bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pseudomonas Cepacia: The Sensitivity of Nosocomial Strains to New Antibiotics
Authors: Ferreira M O Santos , Canica M Manuela , Bacelar M Jesus 
Published: January 2017

Pseudomonas cepacia, considered a phytopathogenic organism for many years, has been shown recently to be widely distributed geographically. The hospital environment has become an important source of this organism but the resistance of Ps. cepacia to most antibiotics has made the treatment of infections a problem. One hundred per cent of the strains tested have proved to be sensitive to the sulphonamides and to novobiocin, 93·0% to the combination of trimethoprim and sulfamethoxazole (co-trimoxazole); 85·2% to minocycline; 77·8% to chloramphenicol and dibekacin and 44·4% to nalidixic acid. One hundred per cent of the strains exhibit resistance to ampicillin, cephalothin, cefamandole, cefoxitin, Colistin, cefuroxime, tetracycline and cefazolin; 88·9% to amikacin, tobramycin and sisomycin; 85·2% to carbenicillin. The new beta-lactams, apalcillin, ceftazidime, N-formimidoyl-thienamycin, piperacillin, cefotaxime and azlocillin proved to be the most potent of the molecules tested, inhibiting 90% of the strains, at concentrations of 4, 8, 8, 8, 32 and 16 mg/l and 100% of the strains at 8, 16, 16, 32, 32 and 64 mg/l, respectively. In contrast to the usual sensitivity patterns of Pseudomonas spp, Ps. cepacia has been shown to be resistant to Colistin, cefsulodin and the aminoglycosides. However, unlike Ps. aeruginosa, Ps. cepacia has been shown, by the dilution method, to be sensitive to co-trimoxazole, 92·3% of the strains being inhibited by 16 mg/l.
Tolerance of Carprofen in Patients with Asthma Caused by Non-Steroidal Anti-Inflammatory Drugs
Authors: Bianco S , Robuschi M , Simone P , Vaghi A , Pasargiklian M 
Published: January 2017

Eight asthmatics with respiratory intolerance to NSAIDs and two subjects (one asthmatic, one healthy) only sensitive (asthma) to pyrazolone drugs were challenged under single-blind conditions with a new NSAID, carprofen. No adverse effects were observed in patients sensitive to pyrazolones. Among the other patients, only three developed considerable bronchial obstruction which was rapidly reversed by inhalation of a β2-stimulant (fenoterol: 2 puffs). Two subjects developed nasal obstruction with rhinorrhoea: in conjunction with bronchoconstriction in one patient and alone in the other. In conclusion, acute administration of carprofen in patients with respiratory intolerance to NSAIDs, in contrast to most other NSAIDs, never creates a situation of real danger even though in some patients it may considerably increase nasal and bronchial resistance.
Differential Dosing of Trazodone in Elderly Depressed Patients: A Study to Investigate Optimal Dosing
Authors: Mukherjee P K , Davey A 
Published: January 2017

We investigated the comparative efficacy and tolerance of two initial starting doses of trazodone in 20 elderly inpatients suffering from depressive illness. The first 2-week phase was double-blind. Patients received either 25 mg trazodone tds or 50 mg tds. After this time the study was open, the dose of trazodone being titrated from the initial starting dose to maximise efficacy and tolerance. Patients received study medication for a total of 6 weeks. Assessments for efficacy included the Hamilton Depression rating scale, Zung anxiety scale, visual analogue scales for depression, euphoria and tension, and global assesments of severity and improvement of condition. Tolerance was assessed by means of a checklist of symptoms and adverse effects. Assessments were performed at base line and at weekly or bi-weekly intervals thereafter. A total of 18 patients were included in the analysis. The Zung and visual analogue scales indicated significant superiority for the high-dose group at Week 2. The Hamilton ratings indicated significant superiority for the high-dose group at Week 6 with a strong trend in favour of the high dose group at Week 2. Measures of severity of illness and improvement indicated more rapid improvement over time in the high-dose group. The treatment was generally well tolerated and at no time did adverse events outweigh therapeutic benefit. The incidence of headache and nausea was more frequent in the high-dose group in the first 2 weeks. The group of elderly patients studied benefited from trazodone therapy initiated at a higher therapeutic dose. This dose (150 mg total daily) was well tolerated and proved effective over the course of 6 weeks' treatment.
Experimental Infection of Goats, Sheep and Calves with the Large Colony Type of Mycoplasma mycoides subsp. mycoides
Authors: Rosendal S. 
Published: January 2017

Goats, sheep and calves were inoculated intravenously with strain Y3343 of the large colony type of Mycoplasma mycoides subsp. mycoides isolated from a goat with polyarthritis. The goats and sheep died of septicemia (one was killed in extremis) within eight days. The goats had leukopenia and granulocytopenia. Coagulopathy was indicated in some goats: the fibrinogen titer, prothrombin and partial thromboplastin times increased with the progress of disease and the number of platelets decreased dramatically in one goat. Goats and sheep had cellulitis at the site of inoculation, pleural hemorrhages, pneumonia, myocarditis, renal infarcts, glomerulitis, adrenal cortical necrosis, enteritis, focal splenic necrosis, polyarthritis and lymphadenitis. Vasculitis and thrombi were seen occasionally, suggesting that vascular changes, perhaps together with coagulopathy, had a role in pathogenesis. One of two experimental calves developed a slight fever, arthritis and minor inflammation of adrenal tissue. Calves seem less susceptible to the mycoplasma organism given intravenously than do goats or sheep.
Osteochondrosis in Feedlot Cattle
Authors: Jensen R. , Park R. D. , Lauerman L. H. , Braddy P. M. , Horton D. P. , Flack D. E. , Cox M. F. , Einertson N. , Miller G. K. , Rehfeld C. E. 
Published: January 2017

Beginning in summer 1977 and continuing through four consecutive seasons, we examined lame limb joints from 106 partially fattened cattle and 28,235 pairs of occipital condyles from fully fattened cattle for osteochondrosis. Of the 106 lame cattle, nine (8.5%) had characteristic lesions, usually in their stifle joints, and of the 28,235 atlanto-occipital joints, 1063 (3.8%) had lesions on their condyles. Slices of affected articular cartilage and subjacent bone were studied radiographically and histologically. Radiographs showed subchondral defects and epiphyseal “cyst-like” lesions, and histologic sections showed disarrayed and degenerated chondrocytes. Splits occurred along osteochondral junctions or in adjacent cartilage or bone. Some bone trabeculae had been replaced by fibrous tissue that, in some areas, extended deep into epiphyses.
Hyperplastic and Neoplastic Changes in Ultimobranchial Remnants and in Parafollicular (C) Cells in Bulls: A Histologic and Immunohistochemical Study
Authors: Ljungberg O. , Nilsson P.-O. 
Published: January 2017

Thyroid glands from 64 bulls with hyperplastic and/or neoplastic changes in ultimobranchial remnants and in the parafollicular (C) cell system were studied structurally and with immunohistochemical methods. Antibodies against thyroglobulin, calcitonin, somatostatin, and neurotensin were used to detect these substances. Two different types of changes were observed. One change was hyperplasia and neoplasia of the ultimobranchial remnants that affected all their epithelial constituents. These included ultimobranchial follicles, cysts and tubules, as well as solid nests formed by basophilic immature cells which were functionally undifferentiated and unreactive with all the antisera used. Differentiated follicular cells that formed thyroid follicles and cribriform structures with immunohistochemical evidence of thyroglobulin production were also found. In addition, differentiated light and cytoplasm-rich cells were scattered in the walls of the thyroid follicles, ultimobranchial follicles, cysts and tubules as well as in the solid component. They were argyrophilic and reacted with antibodies against calcitonin and somatostatin. The other change was a diffuse or multifocal hyperplasia of the parafollicular (C) cells that was present in other parts of the thyroid parenchyma—sometimes with gradual development of sclerotic tumors that had been exclusively formed by these cells. They corresponded to light cytoplasm-rich cells seen in the ultimobranchial lesions that were argyrophilic and harbored material reactive with antibodies against calcitonin and/or somatostatin. The changes observed in the parafollicular cell system resembled lesions seen in human thyroid glands with the familial variant of medullary carcinoma as well as those reported in thyroid glands of patients with longstanding hypercalcemia. Bull ultimobranchial tumors closely resembled a recently defined, intermediate type of human differentiated thyroidal carcinoma that has traits of both medullary and follicular carcinoma.
Dysentery Caused by Escherichia coli (S102-9) in Calves: Natural and Experimental Disease
Authors: Hall G. A. , Reynolds D. J. , Chanter N. , Morgan J. H. , Parsons K. R. , Debney T. G. , Bland A. P. , Bridger J. C. 
Published: January 2017

A dysentery syndrome was recognized among the Institute's calves at 18 to 21 days of age. It was reproduced experimentally in gnotobiotic calves with an atypical Escherichia coli (S102-9) isolated from the affected calves. In both natural and experimental disease the calves passed copious bright red blood in the feces and developed diarrhea. Walls of the colon and rectum were thickened, and the mucosa was reddened and covered by an exudate that contained mucus and blood clots. Bacteria were seen closely adherent to the luminal surfaces of enterocytes, often in cup-shaped depressions or on cytoplasmic pedestals. Microvilli were distorted, disorientated or absent. There was exfoliation of infected enterocytes and a mild acute inflammation of the underlying lamina. In two of five calves with natural disease, the adherent bacteria did not stain by the immunoperoxidase method with antisera raised against E. coli (S102-9). This indicated that there was possibly more than one bacterial cause of the syndrome. Lesions in experimentally infected calves were indistinguishable from those produced by some E. coli which are enteropathogenic for man, rabbits, and pigs.
Surgical Creation of a Chin Dimple
Authors: Moses Jeffrey J. , Lee Jeffrey , Arredondo Antonio 
Published: January 2017

Introduction: The purpose of this case report is to present the methods used to surgically create a chin dimple in a 23-year-old man and to document the results of the surgical technique. Materials and Methods: The method used begins in a manner similar to a routine incision and dissection down the symphysis for a genioplasty. Then bur holes are created in the anterior portion of the symphysis at desired level for the chin dimple. The midline is dissected between the 2 mentalis muscles with a scissors to the subcutaneous tissue, and a defect is created by removing a tissue amount approximately 2 times the anticipated width of the desired dimple using sharp instrumentation or an electrocautery cutting unit. The dermis at the desired level for the chin dimple is sutured to the bony symphysis near the previously made bur holes. Results: The aesthetic results are stable and pleasing. Conclusions: Creation of the surgical chin dimple must take into account all the paired muscle origins and insertions that compose the anatomy of the lower perioral and neck tissue in the midline region at the desired level of the dimple. Anchoring this to the symphyseal prominence creates a resistance to the workings of the muscles and thus creates a more aesthetic and natural chin dimple during facial function.
Transumbilical Breast Augmentation with Adjustable Saline Breast Implants: A Novel Approach to Breast Asymmetry
Authors: Rosen Brent R. , Haiavy Jacob 
Published: January 2017

Objective: To investigate the novel use of adjustable saline breast implants via the transumbilical approach for breast asymmetry. Methods: A retrospective review of medical records of 8 patients who underwent breast augmentation via the transumbilical approach utilizing the adjustable saline implant. Variables reviewed included age of patients, reason for procedure selection, mean number of postimplantation volume changes, range of volume change, and follow-up time. Results: The patients' mean age was 26.3 years. The most common reason for selection of adjustable saline implants was breast and chest wall asymmetry. The mean number of postimplant volume adjustments was 1.33, with a mean addition of 32.5 mL (range of −20 mL to −150 mL). Mean follow-up time was 8 months. Conclusion: Transumbilical placement of adjustable saline breast implants is a reliable technique for use in cases of asymmetry, avoiding scars on the breast and maintaining a remote insertion site.
Permeation of Proteins through a Biodegradable Hydrogel
Authors: Škarda Vaclav , Rypáček František 
Published: January 2017

The permeation of proteins of different molecular weights into a biodegradable hydrogel, a model system for controlled release of biologically active macromolecules, was investigated. The hydrogels were prepared by a crosslinking copolymerization from a biodegradable synthetic polypeptide, poly[N5-(2-hydroxyethyl)-L-glutamine] (PHEG) with methacryloylated side chains and acrylamide. The permeation of sodium azide, trypsin-kallikrein inhibitor (TKI), trypsin, and albumin into the gels with network densities between 0.04 and 0.226 mmol/mL were determined. The permeation of sodium azide was not influenced by the gel network density. The permeability of T[and trypsin was controlled by gels with permeability coefficients ranging from 2.8 x 10−9 to 4.0 x 10−10 mmol/mL. Gels with different network densities controlled the diffusion of peptides and proteins with molecular weights between 6,000 and 60,000. The combined effect of diffusion and biodegradation of the gel on the permeation rate of macromolecules was determined for poly-α,β-[N-(2-hydroxyethyl)-DL-aspartamide]. A decrease in the gel cross-linking density due to the degradation efficiently increased the permeability to the model macromolecule.
Metastatic Pulmonary Angiosarcoma Presenting With Bilateral Secondary Spontaneous Pneumothoraces
Authors: Jimenez Daniel , Antaki James , Kamangar Nader 
Published: January 2017

Background: Spontaneous pneumothorax (SP) is uncommon and can present as a primary disease process or as a result of underlying lung pathology. Several parenchymal lung diseases, such as malignancy, are known to cause SP. One such malignancy, angiosarcoma, has a high propensity to metastasize to the lung and present as cavitary and cystic lesions. Case: We present a case of a 76-year-old male diagnosed with angiosarcoma of the scalp that was found to have extensive cystic pulmonary metastatic lesions. Soon after his initial diagnosis, he presented with severe respiratory distress secondary to a spontaneous left-sided pneumothorax. After intubation and left-sided chest tube placement, the patient developed a right-sided tension pneumothorax requiring emergent chest tube placement. Conclusion: Cutaneous angiosarcoma is a rare malignancy that frequently metastasizes the lung. Spontaneous pneumothorax can be the presenting manifestation of the disease and often results in respiratory failure.
Effects of Reinstitution of Prolonged Mechanical Ventilation on the Outcomes of 370 Patients in a Long-Term Acute Care Hospital
Authors: Sansone Giorgio R. , Frengley J. Dermot , Horland Allan , Vecchione John J. , Kaner Robert J. 
Published: January 2017

Objective: To investigate the effects of the reinstitution of continuous mechanical ventilator support of >21 days in 370 prolonged mechanical ventilation (PMV) patients, all free from ventilator support for ≥5 days. Methods: Four groups were formed based on the time and number of PMV reinstitutions and compared (group A: reinstitutions within 28 days, n = 51; group B: a single reinstitution after 28 days, n = 53; group C: multiple reinstitutions after 28 days, n = 52; and group D: no known reinstitutions, n = 214). Results: Of the 370 patients, 156 (42%) required PMV reinstitutions. Most reinstitutions occurred within 7 months: 51 (33%) of the 156 patients within 28 days and 49 (31%) within the next 6 months. Group comparisons revealed a progression of outcomes from group A, the worst, to group D, the best, with groups B and C having intermediate but significantly different values. Decannulation was associated with an 88% decreased risk of PMV reinstitution and a 43% lower risk of death (all P < .001). Conclusion: Prolonged mechanical ventilation reinstitution rates were high, with most occurring within 7 months of freedom from MV. In general, the longer the period of ventilator freedom, the less the likelihood of a PMV reinstitution. The identification of 4 distinct PMV groups of patients by time and number of reinstitutions added useful prognostic information. Since PMV reinstitutions within 28 days lead to permanent MV support, >28 days of ventilator freedom provided an optimal cut point for assessing the likelihood of again requiring PMV.
N-Terminal Pro-Brain Natriuretic Peptide Concentrations After Hypertensive Intracerebral Hemorrhage: Relationship With Hematoma Size, Hyponatremia, and Intracranial Pressure
Authors: Li Fei , Chen Qian-Xue , Xiang Shou-Gui , Yuan Shi-Zhun , Xu Xi-Zhen 
Published: January 2017

Introduction: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertensive intracerebral hemorrhage (HICH) is poorly understood. This study aimed to investigate the secretion pattern of NT-proBNP in patients with HICH and to assess its relationship with hematoma size, hyponatremia, and intracranial pressure (ICP). Methods: This prospective study enrolled 147 isolated patients with HICH. Blood samples were obtained from each patient, and values of serum NT-proBNP, hematoma size, blood sodium, and ICP were collected for each patient. Results: The peak-to-mean concentration of NT-proBNP was 666.8 ± 355.1 pg/mL observed on day 4. The NT-proBNP levels in patients with hematoma volume >30 mL were significantly higher than those in patients with hematoma volume <30 mL ( P < .05). In patients with severe HICH, the mean concentration of NT-proBNP was statistically higher than that in patients with mild–moderate HICH ( P < .05), and the mean level of NT-proBNP in hyponatremia group was significantly higher than that in normonatremic group ( P < .05). In addition, the linear regression analysis indicated that serum NT-proBNP concentrations were positively correlated with ICP ( r = .703, P < .05) but negatively with blood sodium levels only in patients with severe HICH ( r = −.704, P < .05). The serum NT-proBNP levels on day 4 after admission were positively correlated with hematoma size ( r = .702, P < .05). Conclusion: The NT-proBNP concentrations were elevated progressively and markedly at least in the first 4 days after HICH and reached a peak level on the fourth day. The NT-proBNP levels on day 4 were positively correlated with hematoma size. There was a notable positive correlation between plasma NT-proBNP levels and ICP in patients with severe HICH. Furthermore, only in patients with severe HICH, the plasma NT-proBNP levels presented a significant correlation with hyponatremia, which did not occur in patients with mild–moderate HICH.
Predictive Value of Serum Albumin Level for the Prognosis of Severe Sepsis Without Exogenous Human Albumin Administration: A Prospective Cohort Study
Authors: Yin Mei , Si Lei , Qin Weidong , Li Chen , Zhang Jianning , Yang Hongna , Han Hui , Zhang Fan , Ding Shifang , Zhou Min , Wu Dawei , Chen Xiaomei , Wang Hao 
Published: January 2017

Background: The prognostic significance of serum albumin levels in patients with sepsis has previously been reported; however, these studies have not excluded the potential confounding effect of exogenous albumin administration. In this study, we investigate the predictive value of serum albumin for the prognosis of severe sepsis without the interference of exogenous albumin administration. Methods: A prospective cohort study was conducted from April to November 2014 in the internal and surgical intensive care units of a tertiary care hospital. During the study period, due to a supply shortage, patients were not treated with human albumin. Serum albumin levels were measured, and laboratory and clinical data were collected at the onset of severe sepsis. Prognostic factors were analyzed using receiver operating characteristic curve and multivariate Cox proportional hazard regression analysis. Survival was assessed by Kaplan-Meier method. Results: One hundred sixteen patients were included in the study. The overall 28-day mortality was 26.7%. The most common infection sources were lower respiratory tract, abdomen/pelvis, and bloodstream. Compared to patients who survived, those who died had lower serum albumin levels and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores. Receiver operating characteristic curves demonstrate that albumin level is a strong predictor of 28-day mortality, and the optimal cutoff value maximizing sensitivity and specificity is 29.2 g/L. Through multivariate Cox regression analysis, low serum albumin levels (<29.2 g/L) and APACHE II scores are identified as independent risk factors for mortality. Patients with lower serum albumin levels more often had abdominal/pelvic sources of infection, acute kidney or liver injury, septic shock, and higher APACHE II and SOFA scores. The 28-day survival rate was lower for patients with serum albumin below 29.2 g/L than for patients with serum albumin at or above this level. Conclusion: Having excluded potential confounding effect of exogenous albumin administration, low serum albumin levels are associated with an increased risk of death in patients with severe sepsis.
Effect of Etomidate on Pneumonia Development in Critically Ill, Nontrauma Patients
Authors: Hammond Drayton A. , Vines Claire E. , McPhee Ashley L. , Bhandari Naleen Raj , Jones Kendrea M. , Meena Nikhil , Painter Jacob T. 
Published: January 2017

Purpose: To determine whether etomidate use before intubation increased development of hospital-acquired pneumonia (HAP) in critically ill, nontrauma patients. Materials and Methods: A single-center, retrospective, cohort study of critically ill, nontrauma patients admitted to the medical intensive care unit (ICU) from 2012 to 2015 and intubated with or without etomidate was conducted. Demographics, comorbidities, primary diagnosis, critical illness scores, concomitant medications, and outcomes were obtained from medical records. Student t, chi-square, and Fisher exact tests were performed as appropriate. Relevant characteristics were modeled using logistic regression techniques to determine whether any predicted HAP independently. Results: Of the 174 patients, 94 (54%) received etomidate and 80 (46%) did not. There was no difference in HAP between etomidate and no etomidate groups (13.8% vs 23.7%, P = .092). Duration of mechanical ventilation (4.4 vs 4.6 days, P = .845), ICU length of stay (7.4 vs 6.9 days, P = .547), ICU mortality (14.9% vs 12.5%, P = .648), and hospital mortality (17% vs 16.2%, P = .892) were similar between the groups. For each 1-day increase in mechanical ventilation duration, the likelihood of HAP development increased by 21%. Patients who received etomidate but no neuromuscular-blocking drug were 80% less likely to develop HAP than those who did not receive etomidate or a neuromuscular-blocking drug (odds ratio: 0.202, 95% confidence interval: 0.045-0.908). Conclusion: Etomidate use was not associated with a difference in HAP development in critically ill, nontrauma patients.