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Biomedical subjects

V Sethuraman

Publications and source records attributed to V Sethuraman.

7 recordsLinked to original sources

Evaluation of dosing regimen of respirable rifampicin biodegradable microspheres in the treatment of tuberculosis in the guinea pig.

OBJECTIVES: The efficacy of rifampicin-loaded polymeric microspheres (RPLGA) delivered to guinea pigs infected with Mycobacterium tuberculosis (H37Rv) was compared with a daily dose of nebulized rifampicin suspension. METHODS: Aerosol-infected animals were subjected to multiple dose or single dose treatment with RPLGA, PLGA microspheres or micronized rifampicin suspension aerosols. For comparison with treatment with suspensions of microspheres, additional groups received daily doses of rifampicin-only suspensions for 20 (20-RIF) and 10 (10-RIF) days. RESULTS: Drug and polymer treated multiple dose groups exhibited significantly lower wet lung weights than untreated animals. Spleen wet weights and viable bacterial counts (VBCs) were much lower for drug microsphere treated animals than for all other groups. In multiple dose studies with rifampicin-only suspensions, wet lung weights for 10-RIF and 20-RIF treated animals were much smaller than controls. Likewise, wet spleen weights of 10-RIF and 20-RIF treated animals were much smaller than controls, consistent with reduced inflammation. Spleen VBC of 20-RIF treated animals was much smaller than controls. No statistical differences were observed in the lung VBC among single dose groups. However, a trend similar to that of the wet weights was observed. CONCLUSIONS: Aerosolized RPLGA reduced most measures of tuberculosis (TB) infection. These studies are further evidence for the potential of inhaled aerosol therapy for the treatment of TB. However, additional studies are required to elucidate underlying mechanisms of action and optimize this route of drug delivery.

Administration, Inhalation↗

FTIR, FT-Raman spectra and ab initio DFT vibrational analysis of 2-bromo-4-methyl-phenylamine.

The FTIR and FT-Raman spectra of 2-bromo-4-methyl-phenylamine (BMP) have been recorded. From the standard geometrical parameters the geometry of BMP was optimized at ab initio and DFT levels of theory with complete relaxation in the potential energy surface using 6-311+g(d,p) and 6-311+g(2df,2p) basis sets. Several thermodynamic parameters were also calculated for the minimum energy conformer at ab initio and DFT level of theories. The harmonic vibrational frequencies were calculated and the scaled values have been compared with experimental FTIR and FT-Raman spectra. Majority of the computed wavenumbers were found to be in good agreement with the experimental observations. The experimental spectra also coincide satisfactorily with those of theoretically constructed bar type spectrograms.

Aniline Compounds↗

Routine follow-up office visits after total joint replacement: do asymptomatic patients wish to comply?

A total of 100 patients presenting for routine office follow-up after total hip or knee arthroplasty completed questionnaires evaluating whether they preferred to come to the office for routine follow-up evaluation or whether they would have preferred an evaluation without an office visit. Of 100 patients, 45 would have preferred not to come into the office for a routine evaluation. They were content to mail completed questionnaires and radiographs to their physicians. The other 55 patients preferred office visits. These 2 groups were comparable for age, sex, height, weight, and number of surgeries (P > .11) Preoperative and postoperative scores were similar between the 2 groups (P > .39). None of the patients that would have preferred not to come in to the office believed that quality of care would be compromised. A significant number (45%) of patients would prefer not to come to the office because of the wages saved and time spared. Routine office visits may be eliminated for these patients through the use of health outcome devices, such as the SF-36, along with routine radiographs. The potential to decrease healthcare costs and increase patient satisfaction warrants the identification of these patients. Assessment of the effect on quality of care with elimination of routine follow-up visits requires further study.

Aged↗

Factors influencing choice of implants in total hip arthroplasty and total knee arthroplasty: perspectives of surgeons and patients.

To determine the factors influencing surgeons' choice of implants for total hip arthroplasty (THA) and total knee arthroplasty (TKA), 650 surveys were mailed to all active members of the American Association of Hip and Knee Surgeons practicing in the United States; 364 surveys (56%) were completed and returned. Analysis revealed that the average number of total hip and total knee replacements performed by the respondents in 1997 was 81 and 97; there was substantial regional variation. The average number of hip implant and knee implant brands used by these surgeons in 1997 was 2.4 and 1.8. Anticipated improvement in clinical results and cost of components were the most frequently listed reasons for changing brands. Surgeons were also queried about cost reduction programs at their particular institution. The most frequently listed strategies for cost reduction of implants included surgeon cost-awareness programs and volume discounting. More than half of the respondents (53.5%) anticipate manufacturers to decrease the cost of implants in the next 2 years. Most of the respondents (93.7%) currently have the ability to choose a particular implant. About half (46.7%) anticipate losing some or all control of this decision in the next 3 years. These respondents foresee their hospitals requiring the use of a discounted implant in the future. An additional survey was completed by 102 consecutive patients scheduled either for primary THA (64) or primary TKA (38) at our institution. When asked about implant selection, 93.1% responded that their orthopaedic surgeon should choose the prosthesis; 5.9% responded that their physician in consultation with the patient should choose the prosthesis. When asked what should be the primary determinant of implant choice, cost or quality, the overwhelming majority (97.1%) chose quality. A small percentage (2.9%) chose cost and quality. No patient chose cost alone. A large number of patients (84.8%) responded that they would pay additional costs if their insurance companies or health maintenance organizations refused to pay for a better but more expensive implant. Most patients realized how expensive components are, and 51% of the respondents correctly estimated the cost of an implant. Orthopaedic surgeons perceive that they are losing control of implant choice in THA and TKA. Cost of implants is one of the most significant factors influencing which implant is chosen. Patients (the true payors), however, overwhelmingly want their surgeons to choose the implant used at surgery, and they want quality, not cost, to be the primary determinant of this decision.

Arthroplasty, Replacement, Hip↗