[Evaluation of clinical effectiveness and direct costs of azithromycin treatment for exacerbation of chronic obstructive pulmonary disease in hospitalized patients and ambulatory care]. / Ocena klinicznej skutecznosci oraz porównanie bezposrednich kosztów leczenia azytromycyna chorych z zaostrzeniem przewleklej obturacyjnej choroby pluc leczonych ambulatoryjnie lub w warunkach szpitalnych.

This paper presents the efficacy and cost of therapy with azithromycin for the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Two subgroups were investigated: out-patients and hospitalized patients--20 in each group (17 women and 23 men). Azithromycin 500 mg was administered sequentially once daily. A complete physical examination including temperature, respiratory rate, cough, production and characteristics of sputum so as general aspects of quality of life assessed by COPD exacerbation questionnaire was made in hospitalized patients on a daily base and in a day 10-14 after the end of therapy. Out-patients were assessed in day 1, 3-5 days after the start of study drug treatment and 10-14 days after the end of therapy. Pulmonary function tests were assessed three times during the whole study course. The results of the study suggest similar duration of therapy with azithromycin in both study subgroups, whereas in out-patients decrease and regression of symptoms were statistically significantly quicker with tendency approximately the same in both study subgroups. The cost of therapy with azithromycin was similar in both subgroups but the complete cost of COPD exacerbation treatment was significantly lower in out-patients in comparison to hospitalized patients group (473.71 PLN and 2587.87 respectively).

[Comparative analysis of the effectiveness and costs of azithromycin and cefoperazone treatment of patients during COPD exacerbation]. / Analiza porównawcza skutecznosci i kosztów leczenia azytromycyna i cefoperazonem w okresie zaostrzenia przewleklej obturacyjnej choroby pluc.

UNLABELLED: The effectiveness and costs of azithromycin and cefoperazone treatment of COPD exacerbation have been analysed in this study. Forty patients at the mean age of 65.9 (+/- 11.5) years were enrolled. The subjects were randomly selected and treated either with cefoperazone 2 x 1.0 g i.v. daily (group I = 20 persons) or with azithromycin 1 x 0.5 g (group II = 20 persons), in sequential method. Body temperature, cough intensity, quality and quantity of expectorated sputum, number of breaths per minute and adverse events were recorded daily. The values of pulmonary function tests and leucocytosis were assessed three times during the study. Statistically significant differences between both groups have been found with respect to the mean time of staying in hospital (9.1 days--group I vs 6.1 days--group II), mean total duration of antibiotic therapy (10.1 days--group I vs. 6.6 days--group II) and duration of intravenous antibiotic therapy only [7.5 days (group I) vs 2.9 days (group II)] (p < 0.05). Taking into account the duration of hospitalization, it was shown that the mean total costs of treatment of COPD exacerbation with azithromycin was significantly lower than that of treatment with cefoperazone (2375.9 PLN and 1663.7 PLN, respectively) (p < 0.05). CONCLUSIONS: The effectiveness of treatment with azithromycin in patients with COPD exacerbation was evident. The total costs of treatment of COPD exacerbation with azithromycin is lower than with cefoperazone. Both azithromycin and cefoperazone are safe in the treatment of exacerbation of COPD.

[Immunological phenomenons connected with etiology and pathogenesis of sarcoidosis]. / Zjawiska immunologiczne zwiazane z etiologia i patogeneza sarkoidozy.

Despite of numerous studies on etiology and pathogenesis of sarcoidosis, it has been impossible to explain the reason of disease initiation. The possible beginning of sarcoid process is broken balance of cytokines secreted by T-lymphocytes (Th1 and Th2), which generates various complicated immunological phenomenons. This broken balance of cytokines may be caused by particular antigen in the shape of microorganism or other factor, which disturbs organism's homeostasa.