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Biomedical subjects

D Adam

Publications and source records attributed to D Adam.

At least 163 records · Page 9Linked to original sources
PubMed1989

[Bactericidal activity of enoxacin and ciprofloxacin in body fluids].

Until present studies are lacking which investigate the bactericidal activity of new quinolones in body fluids. Therefore, we determined bactericidal titers of enoxacin (en) and ciprofloxacin (cip) against a typical pathogen in urinary tract infections (Escherichia coli) in urine and against a typical pathogen in respiratory tract infections (Streptococcus pyogenes) in sputum, in each case at the time of peak and trough levels (In vitro data of the test strains: E. coli - MICen = 0.06 mg/l, MICcip = 0.06 mg/l, MBCen = 0.5 mg/l, MBCcip = 0.25 mg/l; Streptococcus pyogenes - MICen = 32 mg/l, MICcip = 1 mg/l, MBCen greater than 64 mg/l, MBCcip greater than 64 mg/l). Following a randomization list, ten healthy volunteers took either 400 mg enoxacin b.i.d. for three days, then (after a break of at least three days) 500 mg ciprofloxacin b.i.d. for three days, or vice versa. Two and 12 hours after the final dose, samples of sputum were taken, urine was collected 2-4 h and 10-12 h after the final dose. The bactericidal titers against E. coli in urine were greater than 1:512 (2-4 h after the final dose) and greater than 1:64 (10-12 h after the final dose) for both quinolones in all cases. On the other hand, as to S. pyogenes were found growth in every dilution of sputum. These results confirm the scepticism against quinolone therapy of respiratory tract infections caused by streptococci.

Ciprofloxacin↗
PubMed1989

[Enoxacin concentrations in lung tissue].

For successful treatment of bacterial lung infections the administered antibiotic must reach sufficiently high concentrations in lung tissue. Therefore, the concentrations of enoxacin in this tissue were measured in ten patients requiring pulmonary surgery. In order to prevent postoperative infection, the patients received 400 mg enoxacin b.i.d. for three days. Eight h after the final dose samples of venous blood were drawn and a sample of lung tissue was removed. Using a microbiological assay, we found the following concentrations (mean +/- S.D.):serum 2.36 (+/- 0.65) mg/l, lung 6.48 (+/- 1.54) mg/kg. With the HPLC-technique the corresponding values method were 2.37 (+/- 0.80) mg/l and 7.41 (+/- 3.01) mg/kg. Thus concentrations of enoxacin in lung tissue are about three times higher than the corresponding serum concentrations.

Aged↗
PubMed1989

[Enoxacin concentration in bone tissue].

For successful treatment of bacterial osteomyelitis the administered antibiotic must reach sufficiently high concentrations in bone tissues. Therefore concentrations of enoxacin in bone in ten patients requiring hip surgery were measured. To prevent a postoperative infection, 400 mg enoxacin b.i.d. for two days were administered. On an average 120 (90-210) min after the final dose samples of venous blood and bone tissue were taken. The bone pieces were divided into corticalis and spongiosa. Using a bio-assay-method the following concentrations were found: (mean +/- S.D.): serum 2.88 ( +/- 0.90) mg/l, corticalis 5.90 ( +/- 0.79) mg/kg, spongiosa 3.95 ( +/- 1.01) mg/kg. Thus enoxacin reaches higher levels in bone tissue than in serum.

Aged↗
PubMed1989

Penetration of ticarcillin/clavulanate into cartilage.

The penetration of ticarcillin and clavulanate into cartilage was investigated in 20 subjects undergoing funnel chest correction. Cartilage samples, obtained 120 or 180 min after administration of ticarcillin/clavulanate (mean dose: ticarcillin 70.0 mg/kg, clavulanate 4.7 mg/kg), were divided into core samples and outer covering portions. After 120 min, the mean ticarcillin in the outer portion was 11.0 mg/kg and that in the core sample was 0.81 mg/kg; at 180 min the mean concentration in the outer portion was 6.47 mg/kg and ticarcillin was undetectable in all but two core samples. Clavulanate was shown to decline with time in spiked cartilage preparations and the results in this investigation may underestimate penetration. Clavulanate was undetectable in most core samples. In the outer portion the mean concentration was 1.30 mg/kg at 120 min and 0.62 mg/kg at 180 min. The penetration gradient requires further elucidation and should be considered when chemotherapy for infection in cartilage is discussed.

Adolescent↗
PubMed1989

Cerebrospinal fluid penetration after single or multiple dosage with ticarcillin/clavulanate.

Penetration of ticarcillin and clavulanate into the cerebrospinal fluid was studied in ten patients with varying degrees of impairment of the blood-brain barrier. In general, penetration of both drugs was relatively low and variable (5.4 +/- 5.8% for clavulanate and 2.0 +/- 4.0% for ticarcillin) but markedly better in those patients with impaired blood/brain barrier.

Adolescent↗
PubMed1989

Pharmacokinetics of ticarcillin/clavulanate in severely burned patients.

A pharmacokinetic trial with ticarcillin/clavulanate was undertaken in patients with severe burns. Timentin 5.2 g (ticarcillin 5 g + clavulanate 200 mg) was administered by iv infusion over 20 min, two or three times daily. Fifteen patients with varying amounts of total body surface (TBS) burned could be evaluated for pharmacokinetic calculations (group A, greater than 20% TBS, n = 7; group B, less than 10% TBS, n = 8). Both groups presented similar pharmacokinetic behaviour. Compared with healthy volunteers, the volume of distribution for both ticarcillin and clavulanate was increased 2.5 times. For ticarcillin the mean elimination half-lives in serum were 95.1 (A) and 86.1 min. (B), respectively; for clavulanate, the half-lives were 144.0 (A) and 132.1 min (B), respectively. The 0-8-h urine recovery of ticarcillin was 84% (A) and 83% (B), and for clavulanate it was 86% (A) and 88% (B) of the administered dose. As a consequence of the increased distribution volumes and the increased AUC's in severely burned patients the highest recommended dose of ticarcillin/clavulanate appears suitable.

Burns↗
PubMed1989

Penetration of amoxycillin/clavulanate into human bone.

Twenty patients undergoing orthopaedic surgery for total hip replacement received a single prophylactic intravenous dose of 2.2 g Augmentin (2 g amoxycillin + 200 mg clavulanate). Bone samples removed during the operation were saved for amoxycillin and clavulanate assay. The proportion of inorganic matter in the bone samples was determined to calculate the concentrations of the drugs in their distribution volume. The cortical and cancellous bone were penetrated to a comparable extent by both compounds yielding maximum concentrations at one hour after the end of the infusion. The mean concentrations of amoxycillin in the cortex and spongy layer were 26.0 and 18.2 mg/kg within 1 h, 23.8 and 19.8 mg/kg in the interval from 1 to 2 h after infusion, and 9.2 and 5.9 mg/kg between 2 and 5 h. The corresponding values for clavulanate were 2.3 and 1.6 mg/kg, 2.5 and 1.6 mg/kg, and 1.0 and 0.7 mg/kg, respectively. No postoperative wound infections occurred in these patients.

Aged↗
PubMed1989

Mutual aid in remote areas: addressing the obstacles.

Mutual aid is a powerful tool for individual and group change and an excellent means of promoting mental and physical health. This article examines the main factors that may hinder the development of self-help groups (SHGs) in rural and remote areas, specifically the Sudbury-Manitoulin region of Northern Ontario. It considers several issues common to rural areas, such as population distribution, geographic isolation, lack and inaccessibility of human and material resources, and local factors such as multiculturalism and multilingualism. One of the strategies considered for overcoming these obstacles is a model for a community mutual-aid organization based on a computerized network of mutual-aid services (central organization with regional units). The originality of the model lies in the recognition of computer technology and telecommunications as promising solutions to the problems of geographic, social and cultural isolation faced by remote and rural communities, solutions that may play a part in fully developing the potential for mutual aid in this type of community.

Community Mental Health Services↗
PubMed1989

Women and stress: a community prevention and health promotion program.

The past few decades have witnessed the launching of many health education and promotion programs for women, including Odyssée, Nouveaux départs and Women and Stress (Stress au féminin). Women and Stress was developed jointly by the Union culturelle des Franco-ontariennes, mental health professionals and representatives of the target audience. Its purpose is to help women take charge of their own health and their own bodies. This 15-hour group program, intended for French-speaking women in Ontario, includes six workshops that identify the symptoms and sources of stress and teach effective stress management strategies. The program is original in that it was designed primarily to be delivered by non-professionals in the community. According to the results of an evaluation by 360 participants, the program was an immediate success: it attained its health education and promotion objectives, and fostered community control in the area of prevention and health promotion.

Canada↗
PubMed1989

[Hemostasis disturbance caused by cephalosporins with an N-methylthiotetrazole side chain. A randomized pilot study].

The mechanism of hypoprothrombinemia induced by cephalosporins containing the N-methylthiotetrazole (NMTT) side chain has been investigated in a randomized clinical, trial (pilot study) with 14 hospitalized patients (main inclusion criteria: age greater than or equal to 50 years, urinary tract infection, normal prothrombin time. Therapy groups: latamoxef (n = 5), cefoperazone (n = 5), cefotaxime (control, n = 4). Duration of treatment: 7 days). Two patients under cefoperazone exhibited a significant increase of prothrombin time, accompanied by the appearance of PIVKA II (prothrombin induced in vitamin K absence). Both cefoperazone (in 4 patients) and latamoxef (in 3 patients) caused the appearance of endogenous vitamin K1 2,3-epoxide, whereas cefotaxime did not. This confirms the hypothesis that NMTT-cephalosporins are inhibitors of hepatic vitamin K epoxide reductase, and that this is at least partly responsible for the clinically observed hypoprothrombinemia. In older patients treated with these antibiotics, prothrombin time should be controlled before as well as under therapy. Unexpectedly, the patients displaying an appearance of vitamin K1 2,3-epoxide showed a statistically significant increase of endogenous plasma vitamin K levels. This effect needs further investigation.

Aged↗
PubMed1987

3-D ventricular myocardial electrical excitation: a minimal orthogonal pathways model.

This study is part of our attempt to develop a fast-responding interactive computer simulator of the left ventricle (LV) which describes the spatial and temporal myocardial characteristics and the global performance of the LV, accounting for the continuous interactions between the electrical activation sequence, fiber mechanics, blood perfusion and transmural metabolism and oxygen demand. Here, the activation propagation front throughout the healthy 3-dimensional LV myocardium is simulated in a macro global level by utilizing an analytical model based on the principle of the propagation of the electric activation signal along minimal pathways in an elliptically assumed LV geometry. The Purkinje network dominates the propagation at the endocardial layer while three orthogonal directions of propagation are assumed within the myocardium. The shortest path consists of the geodetic line at the endocardial layer and the normal that connects the endocardium with the point considered. The generated three-dimensional propagation front maps are in fair agreement with reported experimental data. The study thus presents a new approach that permits a quick reconstruction of the 3-D isochrons in a relatively simple but useful model of the normal heart.

Computer Simulation↗
PubMed1987

Concentrations of ticarcillin and clavulanic acid in human bone after prophylactic administration of 5.2 g of timentin.

The penetration of ticarcillin and clavulanate into their distribution space within human bone was determined after prophylactic administration of 5.2 g of timentin (5 g of ticarcillin plus 0.2 g of clavulanic acid) to 20 patients undergoing hip surgery. All samples were taken 45 to 85 min postadministration. The mean concentrations of ticarcillin in spongiosa and corticalis bone were 57.1 and 70.5 mg/kg, respectively; those of clavulanic acid were 17.8 and 32.5 mg/kg, respectively. No infections occurred in these patients.

Aged↗