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J Jacobs

Publications and source records attributed to J Jacobs.

246 records · Page 14Linked to original sources
PubMedDate not supplied

Comparative antimicrobial activity of ceftibuten against multiply-resistant microorganisms from Belgium.

To study the activity of ceftibuten, we obtained multiply-resistant isolates from approximately 20 hospitals in Belgium. Against Enterobacteriaceae, all of the tested comparative compounds were more active than cefaclor, and ceftibuten and tigemonam were the most active of the agents tested. Ceftibuten MIC50s were less than or equal to 1 microgram/ml for most enteric bacilli species and 85% of strains were susceptible (less than or equal to 8 micrograms/ml). This level of activity compared favorably to that recorded for cefaclor (less than or equal to 8 micrograms/ml), cefetamet (less than or equal to 4 micrograms/ml), and cefteram (less than or equal to 1 microgram/ml), that is, 37%, 69%, and 59%, respectively. Ceftibuten, cefetamet, cefteram, and tigemonam were highly active against isolates of Haemophilus influenzae and Neisseria gonorrhoeae. None of the comparative agents were as active as cefaclor against staphylococcal isolates. Against streptococci, cefteram was the most active, and tigemonam the least active of the agents. The MIC90s of ceftibuten for strains of Streptococcus pneumoniae and Streptococcus pyogenes were 2 micrograms/ml and 0.5 microgram/ml, respectively. Strains of Streptococcus agalactiae were resistant to both ceftibuten and tigemonam; cefaclor and cefteram inhibited 100% of isolates of this species. Strains of Enterococcus faecalis and Pseudomonas aeruginosa were consistently resistant to all of the compounds. Overall, ceftibuten exhibited potent activity against many multiply-resistant clinical isolates.

Bacteria↗
PubMedDate not supplied

Remifentanil in the horse: identification and detection of its major urinary metabolite.

Remifentanil (4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic acid methyl ester) is a mu-opioid receptor agonist with considerable abuse potential in racing horses. The identification of its major equine urinary metabolite, 4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic+ ++ acid, an ester hydrolysis product of remifentanil is reported. Administration of remifentanil HCl (5 mg, intravenous) produced clear-cut locomotor responses, establishing the clinical efficacy of this dose. ELISA analysis of postadministration urine samples readily detected fentanyl equivalents in these samples. Mass spectrometric analysis, using solid-phase extraction and trimethylsilyl (TMS) derivatization, showed the urine samples contained parent remifentanil in low concentrations, peaking at 1 h. More significantly, a major peak was identified as representing 4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic+ ++ acid, arising from ester hydrolysis of remifentanil. This metabolite reached its maximal urinary concentrations at 1 h and was present at up to 10-fold greater concentrations than parent remifentanil. Base hydrolysis of remifentanil yielded a carboxylic acid with the same mass spectral characteristics as those of the equine metabolite. In summary, these data indicate that remifentanil administration results in the appearance of readily detectable amounts of 4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic+ ++ acid in urine. On this basis, screening and confirmation tests for this equine urinary metabolite should be optimized for forensic control of remifentanil.

Analgesics, Opioid↗
PubMedDate not supplied

Evaluation of an Australian miscarriage support programme.

Miscarriage is a frequent and distressing event for women who often require admission to a gynaecology unit for the evacuation of the products of conception. Most women are admitted for day surgery or an overnight stay. The short time frame limits the time nursing staff have to provide support and information for women who have experienced loss through miscarriage. This article presents the qualitative evaluation of a telephone follow-up service provided as part of the Miscarriage Support Programme of Care conducted by staff of the gynaecology inpatient services in an Australian public hospital. The data from this evaluation indicate that miscarriage does have a varying degree of impact on a woman's inpatient experience and emotional recovery. The primary themes of emotional recovery, support after discharge, inpatient experience of care, and usefulness of the literature given to women before discharge, will guide the ongoing development of support and discharge planning by staff of gynaecology inpatient services for women who have experienced miscarriage.

Abortion, Spontaneous↗
PubMedDate not supplied

The coexistence of ribosome-lamella complex and annulate lamellae in chronic lymphocytic leukemia.

An electron microscopic study of peripheral blood and lymph node from a patient with chronic lymphocytic leukemia revealed ribosome-lamella complexes in 11-16% of the peripheral lymphocytes and in 14% of the nodal lymphocytes. Annulate lamellae were seen in 2-8% of the peripheral lymphocytes and in 8% of the nodal lymphocytes. One peripheral blood specimen revealed coexistence annulate lamellae and ribosome-lamella complexes within the same cells in an additional 4% of the lymphocytes. The two structures were connected by continuous strands of apparent endoplasmic reticulum. Although annulate lamellae and ribosome-lamella complex have each been described in chronic lymphocytic leukemia, albeit uncommonly, their unusual association with one another has not previously been documented and might offer a clue as to the origin and role of these interesting structure. The possible ramifications of these observations include relationship of the structures to endoplasmic reticulum and protein synthesis, to in vitro and possible clinical induction by drugs including "antitubulins," and to induction in vitro by viral infection.

Endoplasmic Reticulum↗
PubMedDate not supplied

The cost-effectiveness of idarubicin/cytosine arabinoside versus daunorubicin/cytosine arabinoside in the treatment of adults with acute myeloid leukemia.

The cost-effectiveness of two chemotherapeutic regimens was evaluated from the results of a randomized clinical trial involving patients with previously untreated acute myeloid leukemia. The evaluable subjects were 120 patients with acute myeloid leukemia randomly assigned to receive 12 mg/m2 of idarubicin (IDA) or 50 mg/m2 of daunorubicin (DNR) daily for three days. The patients also received 200 mg/m2 of cytosine arabinoside daily for five days, with an additional 25-mg/m2 bolus on the first day of treatment, the patients underwent a second course at the same doses. The total hospital charges per patient were $59,687 for IDA treatment and $59,567 for DNR treatment; however, the cost per complete remission was lower in the IDA than in the DNR patients ($74,609 vs $102,115). The lower remission rate in the DNR-treated patients, and thus their need for additional care, will increase the cost differences between the two treatments. The hospital charges per year of survival were $36,395 for IDA treatment and $52,714 for DNR treatment. It is concluded that IDA is more cost-effective than DNR in the treatment of adult acute myeloid leukemia.

Acute Disease↗
PubMedDate not supplied

Control of stress and violent behavior: mid-course review of the 1990 health objectives.

Control of stress and violent behavior is 1 of the 15 priority areas addressed in the 1990 health objectives for the nation. For control of stress, improved awareness of appropriate community service agencies and increased scientific knowledge of stress effects are the main objectives. For control of violent behavior, the objectives focus on three major problems: (a) deaths from homicide among young black males, (b) adolescent suicide, and (c) child abuse. Since the last progress report, published in 1984, more than 200 research projects directly related to these objectives have been funded, and a variety of implementation actions have been undertaken. During this period, baseline data on such critical concerns as homicides among blacks and Hispanics, suicide, family violence, and perceived stress have been obtained, thereby encouraging further study and facilitating achievement of the objectives. The mid-decade status report and recommendations that are presented in this article were initiated in a September 1985 review, by the Acting Assistant Secretary for Health, of progress toward achieving the 10 stress and violent behavior objectives selected for Federal implementation by the year 1990. The most recent available data have been used to update information on these 10 priority objectives.

Adolescent↗