Standard versus newer antibacterial agents in the treatment of severe acute exacerbation of chronic obstructive pulmonary disease: a randomized trial of trimethoprim-sulfamethoxazole versus ciprofloxacin.

BACKGROUND. Although the use of antibiotics in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) is largely accepted, controversy remains regarding whether the choice of antibiotic has any impact on outcome. Our aim was to compare the effects of the combination of trimethoprim and sulfamethoxazole and ciprofloxacin in patients treated for severe COPD exacerbation requiring mechanical ventilation.

A clinical score predicting the need for hospitalization in scorpion envenomation.

Objective: Predicting complications is a clinical challenge in the assessment of victims of scorpion envenomation (SE). We sought to develop a clinical score to predict need for hospitalization after scorpion sting.

Methods: We prospectively collected data in patients attending the emergency department after SE in derivation (n = 868) and validation groups (n = 435).

Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock.

Objective: To investigate the effect of norepinephrine on static (right atrial pressure, pulmonary artery occlusion pressure ) and dynamic (pulse pressure variation and arterial systolic pressure variation) preload indicators in experimental hemorrhagic shock.

Design: Prospective controlled experimental study.

Setting: Animal research laboratory.

Neurohormonal activation in severe scorpion envenomation: correlation with hemodynamics and circulating toxin.

We studied the effects of scorpion (Androctonus australis hector) venom on hemodynamics and on the release of catecholamines, neuropeptide Y (NPY), endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) in dog model of severe scorpion envenomation. Nine mongrel anesthetized dogs were submitted to mechanical ventilation through intubation and were administered intravenously purified dried scorpion venom (Androctonus autstralis) 0.05 mg/kg.

Chorioretinal involvement in patients with West Nile virus infection.

Purpose: To characterize and analyze the chorioretinal manifestations of West Nile virus (WNV) infection.

Design: Prospective, noncomparative case series.

Participants: Twenty-nine consecutive patients with serologically confirmed WNV infection in the setting of an outbreak of the disease.

[Mechanical ventilation in intensive care units: indications, modalities and complications. Results of a prospective multicenter survey in Tunisia].

The survey was performed during the month of March 1998 and concerned 9 ICUs located in teaching hospitals. To be included each ICU had to MV for more than 12 hours were included in the study and had a 28 day follow-up in the ICU or until hospital discharge. Collected parameters were indications of MV, modalities of MV and of weaning, complication and outcome at hospital discharge.

A canine study of immunotherapy in scorpion envenomation.

Objective: To evaluate the effects of scorpion venom and antivenom in experimental envenomation.

Design: Prospective, controlled animal study.

Setting: University research laboratory

Subjects: Twenty-nine anesthetized and ventilated dogs.

Once daily oral ofloxacin in chronic obstructive pulmonary disease exacerbation requiring mechanical ventilation: a randomised placebo-controlled trial.

Background: The role of antibiotics in treatment of patients with moderate exacerbations of chronic obstructive pulmonary disease (COPD) is uncertain, but such treatment might be useful in very severe episodes. Our objective was to assess the effects of ofloxacin in patients with exacerbations of COPD who required mechanical ventilation.

Methods: We did a prospective, randomised, double-blind, placebo-controlled trial in 93 patients with acute exacerbation of COPD who required mechanical ventilation.

Efficacy of serotherapy in scorpion sting: a matched-pair study.

Background/objective: Although evidence of scorpion antivenin effectiveness in the clinical setting is lacking, scorpion antivenin is generally considered the only specific treatment for scorpion sting irrespective of its clinical severity. We conducted a matched-pair study to assess the efficacy of systematic administration of scorpion antivenin.

Methods: Among 600 stung patients who participated in a study on the efficacy of high-dose hydrocortisone after scorpion sting, 135 (cases) had been treated with 10 to 20 mL intravenous scorpion antivenin (neutralizing 10 LD50 venom/mL).

Successful weaning from mechanical ventilation following balloon mitral commissurotomy.

Successful weaning from mechanical ventilation (MV) following percutaneous balloon mitral commissurotomy (BMC) is reported in a 59-year-old woman with severe symptomatic rheumatic mitral stenosis. The patient was admitted to the Intensive Care Unit for acute respiratory failure secondary to pulmonary edema requiring intubation and mechanical ventilation. After resolution of the acute phase, she became completely dependent on mechanical ventilatory support.