чем лечить микоплазменный кашель?
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- ольга коробейникова
Феохромоцитома
Сколько лет больному?COUGH REFLEX ARC — Each cough occurs through the stimulation of a complex reflex arc. This is initiated by the irritation of cough receptors that exist not only in the epithelium of the upper and lower respiratory tracts, but also in the pericardium, esophagus, diaphragm, and stomach. Chemical receptors sensitive to acid, cold, heat, capsaicin-like compounds, and other chemical irritants trigger the cough reflex via activation of ion channels of the transient receptor potential vanilloid type 1 (TRPV1) and transient receptor potential ankyrin type 1 (TRPA1) classes [6-10]. (See Neuronal control of the airways , section on 'Reflex regulation'.)Mechanical cough receptors can be stimulated by triggers such as touch or displacement. Laryngeal and tracheobronchial receptors respond to both mechanical and chemical stimuli.Impulses from stimulated cough receptors traverse an afferent pathway via the vagus nerve to a cough center in the medulla, which itself may be under some control by higher cortical centers. Sex-related differences in cough reflex sensitivity explain the observation that women are more likely than men to develop chronic cough [1,11-13].
Сколько лет больному?COUGH REFLEX ARC — Each cough occurs through the stimulation of a complex reflex arc. This is initiated by the irritation of cough receptors that exist not only in the epithelium of the upper and lower respiratory tracts, but also in the pericardium, esophagus, diaphragm, and stomach. Chemical receptors sensitive to acid, cold, heat, capsaicin-like compounds, and other chemical irritants trigger the cough reflex via activation of ion channels of the transient receptor potential vanilloid type 1 (TRPV1) and transient receptor potential ankyrin type 1 (TRPA1) classes [6-10]. (See Neuronal control of the airways , section on 'Reflex regulation'.)Mechanical cough receptors can be stimulated by triggers such as touch or displacement. Laryngeal and tracheobronchial receptors respond to both mechanical and chemical stimuli.Impulses from stimulated cough receptors traverse an afferent pathway via the vagus nerve to a cough center in the medulla, which itself may be under some control by higher cortical centers. Sex-related differences in cough reflex sensitivity explain the observation that women are more likely than men to develop chronic cough [1,11-13].
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- Alexander Istomin ( Истомин )
Внизу схемы лечения взрослых. Мы обычно используем препарат Zmax. Вопросы - пишете на Alexander@Istomin.MD (www.istomin.md) Recommended regimens include azithromycin 10 mg/kg in one dose on the first day and 5 mg/kg in one dose for four days, clarithromycin 15 mg/kg per day in two divided doses for 10 days, or erythromycin 30 to 40 mg/kg per day in four divided doses for 10 days [44]. Azithromycin and clarithromycin have the advantages of less frequent dosing and fewer gastrointestinal disturbances. Tetracycline 20 to 50 mg/kg per day in four divided doses (maximum daily dose 1 to 2 g) and doxycycline 2 to 4 mg/kg per day in one or two divided doses (maximum daily dose 100 to 200 mg) for 10 days also are effective and may be used in children eight years of age or older [45].
- Alexander Istomin ( Истомин )
PubMed TI Reduced lung diffusion capacity after Mycoplasma pneumoniae pneumonia. AU Marc E, Chaussain M, Moulin F, Iniguez JL, Kalifa G, Raymond J, Gendrel D SO Pediatr Infect Dis J. 2000;19(8):706. BACKGROUND: Mycoplasma pneumoniae is a frequent but underdiagnosed cause of community-acquired pneumonia (CAP) in children, and appropriate macrolide treatment is often given late. The aim of this work was to estimate the frequency of pulmonary involvement in children 6 months after a clinical episode of Mycoplasma CAP. METHODS: We measured carbon monoxide diffusion capacity (TLCO) and conducted spirometric tests in 35 children without asthma or chronic lung disease (ages 4.5 to 15 years), 6 months and 1 year after acute CAP caused by M. pneumoniae (23 children), pneumococci (5 children) or viruses (7 children). Only 11 of 23 patients with M. pneumoniae CAP required hospitalization, whereas all the patients with pneumococcal or viral pneumonia were admitted to hospital. RESULTS: Lung volumes and spirometric tests were normal for all children. TLCO was normal 6 months after pneumococcal or viral pneumonia (87 to 112% of expected values for height and sex). After acute M. pneumoniae CAP, 11 of 23 patients (48%) had TLCO values<80% of the expected value. The extent of change in lung diffusion capacity was correlated with the delay to diagnosis and treatment: TLCO was low in 8 of 11 patients given macrolide treatment 10 days or more after the onset of acute symptoms vs. only 3 of 10 patients given appropriate treatment in the first 10 days. TLCO was low in 7 of 7 who received macrolide therapy for<2 weeks. TLCO had increased slightly after 1 year in the 5 patients retested after a new course of macrolide treatment. TLCO reached the lower normal range in 2 patients controlled after 3 years. CONCLUSIONS: The abnormal TLCO values suggest that some children with Mycoplasma pneumonia have reduced pulmonary gas diffusion after recovery from the illness. The reduction is related to delay and short macrolide therapy. AD Department of Pediatrics, H?pital Saint Vincent de Paul, Paris, France. PMID 10959737
- Alexander Istomin ( Истомин )
PubMed TI Rising rates of macrolide-resistant Mycoplasma pneumoniae in the central United States. AU Yamada M, Buller R, Bledsoe S, Storch GA SO Pediatr Infect Dis J. 2012;31(4):409. Macrolide-resistant Mycoplasma pneumoniae is widespread in Asia, and severe cases of pneumonia have been described in children. Little information is available about the resistance pattern in the United States. We collected respiratory samples from 49 patients with Mycoplasma infection in the central United States between 2007 and 2010. We found a macrolide resistance rate of 8.2%. Resistance should be considered when patients with M. pneumoniae infection do not have a satisfactory response to macrolides. Alternative antibiotics include tetracyclines or fluoroquinolones. AD *Department of Pediatrics, Washington University School of Medicine, St. Louis, MO†Clinical Virology Laboratory, St. Louis Children's Hospital, St. Louis, MO. PMID 22209916
- Alexander Istomin ( Истомин )
49 PubMed TI Clinical efficacy of macrolide antibiotics against genetically determined macrolide-resistant Mycoplasma pneumoniae pneumonia in paediatric patients. AU Kawai Y, Miyashita N, Yamaguchi T, Saitoh A, Kondoh E, Fujimoto H, Teranishi H, Inoue M, Wakabayashi T, Akaike H, Ogita S, Kawasaki K, Terada K, Kishi F, Ouchi K SO Respirology. 2012;17(2):354. BACKGROUND AND OBJECTIVE: Since 2000, the prevalence of macrolide-resistant (MR) Mycoplasma pneumoniae has increased among paediatric patients in Japan. To determine the efficacy of macrolides against MR M. pneumoniae pneumonia, microbiological and clinical efficacies were compared during the antibiotic treatment. METHODS: Samples from a total of 30 children with M. pneumoniae pneumonia, as confirmed by PCR and serology, were analyzed. Primers for domain V of 23S rRNA were used, and DNA sequences of the PCR products were compared with the sequence of an M. pneumoniae reference strain. RESULTS: Isolates from 21 patients demonstrated point mutations, and these patients were defined as MR. The remaining nine patients, whose isolates showed no point mutations, were categorized as control (macrolide-sensitive) patients. The number of M. pneumoniae in nasopharyngeal samples from the control group decreased rapidly 48 h after initiation of macrolide treatment and showed a close relationship with clinical outcome. In contrast, the number of M. pneumoniae 48 h after initiation of macrolide treatment were significantly higher in samples from MR patients than in samples from macrolide-sensitive patients. In 15 of 21 MR patients, fever persisted for more than 48 h after the initiation of macrolide treatment. When treatment was changed to minocycline, fever disappeared within 48 h in all these MR patients. There were no differences between MR patients who demonstrated a reduction in fever and those in whom fever persisted after 48 h of macrolide treatment. CONCLUSIONS: The microbiological and clinical efficacies of macrolides for treating patients with MR M. pneumoniae pneumonia were low. These results show that macrolides are clearly less effective in patients with MR M. pneumoniae pneumonia. AD Department of Pediatrics, Kawasaki Medical School, Okayama, Japan. nao@med.kawasaki-m.ac.jp PMID 22077195
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