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PubMedDate not supplied

Decreased in vitro fluoroquinolone concentrations after admixture with an enteral feeding formulation.

BACKGROUND: The purpose of this study was to determine if mixing of fluoroquinolones with a common enteral feeding formulation, Ensure (Ross Products Division, Abbott Laboratories, Columbus, OH), would alter the measured in vitro quinolone concentrations over a 24-hour period. METHODS: Tablets of ciprofloxacin (500 mg), levofloxacin (500 mg), and ofloxacin (300 mg) were crushed and mixed with 240 mL of Ensure, water and calcium chloride (500 mg/L), water and magnesium chloride (200 mg/L), water and calcium chloride and magnesium chloride, and water alone. Fluoroquinolone concentrations of the mixtures were measured, via high-performance liquid chromatography, at baseline and serially over 24 hours. Experiments were performed in duplicate, at three temperatures (5 degrees C, 25 degrees C, and 37 degrees C). RESULTS: Average decreases of 82.5% +/- 1.5% for ciprofloxacin, 61.3% +/- 5.2% for levofloxacin, and 45.7% +/- 10.1% for ofloxacin (mean +/- 95% CI) were observed in vitro for Ensure over the two experimental sets at baseline. Serial analysis revealed no further significant change in any of the quinolone concentrations over the remaining 24-hour period. No significant decrease was noted with the quinolones when mixed in water and calcium, water and magnesium, water and calcium and magnesium, or water alone. This phenomenon appears to be unaffected by time and temperature. CONCLUSIONS: These data suggest there is an immediate and significant loss of fluoroquinolone when mixed with Ensure. An explanation for the loss of fluoroquinolone remains unclear.

Anti-Infective Agents↗
PubMedDate not supplied

Total nutrient admixture: a review.

The TNA system of nutritional support has become very popular and offers some unique advantages over the traditional method of administering TPN to hospitalized and home patients. However, these advantages as outlined in this review, must be carefully weighed against potential disadvantages before the TNA system is employed as a nutritional support modality. It should also be noted that the stability of TNA systems is not well established since many stability studies do not provide specific information regarding formulations tested. In addition, many studies do not utilize methods to determine the entire spectrum of particle size and distribution. Droplet size in TNA systems attain a diameter several times larger than the 0.2 to 0.4 micron of manufacturer's lipid emulsions and naturally occurring chylomicrons. Although the administration of the TNA system has not been associated with any acute toxicity, the long-term consequences of infusing droplets larger than 0.4 micron is not definitely known. In addition, the biological implications of using the TNA system need to be elucidated. Subtle differences in the properties of the lipid emulsion can affect the way it is metabolized by the body. Wretlind has mentioned that two apparently similar soybean oil emulsions, Intralipid, and Lipofundin are handled differently by the body. Minor differences in the phospholipid layer of the droplets were postulated as a cause. Certainly the nature of the emulsifying layer of phospholipid on TNA system droplets is modified and therefore may be metabolized differently. The recent report of enhanced growth of microorganisms in TNA systems is also worrisome.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemical Phenomena↗
PubMedDate not supplied

Potential for microbial contamination of ADD-Vantage admixtures.

OBJECTIVE: To test for potential bacterial contamination of the ADD-Vantage system when the components are assembled in various hospital environments. STUDY DESIGN: One hundred fifty ADD-Vantage units were assembled by three different people in three separate locations within a hospital. Each person assembled ten units per day; the study spanned five days. After 72 hours of incubation, units were inspected for evidence of contamination. SETTING: ADD-Vantage units were assembled by a pharmacist in a laminar-flow hood, a pharmacy student using the pharmacy counter, and a nurse at a patient's bedside table. Personnel at each site wore their regular work attire. Each person observed handwashing techniques normally used during routine working hours. DATA EXTRACTION: Positive results were sent to the hospital microbiology laboratory for determination of growth type. RESULTS: After 72 hours, none of the systems exhibited microbial growth on visual inspection. No differences in microbial contamination of the ADD-Vantage systems relative to assembly site, day of assembly, or person performing the assembly were observed. The incidence of contamination was calculated at less than seven percent. CONCLUSIONS: There is minimal risk of bacterial contamination when ADD-Vantage systems are compounded either on a pharmacy counter or at a patient's bedside. Larger samples must be studied in order to detect differences in the incidence of contamination among assembly sites.

Cimetidine↗
PubMed2005

Characterization of a likelihood based method and effects of markers informativeness in evaluation of admixture and population group assignment.

BACKGROUND: Detection and evaluation of population stratification are crucial issues in the conduct of genetic association studies. Statistical approaches useful for understanding these issues have been proposed; these methods rely on information gained from genotyping sets of markers that reflect population ancestry. Before using these methods, a set of markers informative for differentiating population genetic substructure (PGS) is necessary. We have previously evaluated the performance of a Bayesian clustering method implemented in the software STRUCTURE in detecting PGS with a particular informative marker set. In this study, we implemented a likelihood based method (LBM) in evaluating the informativeness of the same selected marker panel, with respect to assessing potential for stratification in samples of European Americans (EAs) and African Americans (AAs), that are known to be admixed. LBM calculates the probability of a set of genotypes based on observations in a reference population with known specific allele frequencies for each marker, assuming Hardy Weinberg equilibrium (HWE) for each marker and linkage equilibrium among markers. RESULTS: In EAs, the assignment accuracy by LBM exceeded 99% using the most efficient marker FY, and reached perfect assignment accuracy using the 10 most efficient markers excluding FY. In AAs, the assignment accuracy reached 96.4% using FY, and >95% when using at least the 9 most efficient markers. The comparison of the observed and reference allele frequencies (which were derived from previous publications and public databases) shows that allele frequencies observed in EAs matched the reference group more accurately than allele frequencies observed in AAs. As a result, the LBM performed better in EAs than AAs, as might be expected given the dependence of LBMs on prior knowledge of allele frequencies. Performance was not dependent on sample size. CONCLUSION: The performance of the LBM depends on the efficiency and number of markers, and depends greatly on how representative the available reference allele frequencies are for those of the population being assigned. This method is of value when the parental population is known and relevant allele frequencies are available.

Black or African American↗
PubMed2006

Genomes of Helicobacter pylori from native Peruvians suggest admixture of ancestral and modern lineages and reveal a western type cag-pathogenicity island.

BACKGROUND: Helicobacter pylori is presumed to be co-evolved with its human host and is a highly diverse gastric pathogen at genetic levels. Ancient origins of H. pylori in the New World are still debatable. It is not clear how different waves of human migrations in South America contributed to the evolution of strain diversity of H. pylori. The objective of our 'phylogeographic' study was to gain fresh insights into these issues through mapping genetic origins of H. pylori of native Peruvians (of Amerindian ancestry) and their genomic comparison with isolates from Spain, and Japan. RESULTS: For this purpose, we attempted to dissect genetic identity of strains by fluorescent amplified fragment length polymorphism (FAFLP) analysis, multilocus sequence typing (MLST) of the 7 housekeeping genes (atpA, efp, ureI, ppa, mutY, trpC, yphC) and the sequence analyses of the babB adhesin and oipA genes. The whole cag pathogenicity-island (cagPAI) from these strains was analyzed using PCR and the geographic type of cagA phosphorylation motif EPIYA was determined by gene sequencing. We observed that while European genotype (hp-Europe) predominates in native Peruvian strains, approximately 20% of these strains represent a sub-population with an Amerindian ancestry (hsp-Amerind). All of these strains however, irrespective of their ancestral affiliation harbored a complete, 'western' type cagPAI and the motifs surrounding it. This indicates a possible acquisition of cagPAI by the hsp-Amerind strains from the European strains, during decades of co-colonization. CONCLUSION: Our observations suggest presence of ancestral H. pylori (hsp-Amerind) in Peruvian Amerindians which possibly managed to survive and compete against the Spanish strains that arrived to the New World about 500 years ago. We suggest that this might have happened after native Peruvian H. pylori strains acquired cagPAI sequences, either by new acquisition in cag-negative strains or by recombination in cag positive Amerindian strains.

Antigens, Bacterial↗