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Biomedical subjects

E Blake

Publications and source records attributed to E Blake.

25 records · Page 2Linked to original sources
PubMed1981

Serum and urine concentrations of cefoperazone in severe chronic renal failure.

Two studies evaluating the efficacy of cefoperazone in patients with chronic renal failure are described. In study A, 10 patients with severe chronic renal failure were given 1 g of cefoperazone intravenously over 3 minutes. The mean serum cefoperazone concentration at 30 minutes was 119.3 +/- 15.7 microgram/ml, and at 6 hours was 35.9 +/- 5.7 micrograms/ml. The mean serum half-life using the method of least squares was 6.6 +/- 1.15 hours (range, 2.5 to 15.1). The mean half-life from 2 hours onwards was 12.2 +/- 3.51 hours (range, 2.3 to 42.9). The mean peak urinary concentration of cefoperazone was 192 microgram/ml with a very wide individual range of 20 to 920 microgram/ml which was reached 0.5 to 9 hours after injection. In study B, 8 patients with chronic renal failure were treated with 1 to 2 g of cefoperazone intravenously every 12 hours for 5 to 14 days for complicated urinary tract infections. Serum and urine concentrations of cefoperazone were measured 6 hours after each morning dose. The mean 6-hour serum and urine concentrations of cefoperazone for the 4 patients treated with 2 g daily were 63 +/- 11.7 and 87 +/- 11.1 microgram/ml, respectively. The corresponding values for the 4 patients treated with 4 g daily were 106 +/- 20 and 258 +/- 32 microgram/ml. No drug accumulation occurred in any patient. No deterioration in renal function was noted. In conclusion, cefoperazone promises to be an effective and safe broad-spectrum antibiotic for patients with all degrees of renal function impairment. A dosage schedule of 2 to 4 g daily will not lead to significant drug accumulation in the presence of severe renal failure.

Adult↗
PubMed1981

Cefoperazone in the treatment of severe or complicated infections.

We report the use of cefoperazone in 62 cases of serious infection, most of which occurred in patients with renal impairment. 43 severe or complicated urinary tract infections, 11 cases of pneumonia and 8 with other severe sepsis were treated with cefoperazone 1 to 2 g twice daily usually for 5 to 10 days. Of the patients with urinary tract infection, all who were symptomatic showed a rapid clinical response; 26 (61%) were cured including 11 of 16 with chronic renal failure; 12 relapsed and 5 were reinfected with a different pathogen. All of these patients were infected by organisms sensitive to cefoperazone by disc testing but in 5 of those who relapsed the cefoperazone MIC was in fact greater than or equal to 50 microgram/ml. Ten of 11 cases with radiologically confirmed pneumonia were cured with cefoperazone. 7 episodes of pneumonia were in patients with end-stage chronic renal failure (6 were on dialysis) and 1 was in a patient with acute renal failure. Seven of 8 cases with severe sepsis were cured with cefoperazone. 1 patient was withdrawn from the study when acute bronchospasm followed a 2 g intravenous dose. 2 of the successfully treated patients had functioning renal transplants, 2 of 3 with severe chronic renal failure were on dialysis and 1 had acute renal failure. Side effects included minor disturbances of liver function in 6 patients (11%), diarrhoea in 7 (13%) and marked alcohol intolerance in one, 4 patients with chronic renal failure developed a coagulation disorder which was corrected with vitamin K. None of the patients showed deterioration in renal function while receiving cefoperazone. Cefoperazone promises to be an effective drug for the treatment of a wide spectrum of severe infections in hospitalised patients including those with impaired renal function.

Adolescent↗
PubMed1980

Treatment of uncomplicated urinary tract infections with a single dose of co-trimoxazole.

Sixty-four women with an uncomplicated urinary tract infection were randomly allocated to receive treatment with either an 0.96 g, 1.92 g or 2.88 g single oral dose of co-trimoxazole or a conventional five-day course of co-trimoxazole. The success of each group was comparable although it is suggested that a single dose should be at least 1.92 g (four tablets Septrin or Bactrim). This study confirmed previous work that single dose therapy was effective and well tolerated, preferred by the patients and side effects were minimal. This approach to treatment should be strongly encouraged.

Adolescent↗
PubMed1980

Netilmicin in the treatment of severe or complicated urinary tract infections.

Netilmicin is a new aminoglycoside antibiotic with pharmacological similarities to gentamicin, tobramycin and sisomicin. Fourteen of 15 patients with a severe or complicated urinary tract infection were cured by treatment with a seven day course of netilmicin. In one patient the infecting organism was not eradicated. No significant side effects were noted and no ototoxicity was detected. Four patients had a significant, but reversible, deterioration in renal function as defined by an increase in the plasma creatinine of 0.03 mmol/l or greater. Work in experimental animals has shown netilmicin to be significantly less ototoxic and nephrotoxic than other clinically available aminoglycosides. If this finding is confirmed in large-scale comparative trials in man, netilmicin should prove a most useful and effective new antibiotic for the treatment of severe gram-negative sepsis.

Adult↗
PubMed1975

Quantitative studies of translymphnodal passage of tumour cells naturally disseminated from a non immunogenic murine squamous carcinoma.

A squamous cell carcinoma of spontaneous orgin in a WHT/Ht mouse was used to study the frequency with which the regional axillary lymph nodes draining subcutaneous or intradermal tumours gave rise to tumours after their isogeneic transplantation as whole nodes. This frequency (similar to 40%) was found not to vary significantly with the size or duration of the tumour drained and not to be increased by coincident infective, traumatic or antigenic stimuli acting at the tumour site or in adjacent tissue. Because tumour growth occurred in only 2/55 (4%) nodes which were left in situ in mice whose tumours were radically excised, it was concluded that tumour forming node transplants reflected a small and limited content (estimated to be about 13) of transnodally passing tumour cells destined to pass on to the blood; separate experiments showed that tumour cells reaching the blood survived for only a few hours. Nodes from tumour-excised mice gave rise to tumours as frequently when autografted as when isografted to mice with no previous expose to the tumour. A review of the finding reported here and of previous quantitative data for this system enabled us to exclude any implication of anti-tumour immunity from our interpretation of the results of the experiments.

Animals↗
PubMed1973

The effect of lethally irradiated cells on the transplantability of murine tumours.

Fully quantitative isogeneic transplantation assays of viable (V) cells of a CBA carcinoma showed that the relationship between log inoculum and frequency of tumour "takes" accorded strictly with a Poisson distribution and indicated that 6900 cells were required for 50% takes (TD50). Addition of 10(5) lethally irradiated (LI) cells of the same tumour to the inocula reduced the TD50 to about 4 cells, yet the Poisson relationship was retained. From this and other data it is concluded that LI cells act by increasing the proportion of viable cells which contribute to tumour initiation; there was no evidence that LI cells affected the rate of proliferation of viable cells. The ability of non-homologous LI cells to reduce the TD50 was widely variable, but LI cells of one allografted tumour were almost as effective as homologous LI cells. Lethally irradiated cells did not assist the "take" of allografted viable tumour cells. Histological comparison revealed no difference of the tissue reaction to inocula of viable and LI cells, and it is questioned whether radiation induced lysis of these latter cells is required for their effect on viable cells. Evidence relating to a hypothesis that viable cells interact with one another as they do with lethally irradiated cells was conflicting.

Air↗