ABSTRACT
BACKGROUND: Although tetracycline or doxycycline is the drug of choice for the treatment of scrub typhus, they are not recommended for children and pregnant women. Futhermore, the emergence of doxycycline resistant strain of Orientia tustusgamushi has aroused to find new therapeutic drugs. So, this study was aimed to evaluate the clinical efficacy of telithromycin, the first ketolide antibiotic for the treatment of scrub typhus in comparison with doxycycline. MATERIALS AND METHODS: Mild scrub typhus patients who were admitted to two university hospitals located in Incheon city from October 2004 through November 2004 were enrolled. Patients were assigned to telithromcyin (the first day, oral 800 mg every 12 hours and then 800 mg/day) and doxycycline treatment groups (oral 200 mg/day). Time and days to defevescence were analysed to evaluate the efficacy of the two antibiotics. RESULTS: Among a total of fifty patients, twenty six (52.0%) patients were excluded. Twenty four (48.0%) enrolled patients, telithromcyin and doxycycline were administered to thirteen (54.2%) and eleven patients (45.8%), respectively. In telithromycin treatment group, one patient (7.6%) was dropped out due to nausea and diarrhea. In doxycycline group, the mean age was higher (P=0.031) but the duration of fever before admission was shorter (P=0.015) than telithromycin group. There was no treatment failure nor relapse in either treatment groups. The mean time to defevescence was 17.7 hours for telithromycin group and 30.7 hours for doxycycline group (P=0.003). Ten patients (83.3%) in telithromycin group and four patients (36.4%) in doxycycline group became afebrile within the first day (P=0.048). CONCLUSION: Telithromycin has achieved good therapeutic outcome and more rapid response than doxycycline for the treatment of mild to moderate scrup typhus, so it suggests that telithromycin would be an alternative therapeutic agent for scrub typhus.
Subject(s)
Child , Female , Humans , Anti-Bacterial Agents , Diarrhea , Doxycycline , Fever , Hospitals, University , Nausea , Pregnant Women , Recurrence , Scrub Typhus , Tetracycline , Treatment Failure , Typhus, Epidemic Louse-BorneABSTRACT
BACKGROUND: Although tetracycline or doxycycline is the drug of choice for the treatment of scrub typhus, they are not recommended for children and pregnant women. Futhermore, the emergence of doxycycline resistant strain of Orientia tustusgamushi has aroused to find new therapeutic drugs. So, this study was aimed to evaluate the clinical efficacy of telithromycin, the first ketolide antibiotic for the treatment of scrub typhus in comparison with doxycycline. MATERIALS AND METHODS: Mild scrub typhus patients who were admitted to two university hospitals located in Incheon city from October 2004 through November 2004 were enrolled. Patients were assigned to telithromcyin (the first day, oral 800 mg every 12 hours and then 800 mg/day) and doxycycline treatment groups (oral 200 mg/day). Time and days to defevescence were analysed to evaluate the efficacy of the two antibiotics. RESULTS: Among a total of fifty patients, twenty six (52.0%) patients were excluded. Twenty four (48.0%) enrolled patients, telithromcyin and doxycycline were administered to thirteen (54.2%) and eleven patients (45.8%), respectively. In telithromycin treatment group, one patient (7.6%) was dropped out due to nausea and diarrhea. In doxycycline group, the mean age was higher (P=0.031) but the duration of fever before admission was shorter (P=0.015) than telithromycin group. There was no treatment failure nor relapse in either treatment groups. The mean time to defevescence was 17.7 hours for telithromycin group and 30.7 hours for doxycycline group (P=0.003). Ten patients (83.3%) in telithromycin group and four patients (36.4%) in doxycycline group became afebrile within the first day (P=0.048). CONCLUSION: Telithromycin has achieved good therapeutic outcome and more rapid response than doxycycline for the treatment of mild to moderate scrup typhus, so it suggests that telithromycin would be an alternative therapeutic agent for scrub typhus.
Subject(s)
Child , Female , Humans , Anti-Bacterial Agents , Diarrhea , Doxycycline , Fever , Hospitals, University , Nausea , Pregnant Women , Recurrence , Scrub Typhus , Tetracycline , Treatment Failure , Typhus, Epidemic Louse-BorneABSTRACT
Influenza vaccination on health care workers in a university hospital was conducted using inactivated split vaccines from two pharmaceutical companies (A, B), December 2003. Among 1,880 health care workers, 1,404 (74.7%) were vaccinated and 714 (50.8%) responded to the questionnaires about adverse reactions. Pain and redness at the injection site, febrile sensation, and restricted occupational activities were reported by 316 (44.3%), 141 (19.7%), 169 (23.6%), and 62 (8.7%) participants, respectively. There was no serious adverse events. The incidence of adverse reactions was similar to the previous reports. No statistical difference was detected according to the vaccines company.
Subject(s)
Delivery of Health Care , Incidence , Influenza, Human , Sensation , Vaccination , Vaccines , Surveys and QuestionnairesABSTRACT
Influenza vaccination on health care workers in a university hospital was conducted using inactivated split vaccines from two pharmaceutical companies (A, B), December 2003. Among 1,880 health care workers, 1,404 (74.7%) were vaccinated and 714 (50.8%) responded to the questionnaires about adverse reactions. Pain and redness at the injection site, febrile sensation, and restricted occupational activities were reported by 316 (44.3%), 141 (19.7%), 169 (23.6%), and 62 (8.7%) participants, respectively. There was no serious adverse events. The incidence of adverse reactions was similar to the previous reports. No statistical difference was detected according to the vaccines company.
Subject(s)
Delivery of Health Care , Incidence , Influenza, Human , Sensation , Vaccination , Vaccines , Surveys and QuestionnairesABSTRACT
Primary undifferentiated cardiac sarcomas are extremely rare, and typically undergo aggressive local spread. The prognosis of undifferentiated sarcoma is reported to be very poor even if surgical resection, with or without adjuvant chemotherapy and radiotherapy, is performed. Here we present our case of primary undifferentiated sarcoma of the left atrium. A 33-year-old woman presented with a month history of progressive breathlessness and exertional chest pain. Transthoracic echocardiography showed a large mobile mass obstructing much of the left atrium. At surgery a superseptal approach to the atria enabled removal of all the left heart tumor which was attached to the left upper pulmonary vein. Immunochemistry staining revealed the undifferentiated atrial sarcoma. She received three cycles of darcabazine and adriamycin and after three months there was evidence of tumor recurrence. Eleven months later from operation, she died with congestive heart failure.
Subject(s)
Adult , Female , Humans , Chemotherapy, Adjuvant , Chest Pain , Doxorubicin , Echocardiography , Heart Atria , Heart Failure , Heart Neoplasms , Immunochemistry , Prognosis , Pulmonary Veins , Radiotherapy , Recurrence , SarcomaABSTRACT
Double coronary artery with coronary arteriovenous fistula is a very unusual anomaly and has not been reported in Korea. Coronary arteriovenous fistula consists of communication between one of the coronary arteries and a cardiac chamber or vein. It generally drains into the right ventricle, right atrium, coronary sinus, or pulmonary artery. It is being diagnosed with increasing frequency with combined use of coronary angiography and contrast echocardiography. In the present case, coronary angiography showed double right coronary artery with separated ostia. We confirmed that one of them drained into right ventricular chamber by contrast echocardiography performed after intraaortic contrast injection.