Comparison of Trimethoprim-Sulfamethoxazole with Ampicillin in Acute Infectious Exacerbations of Chronic Bronchitis: A Double-Blind Crossover Study

Two separate acute bacterial exacerbations of chronic bronchitis or chronic asthmatic bronchitis were treated in 20 patients in a double-blind crossover study. One course of treatment consisted of 320 mg of trimethoprim (TMP) plus 1,600 mg of sulfamethoxazole (SMZ) daily and the other of 2 g of ampicillin daily; each drug was given for 14 days. Patients were observed initially, twice a week during therapy, and weekly after therapy. Observations that were recorded included graded chest symptoms and physical findings, vital signs, pulmonary function, hematologic parameters, and objective sputum measurements (daily volume, purulence, differential quantitative cytology, quantitative bacterial counts, physical properties, levels of lactate dehydrogenase with its isoenzymes, levels of myeloperoxidase, and presence of deoxyribonucleic acid fibers). Both antibiotic regimens were effective in resolving these acute bacterial exacerbations. Paired z-test analysis revealed few and minor differences between TMP-SMZ and ampicillin during therapy, although three patients did not complete TMP-SMZ therapy because of adverse reactions. However, the period between the two bacterial exacerbations was significantly longer after ampicillin therapy. Innovative in this investigation are the study design and the objective quantitative measurements of inflammatory response and bacterial populations in sputu

Use of Transition Probabilities to Estimate the Effect of Smoking on the Duration of Episodes of Respiratory Symptoms in Diary Data: The Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA)

Incompletely documented symptom episodes pose methodological problems in the analysis of diary data. The aim of this study was to develop a method of estimating the average durations of symptomatic and nonsymptomatic episodes, respectively, coping with the problem of bias due to undocumented days and censored episodes that is found in most diary studies. The authors derived their outcome variables from a Markov model using transition probabilities. To evaluate this method, the authors assessed the impact of active smoking on the duration of episodes of bronchitis symptoms and the corresponding nonsymptomatic periods, respectively, using diary data (1992-1993) obtained from 801 participants in the Swiss Study on Air Pollution and Lung Diseases in Adults. Covariate-adjusted distribution curves for the mean durations of individual episodes were estimated by Cox regression. Median values for light smokers (<10 cigarettes/day) were 60.0 sympton-free days (95% confidence interval (CI) 42.0-78.5) and 4.0 symptomatic days (95% CI 3.0-6.0), respectively, compared with medians of only 21.0 days 95% CI 16.2-29.8) for periods without bronchitis symptoms and 6.0 days (95% CI 4.9-9.0) for episodes of bronchitis symptoms in heavy smokers(≥30 cigarettes/day). The authors suggest that the Markov method is a feasible approach to the assessment of long term effects of smoking and environmental risk factors on the average duration of symptomatic and nonsymptomatic respiratory episodes. Am J Epidemiol 1998;148:600-

Límits i intimitat: reflexions sobre una experiència de treball en grup i de grup per al manteniment de la ment de l’analista

Els autors presenten la seva experiència grupal en un taller realitzat amb el mètode del psicodrama analític. Ells mateixo ssón els participants i protagonistes d’unes trobades periòdiques que els ofereixen la possibilitat de crear un espai i un temps on compartir emocions, experimentar el naixement d’un self grupal i on s’activen processos transformatius. Jugar amb els personatges que es representen esdevé una experiència terapèutica. Ens expliquen la tècnica del seu treball i ens en mostren unes vinyetes clíniques. D’acord amb els autors, aquesta experiència permet exercir el “manteniment de l afunció analítica de la ment de l’analista”, l’instrument principal de la nostra feina. A més, ha representat un factord’apropament íntim personal i professional molt poderós entre els participants

SAPALDIA: Methods and participation in the cross-sectional part of the Swiss Study on Air Pollution and Lung Diseases in Adults

Summary: SAPALDIA-the Swiss Study on Air Pollution and Lung Diseases in Adults-focuses on the long term health effects of low to moderate levels of air pollutants as typically seen in different parts of Switzerland. The aim of the SAPALDIA cross-sectional study carried out in 1991 was to determine the prevalence of bronchial asthma, chronic bronchitis and allergic conditions in the adult population of Switzerland and to identify and to determine the respective importance of potentially influencing factors. These could be both personal (smoking habits, allergy status, family history, occupation) and environmental (outdoor and indoor pollution, aeroallergens, climate). A further aim of the cross-sectional study consisted in the identification of individuals susceptible to present symptoms during a two year observation period and to be included in the SAPALDIA follow-up study. This technical report represents the methodological documentation for the cross-sectional study of SAPALDIA. The instruments and the methods of standardisation are presented and discussed. The medical examination consisted of a computerised interview using a standardised questionnaire, the taking of a blood sample for serological tests, allergy skin testing, the measurement of endexpiratory CO and body height, and pulmonary function testing followed by methacholine challenge testing or bronchodilatation testing. The pattern of participation and the 9651 participants of the study, representing 59.3% of the sample, are described. Based on information on non-participants gained by telephone interviews and mailed short questionnaires, possible selection biases are quantified and discusse

Lìmits i intimitat: reflexions sobre una experiència de treball en grup i de grup al manteniment de la ment de l'analista

Esl autors presenten la seva experiència grupal en un taller reatitzat amb el mètode del psicodrama analìtic. Ells amteixos sòn els participants i protagonistes d'unes trobades periòdiques que els ofereixen la possibilitat de crear un espai i un temps on compartir emocions, experimentar el naixement d'un self grupal i on s'activen processos transformatius. Jugar amb els personatges que es representen esdevé una experiència terapèutica. Ens expliquen la tècnica del seu treball i ens en mostren unes vinyetes clìniques. D'acord amb esl autors, acquesta experiència permet exercir el "manteniment de la funciò analitica de la ment de l'analista", l'instrument rpincipal de la nostra feina. A més, ha reparesentat un factor d'apropament ìntim personal i professional molt poderòs entre els participants

Il dolore "del" e "nell'"analista: riflessioni di un gruppo per la "manutenzione" della capacità di sentire e trasformare

Il lavoro porta una serie di riflessioni sul dolore così come emerge e viene trasformato in un lavoro di gruppo, negli incontri che si tengono da tre anni, nel gruppo di studio sulla "manutenzione della capacità intuitiva dell'analista al lavoro". Tali riflessioni partono dall'esperienza concreta che è fatta e che è osservata e analizzata dai partecipanti stessi, tutti analisti della SPI

Psicoanalisi in/di gruppo, processo inconscio e l'arte della manutenzione... dell'analista

In questo lavoro gli autori presentano l’originale esperienza di un gruppo di psicoanalisti della Società Psicoanalitica Italiana che si ritrovano regolarmente da quasi quattro anni una volta al mese per fare una seduta di psicodramma analitico dove portare le proprie emozioni e la propria storia per poi analizzare assieme le dinamiche gruppali e istituzionali che emergono. Durante questi anni di lavoro si è evidenziato come spesso si crea un qualcosa di originale che appartiene al gruppo e che è stato dai membri identificato come un possibile Oggetto Interno Gruppale