Eficacia del tinidazol en la profilaxis terapéutica de la colitis amebiana en pacientes con leucemia aguda de novo que reciben quimioterapia intensiva / Efficacy of tinidazole in the therapeutic prophylaxis of amoebic colitis in patients with de novo acute leukemia receiving intensive chemotherapy

Resumen Introducción: En México la seroprevalencia de la Entamoeba histolytica es del 8.4%. La amebiasis intestinal en pacientes con leucemia aguda de novo posterior al inicio de quimioterapia (QT), en el Servicio de Hematología del CMN 20 de Noviembre, es del 12%, aún si muestran test coprológico negativo basal. Objetivo: Averiguar si la administración de tinidazol, en pacientes con leucemia aguda y coprológico negativo, al principio de la QT, disminuye la incidencia de colitis amebiana durante la inducción a la remisión. Método: Prospectivo y no comparativo. Enfermos con diagnóstico de leucemia aguda de novo que inician QT de inducción y coprológico inicial. Se indicó tinidazol, 2 g/día durante 5 días en la primera semana de comenzada QT. Se vigilaron hasta que la inducción concluyó y se inició la recuperación hematopoyética. Resultados: 38 pacientes, 15 mujeres y 23 hombres con edad media de 44 años (16-72). Con leucemia aguda linfoblástica 19, con mieloblástica 16 y con promielocítica 3. Casos sin y con amebiasis intestinal, 35 y 3, respectivamente. Los pacientes con amebiasis solo recibieron tinidazol durante 3 días y se dio después de 2 días de empezada la QT. Conclusión: El tinidazol, en pacientes con leucemia aguda de novo que inician QT de inducción, es efectivo en la prevención de la amebiasis intestinal, durante la etapa de inducción, si se administra a 2 g/día, durante cinco días, a partir del día 1 de la QT.

Abstract Introduction: In Mexico, seroprevalence of Entamoeba histolytica is 8.4%. The intestinal amebiasis in patients with acute leukemia of novo, after the start of chemotherapy (CT) in the Hematology Service of the CMN 20 de Noviembre is 12%, even if patients show a negative baseline coprological test. Objective: To find out if the administration of tinidazole, in patients with acute leukemia and negative coprological test, at the beginning of the CT, decreases the incidence of amoebic colitis during the induction to remission. Method: Prospective and not comparative study. Patients with de novo diagnosis of acute leukemia who initiate induction and initial coprological CT. Tinidazole was indicated, 2 g/day for 5 days in the first week of CT started. They were monitored until the induction was concluded and hematopoietic recovery started. Results: 38 patients, 15 women and 23 men with a mean age of 44 years (16-72), with acute lymphoblastic leukemia 19, myeloblastic 16 and promyelocytic 3. Cases without and with intestinal amebiasis were 35 and 3, respectively. Patients with amebiasis only received tinidazole for 3 days and it was given 2 days after the CT started. Conclusion: Tinidazole, in patients with acute de novo leukemia who initiate induction CT, is effective in the prevention of intestinal amebiasis, during the induction stage, if administered at 2 g/day, for five days, starting on day 1 of the CT.

Oxymatrine alleviates periodontitis in rats by inhibiting inflammatory factor secretion and regulating MMPs/TIMP protein expression

Abstract Purpose: To investigate the effect of oxymatrine on periodontitis in rats and related mechanism. Methods: Ninety SD rats were divided into control, model, 10, 20 and 40 mg/kg oxymatrine and tinidazole groups. The periodontitis model was established in later 5 groups. The 10, 20 and 40 mg/kg oxymatrine groups were intragastrically administrated with 10, 20 and 40 mg/kg oxymatrine, respectively. The tinidazole group was intragastrically administrated with 100 mg/kg tinidazole. The treatment duration was 4 weeks. The tooth mobility, gingival and plaque indexes, serum inflammatory factor levels and gingival tissue matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase (TIMP) protein levels were detected. Results: After treatment, compared with model group, in 40 mg/kg oxymatrine group the rat general conditions were obviously improved, the tooth mobility, gingival index and plaque index were significantly decreased (P<0.05), the serum tumor necrosis factor-α, interleukin-1β and prostaglandin E2 levels were significantly decreased (P<0.05), the MMP-2 and MMP-9 protein levels were significantly decreased (P<0.05), and the TIMP-2 protein level was significantly increased (P<0.05). Conclusions: Oxymatrine can alleviate the experimental periodontitis in rats. The mechanism may be related to its inhibiting inflammatory factor secretion and regulating MMPs/TIMP protein expression.

Efficacy of bismuth containing quadruple therapies on Helicobacter pylori eradication in patients with history of antibiotic treatment / 中南大学学报(医学版)

To investigate the efficacy of bismuth containing quadruple therapies on Helicobacter pylori (Hp) eradication in patients with history of antibiotic treatment. 
 Methods: Hp infected patients (n=327) were allocated into 3 groups. Group A (n=52), patients had no antibiotic history and they took medicine of proton pump inhibitors (PPI) and livzon triple (clarithromycin, tinidazole, and bismuth); group B (n=80), patients had the antibiotic history except for amoxicillin and clarithromycin, and they were treated with PPI, amoxicillin, clarithromycin, and bismuth; group C (n=195), patients suffered failures of Hp therapy or with history of antibiotic abuse, and they were treated with PPI, doxycycline, furazolidone, and bismuth.
 Results: Both the intention-to-treat (ITT) analysis (group A 63.5%, group B 76.2%, group C 82.6%, P<0.05) and the pre-protocol (PP) analysis (group A 76.7%, group B 92.4%, group C 96.4%, P<0.05) showed significant difference among the 3 groups, revealing higher elimination in group B and C. The side-effects (20.2%) were mild and tolerable (group A, 28.0%; group B, 10.7%; group C, 22.0%).
 Conclusion: Proton pump inhibitors together with the livzon triple regimen have a low rate of Hp eradication and a higher incidence of adverse reactions. The quadruple therapy containing clarithromycin and metronidazole drugs can achieve the satisfactory outcomes based on patient's antibiotic history. For patients with multiple antibiotics, the quadruple therapy containing furazolidone and doxycycline may achieve the satisfactory outcomes, but the adverse resction would be relatively higher.

Effect of Helicobacter pylori eradication on reflux esophagitis therapy: a multi-center randomized control study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Helicobacter pylori (H. pylori) frequently colonizes the stomach. Gastroesophageal reflux disease (GERD) is a common and costly disease. But the relationship of H. pylori and GERD is still unclear. This study aimed to explore the effect of H. pylori and its eradication on reflux esophagitis therapy.</p><p><b>METHODS</b>Patients diagnosed with reflux esophagitis by endoscopy were enrolled; based on rapid urease test and Warth-Starry stain, they were divided into H. pylori positive and negative groups. H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days, then esomeprazole 20 mg bid for 46 days. The other patients received esomeprazole 20 mg bid therapy for 8 weeks. After treatment, three patient groups were obtained: H. pylori positive eradicated, H. pylori positive uneradicated, and H. pylori negative. Before and after therapy, reflux symptoms were scored and compared. Healing rates were compared among groups. The χ2 test and t-test were used, respectively, for enumeration and measurement data.</p><p><b>RESULTS</b>There were 176 H. pylori positive (with 92 eradication cases) and 180 negative cases. Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4% and 79.8% (P = 0.911), with reflux symptom scores of 0.22 and 0.14 (P = 0.588). Healing rates of esophagitis in the H. pylori positive uneradicated and H. pylori negative groups were, respectively, 79.8% and 82.2% (P = 0.848); reflux symptom scores were 0.14 and 0.21 (P = 0.546).</p><p><b>CONCLUSIONS</b>Based on esomeprazole therapy, H. pylori infection and eradication have no significant effect on reflux esophagitis therapy.</p>

Does Standard Triple Therapy Still Have a Role in First-Line Helicobacter pylori Eradication in Korea?

No abstract available.

Meta-Analysis of First-Line Triple Therapy for Helicobacter pylori Eradication in Korea: Is It Time to Change?

Proton pump inhibitor (PPI)-based triple therapy consisting of PPI, amoxicillin, and clarithromycin, is the recommended first-line treatment for Helicobacter pylori infection. However, the eradication rate of triple therapy has declined over the past few decades. We analyzed the eradication rate and adverse events of triple therapy to evaluate current practices in Korea. A comprehensive literature search was performed up to August 2013 of 104 relevant studies comprising 42,124 patients. The overall eradication rate was 74.6% (95% confidence interval [CI], 72.1%-77.2%) by intention-to-treat analysis and 82.0% (95% CI, 80.8%-83.2%) by per-protocol analysis. The eradication rate decreased significantly from 1998 to 2013 (P < 0.001 for both intention-to-treat and per-protocol analyses). Adverse events were reported in 41 studies with 8,018 subjects with an overall incidence rate of 20.4% (95% CI, 19.6%-21.3%). The available data suggest that the effectiveness of standard triple therapy for H. pylori eradication has decreased to an unacceptable level. A novel therapeutic strategy is warranted to improve the effectiveness of first-line treatment for H. pylori infection in Korea.

High occurrence of giardiasis in children living on a 'landless farm workers' settlement in Araras, São Paulo, Brazil / Alta ocorrência de giardíase em crianças do Assentamento Sem Terra, Araras, São Paulo, Brasil

Enteric parasitosis remains an important public health problem in many areas around the world including in Brazil, and it is frequently associated with poverty and lack of sanitation facilities. Research carried out over the course of a year revealed that 96.6% (28/29) of children randomly selected from a 'landless farm workers' settlement in Araras, São Paulo, aged 4 - 15 years, presented Giardia intestinalis cysts. After referral to the neighborhood Health Office, all the children received tinidazole, given as a single dose of 50 mg/kg and 12 months later, new fecal samples were collected and analyzed. Despite the low adherence to the study, a high percentage (64.3% - 9/14) of the children remained positive for the parasite. This study showed a high positivity of giardiasis in child residents of the settlement, even after treatment; adults were not sensitized to the study and did not collected and/or deliver children fecal samples. The precarious living conditions are consistent with a high susceptibility to parasitic diseases, suggesting that the treatment of the infected individuals without identifying and eradicating the means of contamination is simply a palliative measure.

Enteroparasitoses continuam a ser um importante problema de saúde pública em muitas áreas ao redor do mundo, bem como no Brasil, e está frequentemente associada com a pobreza e à falta de saneamento básico. Pesquisa realizada em um ano revelou que 96,6% (28/29) das crianças com idades entre quatro e 15 anos, recrutadas aleatoriamente no Assentamento Sem Terra em Araras, São Paulo, apresentaram cistos de Giardia intestinalis. Após o encaminhamento ao Posto de Saúde do bairro, todos receberam tinidazol, dose única de 50 mg/kg. Após 12 meses, novas amostras de fezes foram coletadas e analisadas. Apesar da baixa adesão ao estudo, um percentual elevado (64,3% - 9/14) de crianças permaneceu positivo para o protozoário. Este estudo mostrou alta positividade de giardíase nas crianças moradoras do assentamento, mesmo após o tratamento; indivíduos adultos não se mostraram sensibilizados com o estudo e não coletaram e/ou entregaram amostras fecais dos filhos; e o tratamento dos indivíduos infectados, sem identificação e erradicação das formas de contaminação, só funciona como medida paliativa.

Estudio piloto: terapia secuencial en la erradicación del helicobacter pylori en el Hospital Cayetano Heredia / Pilot study: sequential therapy in erradicating helicobacter pylori in the Cayetano Heredia Hospital

INTRODUCCIÓN: La terapia secuencial nace como una alternativa a la creciente resistencia antibiótica del Helicobacter pylori (HP) a la terapia triple (estándar). A pesar de los resultados satisfactorios que ha tenido en Europa, en nuestro medio no tenemos referencia de un estudio al respecto. OBJETIVOS: Evaluar la tasa de erradicación del Helicobacter pylori empleando la terapia secuencial y evidenciar sus efectos adversos. METODOLOGÍA: Se realiza un estudio prospectivo, observacional, descriptivo, abierto. Se evaluaron 31 pacientes que recibieron tratamiento con terapia secuencial de la siguiente forma, los 5 primeros días omeprazol 20 mg y amoxicilina de 1 g cada 12 horas y los 5 días siguientes omeprazol 20 mg, claritromicina 500 mg y tinidazol de 500 mg cada 12 horas. A las 4 semanas de terminado el tratamiento se le realizó a cada paciente una prueba de aliento con carbono 13 para comprobar la erradicación del HP. RESULTADOS: Se incluyeron a 31 pacientes, un paciente fue excluido del protocolo por presentar RAM a la amoxicilina. De los 30 pacientes restantes que completaron el tratamiento, 22 (73%) resultaron negativos en la prueba del aliento y 8 (27%) resultaron positivos. De los pacientes que completaron el tratamiento, 10 presentaron eventos adversos menores al tratamiento, principalmente epigastralgia y náuseas. CONCLUSIONES: La terapia secuencial tuvo una tasa de erradicación del 73% la cual es mucho menor a la reportada en los estudios europeos. Sin embargo, es una terapia de fácil acceso, de menor costo y con menores efectos colaterales.

BACKGROUND: Sequential therapy is used as an alternative to growing antibiotic resistance of Helicobacter pylori to the standard triple therapy. Despite the success it had in Europe, we have no information regarding this therapy in our region. OBJECTIVES: To evaluate the eradication rate of Helicobacter pylori using sequential therapy and show its adverse effects. METHODS: We performed a prospective, observational, open descriptive study. 31 patients were evaluated who were treated with sequential therapy in the following way: the first 5 days omeprazole 20 mg and amoxicillin 1 g every 12 hours and following 5 days omeprazole 20 mg, clarithromycin 500 mg and tinidazole 500 mg every 12 hours. After four weeks of treatment, each patient had a C13 urea breath test to check for eradication.RESULTS: 31 patients were included, one patient was excluded from the protocol due to adverse drug react to amoxicillin. Of the remaining 30 patients who completed treatment, 22 (73%) were negative to breath test and 8 (27%) were positive. Of the patients who completed treatment, 10 had minor adverse events to treatment, the main symptoms were epigastralgia and nausea. CONCLUSIONS: Sequential therapy had an eradication rate of 73% which is much lower than that reported in European studies. However, therapy is easily accesible with lower cost and fewer side effects tan standard therapy.

Preparation and in vitro and in vivo study on tinidazole in situ forming sustained-release injection / 药学学报

This study is to prepare the in situ forming sustained-release injection which can perform sustained release behavior at the periodontal site for 7 days and to evaluate its in vitro and in vivo properties. After preparation of in situ forming sustained-release injection the in situ time was studied. And the surface of the solid injection was characterized by SEM. The rheological curve at 0 degrees C, 25 degrees C, 37 degrees C was determined and the impact of the temperature on the viscosity was examined. The in vitro release behavior was investigated. At last, rabbit periodontitis model was established to study its pharmacokinetics. The injection was stable, hard to stratify and decompose. The in situ forming time was about 6 seconds. It can easily adhere into periodontal pockets. There were lots of holes on the surface of the solid injection for the drug to diffuse. The drug releasing curves could be fit by Korsmeyer-Peppas equation. The drug smoothly released for 7 days at pH 7.4 PBS buffer with a very slight burst release and maintained a certain concentration. In vivo pharmacokinetics results indicated that after administration with the in situ forming injection, achievement of tinidazole (TNZ) concentration in gingival crevicular fluid (GCF) was more comparable and long-lasting than usual solution of TNZ management and relatively constant TNZ levels were attained until 168 h. All these results supported the prospect of tinidazole in situ forming sustained-release injection in clinical applications.

Experimental study of the dielectric behavior of tinidazole in acetone at 25°C / Estudio experimental del comportamiento dieléctrico del tinidazol en acetona a 25°C

Tinidazole is an anti-parasitic drug widely used nowadays in therapeutics. Nevertheless, it has not been well characterized from a physicochemical point of view. In this context, by means of optical experimental methods and dielectric spectroscopy applied to diluted solutions of Tinidazole in Acetone, molar polarizations of the solute, ₀P₂, and the solvent, ₀P₁, and the average dipolar moment of tinidazole associated to acetone, were estimated, resulting in 9.18 D. Since this value is higher than the theoretical m of the two main conformers of isolated tinidazole, that is, 3.22 and 4.29 D, respectively, the formation of interactions between the solute and the solvent is assumed. An effect of intermolecular association by van der Waals and hydrogen bond interactions conducting to a modification of the partial molar volume of the solute is thus expected. From the experimental and analysis by using the Halverstadt-Kumler’s method, it can be seen that the partial molar volume had a 24% reduction as compared with the theoretical value, which would confirm the presence of such interactions.

El tinidazol es un fármaco antiparasitario ampliamente utilizado en la actualidad. Sin embargo, este fármaco no ha sido bien caracterizado desde un punto de vista fisicoquímico. Por esta razón, mediante algunos métodos ópticos y espectroscopía dieléctrica, aplicados a soluciones diluidas de tinidazol en acetona, se estimaron las polarizabilidades molares del soluto, 0P2, y del solvente, 0P1, además del momento dipolar promedio, , del fármaco asociado a la acetona, obteniendo un valor = 9,18 D. Puesto que este valor es mayor que el obtenido teóricamente para los dos confórmeros rincipales, osea 3,22 y 4,29 D, respectivamente, se asume la presencia significativa de interacciones entre el soluto y el solvente. Por lo tanto, se espera que la asociación intermolecular soluto-solvente, establecida por fuerzas de van der Waals y por enlaces de hidrógeno, conduzca a la modificación del volumen molar parcial del soluto, . A partir del análisis experimental mediante el método de Halverstadt-Kumler se observa una reducción del 24% en el valor de , al compararlo con el valor teórico, lo cual podría confirmar la presencia de tales interacciones.

Importance of CYP2C19 genetic polymorphism in the eradication of Helicobacter pylori in north Indians.

Background & objectives: Genetic polymorphism of CYP2C19 is known to occur with a frequency of 12 per cent in north Indian population. But no study correlated CYP2C19 genetic polymorphism with eradication of Helicobacter pylori in north Indian gastritis patients positive for H. pylori and hence this study. Methods: Ninety one consecutive patients positive for H. pylori fulfilling the study criteria were phenotyped and genotyped for CYP2C19. They were given 20 mg omeprazole (OPZ), 750 mg amoxicillin (AMC) and 500 mg tinidazole (TNZ) (bid) for 7 days followed by 20 mg OPZ (qd) for 21 days. Non eradicated extensive metabolizers (EMs) were retreated with 40 mg OPZ (bid) and 500 mg AMC (qid) for 14 days. Results: EMs and poor metabolizers (PMs) excreted 4.26 ± 0.34 (95% CI 3.59-4.92) and 0.73 ± 0.05 (95% CI 0.63-0.82) μmol 5-OH-OPZ in 8 h, respectively. After initial therapy, EMs demonstrated 37 per cent (95% CI: 24.5-49.5) and PMs 92 per cent (95% CI: 77-107) eradication of H. pylori. Non eradicated EMs after retreatment demonstrated 90 per cent (95% CI: 79-101) eradication. Interpretation & conclusions: This study demonstrated a direct correlation between CYP2C19 genetic polymorphism and H. pylori eradication in north Indian patients with gastritis. Knowing the CYP2C19 phenotype of a patient may help in prescribing optimum dose of proton pump inhibitor to achieve better therapeutic outcome.

Effect of Combination of Anticancer Agents and Nitroimidazoles on the Survival of Human Hepatocellular Carcinoma Cells under Hypoxic Conditions

PURPOSE: In a previous study, we have shown that anticancer agents inhibiting topoisomerases improve survival of tumor cells under hypoxic condition. In the present study, we evaluated whether and how cell survival effect of the anticancer agents under hypoxic conditions could be eliminated by the addition of nitroimidazoles, a class of bioreductive agents. METHODS: Human hepatocellular carcinoma cells (HepG2) were incubated with different combinations of pimonidazole (1~1,000 microg/ml) and doxorubicin (0.1 or 1 microg/ml) concentrations under different O2 concentrations [1, 3, 5, 10 and 21 O2]. Then cell numbers, glucose concentrations and lactic acid concentrations in the medium were measured, and DNA fragmentation assay was performed. Finally, different combinations of nitroimidazoles, such as pimonidazole, misonidazole, etanidazole, tinidazole, metronidazole, ornidazole or dimetridazole, and anticancer agents, such as doxorubicin, campothecin, epirubicin, dactinomycin, etoposide or mitomycin C was added to the cell culture medium under hypoxic conditions (1% O2). RESULTS: Pimonidazole at a concentration of 100 microg/ml eliminated cell survival effect of doxorubicin at the concentrations of 0.1 and 1 microg/ml under hypoxic condition (1% O2) by promoting apoptosis. Almost all the cells died even after 24 hours of incubation for all the oxygen concentrations at a combination of 100 microg/ml pimonidazole and 1 microg/ml doxorubicin. Finally, pimonidazole at a concentration of 100 microg/ml, and misonidazole or etanidazole at a concentration of 1,000 microg/ml eliminated cell survival effect of all the anticancer agents tested under hypoxic condition. CONCLUSION: Combination therapy of doxorubicin (adriamycin) with pimonidazole can maximize dororubicin efficacy by eliminating cell survival effect of doxorubicin under hypoxic conditions in treating solid tumors, such as breast cancer.

Effects of metronidazole, tinidazole, captopril and valsartan on taste and serum levels of zinc and magnesium

To study the effect of metronidazole, tinidazole, captopril and valsartan on the levels of zinc and magnesium in the serum of rabbits and humans and the histology of taste buds in rabbits. We conducted this study in the College of Medicine and Teaching Hospital, Basrah, Iraq from April 2005 to September 2006. It was in 2 parts: a clinical observational study of 54 patients treated with one of these drugs. The second part involved oral administration of metronidazole [45mg/kg], tinidazole [40mg/kg], captopril [3mg/kg] or valsartan [3mg/kg] or normal saline to 42 rabbits randomly. Serum zinc and magnesium were measured, and histological sections of tongues were examined for taste buds. In rabbits, oral metronidazole [13.6%] or tinidazole [7%] resulted in a significant reduction in serum zinc. Reductions in captopril [6.7%] and valsartan [4.2%] were smaller and insignificant. Body weight increased by 15.5gm [1391 +/- 225.3 gm to 1407 +/- 223.2 gm] in the control group, a lesser increase of approximately 8 gm, was found in the metronidazole group [1452 +/- 222.6 gm to 1460 +/- 221.9 gm]. Rabbit tongues showed moderate degeneration of taste buds caused by tinidazole, severe degeneration of captopril and minimal changes of valsartan. In humans, the drugs did not result in significant changes in serum zinc or magnesium. Approximately 73.3% of patients in the metronidazole group and 11.1% in the valsartan group had taste changes. It is concluded that metronidazole and tinidazole, but not captopril or valsartan resulted in a significant reduction of zinc level in rabbit, but not in human. Captopril and not valsartan caused severe degeneration in taste buds. Serum zinc level seems not to be related to taste buds changes

Efficacy of two plant extracts against vaginal trichomoniasis

Trichomoniasis vaginalis is now an important worldwide health problem. Metronidazole has so far been used in treatment, but the metronidazole-resistant strains and unpleasant adverse effects have been developed. Treatment of patients with metronidazole refractory vaginal trichomoniasis constitutes a major therapeutic challenge and treatment options are extremely limited. In the present study, 33 metronidazole-resistant T. vaginalis females were treated with a combined course of metronidazole and tinidazole. Those still resistant to the combined treatment were given Commiphora molmol [Myrrh] as two capsules for six to eight successive days on an empty stomach two hours before breakfast. Also, natural plant extract purified from [Roman] was in-vitro investigated for its efficacy against T. vaginalis on fresh Diamond media. The anti-trichomoniasis vaginalis activity of both P. granatum [in-vitro] and C. molmol [in-vivo] extracts gave promising results

Tinidazol versus cefazolina na antibioticoprofilaxia de histerectomia vaginal e abdominal / Tinidazole versus cefazolin in antibiotic prophylaxis of vaginal and abdominal hysterectomy

OBJETIVO: comparar a eficácia do tinidazol e da cefazolina na antibioticoprofilaxia da morbidade febril e infecciosa pós-histerectomia vaginal e abdominal. MÉTODOS: estudo clínico randomizado, no qual as mulheres internadas para histerectomia foram aleatorizadas para um dos seguintes grupos de antibioticoprofilaxia: Grupo C (2 g de cefazolina EV na indução anestésica); Grupo T (2 g de tinidazol VO 12 horas antes da cirurgia); ou Grupo C+T (2 g de tinidazol VO 12 horas antes da cirurgia e 2 g de cefazolina EV na indução anestésica). Amostras cervicovaginais foram coletadas para culturas específicas e o diagnóstico de vaginose bacteriana (VB) foi baseado nos critérios de Amsel e Nugent. As pacientes foram reavaliadas sete e 30 dias após a cirurgia para sinais de morbidade febril e/ou infecciosa. Para avaliar as diferenças entre os três grupos, realizaram-se os testes do χ2 ou exato de Fisher com nível de significância de 5%. Calulou-se o poder da amostra (1-β) através do programa SAS. RESULTADOS: morbidade infecciosa sete dias após a histerectomia foi diagnosticada em 6,6% das mulheres, mas não houve diferença significativa na distribuição entre os três grupos estudados (p=0,12). Não diagnosticou-se morbidade febril ou infecciosa no pós-operatório imediato ou após 30 dias da cirurgia. A freqüência de VB no pré-operatório foi significativamente maior entre as mulheres submetidas à histerectomia vaginal do que naquelas submetidas à histerectomia abdominal (27 versus 7%, p=0,02). Também se observou freqüência maior de VB após 30 dias entre as mulheres submetidas à histerectomia vaginal (20 versus 8%), porém sem significância estatística (p=0,19). CONCLUSÕES: o uso do tinizadol, isoladamente ou em associação com cefazolina, não apresentou maior eficácia que o uso de apenas cefazolina na prevenção de morbidade febril ou infecciosa pós-histerectomia...

PURPOSE: to compare the efficacy of tinidazole and cephazolin on the febrile and infectious morbidity of post vaginal and abdominal hysterectomy antibiotic prophylaxis. METHODS: randomized clinical study, where women admitted to hospital for hysterectomy were randomly allocated in one of the following antibiotic prophylaxis groups: Group C (2 g of IV cephazolin in the anesthetic induction); Group T (2 g of tinidazole orally, 12 hours before the surgery); or Group C+T (2 g of tinidazole orally 12 hours before the surgery and 2g of IV cephazolin in the anesthetic induction). Cervicovaginal smears were collected for specific cultures and the diagnosis of bacterial vaginosis (BV) was based in Amsel and Nugent's criteria. The patients were reevaluated 7 and 30 days after the surgery for signs of febrile and/or infectious morbidity. The χ2 or the Fisher's exact test was used to assess differences among the three groups, with a significance level of 5%. The sample power (1-β) was calculated through the SAS program. RESULTS: seven days after the hysterectomy, infectious morbidity was diagnosed in 6.6% of the women, but with no significant difference among the three groups studied (p=0.12). There was no febrile or infectious morbidity at the immediate post-surgical period or after 30 days from the surgery. BV ratio at the pre-surgical period was significantly higher among the women submitted to vaginal hysterectomy, rather than among the ones submitted to abdominal hysterectomy (27 versus 7%, p=0.02). BV ratio was also higher after 30 days, among the women submitted to vaginal hysterectomy (20 versus 8%), though without statistical significance (p=0.19). CONCLUSIONS: the use of tinidazole, isolated or associated with cephazolin has not presented higher efficacy, than the use of cephazolin, alone to prevent febrile or infectious morbidity post hysterectomy...

A comparative study of injection placentrex and conventional therapy in treatment of pelvic inflammatory disease.

To compare the effect of placentrex injection given along with conventional therapy, with conventional treatment alone on the symptoms and signs of pelvic inflammatory disease (PID) ie, abdominal pain, dysmenorrhoea and adnexal tenderness, 50 out of 100 women with PID were randomly assigned to receive intramuscular placentrex injection along with two-week conventional therapy and 50 received conventional treatment only. Abdominal pain, dysmenorrhoea and adnexal tenderness were evaluated at the end of 2 months. There was marked reduction in the sign of adnexal tenderness in the placentrex group as compared to conventional treatment group (p < 0.001). Subjective symptoms of lower abdominal pain and dysmenorrhoea were also relieved better in placentrex group (p < 0.01 and 0.05 respectively). This study showed significant and persistent improvement of signs and symptoms of PID in women who received injection placentrex.

Secnidazole for metronidazole-resistant amebiasis

It is presented the case of a patient with intestinal colonization by Entamoeba histolytica, Entamoeba coli e Iodamoeba butschilli. Two treatments with metronidazole did not eradicate the protozoans, however, a treatment with secnidazole showed to be effective.

Apresenta-se uma mulher com colonização intestinal por Entamoeba histolytica, Entamoeba coli e lodamoeba butschilli. Dois tratamentos com metronidazol oral não erradicaram os protozoários, porém, um tratamento com secnidazol mostrou-se eficaz.

effect of helicobacter pylori eradication on gastric apoptosis in cirrhotic patients

Helicobacter [H] pylori was found to be present in a high percentage of cirrhotic patients, H. pylori colonized stomach contain more apoptotic epithelial cells than normal stomach. The aim of this work was to evaluate efficacy and safety of a triple therapy [Lanzoprazole, Tinidazole and Clarithromycin] in eradication of H. pylori and the effect of H. pylori eradication on the gastric mucosal apoptosis among cirrhotic patients. Fifty patients were classified into two groups: Group [I]: Twenty-five patients with liver cirrhosis and H. pylori positive. Group [II]: Twenty-five non-cirrhotic patients with manifestations of peptic disease and H. pylori positive. All patients were enrolled in a 7 days triple therapy with Lanzoprazole [30 mg], Tinidazole [500 mg] and Clarithromycin [250 mg], each twice / day. Apoptosis was determined before and after 4-6 weeks of H. pylori eradications. Eradication of H. pylori was achieved in 21 patients [84%] in cirrhotic patients, while it was eradicated in 22 patients [88%] in non-cirrhotic patients. The highest apoptotic figure was recorded in-group I before eradication [14.62 +/- 2.08]; it is significantly decreased after eradication of H. pylori [4.34 +/- 1.34, P <0.01]. In-group II a significant reduction of the apoptotic index from [12.2 +/- 10.6 to 2.75 +/- 1.06, P <0.01] after eradication of H. pylori. In conclusion, one-week triple therapy by Lanzoprazole, Tinidazole and Clarithromycin was effective and safe in eradication of the H. pylori in cirrhotic and non-cirrhotic patients. Hepatic cirrhosis increased gastric apoptosis. H. pylori eradication reduced gastric apoptosis among cirrhotic and non-cirrhotic patients

Development of time and pH dependent controlled release colon specific delivery of tinidazole

Tinidazole is used in treatment of amoebiasis and other protozoal infections in doses of 2.0 g/ day [60 mg/kg] for three days. In the present paper, controlled release formulation of tinidazole was developed with an objective to achieve colon specific drug delivery with reduced frequency of dosing, to minimize gastric side effects and thus to increase patient compliance. Matrix systems of tinidazole [500 mg] were prepared by using swellable and pH dependent polymers like hydroxypropyl methylcellulose [HPMC K4M and K15M] and eudragit [eudragit L-100 and S-100]. Prepared tablets were enteric coated in order to overcome variability in gastric emptying time and delay in the release, to reduce gastric side effects and to provide prolonged localized action in colon. Process of manufacture was optimized during the scale up studies. Bioavailability study [using parallel group design] was carried of on conventional marketed, developed uncoated and enteric coated tablets in healthy human volunteers. Bioavailability study showed that greater portion of tinidazole was released in the large intestine and drug level in plasma was above 4 micro g/mL in blood for 24 hours. From the results of this study it appears that, the proposed single enteric coated tinidazole [500 mg] tablet per day could be used in place of 3-4 doses of 500 mg tinidazole conventional tablet with better control of drug release for targeted drug delivery. In addition developed colon-specific drug delivery system [CDDS] was relatively inexpensive and easy to manufacture using conventional pharmaceutical coating technique

Effect of organochlorine [DDT] exposure on experimental giardiasis

This work studied the effect of sub-chronic DDT exposure on the course of experimental giardiasis and efficacy of its treatment. A total of 160 mice were divided into six groups: G1: 30 mice received DDT and infected with Giardia lamblia. G2: 30 mice received DDT, infected and treated with tinidazole [TNZ]. G3: 30 mice infected with Giardia. G4: 30 mice infected and treated with TNZ. G5: 30 mice received DDT only. G6: 10 mice served as normal control. Mice were sacrificed at 7, 14, 21 and 28 days P.I. All groups were subjected to cyst count/2 hours collected stool, trophozoite count in intestine, histopathological examination of small intestinal section and avidin biotin peroxidase technique for local IgA staining. Also, IFN-gama was measured in sera. DDT caused early shedding of many cysts and increase in trophozoite counts for a long time, decreased intra epithelial lymphocytes, low levels of IgA and IFN-gama and severe histopathological changes in intestinal sections in G1 as compared to G3. Also, DDT reduced the efficacy of TNZ treatment in G2 as compared to G4. The results strongly support the immunomodulating effect of DDT on experimental giardiasis that might be responsible for persistence of infection, resistance to treatment and re-infection in DDT exposed persons