Severe measles pneumonia in adults with respiratory failure: role of ribavirin and high-dose vitamin A.

Although measles is usually considered a benign viral disease of childhood, adults may be affected at any age and may experience severe respiratory or neurologic consequences. We present three adult cases (one of whom was pregnant) admitted to our University Hospital who were diagnosed to have measles and who had uncommon clinical features such as hepatitis and hyponatremia. All patients were markedly hypoxic; one required mechanical ventilation. Two patients received therapy with intravenous ribavirin and all patients received high-dose vitamin A for 3 days. Therapy with intravenous ribavirin and vitamin A were well tolerated by our patients except one patient who developed acute renal failure and were associated with reversal of respiratory compromise. Life-threatening measles pneumonitis in adults may be more common than previously appreciated, regardless of the patient's immune status, and ribavirin and high-dose vitamin A might be a treatment option.

Use of probiotics in various diseases: evidence and promises.

The utilization of live microorganisms as therapeutics has been gaining increasing attention over the last years with the addition of scientific knowledge on their traditional uses. Probiotics are defined as "live micro­organisms which when administered in adequate amounts, confer a health benefit on the host". The normal intestinal microbiota prevents the colonization of pathogenic bacteria and has important immune functions. It has been hypothesized that the sudden change in the intestinal microbiota that parallels the modern life practices of humans might have contributed to the rise in the incidence of particular diseases. Bacteria and yeasts may be used as probiotics either in the form of a single strain or combination of microorganisms or mixed with prebiotics. Probiotics have been used for various disease states from gastrointestinal diseases to infections and even to diabetes and atopic diseases. Drawing firm conclusions about the clinical efficacy of probiotics is hard because of the heterogeneity of patient populations, probiotic strains, dosages, and commercial preparations. However, probiotics represent a very exciting and promising area of research due to the ever-increasing antibiotic resistance rates and the ability of some probiotics to modify the course of diseases.