RESUMO
The widespread use of antiviral drugs against HIV has increased the prevalence of HIV-1 resistant strains among naïve individuals due to transmission of resistant strains. The purpose of this study was to investigate the presence of HIV-1 strains harboring resistance mutations in naïve patients in Greece. Blood samples were collected from 25 individuals. The DNA sequence of protease and partial reverse transcriptase regions (codons 41-223) were obtained by direct sequencing. Our results showed the absence of any primary resistance mutations in the study population. However, we were able to identify high prevalence of sequence polymorphisms at positions in reverse transcriptase region associated mainly with resistance to NNRTIs. Moreover, in protease region several secondary mutations were detected, suggesting the higher genetic variability of this region. The clinical significance of the polymorphisms associated with reduced susceptibility to NNRTIs remains to be clarified.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , HIV-1/genética , Mutação , Sequência de Aminoácidos , Frequência do Gene , Genótipo , Grécia , Infecções por HIV/tratamento farmacológico , Protease de HIV/genética , Transcriptase Reversa do HIV/genética , Humanos , Dados de Sequência Molecular , Polimorfismo Genético , Inibidores da Transcriptase Reversa/farmacologiaRESUMO
A trial was carried out in 30 patients to assess the effectiveness of indanyl carbenicillin in acute or chronic urinary tract infections, many of which were complicated by a pathological urological or medical condition. In all patients, infection was due to a single species of pathogen: E. coli (19), Proteus (6), and Pseudomonas (5). Oral doses of 1 g indanyl carbenicillin were given 6-hourly for an average of 10 days. Results showed a clinical and bacteriological cure in 13 (43.8%) patients. In 6 patients, although there was initial clinical improvement, the pathogen developed resistance during therapy. In 7 patients, there was super-infection with another organism. Four patients were withdrawn early in treatment because of side-effects, mainly gastrointestinal in origin. Indanyl carbenicillin proved very effective in eradicating all strains of Proteus and Pseudomonas and 12 (70.6%) of the 17 strains of E. coli in patients completing the full course of treatment.
Assuntos
Carbenicilina/análogos & derivados , Carbenicilina/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Doença Aguda , Adulto , Idoso , Carbenicilina/administração & dosagem , Carbenicilina/efeitos adversos , Doença Crônica , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Proteus/tratamento farmacológico , Infecções por Pseudomonas/tratamento farmacológicoRESUMO
The pharmacokinetics of the maxillary sinus fluid were studied in 42 patients (26 males and 16 females), suffering from chronic maxillary sinusitis, after oral administration of 0.5g or 1g cefaclor. A thin plastic catheter, for sinus secretion sampling, was inserted in the sinus cavity and remained in place throughout the study. Sinus fluid levels of cefaclor (0.5g), measured by agar and well-diffusion microbiological method, ranged between 0.17-0.19, 0.28-0.42, 0.18-0.22 and 0.12-0.16 microgram/ml at 2, 4, 6 and 8 hour intervals respectively. Levels ranging between 0.15-0.26, 0.37-0.90, 0.23-0.27 and 0.16-0.19 microgram/ml were found after the administration of 1g cefaclor at the same time intervals respectively. Higher levels were found in purulent nasal material than in cystic fluid aspirates.
Assuntos
Cefaclor/farmacocinética , Sinusite Maxilar/metabolismo , Administração Oral , Adulto , Líquidos Corporais/metabolismo , Cefaclor/administração & dosagem , Doença Crônica , Feminino , Humanos , Masculino , Sinusite Maxilar/microbiologia , Seios Paranasais/metabolismoRESUMO
The aim of the present survey was to evaluate nurses' knowledge regarding sepsis in Greece. A total of 835 registered nurses (125 males/710 females) from tertiary hospitals in Greece were interviewed from April 2008 to December 2009. All participants completed a self-completed questionnaire about assessment of sepsis (see Figure 1). Basic demographic information was recorded. The protocol and questionnaire were approved by the Ethics Committees of participating hospitals. The majority of the participants answered correctly regarding awareness of systemic inflammation - 83.5% regarding the role of temperature in the definition of systemic inflammation; 81.3% regarding the importance of white blood cell count; and 49.9% and 46.3% regarding the role of tachycardia and tachypnoea, respectively. The same pattern was observed regarding the answers about the assessment of sepsis - 79.4% of the nurses answered correctly about the role of blood pressure; 70.9% about the role of urine volume; and 43.5% about the importance of oxygen saturation. Finally, 57.2% of the participants confirmed that in practice they followed the current guidelines for the diagnosis and treatment of patients with sepsis. The study has established baseline data with which future studies can be compared.