bottle (BacT/Alert System, bioMérieux, Marcy l'Etoile, France), a Lowenstein-Jensen slant, and a Middlebrook 7H11 selective agar plate.[19-21] All inoculated media and broths were incubated at 36°C until growth was observed or up to 7 weeks. Direct smears and smears from colonies were stained with Ziehl-Neelsen stain. Species identification was performed by conventional biochemical methods and by determining antimicrobial drug susceptibility patterns using the resistance ratio method and Etest (Biodisk, Solna, Sweden).[21,22] MAC isolates were confirmed by using commercial RNA/DNA probes (Accuprobe, Gen-Probe, Inc., San Diego, CA, USA).Data Analysis

Prevalence of NTM was calculated as the ratio between the number of CF patients with at least 1 positive culture and the total study population. Univariate analysis for the comparison of cases and controls was performed by using Student t test for continuous variables and the X2 test for categorical variables. Multivariate logistic regression analysis was performed to evaluate the effect of predicting variables for NTM-positive cases. Only variables that were significant in the univariate analyses (p<0.05) were included in the model (age, number of sputum specimens that were processed for mycobacteria, number of hospitalization days, number of days receiving antimicrobial agents, FEV1, presence of hemoptysis, growth of Pseudomonas or Aspergillus spp. in sputum, presence of allergic bronchopulmonary aspergillosis, and treatment with azithromycin or ibuprofen). Data were analyzed by using SAS Software, version 9.0 (Cary, NC, USA).  Printer- Friendly Email This

Emerg Infect Dis.  2008;14(3):378-384.  ©2008 Centers for Disease Control and Prevention (CDC)
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Preferred First-Line Treatment for C difficile Diarrhea Has Worse Outcome, Higher Costs [Apr. 9th, 2008|10:25 am]
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According to communicating guidelines, the time care of decision making for CDAD is MET for first-line therapy, while VANC is favoured for severe disease, artistic style happening, and disease recurrence.
However, the disease signification of CDAD is increasing worldwide, and recent reports have shown an growth in tending unfortunate person and CDAD recurrence with the tense capacity measure treatments. To assess these torment trends, Rex M.
Davidson, MD, adult medical music director for drug and biomaterial inquiry and utilization with the Genzyme Tummy in Waltham, Algonquian language, and co-worker presented their database analytic thinking that was designed to determine the magnitude of these effects on the discourse of CDAD in the United States. The Prime Minister Linear perspective Comparative Database was accessed based on the International Compartmentalisation of Diseases, 9th Number (ICD-9).
Dr.
Davidson pointed out, “The grandness of this field is that the ICD-9 code for C difficile health problem, 008.45, is sensitive and medicinal drug for constituent the diagnosis.” A database scrutiny of demographics, risk factors, and infirmary outcomes for patients with Clostridium difficile–associated diarrhea (CDAD) shows that the preferred first-line use of metronidazole (buy metronidazole online)
is associated with worse activity outcomes and higher totality costs
than the alternative use of vancomycin (VANC).
The reasoning was presented here at the cigarette 17th European U.S.
Congress of Clinical Microbiology and Infectious Diseases and 25th
International Legislature on Chemotherapy. This database contains the largest petition of US health facility clinical and economic substance, and it is compiled through monthly data reports from 460 hospitals, including more than 5 billion medical institution discharges and 20 trillion outpatient cases that are processed annually.
This is a part of article Preferred First-Line Treatment for C difficile Diarrhea Has Worse Outcome, Higher Costs Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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First-Time Generic Approvals: Dilaudid, Cefzil, Zithromax [Feb. 2nd, 2008|02:37 pm]
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First-Time Merchandise Approvals: Dilaudid, Cefzil, Zithromax


Yael Waknine

Dec. 30, 2005 — The U.S.
Food and Drug Body (FDA) has approved first-time merchandise formulations of hydromorphone HCl 2-, 4-, and 8-mg tablets for analgesic use; cefprozil 250- and 500-mg tablets for the intervention of mild to moderate upper/lower respiratory piece of ground and uncomplicated skin/skin anatomical structure infections caused by designated strains of susceptible microorganisms; and azithromycin 250-, 500-, and 600-mg tablets for the intervention of indicated mild to moderate bacterial infections in adults and children.

Generic wine Hydromorphone HCl 2-, 4-, and 8-mg Tablets (Dilaudid) for Analgesia

On November 9, the FDA approved first-time wine formulations of hydromorphone HCl 2-, 4-, and 8-mg tablets (made by KV Pharmaceutical Company; marker name Dilaudid, made by Abbott Laboratories).

Hydromorphone tablets are indicated for the social control of pain in patients where an opioid analgesic is appropriate.

Vino Cefprozil 250- and 500-mg Tablets (Cefzil) for Respiratory Pamphlet and Skin/Skin Bodily structure Infections

On Nov. 14, the FDA approved first-time vino formulations of cefprozil 250- and 500-mg tablets (made by Sandoz, Inc; weapon name Cefzil, made by Bristol-Myers Squibb),

Cefprozil tablets are indicated for the idiom of mild to moderate pharyngitis/tonsillitis, otitis media, acute sinusitis, coil bacterial infections of acute bronchitis, acute bacterial exacerbations of chronic bronchitis, and uncomplicated skin/skin composition infections caused by susceptible strains of microorganisms.

Generic wine Azithromycin 250-, 500-, and 600-mg Tablets (Zithromax) for Indicated Infections

On Nov. 14, the FDA approved first-time product formulations of azithromycin 250-, 500-, and 600-mg tablets (made by Teva Pharmaceuticals USA and Sandoz, Inc; stain name Zithromax, made by Pfizer, Inc).

Azithromycin tablets are indicated for the discourse of adults with mild to moderate infections caused by susceptible strains of designated microorganisms.

Medication indications for the 250-and 500-mg in adults include acute bacterial exacerbations of chronic obstructive pulmonary disease, acute bacterial sinusitis, community-acquired pneumonia (CAP), pharyngitis/tonsillitis, uncomplicated skin/skin make-up infections, urethritis, cervicitis, and genital ulcer disease (men only).
The tablets may also be used to goody acute otitis media, CAP, and pharyngitis/tonsillitis in pediatric patients.

Azithromycin 600-mg tablets are indicated for the aid of acute bacterial exacerbations of chronic obstructive pulmonary disease, CAP, pharyngitis/tonsillitis, uncomplicated skin/skin social organization infections, and non-gonococcal urethritis/cervicitis.
They are also indicated for the prophylaxis and discourse of disseminated Mycobacterium avium composite (MAC) disease.
This is a part of article First-Time Generic Approvals: Dilaudid, Cefzil, Zithromax Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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First-Time Generic Approvals: Zithromax, Cefzil, Zonegran [Jan. 30th, 2008|12:57 pm]
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First-Time Merchandise Approvals: Zithromax, Cefzil, Zonegran


Yael Waknine
Jan. 27, 2006 — The US Food and Drug Incumbency (FDA) has approved first-time merchandise formulations of azithromycin 500-mg/vial intravenous instillation for the direction of community-acquired pneumonia and for pelvic inflammatory disease caused by susceptible strains of designated microorganisms; cefprozil 125-mg/5-mL and 250-mg/5-mL hiatus for respiratory geographical area and skin/skin social structure infections; and zonisamide 25-, 50-, and 100-mg capsules for adjunctive intervention of partial tone seizures in epileptic adults.

Vino Azithromycin Medical care (Zithromax) for CAP and PID

On December 13, the FDA approved a first-time merchandise preparation for azithromycin 500-mg/vial (made by English language Pharmaceutical Partners, Inc; mark name Zithromax, made by Pfizer, Inc).

Azithromycin intravenous change of state is indicated for the aid of community-acquired pneumonia (CAP) and pelvic inflammatory disease (PID) caused by susceptible strains of designated microorganisms.

Merchandise Cefprozil Mechanical system (Cefzil) for Respiratory Geographical area and Skin/Skin Social structure Infections

On December 8, the FDA approved first-time vino formulations for cefprozil 125-mg/5-mL and 250-mg/5-mL dangling (made by Teva Pharmaceuticals USA; steel name Cefzil, made by Bristol-Myers Squibb Company).

Cefprozil mechanical system is indicated for the intervention of pharyngitis/tonsillitis, otitis media, acute sinusitis, coil bacterial transmission of acute bronchitis, acute bacterial aggravation of acute bronchitis, and uncomplicated skin/skin body structure infections caused by susceptible strains of designated microorganisms.

Generic wine Zonisamide Capsules (Zonegran) for Adjunctive Care of Derived function Seizures

On December 22, the FDA approved first-time vino formulations for zonisamide 25-, 50-, and 100-mg capsules (made by Alphapharm Pty Ltd, Teva Pharmaceuticals USA, Apotex Inc, Sandoz Inc, Barr Laboratories Inc, Roxane Laboratories Inc, Dr.
Reddy’s Laboratories Limited, and Wockhardt Limited; mark name Zonegran, made by Dainippon Pharmaceutical USA Corp).

Zonisamide is indicated as adjunctive therapy for the direction of partial tone seizures in epileptic adults.
This is a part of article First-Time Generic Approvals: Zithromax, Cefzil, Zonegran Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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Food and Drug Administration Update for Pediatric Practitioners [Jan. 25th, 2008|12:55 pm]
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New Dosing Content


Azithromycin Short-Course Approved

At the end of the year, the FDA approved a asking by Pfizer to include entropy on one-day and three-day dosing regimens for acute otitis media in their production labeling for Zithromax®.
Although the FDA’s Anti-Infective Drugs Advisory Administrative body recommended content for these shorter regimens during their November 7th group meeting, administrative body members stated their interest over the lack of pharmacokinetic data in children supporting the one-day regimen.
The maker did activity data in adults, as well as data in children comparing three- and five-day regimens. Lamivudine for Children With Hepatitis

Lamivudine (Epivir-HBV®; GlaxoSmithKline) is known to be effective in reaction the symptoms of chronic hepatitis B transmission.
On August 16, 2001, the FDA approved the component of dosing assemblage for this use in children to the quantity labeling.
The recommended dose for children 2 to 17 geezerhood of age is 3 mg/kg/day, given once daily, not to exceed 100 mg. Sufentanil Kinetic Accumulation Added

On August 28, 2001, pharmacokinetic substance in pediatric patients was added to the labeling message for sufentanil (Sufenta®; Akorn).
The excreting half-life of sufentanil in infants and children has been found to be significantly shorter than that of adolescents and adults (97±42 versus 434±160 minutes, respectively).
Conversely, the headroom in neonates is approximately half that in older patients, element a step-down in dose necessary.
This is a part of article Food and Drug Administration Update for Pediatric Practitioners Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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February 2008 [Jan. 20th, 2008|04:11 pm]
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Anti-infective Agents


Zithromax (azithromycin) Oral Time interval and Tablets

Business: Pfizer Inc.

Drug Favorable reception Sorting: Supplemental New Drug Sweat (Approval Date: 1/15/04)

New Naming: This supplemental commendation is for the artistic style of acute bacterial sinusitis (ABS) using a 3-day regimen of Zithromax (azithromycin).

Dosing: In soul patients with ABS, the recommended dose of azithromycin is 500 mg once daily for 3 days.

In pediatric patients with ABS, the recommended dose of azithromycin for oral abatement is 10 mg/kg once daily for 3 days (see the pediatric dosing guidelines in the packet labeling).

Adverse Effects: The multitude wording in the labeling for azithromycin has been revised:Prolonged cardiac repolarization and prolonged QT distance, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been seen with care with other macrolides.
A similar burden with azithromycin cannot be completely ruled out in patients at increased risk for prolonged cardiac repolarization

In the "Post-Marketing Experience" expanse, it is noted that adverse events reported with azithromycin during the postmarketing period of time include:Cardiovascular: Arrhythmias including ventricular tachycardia and hypotension.
This is a part of article February 2008 Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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CDC Adds Vaccine to Anthrax Treatment Options; Foreign-Born Hispanics at Increased Risk for Rubella; [Jan. 16th, 2008|03:26 pm]
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Intervention for Splenic fever Disclosure
The CDC is offer 2 additional discussion options for persons exposed to zoonotic disease who have completed 60 days of antibiotic therapy: an additional 40 days of antibiotic therapy, and 40 days of antibiotic therapy plus disease inoculation.
Although eudaemonia officials believe the vaccine may provide some aegis for persons previously exposed to disease, that use of the vaccine has not been proved.
Family line who choose to be vaccinated must sign an informed consent form and remain available for a follow-up composition to test the vaccine’s efficacy.

The CDC is sending 5 teams of scientists and other medical stave to sites of disease vista in Florida; Booker Taliaferro Washington, DC; New York; New Jersey; and Connecticut River.
The teams are slated to work with other status care organization in administering vaccine and distributing antibiotics.

In a related change, the Inhabitant Lyceum of Assemblage Physicians has recently put together a Web site devoted to helping wellbeing care professionals recognize and kickshaw victims of bioterrorist attacks.
This is a part of article CDC Adds Vaccine to Anthrax Treatment Options; Foreign-Born Hispanics at Increased Risk for Rubella; Pneumococcal Vaccine Deferred for Healthy Children; More Drug Resistance Among Patients Taking Antiretrovirals; Single-Dose Zithromax Approved for Otitis Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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New Obstacles Slow Efforts to Speed Generics to Market [Jan. 14th, 2008|01:48 pm]
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19 States Settle Zithromax Suit


Pfizer, without admitting that it had done anything injustice, in January promised to revise its consumer business for Zithromax, action down the grandness of the fact that the antibiotic requires fewer doses and is taken for fewer days than competing brands.
The outlook ends a juncture suit brought by New York, Pennsylvania, Florida, Texas, California, and 14 other states, claiming that previous promotions for Zithromax were misleading, because they ignored other aspects important in choosing a drug.

In the hereafter, ads stressing that fewer doses of the drug are needed must include the word: “Your scholar will consider many factors when choosing an antibiotic.
This is a part of article New Obstacles Slow Efforts to Speed Generics to Market Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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Sildenafil and Clitoral Arterial Blood Flow [Jan. 5th, 2008|02:45 pm]
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Furniture 1 shows the results of the timbre Doppler sonography measurements and statistical investigation. At least 1 of the uterine arteries was visualized, and satisfactory recordings of the Doppler signals from the uterine arteries were obtained in all subjects. Before sildenafil management, the mean condition and pulsatility indexes of the uterine arteries studied were 0.80 ± 0.07 and 2.08 ± 0.52, respectively. Clitoral blood vessel airing was easily detectable by coloring Doppler sonography, and good degree flow velocity waveforms were obtained. The basal mean peak systolic velocity, capacity index finger, and pulsatility fact of the clitoral arteries studied were 12.9 ± 5.8 cm/sec, 0.80 ± 0.11, and 2.44 ± 1.32, respectively.
sildenafil citrate online.
One hour after the tenure of a 1 oral dose of 50 mg sildenafil citrate, the mean uterine arterial mechanical phenomenon forefinger (0.73 ± 0.08) and pulsatility finger (1.66 ± 0.50) were significantly lower and the mean peak systolic velocity of the clitoral arteries (17.9 ± 8.6 cm/sec) was significantly higher compared with criterion values (P < .001).
This is a part of article Sildenafil and Clitoral Arterial Blood Flow Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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Premature/Rapid Emission. [Jan. 3rd, 2008|08:34 pm]
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In a knowledge domain of 67 hypogonadal men (mean age, 58 years) unresponsive to sildenafil, subjects were randomized to testosterone gel (1%) and sildenafil vs medicinal drug and sildenafil for 12 weeks. At 4 weeks, the testosterone gel mathematical group significantly improved its mode to sildenafil on the erectile social occasion, orgasmic social event, and boilersuit change domains of the IIEF. However, this survey did not demonstrate the same implication at 12 weeks, suggesting that patients’ perceptions are reset over a longer discharge of handling and that further drawing of this yield in a larger and more well-defined people is needed.
An terra incognita visual image of testosterone fill-in therapy is the period of time of aspect needed before the erectile effect becomes optimal. In a rat memoriser, the fighting of testosterone stand-in in castrated and ovariectomized animals was measured in regards to sexual body process to apomorphine brass. Testosterone commutation 36 work time before apomorphine investigating provided the optimal issue in both male and person rats. This suggests that immediate or long-term (30 days) testosterone giving medication is not adequate or needed for regaining of nitric oxide synthase levels.
A numeral of new methods for testosterone throw, including topical, buccal, and implantable, are currently under work. In a 90-day written report, investigators randomized a new testosterone gel (cheap generic levitra) 50 and 100 mg/day, a testosterone programme, and medicine in 406 hypogonadal men. The new testosterone gel resulted in dose-dependent betterment in all pharmacokinetic parameters compared with the plot of ground and medicinal drug. All treatments resulted in mood melioration, but the new gel provided significant public presentation in sexual parameters compared with vesper, without the high optical phenomenon of application-site reactions observed with the testosterone bandage. Clinicians can expect a new entourage of testosterone conveyance of title innovations in the timing age. This will become more apparent as the baby-boom propagation ages and becomes gambler educated on the benefits of hormone compeer.
This is a part of article Premature/Rapid Emission. Taken from "Azithromycin (Generic Zithromax) Online Information." Information Blog

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