bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONCEPTS OF SEROMA FORMATION AND PREVENTION IN BREAST CANCER SURGERY
Authors: Agrawal Amit , Ayantunde Abraham Abiodun , Cheung Kwok Leung 
Published: December 2006

Background:  Seroma formation is the commonest early sequel to breast cancer surgery especially when axillary dissection is undertaken. It is associated with significant morbidity and financial burden. The main pathophysiology of seroma is still poorly understood and remains controversial. The optimal ways to reduce the incidence of seroma formation are unknown. The aim of this paper is to review the concepts of pathophysiology of seroma formation following mastectomy and breast‐conserving surgery for cancer. The various techniques in practice to reduce its incidence and treatment are outlined.Method:  MEDLINE search of published work on the subject with respect to its pathophysiology, prevention and treatment was carried out. Manual retrieval of relevant articles in the reference lists of the original papers from the MEDLINE was then carried out.Result:  The pathophysiology and mechanism of seroma formation in breast cancer surgery remains controversial and not fully understood. Methods of prevention and treatment of seroma remain varied and inconclusive.Conclusion:  Evidence suggests an increase in the incidence of seroma because of thermal trauma from electrocautery dissection, but this is indispensable for surgical haemostasis. Obliteration of dead space by various flap apposition techniques has been shown to be advantageous in reducing incidence and volume of seroma. Low‐pressure suction drainage reduces seroma volume and duration of drainage leading to earlier drain removal. Preventive measures have to be tailored according to individual patient and operative factors.
In vivo pharmacodynamic interactions between two drugs used in orthostatic hypotension – midodrine and dihydroergotamine
Authors: Jourdan Géraldine , Verwaerde Patrick , Pathak Atul , Tran Marie‐Antoinette , Montastruc Jean‐Louis , Senard Jean‐Michel 
Published: December 2006

AbstractA combination of midodrine and dihydroergotamine (DHE) is frequently used clinically in patients suffering from severe orthostatic hypotension (OH). Whereas midodrine acts as a selective, peripheral alpha1‐receptor agonist, DHE displays complex pharmacology and can behave as an alpha‐adrenergic receptor agonist or antagonist. Surprisingly, the consequences of such a combination on blood pressure have never been investigated. The present study was performed in order to evaluate the pressor effects induced by the administration of both midodrine and DHE in old conscious dogs (n = 6) in experimental condition reproducing autonomic failure‐related baroreflex dysfunction (atropine 0.1 mg/kg). For this purpose, we first studied the relative potency and intrinsic activity of each agonist and noradrenaline (NA) for the alpha1‐adrenergic receptor. The orders of potency obtained in our study were 0.35, 11 and 400 μg/kg for NA, DHE and midodrine, and intrinsic activity: NA > midodrine > DHE. These results strongly suggest that DHE really acts in vivo as an alpha1‐adrenoceptor partial agonist. Afterwards, the pressor effects of coadministration of midodrine (0.4 mg/kg) and DHE (15 μg/kg) were investigated: in one setting, midodrine was first administered, followed by DHE; in another, DHE was first administered, followed by midodrine. Our results show that in conscious dogs, the combination of midodrine and DHE leads to near‐complete abolition of the pressor effect induced by the first administered drug. This in vivo proof of such antagonistic effects on blood pressure could explain clinical observations of worsening of OH in humans administered midodrine plus DHE. Although in vivo results obtained in conscious healthy dogs need to be experimentally and clinically confirmed in humans suffering from OH, these results strongly suggest that a midodrine–DHE combined treatment should be avoided in clinical practice.
CO2 elimination at varying inspiratory pause in acute lung injury
Authors: Aboab J. , Niklason L. , Uttman L. , Kouatchet A. , Brochard L. , Jonson B. 
Published: December 2006

SummaryPrevious studies have indicated that, during mechanical ventilation, an inspiratory pause enhances gas exchange. This has been attributed to prolonged time during which fresh gas of the tidal volume is present in the respiratory zone and is available for distribution in the lung periphery. The mean distribution time of inspired gas (MDT) is the mean time during which fractions of fresh gas are present in the respiratory zone. All ventilators allow setting of pause time, TP, which is a determinant of MDT. The objective of the present study was to test in patients the hypothesis that the volume of CO2 eliminated per breath, VTCO2, is correlated to the logarithm of MDT as previously found in animal models. Eleven patients with acute lung injury were studied. When TP increased from 0% to 30%, MDT increased fourfold. A change of TP from 10% to 0% reduced VTCO2 by 14%, while a change to 30% increased VTCO2 by 19%. The relationship between VTCO2 and MDT was in accordance with the logarithmic hypothesis. The change in VTCO2 reflected to equal extent changes in airway dead space and alveolar PCO2 read from the alveolar plateau of the single breath test for CO2. By varying TP, effects are observed on VTCO2, airway dead space and alveolar PCO2. These effects depend on perfusion, gas distribution and diffusion in the lung periphery, which need to be further elucidated.
Reliability and validity of the lung volume measurement made by the BOD POD body composition system
Authors: Davis James A. , Dorado Silvia , Keays Kathleen A. , Reigel Kimberly A. , Valencia Kristoffer S. , Pham Patrick H. 
Published: December 2006

SummaryThe BOD POD Body Composition System uses air‐displacement plethysmography to measure body volume. To correct the body volume measurement for the subject's lung volume, the BOD POD utilizes pulmonary plethysmography to measure functional residual capacity (FRC) at mid‐exhalation as that is the subject's lung volume during the body volume measurement. Normally, FRC is measured at end‐exhalation. The BOD POD FRC measurement can be corrected to an end‐exhalation volume by subtracting approximately one‐half of the measured tidal volume. Our purpose was to determine the reliability and validity of the BOD POD FRC measurement at end‐exhalation. Ninety‐two healthy adults (half female) underwent duplicate FRC measurements by the BOD POD and one FRC measurement by a traditional gas dilution technique. The latter method was used as the reference method for the validity component of the study. The order of the FRC measurements by the two methods was randomized. The test–retest correlation coefficients for the duplicate BOD POD FRC measurements for the male and female subjects were 0·966 and 0·948, respectively. The mean differences between the BOD POD FRC trial #1 measurement and gas dilution FRC measurement for the male and female subjects were −32 and −23 ml, respectively. Neither difference was statistically significant. The correlation coefficients for these two measurements in the male and female subjects were 0·925 and 0·917, respectively. Based on these results, we conclude that the BOD POD FRC measurement in healthy males and females is both reliable and valid.
Disturbed glucose metabolism is associated with left ventricular dysfunction using tissue Doppler imaging in patients with myocardial infarction
Authors: Henareh Loghman , Lind Britta , Brodin Lars‐Åke , Agewall Stefan 
Published: December 2006

SummaryAims:  To investigate the association between glucose abnormalities and left ventricular (LV) function assessed by tissue Doppler imaging (TDI) in patients with previous history of myocardial infarction and without known diabetes mellitus.Patients and methods:  In a cross‐sectional study, 123 patients, aged 31–80 years, with a history of previous myocardial infarction and without known diabetes mellitus were examined with TDI echocardiography. A standard oral glucose test (OGTT) with 75 g of glucose was performed.Results:  Two‐hour plasma glucose were significantly and negatively associated with TDI parameters such as LV ejection time; early diastolic filling velocity (E′‐v); ratio of the early to late diastolic filling velocity (E′/A′) and positively associated with regional myocardial performance index (MPI) (P<0·05). Left ventricular ejection time and MPI were significantly higher; E′/A′ and E′‐v were significantly lower in patients with disturbed glucose metabolism compared with patients with normal glucose tolerance (P<0·01). These differences remain significant also when the patients with DM were excluded.Conclusions:  The present study demonstrates that disturbed glucose metabolism is associated with more pronounced LV dysfunction using TDI in patients with myocardial infarction. These abnormalities in LV function were more common not only in subjects with diabetes, but also in patients with prediabetic condition, impaired glucose intolerance.
Amoxicillin Is Effective against Penicillin-ResistantStreptococcus pneumoniaeStrains in a Mouse Pneumonia Model Simulating Human Pharmacokinetics
Authors: Abgueguen Pierre , Azoulay-Dupuis Esther , Noel Violaine , Moine Pierre , Rieux Veronique , Fantin Bruno , Bedos Jean-Pierre 
Published: December 2006

ABSTRACTHigh-dose oral amoxicillin (3 g/day) is the recommended empirical outpatient treatment of community-acquired pneumonia (CAP) in many European guidelines. To investigate the clinical efficacy of this treatment in CAP caused byStreptococcus pneumoniaestrains with MICs of amoxicillin ≥2 μg/ml, we used a lethal bacteremic pneumonia model in leukopenic female Swiss mice with induced renal failure to replicate amoxicillin kinetics in humans given 1 g/8 h orally. Amoxicillin (15 mg/kg of body weight/8 h subcutaneously) was given for 3 days. We used fourS. pneumoniaestrains with differing amoxicillin susceptibility and tolerance profiles. Rapid bacterial killing occurred with an amoxicillin-susceptible nontolerant strain: after 4 h, blood cultures were negative and lung homogenate counts under the 2 log10CFU/ml detection threshold (6.5 log10CFU/ml in controls,P< 0.01). With an amoxicillin-intermediate nontolerant strain, significant pulmonary bacterial clearance was observed after 24 h (4.3 versus 7.9 log10CFU/ml,P< 0.01), and counts were undetectable 12 h after treatment completion. With an amoxicillin-intermediate tolerant strain, 24-h bacterial clearance was similar (5.4 versus 8.3 log10CFU/ml,P< 0.05), but 12 h after treatment completion, lung homogenates contained 3.3 log10CFU/ml. Similar results were obtained with an amoxicillin-resistant and -tolerant strain. Day 10 survival rates were usually similar across strains. Amoxicillin with pharmacokinetics simulating 1 g/8 h orally in humans is bactericidal in mice with pneumonia due toS. pneumoniaefor which MICs were 2 to 4 μg/ml. The killing rate depends not only on resistance but also on tolerance of theS. pneumoniaestrains.
Optimal Antimicrobial Catheter Lock Solution, Using Different Combinations of Minocycline, EDTA, and 25-Percent Ethanol, Rapidly Eradicates Organisms Embedded in Biofilm
Authors: Raad Issam , Hanna Hend , Dvorak Tanya , Chaiban Gassan , Hachem Ray 
Published: December 2006

ABSTRACT

Antimicrobial lock solutions may be needed to salvage indwelling catheters in patients requiring continuous intravenous therapy. We determined the activity of minocycline, EDTA, and 25% ethanol, alone or in combination, against methicillin-resistant
Staphylococcus aureus
and
Candida parapsilosis
catheter-related bloodstream infection strains in two established models of biofilm colonization. Biofilm-colonized catheter segments from a modified Robbins device and a silicone disk biofilm colonization model were exposed to these antimicrobial agents for 15 or 60 min, respectively. After exposure, segments were sonicated and cultured. To determine regrowth after incubation at 37°C, following the brief exposure to the antimicrobial agents, an equal number of segments were washed, reincubated for 24 h, and then sonicated and cultured. The triple combination of minocycline-EDTA (M-EDTA) in 25% ethanol was the only antimicrobial lock solution that completely eradicated
S. aureus
and
C. parapsilosis
in biofilm of all segments tested in the two models, and it completely prevented regrowth. In addition, M-EDTA in 25% ethanol was significantly more effective in rapidly eradicating the growth or regrowth of methicillin-resistant
S. aureus
and
C. parapsilosis
biofilm colonization in the two models than the other solutions—minocycline, EDTA, M-EDTA, 25% ethanol, and EDTA in ethanol. We conclude that M-EDTA in 25% ethanol is highly effective at rapidly eradicating
S. aureus
and
C. parapsilosis
embedded in biofilm adhering to catheter segments.
Antibiotic Susceptibility Profile of Bifidobacteria as Affected by Oxgall, Acid, and Hydrogen Peroxide Stress
Authors: Kheadr E. , Dabour N. , Le Lay C. , Lacroix C. , Fliss I. 
Published: December 2006

ABSTRACT

The effects of acid, oxgall, and H
2
O
2
on susceptibilities to antibiotics and nisin were examined for 13 strains of bifidobacteria. Susceptibilities to ampicillin, cloxacillin, penicillin, vancomycin, kanamycin, neomycin, paramomycin, streptomycin, chloramphenicol, erythromycin, tetracycline, and nisin A were assayed by a microdilution broth method. Acid-, oxgall- and H
2
O
2
-stressed variants were produced and assayed. Exposure to a pH of 2.0 for 60 min reduced susceptibilities to cloxacillin and nisin A but increased susceptibilities to ampicillin, vancomycin, aminoglycosides, chloramphenicol, and erythromycin in a strain-dependent manner. Exposure to oxgall (0.3%) for 90 min increased susceptibilities to cell wall-directed antibiotics and aminoglycosides but increased resistances to tetracycline and nisin A. Oxidative stress increased the susceptibilities of 70% of the strains to ampicillin and chloramphenicol, of 50% of the strains to cloxacillin and tetracycline, and of 40% of the strains to erythromycin but did not affect susceptibilities to vancomycin, kanamycin, and nisin A. This study shows that exposure of bifidobacteria to stressful conditions resembling those in the gastrointestinal tract may substantially modify their susceptibilities to antibiotics and may thus affect their probiotic capacities, especially when they are used for the management of intestinal infections and antibiotic-associated diarrhea.
Effect of Carbapenem Administration on Establishment of Intestinal Colonization by Vancomycin-Resistant Enterococci and
Klebsiella pneumoniae
in Mice
Authors: Stiefel Usha , Pultz Nicole J. , Donskey Curtis J. 
Published: December 2006

ABSTRACT

In a mouse model, ertapenem inhibited the anaerobic intestinal microflora and promoted overgrowth of enterococci, whereas imipenem-cilastatin had no effect on the indigenous microflora. Ertapenem, but not imipenem-cilastatin, promoted modest overgrowth of vancomycin-resistant enterococci when exposure occurred during treatment. Neither agent promoted colonization with extended-spectrum beta-lactamase-producing
Klebsiella pneumoniae
.
The 6-Fluoro-8-Methoxy Quinolone Gatifloxacin Down-Regulates Interleukin-8 Production in Prostate Cell Line PC-3
Authors: Takeyama Koh , Mitsuzawa Hiroaki , Nishitani Chiaki , Shimizu Takeyuki , Sano Hitomi , Kunishima Yasuharu , Takahashi Satoshi , Hotta Hiroshi , Matsukawa Masanori , Shibata Ken-ichiro , Tsukamoto Taiji , Kuroki Yoshio 
Published: December 2006

ABSTRACTFluoroquinolones exhibit immunomodulatory effects on monocytes and macrophages, in addition to their bactericidal activities. It remains unknown even whether the quinolones act directly on the prostate. This study was based on the understanding of the molecular mechanisms of the actions of the fluoroquinolones that can be used for the treatment of chronic prostatitis/chronic pelvic pain syndrome. We investigated whether the 6-fluroro-8-methoxy quinolone gatifloxacin (GFLX) affected the production and secretion of interleukin-8 (IL-8) in the prostate cell line PC-3. GFLX decreased the level of IL-8 release from unstimulated PC-3 cells. GFLX also attenuated IL-8 secretion from PC-3 cells stimulated with peptidoglycan,Mycoplasma hominis, phorbol ester, and tumor necrosis factor alpha (TNF-α), indicating that GFLX exhibits an anti-inflammatory effect on the prostate cell line. However, GFLX failed to alter activation of the NF-κB and AP-1 elicited by these stimulants. GFLX significantly attenuated the expression of IL-8 mRNA in TNF-α-stimulated PC-3 cells and down-regulated the transcriptional activity of the 5′-flanking region of the IL-8 gene from −1481 to +44 bp. The deletion construct without the 5′-flanking region from −1481 to −170 bp but not the construct without the region from −1481 to −188 bp reversed the suppressive effect of GFLX on IL-8 promoter activity. These results demonstrate that GFLX suppresses IL-8 expression in the prostate cell line by decreasing the promoter activity of the IL-8 gene.
Pharmacokinetics and Disposition of CS-023 (RO4908463), a Novel Parenteral Carbapenem, in Animals
Authors: Shibayama Takahiro , Matsushita Yoko , Kawai Kenji , Hirota Takashi , Ikeda Toshihiko , Kuwahara Shogo 
Published: December 2006

ABSTRACT

The distribution, metabolism, and excretion of CS-023 (RO4908463), a new carbapenem, were investigated in rats and monkeys after a single intravenous administration of [
14
C]CS-023. In addition, the drug's pharmacokinetics were examined in rats, dogs, and monkeys. Whole-body autoradioluminograms of rats indicated that the radioactivity is distributed throughout the body immediately after administration except for the central nervous system and testes. The highest radioactivity was found in the kidneys, which are responsible for the excretion of CS-023. R-131624 with an open β-lactam ring, the pharmacologically inactive form, was detected in the plasma and urine as the major metabolite. In rat plasma, the R-131624 levels became higher than CS-023 levels at 30 min postdose and thereafter, while in monkey plasma, CS-023 accounted for most of the radioactivity, with low levels of R-131624. More than 80% of the radioactivity administered was recovered in the urine, and CS-023 and R-131624 accounted for 29.6% and 31.4%, respectively, of the dose in rats and 51.2% and 18.5%, respectively, of the dose in monkeys. The faster metabolism to R-131624 in rats than in monkeys was likely due to the metabolism by dehydropeptidase I in rat lungs. The plasma elimination half-life of CS-023 was 0.16 h in rats, 0.75 h in dogs, and 1.4 h in monkeys. There were no appreciable interspecies differences among the animals tested in either volume of distribution (172 to 259 ml/kg) or serum protein binding (5.0 to 15.6%). The total clearance in monkeys (1.62 ml/min/kg) was lower than that in rats (15.1 ml/min/kg) or dogs (4.19 ml/min/kg).
Human β-Defensins Kill
Candida albicans
in an Energy-Dependent and Salt-Sensitive Manner without Causing Membrane Disruption
Authors: Vylkova Slavena , Nayyar Namrata , Li Wansheng , Edgerton Mira 
Published: December 2006

ABSTRACT

Human β-defensin 2 (hBD-2) and hBD-3 have potent fungicidal activity in the micromolar range. Although little is known about their mechanism of action against
Candida
species, some similarities to the antifungal mechanism of salivary peptide histatin 5 (Hst 5) seem to exist. Since hBD-2 and hBD-3 have been reported to cause direct disruption of target cell membranes, we compared the effects of hBD-2 and hBD-3 on
Candida albicans
membrane integrity. Incubation of calcein-loaded
C. albicans
cells with a dose of hBD-2 lethal for 90% of the strains tested (LD
90
) resulted in a maximal dye efflux of only 10.3% ± 2.8% at 90 min, similar to that induced by Hst 5. In contrast, an LD
90
of hBD-3 more than doubled calcein release from cells yet did not result in more than 24% of total release, showing that neither peptide caused gross membrane damage. As for Hst 5, killing of
C. albicans
cells by hBD-2 and hBD-3 was salt sensitive; however, Ca
2+
and Mg
2+
inhibited hBD-2 but not hBD-3 fungicidal activity. Pretreatment of
C. albicans
cells with sodium azide resulted in significantly decreased ATP release and susceptibility of cells to hBD-2 and hBD-3. However, hBD-3 killing was partially restored at concentrations of ≥0.8 μM, showing energy-independent mechanisms at higher doses.
C. glabrata
resistance to Hst 5, hBD-2, and hBD-3 is not a result of loss of expression of cell wall Ssa proteins. The candidacidal effects of hBD-2-hBD-3 and Hst 5-hBD-2 were additive, while the index of interaction between Hst 5 and hBD-3 was 0.717 (
P
< 0.05). Thus, the candidacidal action of hBD-2 shows many similarities to that of Hst 5 in terms of salt sensitivity, ion selectivity, and energy requirements while hBD-3 exhibits biphasic concentration-dependent mechanisms of candidacidal action complementary to those of Hst 5.
Hepatitis C Virus (HCV) NS5B Nonnucleoside Inhibitors Specifically Block Single-Stranded Viral RNA Synthesis Catalyzed by HCV Replication Complexes In Vitro
Authors: Yang Wengang , Sun Yongnian , Phadke Avinash , Deshpande Milind , Huang Mingjun 
Published: December 2006

ABSTRACT
Replication complexes of hepatitis C virus synthesized two major species of viral RNA in vitro, double stranded and single stranded. NS5B nonnucleoside inhibitors inhibited dose dependently the synthesis of single-stranded RNA but not double-stranded RNA. Moreover, replication complexes carrying a mutation resistant to a nonnucleoside inhibitor lost their susceptibilities to the inhibitor.
Pharmacokinetics of Intravenous Linezolid in Cerebrospinal Fluid and Plasma in Neurointensive Care Patients with Staphylococcal Ventriculitis Associated with External Ventricular Drains
Authors: Beer Ronny , Engelhardt Klaus W. , Pfausler Bettina , Broessner Gregor , Helbok Raimund , Lackner Peter , Brenneis Christian , Kaehler Stefan T. , Georgopoulos Apostolos , Schmutzhard Erich 
Published: December 2006

ABSTRACTThe pharmacokinetic profile of linezolid in cerebrospinal fluid (CSF) in five neurointensive care patients with staphylococcal ventriculitis was studied. The mean area under concentration-time curve (± standard deviation) was 63 ± 18.9 mg · h/liter, with a CSF-to-plasma ratio of 0.8 ± 0.3. Times above MIC in CSF were 99.8% and 57.2% for pathogens with MICs of 2 mg/liter and 4 mg/liter, respectively.