bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial Endocarditis at a Tertiary Hospital – How Do We Improve Diagnosis and Delay of Treatment?
Authors: Kjerulf Anne , Tvede Michael , Aldershvile Jan , Høiby Niels 
Published: April 2003

During a period of 3.5 years, endocarditis was suspected in 151 patients admitted to Rigshospitalet. 140 were available for this study. In 59 of the 140 patients, the diagnosis was confirmed, and 36 had positive blood cultures. Echocardiographic findings compatible with the diagnosis were present in 92% of the 59 cases. The most common causes of endocarditis were <i>Staphylococcus aureus</i> and viridans streptococci. Patients with endocarditis caused by <i>S. aureus</i> had significantly (p = 0.002) more embolic episodes compared to patients having endocarditis caused by the viridans streptococci. The diagnosis was established at a mean of 3–4 weeks after the onset of symptoms and 2 weeks after admission to hospital. In order to minimize diagnostic delay, the following aspects may be important: (1) earlier detection of endocarditis among physicians examining patients at risk; (2) educating patients with cardiac disease and cardiac valve prosthesis; (3) earlier antibiotic therapy, and (4) developing further diagnostics for endocarditis.
Mechanism of Antiarrhythmic Effects of Class Ic Drugs in Paroxysmal Atrial Fibrillation in Man
Authors: Matsuo Kunihiro , Kumagai Koichiro , Annoura Miyuki , Ideishi Munehito , Arakawa Kikuo 
Published: April 2003

While class Ic antiarrhythmic drugs are effective in treating patients with atrial fibrillation, their mechanism of action is poorly understood. We performed electrophysiological studies before and after their administration to 22 patients with paroxysmal atrial fibrillation. Atrial refractoriness, maximal interatrial conduction delay and the wavelength index were measured at two basic cycle lengths (600 or 400 ms). Both drugs studied increased atrial refractoriness and wavelength index. Flecainide reduced the maximal interatrial conduction delay, but pilsicainide did not. Each drug increased the wavelength index in a tachycardia-dependent manner. Class Ic drugs may reduce atrial vulnerability by increasing the wavelength of the reentrant circuit during periods of rapid heart rate.
Limitation of Left Ventricular Hypertrophy and Dysfunction by ACE Inhibition after Anterior Q-Wave Myocardial Infarction
Authors: Jugdutt Bodh I. , Humen Dennis P. 
Published: April 2003

To determine whether limitation of left ventricular (LV) hypertrophy with angiotensin-converting enzyme inhibition after myocardial infarction (MI) is associated with improved systolic and diastolic function, quantitative two-dimensional echocardiograms and Doppler of 40 patients, who were randomized on day 3 after a first Q-wave anterior MI to receive therapy with captopril (12.5 mg t.i.d.) or placebo for 6 weeks, were analyzed for LV volumes (Simpson’s rule) and mass (3D reconstruction), remodeling parameters and peak early (E) and late (A) transmitral flow velocities and deceleration times (DT) at 3 days, 6 weeks, 6 months and 1 year. Compared to placebo over 1 year, captopril <i>limited</i> (p < 0.001) the increase in diastolic volume and mass, <i>increased</i> LV ejection fraction and diastolic E/A ratio, and <i>decreased</i> DT, the frequency of E and A reversal, infarct expansion and aneurysm frequency but volume/mass ratio was unchanged. Captopril over the first 6 weeks after a first Q-wave anterior MI limited LV remodeling and hypertrophy and improved both systolic and diastolic function up to 1 year.
Cardiac Troponin T Levels at 96 Hours Reflect Myocardial Infarct Size: A Pathoanatomical Study
Authors: Remppis Andrew , Ehlermann Philipp , Giannitsis Evangelos , Greten Tobias , Most Patrick , Müller-Bardorff Margit , Katus Hugo A. 
Published: April 2003

We determined the utility of single-point measurements of circulating cardiac troponin T (cTnT) for the noninvasive estimation of infarct size in 16 beagle dogs after left anterior descending artery (LAD) ligation. Pathoanatomical infarct sizes were determined by the triphenyltetrazolium chloride method and correlated with serum concentration changes of cTnT. Peak cTnT levels (14.10 ± 4.71 μg/l) were reached after 110 ± 21 h. A significant correlation was found between peak cTnT levels (p = 0.0001, r = 0.83) or cumulative cTnT levels and relative infarct size (p = 0.0010, r = 0.72). A single cTnT measurement 96 h after LAD ligation was equally predictive of infarct size (p = 0.0010, r = 0.74) as peak or cumulative cTnT levels derived from serial sampling. cTnT levels at 96 h may thus be useful for practical and cost-effective estimation of infarct size.
Helicobacter pylori: In vitro Induction of Resistance to Azithromycin
Authors: Kalenić Smilja , Plečko Vanda , Krešić Sanja , Presečki Vladimir , Tripković Vesna , Žele-Stračević Lidija , Katičić Mirjana , Dominis Mara 
Published: April 2003

<i>Helicobacter pylori</i> resistance to macrolides is possibly an important factor for the failure of macrolide therapy for <i>H. pylori</i> infection. The aim of this study was to assess the propensity of <i>H. pylori</i> to develop in vitro resistance to azithromycin. In 73 clinical isolates taken from patients before starting antimicrobial therapy of <i>H. pylori</i> infection, MIC was determined using an agar dilution method (Müller-Hinton agar with 7.5% unlysed horse blood, pH = 7.2, at 35°C, during 72 h in a humid microaerobic atmosphere). Each strain was first cultivated at half minimal inhibitory concentration (MIC) then in doubling concentrations until growth arrest. All experiments for induction of resistance were performed on the same media, incubation temperature, atmosphere and time of MIC determination. MIC interpretative standards for sensitivity, intermediate sensitivity and resistance of <i>H. pylori</i> to azithromycin were ≤2, 4 and ≥8 mg/l, respectively. Of 73 strains, 5 died during the experiments, and in the remaining 68 strains, serial passage with increasing azithromycin concentrations resulted in the development of resistance in 19 (26.9%) strains. Two strains had an MIC of 16 mg/l azithromycin. Thirty-three (48.5%) strains kept the same MIC or doubled their MIC, 16 (23.5%) strains had 4- to 16-fold MIC but still remained sensitive, 2 resistant strains had 128-fold MICs and 17 resistant strains had increased their MICs more than 128 times. Seventeen highly resistant strains (MIC >128 mg/l) were kept frozen at –70°C for 3 months in a brain-heart infusion broth with 15% glycerol. MIC was assessed again to determine the stability of resistance. Eleven strains kept MICs >128 mg/l, 2 became sensitive and 1 intermediate, but reverted easily, after only 2 passages, to an MIC of >128 mg/l azithromycin. Although macrolides are very active against <i>H. pylori</i>, the propensity to develop resistance in a high proportion of strains has a clear impact on the choice of the right combinations of macrolides with other agents as well as the dosage of the macrolide antibiotics.
Once-Daily Use of Ofloxacin for Prophylaxis in Breast Cancer Surgery
Authors: Morimoto Ken , Kinoshita Hiroaki 
Published: April 2003

The 150 consecutive patients who were hospitalized for breast cancer at our department between September 1992 and November 1995 were enrolled in this open study after having given their informed consent. Patients were assigned randomly to receive ofloxacin in daily doses of 200 mg to be taken in a single dose or a total dose of 600 mg divided into three doses postoperatively for 5 days. Ten patients (8 found to be without malignancies) were excluded from evaluation. Wound infections developed in 8 (12%) of the 69 patients in the 200-mg group and 12 (17%) of the 71 patients in the 600-mg group. Postoperative wound care lasted a median of 19 days (25th and 75th percentiles, 15 and 29 days) for patients given 200 mg and 16 days (13 and 25 days) for those given 600 mg; the difference was not statistically significant (Wilcoxon’s U test). Signs or symptoms suggesting ofloxacin toxicity were not observed, and several significant differences were found in laboratory test results between the two groups both before and after treatment. Abnormal changes after treatment were found in many individuals, but the rate of occurrence was similar in the two groups (U test). When ofloxacin is used for prophylaxis after breast surgery, we recommend a once-daily administration of 200 mg orally for financial reasons and increased patient compliance.
Antibacterial Activity of Peritoneal Exudate in Patients Treated with2 g Cefotiam for Surgical Anti-Microbial Prophylaxis
Authors: Miglioli P.A. , Schoeffel U. , Gabroska E. , Allerberger F. 
Published: April 2003

The objective of this study was to investigate the presence of antibacterial activity in peritoneal exudate (PE) of patients treated with cefotiam (CFT). CFT (2 g) was administered as a ‘single-shot’ antimicrobial prophylaxis to 6 patients at the beginning of colorectal resection. Samples of PE were collected from each patient on days 1, 2 and 3 after surgery. CFT was detectable in the samples of day 1 for 5 of the 6 patients. The influence of PE on antibacterial activity of the antimicrobial drug was evaluated carrying out the MICs of CFT against <i>Escherichia coli</i> K-12, <i>E. coli</i> (ATCC 10798), <i>Klebsiella pneumoniae</i> (ATCC 1003), <i>Proteus rettgeri</i> (Sanelli) and <i>Staphylococcus aureus</i> (ATCC 29213) with and without the addition of PE. The presence of PE enhanced the antimicrobial activity of CFT against gram-negative strains, but not against <i>S. aureus</i> (ATCC 29213). These results suggest the presence of substances in PE that possess endogenous antibacterial activity. Thus, antimicrobial activity in PE cannot be predicted by evaluating pathogen sensitivity in vitro only.
Single-Dose Pharmacokinetic Study of Ciprofloxacin and Fleroxacin in Healthy Adult Nigerian Volunteers
Authors: Chukwuani C.M. , Coker H.A.B. , Oduola A.M.J. , Ifudu N.D. , Sowunmi A. 
Published: April 2003

The kinetics of absorption, distribution and elimination of ciprofloxacin and fleroxacin (following an intravenous dose of 200 mg), were evaluated in 24 adult healthy male Nigerian volunteers. Appropriate mathematical models were applied with the aid of a microcomputer software program for the estimation of the basic pharmacokinetic parameters. Appropriate statistical tests and profiles formed the basis for accepting or rejecting a proposed model. For parametric comparisons between the profile of the two drugs, the null hypothesis of no difference in their pharmacokinetic profile was proposed. All statistical tests were performed at a significance level of 95% (α = 0.05) and the 95% confidence level was determined where appropriate. Additionally, the model-independent or stochastic method of analysis was also employed in the pharmacokinetic evaluation of the blood level data. The parametric estimates obtained from both methods were compared. The plasma elimination half-life (t<sub>1/2</sub>) was estimated as 13.8 ± 5.5 h for fleroxacin and 7.5 ± 4.0 h for ciprofloxacin; the maximal plasma concentration (C<sub>max</sub>) was 0.8 ± 0.3 and 2.3 ± 1.0 mg/l for fleroxacin and ciprofloxacin, respectively, whilst the volume of distribution (V<sub>d</sub>) was 2.5 ± 1.6 and 0.4 ± 0.3 liters/kg for fleroxacin and ciprofloxacin, respectively. 71 and 70% of unchanged drug were excreted in urine for fleroxacin and ciprofloxacin, respectively. With respect to comparative values, the results confirmed trends already observed in the literature, particularly as regards the t<sub>1/2</sub>. However, for fleroxacin there was a significant deviation from the literature trends with respect to V<sub>d</sub>, C<sub>max</sub> and AUC. The results also confirmed earlier findings, advocating a once-daily dosage schedule for fleroxacin also in the Negroid population.
In vitro Susceptibilities of Enterococcal Blood Culture Isolates from the Hamburg Area to Ten Antibiotics
Authors: Elsner Holger-Andreas , Sobottka Ingo , Feucht Heinz-Hubert , Claussen Matthias , Kaulfers Paul-Michael , Laufs Rainer , Mack Dietrich 
Published: April 2003

Treatment of enterococcal infections is often difficult because of intrinsic and acquired resistance to a variety of antimicrobial agents. Between January 1993 and May 1997, enterococci were isolated from blood cultures of 117 patients at the Institute of Medical Microbiology and Immunology, University Hospital Eppendorf, Hamburg, Germany. Eightynine (76%) isolates were phenotypically identified as <i>Enterococcus faecalis</i>, and 24 (21%) as <i>Enterococcus faecium</i>. All <i>E. faecalis</i> isolates, but only 17% of the <i>E. faecium</i> isolates were susceptible to ampicillin. Two <i>E. faecium</i> isolates (8%) but no <i>E. faecalis</i> were vancomycin resistant (<i>vanA</i> genotype). Quinupristin/dalfopristin shows a high degree of susceptiblity of <i>E. faecium</i> (79%) and may be suitable for the therapy of infections caused by glycopeptide-resistant <i>E. faecium</i> strains.
Effect of Varidase (Streptokinase) on Biofilm Formed by <i>Staphylococcus aureus</i>
Authors: Nemoto Ken , Hirota Katsuhiko , Ono Tsuneko , Murakami Kinya , Murakami Keiji , Nagao Daisuke , Miyake Yoichiro 
Published: April 2003

<i>Staphylococcus aureus</i> forms a fibrin-rich biofilm in the presence of plasma which is highly resistant to attack by the human immune system and to chemotherapy. Varidase, composed mainly of streptokinase, is used for hydrolyzing clots. In this study, we attempted to destroy the biofilm of <i>S. aureus</i> with Varidase and to apply this drug in the treatment of staphylococcal infections. Four clinical isolates were used in the experiments. These organisms formed a several-millimeter-thick biofilm on type IV collagen coated coverslips in trypticase soy broth containing 50% human plasma. The biofilm was composed of bacterial cell which adhered to fibrillar fibers and of sediment derived from plasma. 10,000 U/ml of Varidase, the dose which is used clinically, removed the sediment and reduced the number of live bacteria in biofilms to less than 20% of control. 200 U/ml of Varidase was also effective against biofilms of the organisms. An equal combination of Varidase and ofloxacin had an additive effect on the bacteria. The results of this study demonstrate that Varidase is highly effective in destroying biofilms of <i>S. aureus</i> in vitro and suggest that this drug would be useful for treating staphylococcal infections.
Susceptibility of Clinical Strains of Herpes simplex Virus to Three Nucleoside Analogues
Authors: Edert Danielle Y. , Finance Chantal M.-T. , Le Faou Alain E. 
Published: April 2003

The susceptibility of clinical isolates of herpes simplex virus 1 (HSV1) (58 strains) and 2 (HSV2) (17 strains) from the Centre Hospitalier et Universitaire de Nancy to three nucleoside analogues was compared by the dye uptake method. As expected, all strains of HSV2 were resistant to brovavir or sorivudine. Aciclovir and penciclovir activities were comparable; 2 strains of HSV1 were resistant to these two compounds. Four strains isolated from immunocompromised patients gave different results with brovavir as compared to aciclovir; resistance to aciclovir (1 strain of HSV1) did not correlate with resistance to brovavir (3 strains of HSV1). Following up antiviral susceptibility is of interest for the detection of resistant strains in immunocompromised patients receiving prophylactic aciclovir.
The Lateralizing Value of Ictal Clinical Symptoms in Uniregional Temporal Lobe Epilepsy
Authors: Steinhoff B.J. , Schindler M. , Herrendorf G. , Kurth C. , Bittermann H.-J. , Paulus W. 
Published: April 2003

In order to assess the lateralizing value of several ictal and postictal clinical symptoms in temporal lobe epilepsy (TLE), we analyzed 89 seizures of 20 left dominant patients with intractable left (n = 9) versus right (n = 11) TLE who had undergone successful anterior temporal lobectomy. In left TLE, movement arrest at seizure onset, postictal dysphasia >120 s and postictal dyslexia >180 s were the most typical findings and associated with a sensitivity of 94, 94, and 100%, respectively. The highest specificity of 100% each was evident for contralateral versions of eyes and head and dystonic posturing. In right TLE, the highest sensitivity was seen for whole-body movements at seizure onset, postictal dysphasia <120 s and postictal dyslexia <180 s with figures of 82, 87, and 93%, respectively. As compared to left TLE, contralateral version and dystonic posturing, ictal speech, and postictal dyslexia <180 s each had a specificity of 100%. The careful combined analysis of certain ictal clinical signs combined with consistent findings of interictal EEG and neuroimaging studies may be often sufficient to proceed with epilepsy surgery without invasive recordings even if ictal scalp EEG is not unambiguous.
Detecting New Lesion Formation in Multiple Sclerosis: The Relative Contributions of Monthly Dual-Echo and T<sub>1</sub>-Weighted Scans after Triple-Dose Gadolinium
Authors: Filippi M. , Mastronardo G. , Rocca M.A. , Capra R. , Gasperini C. , Rovaris M. , Bastianello S. , Comi G. 
Published: April 2003

In this study, we evaluated the frequency of formation of new lesions on brain magnetic resonance imaging (MRI) from patients with relapsing-remitting multiple sclerosis (MS) and defined the relative contributions of unenhanced and enhanced MRI. Every 4 weeks for 3 months, dual-echo and postcontrast T<sub>1</sub>-weighted (5 min after the injection of 0.3 mmol/kg gadolinium-DTPA) scans were obtained from 28 patients with relapsing-remitting MS. New lesions were defined as those present on dual-echo and/or postcontrast T<sub>1</sub>-weighted scans but with no corresponding MRI abnormalities on any of the preceding scans. A total of 111 newly formed lesions were detected during the follow-up on dual-echo and postcontrast T<sub>1</sub>-weighted scans (i.e., an average of 1.3 lesions per patient per month). Ninety-eight (88%) of such lesions were seen on both dual-echo and postcontrast T<sub>1</sub>-weighted scans, whilst 13 (12%) were seen only with one of the two techniques: 9 only on dual-echo and 4 only on postcontrast scans. Five of the 98 new lesions seen by both techniques were seen by postcontrast scans 1 month before their appearance on dual-echo scans. Our study suggests that both dual-echo and postcontrast T<sub>1</sub>-weighted scans are useful to detect newly formed lesions in patients with MS. This is of importance when using MRI to monitor the efficacy of treatments which may halt MS lesion formation.
The Barcelona Stroke Registry
Authors: Martí-Vilalta J.L. , Arboix A. 
Published: April 2003

The Barcelona Stroke Registry was established to collect clinical data of hospitalized patients with stroke, in order to study their clinical characteristics and outcome. Data were collected over a 17-year period in 3,577 consecutive patients with first-ever stroke admitted to a stroke unit in two university hospitals in the city of Barcelona (Catalonia, Spain). Patients were generally admitted within 48 h from stroke onset, were evaluated by a neurologist, and clinical data were collected using a standardized protocol. All subjects underwent computerized tomography (CT) examination. Data on the 3,577 patients revealed the following stroke subtypes: cerebral infarction (81%), corresponding to the varieties of atherothrombotic (39.5%), cardioembolic (17.5%), lacunar (11%), unusual (5%), or unknown (8%); and cerebral hemorrhage. We analyzed age distribution (mean age 66 years); risk factors (the most frequent being hypertension, present in 54% of cerebral infarctions and in 65% of hemorrhages); clinical manifestations (the most salient being abrupt onset in one half of the cases; high frequency of decreased consciousness in cardioembolic infarction; headache, seizures and nuclear palsy in ‘unusual’ cerebral infarctions; vomiting and coma in hemorrhage); localizations by vascular territories; mechanisms of the various stroke subtypes; complications (present in one third of patients, with a mortality of 14%), and outcome. Two out of 3 hospitalized stroke patients are first-ever stroke sufferers. Neuroimaging shows a cerebral infarct in 86.5% of cases. Clinical and laboratory investigations cannot determine the mechanism of 8% of infarcts and of 23% of hemorrhages. The high frequency of medical complications, mortality, and disability highlights the need to establish stroke units and stroke registries in order to perform further research into the diagnosis and management of patients with cerebrovascular disease.
Electrophysiological, Neuropsychological and Clinical Findings in Multiple Sclerosis Patients Receiving Interferon β-1b: A 1-Year Follow-Up
Authors: Gerschlager W. , Beisteiner R. , Deecke L. , Dirnberger G. , Endl W. , Kollegger H. , Lindinger G. , Vass K. , Lang W. 
Published: April 2003

We assessed serial event-related potentials (ERPs) as well as neuropsychological and clinical test findings in a group of multiple sclerosis (MS) patients (n = 14) treated with interferon β-1b (INF-β-1b) compared to normal controls (n = 14). All investigations were done within 1 week before INF-β-1b therapy was started and 12 months later. An auditory oddball paradigm was employed. No significant differences in the N100, P200, N200 or P300 latencies between patients and control group were found, but 3 out of 14 MS patients developed abnormal P300 latencies (more than 2 standard errors from the mean) after 1 year of INF-β-1b therapy. This was not reflected by the respective neurological impairment as assessed by the Expanded Disability Status Scale score. ERPs might be a useful tool in clinical studies in order to evaluate drug effects on cognition, but for a final statement, the analysis of ERPs in a larger group of patients is required.
Cytoprotective Effect of Trimetazidine on 75 min Warm Renal Ischemia-Reperfusion Injury in Rats
Authors: Özden A. , Aybek Z. , Saydam N. , Çalli N. , Saydam O. , Düzcan E. , Güner G. 
Published: April 2003

In this experimental study, we evaluated the effect of trimetazidine (TMZ) on renal ischemia-reperfusion (IR) injury in Sprague-Dawley rats. Renal IR was achieved by a 75-min clamping of the left renal pedicle and subsequent 24 h reperfusion, after right nephrectomy was performed. The rats were randomly divided into three groups: group 1 (sham operated: no IR injury), group 2 (ischemic control: saline treatment), and group 3 (3 mg/kg TMZ before ischemia). After 24 h of reperfusion, blood samples and renal tissue samples were taken to measure the levels of creatinine, tissue malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) activity. Histopathological changes were evaluated. In addition, the 7-day survival rates in each group were evaluated. We found significant increases in the levels of creatinine and tissue MDA, severe acute tubular necrosis, and a significant decrease in the activity of the GSH-Px in group 2. There were significant decreases in the levels of creatinine and tissue MDA, mild acute tubular necrosis, and a significant increase in activity of the GSH-Px in group 3 when compared with the control group (p <0.05). Statistically significant differences (p <0.05) in survival were noted between the ischemic control and sham-operated and TMZ groups. We have concluded that TMZ is able to protect the kidney from warm IR injury.