Adjunctive therapy of allergic bronchopulmonary aspergillosis with itraconazole.


:Itraconazole is a new orally active antifungal triazole with impressive activity against Aspergillus spp. Six patients with allergic bronchopulmonary aspergillosis (ABPA), aged 14 to 49 years, were treated with oral itraconazole (200 mg twice daily) for a mean of 3.9 months (range, one to six months; three patients continue on therapy). Two patients received two courses. Three patients had underlying cystic fibrosis, and three had severe asthma; four of the six required continuous high-dose systemic prednisone (mean, 43 mg/day; confidence interval [CI], 23 to 63 mg/day) at the start of therapy. In those treated for two months or longer, the mean total serum IgE level fell from 2,462 U/ml (CI, 752 to 4,202 U/ml) to 502 U/ml (CI, 123 to 880 U/ml) during each course, and the mean daily steroid dosage was decreased to a mean of 24 mg/day (CI, 11 to 37 mg/day). All patients experienced improvement in pulmonary function during the trial, with mean FEV, increasing from 1.43 to 1.77L/sec and mean FVC from 2.3 to 2.9 L in those treated for two months or longer. The mean steady-state serum concentration of itraconazole was 5.1 micrograms/ml (range, 1.8 micrograms/ml to 7.3 micrograms/ml); the patient with the lowest concentrations had the least significant clinical response. Cultures of sputum from two of three patients became negative for A fumigatus during therapy. No adverse clinical effects occurred except loss of libido in one patient. We conclude that oral itraconazole may be an effective adjunctive therapy in ABPA, possibly by clearing the airway of Aspergillus, and that randomized trials of this agent are warranted to better define its usefulness in this disorder.






Denning DW,Van Wye JE,Lewiston NJ,Stevens DA




Has Abstract


1991-09-01 00:00:00
















  • Catheter-induced tricuspid regurgitation. Incidence and clinical significance.

    abstract::The incidence and severity of catheter-induced tricuspid regurgitation has not been studied extensively. Given the frequency with which right heart catheters are employed to measure cardiac output, it is important to know whether the severity of catheter-induced tricuspid regurgitation is sufficient to invalidate the ...


    pub_type: 杂志文章


    authors: Stewart D,Leman RB,Kaiser J,Mann DL

    更新日期:1991-03-01 00:00:00

  • Unsuspected infrahepatic interruption of inferior vena cava associated with floppy mitral valve, mitral valve prolapse, and severe mitral regurgitation.

    abstract::We describe a case of unsuspected infrahepatic interruption of the inferior vena cava with hemiazygos continuation in a 67-year-old man presenting with chest pain and evidence of mitral regurgitation. He had no persistent superior vena cava, with the hemiazygos draining directly into the right superior vena cava. Poly...


    pub_type: 杂志文章,评审


    authors: Dellavalle A,Ribichini F,Steffenino G

    更新日期:1994-11-01 00:00:00

  • Outcomes up to 5 years after severe, acute respiratory failure.

    abstract:STUDY OBJECTIVE:To use an existing database from a large cohort study with follow-up as long as 5.5 years to assess the extended prognosis of patients who survived their hospitalizations for severe acute respiratory failure (ARF). DESIGN, SETTING, AND PATIENTS:Secondary analysis of an inception cohort of 1,722 patient...


    pub_type: 杂志文章


    authors: Garland A,Dawson NV,Altmann I,Thomas CL,Phillips RS,Tsevat J,Desbiens NA,Bellamy PE,Knaus WA,Connors AF Jr,SUPPORT Investigators.

    更新日期:2004-12-01 00:00:00

  • A cross-cultural comparison of critical care delivery: Japan and the United States.

    abstract:OBJECTIVE:To compare the utilization and outcomes of critical care services in a cohort of hospitals in the United States and Japan. DESIGN:Prospective data collection on 5,107 patients and detailed organizational characteristics from each of the participating Japanese study hospitals between 1993 and 1995, with compa...


    pub_type: 杂志文章


    authors: Sirio CA,Tajimi K,Taenaka N,Ujike Y,Okamoto K,Katsuya H

    更新日期:2002-02-01 00:00:00

  • Esophageal pressure measurements in cardiopulmonary exercise testing.

    abstract:STUDY OBJECTIVES:We sought to determine the adaptability and effectiveness of a new esophageal balloon technique to measure changes in esophageal pressure (Pes) as a reflection of pleural pressure with progressive incremental exercise testing in normal subjects. DESIGN:An 8F (0.9 cm) esophageal balloon catheter (Smart...


    pub_type: 杂志文章


    authors: Thomas AM,Turner RE,Tenholder MF

    更新日期:1997-09-01 00:00:00

  • An unusual case of pneumorrhachis following resection of lung carcinoma.

    abstract::We report an unusual case of a patient with a bronchopleural-subcutaneous fistula that occurred 3 years following a lobectomy and en bloc chest wall resection for carcinoma. Following a sudden resolution of subcutaneous emphysema, an epidural air collection developed. Spontaneous pneumorrhachis is a previously unrepor...


    pub_type: 杂志文章


    authors: Ristagno RL,Hiratzka LF,Rost RC Jr

    更新日期:2002-05-01 00:00:00

  • Longitudinal changes in bronchial responsiveness associated with swine confinement dust exposure.

    abstract:STUDY OBJECTIVES:Acute exposure to the air in swine confinement units causes bronchial hyperresponsiveness and inflammation of the airways. This study was performed to assess the longitudinal development of bronchial responsiveness in pig farmers and to establish exposure-response relationships. METHODS:A cohort of 17...


    pub_type: 杂志文章


    authors: Vogelzang PF,van der Gulden JW,Folgering H,Heederik D,Tielen MJ,van Schayck CP

    更新日期:2000-05-01 00:00:00

  • Long-term reproducibility of respiratory gas exchange measurements during exercise in patients with stable cardiac failure.

    abstract::Present-day technology has greatly facilitated the monitoring of respiratory gas exchange in the clinical exercise laboratory. Despite the growing use of these techniques to assess the severity and progression of disease or therapeutic response in patients with heart failure, the long-term reproducibility of oxygen up...


    pub_type: 杂志文章


    authors: Janicki JS,Gupta S,Ferris ST,McElroy PA

    更新日期:1990-01-01 00:00:00

  • Enhanced responses to aerosolized bronchodilator therapy in asthma using respiratory maneuvers.

    abstract::To determine if respiratory maneuvers may enhance the response to inhaled bronchodilator drugs, we evaluated the bronchodilator responses when isoproterenol was: inhaled as a bolus high (80 percent VC) compared to low (20 percent VC) lung volumes, and inhaled as a single 800 microgram dose compared to four 200 microgr...


    pub_type: 杂志文章


    authors: Riley DJ,Liu RT,Edelman NH

    更新日期:1979-11-01 00:00:00

  • Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions.

    abstract:STUDY OBJECTIVE:To evaluate the efficacy of small-bore (12 French vanSonnenberg) catheters compared with standard large-bore chest tubes in the drainage and sclerotherapy of malignant pleural effusions. DESIGN:Retrospective review. SETTING:An academic tertiary care hospital. PATIENTS:Adult patients with documented n...


    pub_type: 杂志文章


    authors: Parulekar W,Di Primio G,Matzinger F,Dennie C,Bociek G

    更新日期:2001-07-01 00:00:00

  • Pneumonia due to Haemophilus influenzae among mechanically ventilated patients. Incidence, outcome, and risk factors.

    abstract::Incidence and potential risk factors for pneumonia due to Haemophilus influenzae in adults treated with mechanical ventilation in a medical-surgical ICU were investigated. Diagnosis was established in 91 episodes and H influenzae was isolated in 20 of them. Mean onset of ventilator-associated pneumonia (VAP) due to H ...


    pub_type: 杂志文章


    authors: Rello J,Ricart M,Ausina V,Net A,Prats G

    更新日期:1992-11-01 00:00:00

  • Effects of hypercapnia on BP in hypoalbuminemic and Nagase analbuminemic rats.

    abstract:STUDY OBJECTIVE:To determine if animals with abnormally low albumin levels are more susceptible to the effects of hypercapnia on BP compared to normal animals. DESIGN:Prospective, controlled laboratory experiment. SETTING:University research laboratory. ANIMALS:Eighteen male Sprague-Dawley rats: 6 rats 10 to 12 week...


    pub_type: 杂志文章


    authors: Gómez JL,Gunnerson KJ,Song M,Li J,Kellum JA

    更新日期:2007-05-01 00:00:00

  • Pulmonary mass and air meniscus sign in a 19-year-old man.

    abstract::Sacrococcygeal teratoma is rarely diagnosed in adults. Pulmonary mass as the presenting clinical form of the malignant variety of this germ-cell tumor is exceptional. We report herein such a case with the noticeable peculiarity of showing the air meniscus sign on chest roentgenographic examination. ...


    pub_type: 杂志文章


    authors: Roig J,Aguilar X,Maestre J,Domingo C,Morera J

    更新日期:1991-08-01 00:00:00

  • A rare endobronchial neurilemmoma (Schwannoma).

    abstract::Primary neurogenic tumors of the lung are rare. Often, their histologic behavior presents a treatment dilemma. We present a case of benign endobronchial neurilemmoma managed by means of YAG laser resection together with a brief discussion of the management options available for these tumors. ...


    pub_type: 杂志文章


    authors: Feldhaus RJ,Anene C,Bogard P

    更新日期:1989-02-01 00:00:00

  • How tumor stage affects surgeons' surveillance strategies after lung cancer surgery.

    abstract::The factors that influence decision making among surgeons are not well understood. We evaluated how tumor stage in patients subjected to potentially curative surgery for lung cancer affects the self-reported follow-up strategies employed by practicing surgeons. Hypothetical patient profiles and a detailed questionnair...


    pub_type: 杂志文章


    authors: Johnson FE,Naunheim KS,Coplin MA,Virgo KS

    更新日期:1997-01-01 00:00:00

  • Beliefs among pulmonologists and thoracic surgeons in the therapeutic approach to non-small cell lung cancer.

    abstract:STUDY OBJECTIVES:The physicians who initially evaluate patients with non-small cell lung cancer (NSCLC) strongly impact the course of therapy. Their beliefs in treatment and prognosis may contribute to practices of variable quality and appropriateness. We sought to better describe beliefs among pulmonologists and thora...


    pub_type: 杂志文章


    authors: Schroen AT,Detterbeck FC,Crawford R,Rivera MP,Socinski MA

    更新日期:2000-07-01 00:00:00

  • Continuous fiberoptic arterial and venous blood gas monitoring in hemorrhagic shock.

    abstract:STUDY OBJECTIVE:To compare the performance of continuous fiberoptic blood gas monitoring with standard, intermittent blood gas sampling in the measurement of arterial and central venous blood gases during marked hemodynamic changes. DESIGN:Prospective, consecutive, enrollment, experimental study. SETTING:Research lab...


    pub_type: 杂志文章


    authors: Oropello JM,Manasia A,Hannon E,Leibowitz A,Benjamin E

    更新日期:1996-04-01 00:00:00

  • Cross-sectional echocardiographic detection of aortic ring abscess in bacterial endocarditis.

    abstract::The diagnosis of aortic ring abscess by cross-sectional echocardiography has not been reported. In this paper, a case of bacterial endocarditis of the aortic valve extending to the aortic ring and the mitral valve is reported. The role of cross-sectional echocardiography in defining the anatomic distortion of the aort...


    pub_type: 杂志文章


    authors: Mardelli TJ,Ogawa S,Hubbard FE,Dreifus LS,Meixell LL

    更新日期:1978-11-01 00:00:00

  • Bardet Biedl syndrome: motile ciliary phenotype.

    abstract:BACKGROUND:Cilia line the surface of the respiratory tract and beat in a coordinated wave to protect the lungs against infection. Bardet Biedl Syndrome (BBS) is a rare condition attributed to cilia dysfunction. Murine models of BBS suggest a respiratory phenotype; however, no reports have studied the translation of the...


    pub_type: 杂志文章


    authors: Shoemark A,Dixon M,Beales PL,Hogg CL

    更新日期:2015-03-01 00:00:00

  • Integrated electronic display model for teaching bronchoscopy.

    abstract::The integrated electronic display model for teaching bronchoscopic technique has been most helpful in guiding the student-bronchoscopist, especially in the early stages of reorientation in both the procedure for insertion and the practice of identification of the individual segmental orifice. The display board is elec...


    pub_type: 杂志文章


    authors: Cunanan OS,Mazza JE

    更新日期:1977-09-01 00:00:00

  • Intrapleural talc for the prevention of recurrent pneumothorax.

    abstract::The ipsilateral recurrence rate after the first spontaneous pneumothorax treated with tube thoracostomy is reported to be between 23 percent and 52 percent. The incidence of recurrence after the first recurrence is substantially higher. Chemical pleurodesis has been attempted to decrease the recurrence rate. Tetracycl...


    pub_type: 杂志文章


    authors: Milanez JR,Vargas FS,Filomeno LT,Fernandez A,Jatene A,Light RW

    更新日期:1994-10-01 00:00:00

  • Contrasting cardiovascular and respiratory responses to exercise in mitral valve and chronic obstructive pulmonary diseases.

    abstract::The role of cardiovascular and pulmonary limitation in performing maximal exercise is contrasted in patients with mitral valve disease (MVD) and chronic obstructive pulmonary disease (COPD). The ventilatory (VE) gas exchange (VO2 and VCO2) and heart rate (HR) responses to an incremental cycle ergometer exercise were m...


    pub_type: 杂志文章


    authors: Nery LE,Wasserman K,French W,Oren A,Davis JA

    更新日期:1983-03-01 00:00:00

  • Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group.

    abstract:OBJECTIVE:To describe the clinical correlates of asthma in a community-based sample of elderly persons. PARTICIPANTS:A community sample of 4,581 persons > or = 65 years old from the Cardiovascular Health Study. MEASUREMENTS:Standardized respiratory, sleep, and quality-of-life (QOL) questions, a medication inventory, ...


    pub_type: 杂志文章


    authors: Enright PL,McClelland RL,Newman AB,Gottlieb DJ,Lebowitz MD

    更新日期:1999-09-01 00:00:00

  • Smoking cessation counseling: a practice management perspective.

    abstract::Individuals continue to smoke despite its numerous proven adverse health effects. Now viewed as a chronic medical condition, health-care professionals are more involved in cessation efforts. Physicians are often the first line of defense, providing intervention through prescription management and counseling. Some insu...


    pub_type: 杂志文章


    authors: Pohlig C

    更新日期:2006-10-01 00:00:00

  • Marginal utility of montelukast for persistent asthma.

    abstract:BACKGROUND:The efficacy of a new pharmacologic agent for asthma, in this instance the leukotriene receptor antagonist montelukast, is determined in controlled trials in research subjects. The utility of a new drug is determined by multiple uncontrollable factors in individual patients. OBJECTIVE:To assess the utility ...


    pub_type: 临床试验,杂志文章


    authors: Mathison DA,Koziol JA

    更新日期:2002-02-01 00:00:00

  • A prospective long-term study of 220 patients with a retrievable vena cava filter for secondary prevention of venous thromboembolism.

    abstract:BACKGROUND:The immediate and long-term clinical events associated with the placement and removal of a retrievable filter (ALN filter; ALN Implants Chirurgicaux; Ghisonaccia, France) remain largely unknown. METHODS:This was a prospective cohort study with an 18-month follow-up. All consecutive patients scheduled for pl...


    pub_type: 杂志文章


    authors: Mismetti P,Rivron-Guillot K,Quenet S,Décousus H,Laporte S,Epinat M,Barral FG

    更新日期:2007-01-01 00:00:00

  • Community-acquired pneumonia guidelines--an international comparison: a view from Europe.

    abstract::Following an outline that details the pathogens causing community-acquired pneumonia (CAP) identified in studies from Europe, this article reviews the guidelines for the management of CAP in four European countries--France, Italy, Spain, and the United Kingdom. The method behind the development of each document is des...


    pub_type: 杂志文章


    authors: Woodhead M

    更新日期:1998-03-01 00:00:00

  • Transmitral flow changes during dipyridamole-induced ischemia. A Doppler-echocardiographic study.

    abstract::Myocardial ischemia results in altered left ventricular (LV) diastolic compliance, reflected by an abnormal mitral inflow pattern on Doppler echocardiography. To investigate the relationship of Doppler echocardiography and regional myocardial systolic function during dipyridamole infusion, we evaluated transmitral flo...


    pub_type: 杂志文章


    authors: Lattanzi F,Picano E,Masini M,De Prisco F,Distante A,L'Abbate A

    更新日期:1989-05-01 00:00:00

  • 8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy.

    abstract:STUDY OBJECTIVES:Obstructive sleep apnea (OSA) is characterized by recurrent apnea during sleep that may compromise oxidative balance. Oxidative stress is increased in the blood and in the airways of OSA patients. DESIGN:The aim of this study was to investigate whether oxidative stress is determined by nocturnal apnea...


    pub_type: 杂志文章


    authors: Carpagnano GE,Kharitonov SA,Resta O,Foschino-Barbaro MP,Gramiccioni E,Barnes PJ

    更新日期:2003-10-01 00:00:00

  • Rapid diagnosis of primary influenza pneumonia.

    abstract::Primary influenza pneumonia is a disease of high mortality. Differentiation between a bacterial and viral etiology for the pulmonary infiltrates frequently presents a diagnostic dilemma. Rapid diagnosis is essential; and once established, the patient requires careful supportive therapy. This report describes two patie...


    pub_type: 杂志文章


    authors: Bogart DB,Liu C,Ruth WE,Kerby GR,Williams CH

    更新日期:1975-10-01 00:00:00