RESUMO
Pneumonia severity scoring systems have been developed to identify patients at highest mortality risk, and are used in guidelines to limit use of broad-spectrum antibiotics to patients with severe community-acquired pneumonia. A retrospective audit of hospitalised general internal medicine patients with pneumonia was performed to assess the diagnostic performance of various pneumonia severity scores in an elderly general internal medicine population.
Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Pacientes Internados/estatística & dados numéricos , Pneumonia/diagnóstico , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , Infecções Comunitárias Adquiridas/classificação , Infecções Comunitárias Adquiridas/mortalidade , Comorbidade , Demência/epidemiologia , Feminino , Hospitalização , Humanos , Institucionalização , Masculino , Auditoria Médica , Neoplasias/epidemiologia , Pneumonia/classificação , Pneumonia/mortalidade , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Análise de Sobrevida , Vitória/epidemiologiaRESUMO
A novel series of nonpeptide angiotensin II (AII) receptor antagonists is reported, derived from linkage of the biphenylyltetrazole moiety found in previously described antagonists via a methyleneoxy chain to the 4-position of a 3-substituted 2,6-dialkylpyridine. When evaluated in an in vitro binding assay using a guinea pig adrenal membrane preparation, compounds in this series generally gave IC50 values in the range 0.005-0.5 microM. A variety of substituents was found to be effective at the 3-position of the pyridine ring. On intravenous administration in a normotensive rat model, the more potent compounds inhibited the AII-induced pressor response with ED50 values in the range 0.1-1.0 mg/kg. One of the compounds, 2-ethyl-5,6,7,8-tetrahydro-4-([2'-(1H-tetrazol-5-yl)biphenyl-4y l] methoxy)quinoline (26), demonstrated good oral activity in two rat models. At doses in the range 1-10 mg/kg po in AII-infused, conscious, normotensive rats, the compound exhibited a dose-related inhibition of the pressor response with a good duration of action at the higher doses. In a renal hypertensive rat model compound 26 showed a rapid and sustained lowering of blood pressure at a dose of 5 mg/kg po. Based on its profile, this compound, designated ICI D6888, has been selected for evaluation in volunteers.
