Respiratory mechanics and arterial blood gases in relation to survival

This study was performed on 37 patients presenting with acute respiratory failure, who were classified as 26 COPD patients with a mean age of 60.3 [range 31-76 years] and 11 patients with restrictive lung disease with a mean age of 42.2 [range 18-72 years]. Airway pressure [peak, plateau and mean airway pressures], lung mechanics and arterial blood gases were measured and compared in survivors [29 patients] and non-survivors [8 patients] as regards the initial measurements taken immediately after mechanical ventilation, final measurements and the pattern of changes throughout the course of mechanical ventilation. Comparing both groups, data showed that in the initial measurements, there was a highly significant difference in static compliance [cstat] and airway pressures [peak, plateau and mean airway pressure], but an insignificant difference was found in airway resistance, AutoPEEP, work rate and ABG. While, in the final measurements, with an improvement of the lung mechanics in survivors, there was a significant difference between the two groups in all the above-mentioned measurements, except ABG which still showed an insignificant difference

Soluble interleukin-2 receptor, interleukin-4 and interferon-Gamma in bronchoalveolar lavage fluid of asthmatic patients

To clarify the role of immunoregulatory cytokines in pathogenesis of bronchial asthma, soluble interleukin-[2] receptor [sIL-[2R]], interleukin-4 [IL-[4]] and interferon- gamma [lFN-gama] as products of T -cell activation were estimated in bronchoalveolar lavage [BAL] fluid of asthmatic patients. Their levels were correlated with the degree of bronchial hyperreactivity [BHR] [PD[20]], sIL-[2R] and IL-[4] levels were significantly higher in asthmatics than normal controls. In extrinsic asthma their levels were significantly higher than that in intrinsic asthma. IL-[4] levels showed significant inverse correlation with PD[20] in extrinsic asthma. sIL-[2R] level showed insignificant inverse correlation with PD[20] in both extrinsic and intrinsic asthma, IL-[4] was poorly correlated with PD[20] in intrinsic asthma. There was no significant difference in concentration of IFN-gama between asthmatics and normal controls, however, it was slightly higher in normal control. The results of this study suggest that the elevated T-cell markers [sIL-[2R], IL-[4]] in BAL fluid from asthmatic patients is an indication that T-cell activation is present in asthma. The higher level of these cytokines in atopic asthma and their correlation with BHR suggest the preferential activation of the. TH[2]. The lower level of IFN-gama may suggest its role in the treatment of bronchial asthma and this may open the way for further studies

Evaluation of neutrophil chemotaxis and chemokinesis in patients with asthma

In order to evaluate neutrophil function in asthma, we studied high and low densities neutrophil chemotaxis and chemokinesis in 26 asthmatic patients during an asymptomatic period, in 12 patients during an exacerbation and in 20 normal controls. Neutrophils of low density showed a significant increase in chemotaxis both during the asymptomatic and exacerbation periods while chemokinesis was unchanged. Neutrophils of the high density showed no significant differences in chemotaxis and chemokinesis in patients and controls. These results suggest that neutrophils of low density are implicated in the genesis of bronchial hyperreactivity and late phase reactions underlining asthma

Anaerobes in female genital tract potential infection, respiratory infection and post-operative wound infection: a concise study

Sixty cases were included in this study selected as 30 with female genital tract potential infection, preterm premature repture of membranes, 20 with respiratory infection and 10 with post-operative wound infection. Cases were subjected to different techniques for primary isolation of anaerobes. Anaerobic isolates were further identified, characterized and submitted to antibiotic susceptibility to 5 antibiotics using the disc diffusion method. Twenty nine cases [43.3%] were positive for an aerobes 12/30 in female genital tract potential infection group [40%], 12/20 in respiratory infection group [60%] and 5/10 in postoperative wound infection group [50%]. Bacteroides were the most frequently isolated anaerobes, secondly isolated was fusobacteria followed by viellonella, peptostreptococci and lactobailli. The highest results were yielded by direct plating on non-selective media and by enrichment in liquid media with subculture on selective media. [with cumulation of positive results on different selective media]. Metronidazole and clindamycin were the most active antimicrobial agents against anaerobes. The present study adds to the concept of using more than one technique for better yield of isolation and the utmost importance of incorporation of metronidazole and clindamycin in any antibiotic consideration