Role of linezolid therapeutic drug monitoring in the treatment of MRSA tracheo-pulmonary infection in a 10-month-old infant.

The paper reports on the use of therapeutic drug monitoring for linezolid in the decision-making process to continue or not its administration in an infant. Linezolid is effective against methicillin-resistant Staphylococcus aureus but is off-label in pediatrics. The use of therapeutic drug monitoring, as in our case, allows an informed decision on administration of the drug (in this case on withdrawal) increasing patients safety.

Inhaled lead exposure affects tracheal responsiveness and lung inflammation in guinea pigs during sensitization.

Total and differential white blood cells (WBC), and cytokines, levels in serum were examined in guinea pigs exposed to inhaled lead acetate. Different groups of guinea pigs including: control (group C), sensitized group (group S), and exposed animals to aerosol of three lead concentrations during sensitization (n = 6 for each group) were studied. Total and differential WBC counts of lung lavage, serum cytokine (IFNγ and IL-4), levels and tracheal responsiveness to methacholine and ovalbumin were measured. All measured values were significantly increased except for IFNγ/IL-4 ratio which was significantly decreased in nonexposed sensitized and those exposed to all lead concentrations compared to control group (p < 0.05 to p < 0.001). Most measured values in animals exposed to higher lead concentration were also significantly higher than group S except for tracheal responsiveness to methacholine and lymphocyte count. Lead concentration significantly increased in lung tissues of animals exposed to all three lead concentrations (p < 0.001 for all cases). These results showed that lead exposure during sensitization can induce greater increase in tracheal responsiveness, total WBC, eosinophil, neutrophil, and basophil counts as well as serum level of IL-4. It can also cause a decrease in lymphocyte count, IFNγ level, and IFNγ/IL-4 ratio especially in its high concentration. Therefore inhaled lead exposure may cause increased severity of asthma during development of the disease.

Liver disease in dogs with tracheal collapse.

BACKGROUND: Hepatopathy in dogs with chronic respiratory diseases is poorly recognized. The aim of this study was to evaluate liver parameters alanine transferase, alkaline phosphatase, and glutamate dehydrogenase, as well as basal and stimulated bile acid concentration, in dogs with tracheal collapse. HYPOTHESIS: Dogs with tracheal collapse have hepatopathy. ANIMALS: 26 dogs with tracheal collapse. MATERIALS AND METHODS: Gall bladder contraction was stimulated by intramuscular injection of a synthetic cholecystokinin analogue (ceruletide). Twelve healthy Beagle dogs and 30 dogs of various breeds investigated previously without evidence of hepatic, gastrointestinal, or respiratory diseases served as control. Amelioration of liver variables was assessed after stent implantation. RESULTS: Twelve of 26 (46%) dogs had increased serum activity of 2 or more liver enzymes. Serum basal bile acid concentrations were high in 24 of 26 dogs. Twenty- and 40-minute stimulated bile acids were significantly higher in dogs with tracheal collapse (64.2 +130.0/-43.0 micromol/L and 82.6 +164.0/-57.1 micromol/L) compared to the control dogs (7.0 +/- 3.6 micromol/L and 6.4 +/- 3.5 micromol/L). All twelve dogs reevaluated after a median of 58 days (48-219 days) had a normal breathing pattern and significantly decreased 20 and 40 minutes stimulated bile acids (50.0 +92.7/-32.8 micromol/L, 52.8 +97.6/-34.3 micromol/L; P = .0043), whereas plasma liver enzyme activities were not significantly influenced. CONCLUSION AND CLINICAL IMPORTANCE: There was a significant hepatic dysfunction in the majority of dogs with a tracheal collapse. Liver function should be routinely assessed in dogs with severe respiratory disease.

Tracheobronchopathia osteochondroplastica.

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder with unknown aetiology. We report one case of TO in a patient with non-Hodgkin pulmonary lymphoma and benign epidermal and trichylemmal cysts on the periorbital region and scalp. To the authors' knowledge, the coincidence of these processes has never been described before. The case was evaluated with conventional X-ray, computed tomography, magnetic resonance imaging, fibre-optic bronchoscopy with 2 months interval, histopathological evaluation, Tc-99 m MDP bone scintigraphy and microbiological studies including PCR testing of bronchial biopsy and lavage specimens for Mycobacterium tuberculosis. Additionally, case reports of TO in the Turkish literature are summarized.