The structural basis for the cross-reactivity between the Escherichia coli K13, K20 and K23 capsular polysaccharides is the ----)-beta-ribofuranosyl-(1----7)-beta-2-keto-3-deoxyoctonate polymer. Monoclonal antibodies against E. coli K13 which require O-acetyl-2-keto-3-deoxyoctonate for binding were further investigated. Such antibodies, of both the IgG and the IgM isotype, opsonized E. coli K13 in vitro and protected against intraperitoneal infection in mice as well as ascending pyelonephritis in rats. A monoclonal IgG1 anti-idiotype, specific for the K13 polysaccharide combining site of a protective IgM idiotype, primed for protection against intraperitoneal infection with live E. coli K13 following K13 injections at four as well as 12 weeks of age. the K13 polysaccharide alone did not immunize and protect. The monoclonal anti-K13 idiotype only primed for protection at four weeks of age. These findings suggest a strong effect of a single idiotype on the outcome of a bacterial infection.

Animals↗

PubMedDate not supplied

Rhinocerebral mucormycosis with CT scan findings: a case report.

A case of rhinocerebral mucormycosis in a diabetic patient is presented. The radiologic findings of the disease with differential diagnosis are reviewed. Almost complete cure with surgical excision and Amphotericin B was accomplished.

Diagnosis, Differential↗

PubMedDate not supplied

Intravenous maintenance with a saline lock intermittent infusion device in the prehospital environment.

INTRODUCTION: A study was done with EMS personnel to determine the ease of use and acceptance of a saline lock (SL), intermittent infusion device in place of traditional intravenous tubing and fluid bags for prehospital intravenous (IV) maintenance. STUDY HYPOTHESES: Saline lock, intermittent infusion device use in specific clinical scenarios is easier, less expensive, and as effective as traditional IV tubing and fluid bags. The emergency medical technician-paramedic (EMT-P) would accept the implementation of saline locks in the emergency medical services (EMS) system. METHODS: This was a prospective, non-blinded study with the EMS providers under the medical command of a suburban community hospital's emergency department. Patients were included if prophylactic IV access or medication administration was required by clinical protocols. Excluded from the study were those patients requiring IV access for fluid infusion, constant drug infusion, cardiac arrests, or transport to another hospital's emergency department (ED). Intravenous access was achieved with the usual catheter over needle cannulation techniques. The device (Interlink Injection Site SL) was attached to the hub of the IV cannula and flushed with 2 cc of 0.9% saline from prefilled carpujects. RESULTS: There were completed questionnaires for 79 successful SL initiated in 98 attempts of IV access on 80 patients over a four-month period. When compared to traditional IV fluid bags, SL were judged by the paramedics to be less time-consuming to initiate and maintain (55 of 79 or 70%), easier to use (51 of 79 or 65%) and facilitated patient transportation (73 of 79 or 92%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Unintentional firearm deaths: can they be reduced by lowering gun ownership levels?

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Accidents, Home↗

PubMedDate not supplied

The production of menaquinones (vitamin K2) by intestinal bacteria and their role in maintaining coagulation homeostasis.

Vitamin K is an essential cofactor necessary for the production of clotting factors II, VII, IX, and X in humans and has recently been found to be an essential factor for many other proteins in the body. There are two sources of this essential vitamin, including vitamin K1, or phylloquinone which is primarily found in green leafy vegetables and vitamin K2 or menaquinone which is synthesized by certain intestinal bacteria. The precise contribution of the bacterially synthesized menaquinone to overall vitamin K requirements in man is unknown. This paper reviews the available literature regarding the production and liberation of menaquinones from bacteria, the animal experiments which have been done to examine the absorption of menaquinones and the indirect and direct evidence in humans regarding utilization of menaquinones. The preponderance of the evidence suggests that bacterially synthesized menaquinones, particularly in the ileum can and do play a significant role in contributing to vitamin K requirements in humans to prevent clinically significant coagulopathy, especially during periods of episodic dietary lack of the vitamin.

Animals↗

PubMedDate not supplied

Hemodynamic response to OKT3 in orthotopic heart transplant recipients: evidence for reversible myocardial dysfunction.

The murine-derived monoclonal antibody OKT3 has been shown to be a useful immunosuppressive agent in transplant recipients; but it may cause cardiac instability and hemodynamic findings similar to those seen in septic shock after a first dose. Eight patients who received orthotopic heart transplants and were randomized to OKT3 therapy for immunosuppression were evaluated with serial hemodynamic and radionuclide monitoring for an 8-hour period during the first dose of OKT3. Cytokines including tumor necrosis factor-alpha, interleukin-1 and -2, and interferon-gamma were measured hourly to determine the potential mechanism of action of OKT3. All patients tolerated OKT3, although most had symptoms--pyrexia, chills, dyspnea, nausea and vomiting, and fever--within an hour after the dose. All patients exhibited a biphasic hemodynamic response to the first dose of OKT3. The initial hemodynamic response was characterized by a hyperdynamic phase with involvement in cardiac function as measured by cardiac output and ejection fraction. Left ventricular ejection fraction increased from 68% +/- 10% to 79 +/- 11% and was accompanied by increases in right ventricular ejection fraction and increases in cardiac index from 2.1 +/- 1.1 to 3.8 +/- 1.3 L/min/m2. The increase in ejection fraction was accompanied by a significant decrease in systemic vascular resistance index, from 2190 +/- 740 to 1608 +/- 573 dyne.sec.cm-5. The improvement in left ventricular ejection was caused by a significant decrease in end-systolic volume index (18 +/- 9.5 to 11 +/- 7 ml/m2). This occurred within the first 2 hours after OKT3 and was followed by cardiac index and ejection fraction returning to baseline in the next 2 to 3 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Monoclonal versus polyclonal antibody therapy for prophylaxis against rejection after heart transplantation.

Between August 1986 and December 1987, 88 patients received either RATG or OKT3 for immunoprophylaxis before heart transplantation. By the end of the first month after transplantation, 25% of the patients who received RATG had experienced a rejection episode compared with 43% of those receiving OKT3. This difference was persistent as many as 4 months after transplantation. While 50% of the OKT3 patients had a second episode of rejection, only 35% of the RATG patients did so. Randomization of these agents was complicated by severe cardiopulmonary side effects attributed to the first dose of OKT3. Five hours after the first dose of OKT3, a 25% drop in mean arterial pressure, accompanied by significant hypoxia, was seen in a majority of patients. There was no difference in the incidence of infection between the two groups.

Antibodies, Monoclonal↗

PubMedDate not supplied

In business--how one nurse turned a small investment into a small fortune.. Interview by Rose G. Foltz.

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Commerce↗

PubMedDate not supplied

[Comparative study of illegal cocaine samples with high pressure liquid chromatography and photodiode array detection].

A method for the differentiation of illicit cocaine samples by HPLC/PDAD was presented. By this technique, the determination of the aliquots of cis- and trans-cinnamoylcocaine in relation to cocaine as well as the determination of minor alkaloids such as tropacocaine, norcocaine, N-formylcocaine and N-benzoylmethylecgonine as additional "finger-prints" proved to be a practical and always reproducible tool.

Chromatography, High Pressure Liquid↗