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1.
Eur J Clin Microbiol Infect Dis ; 42(3): 339-345, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36720769

RESUMO

The study aims to characterise the species identification and antimicrobial susceptibility testing (AST) results of Nocardial isolates from adult patients across major public hospitals in Queensland, Australia, over a 15-year period. A multi-centre retrospective observational study of Nocardia sp. isolates was conducted from 7 major public hospitals in Queensland, Australia, over a 15-year period. Clinical samples from patients aged ≥ 18 years that isolated Nocardia sp. were included. Demographic and clinical data were collected, along with species identification and AST results. Overall, 484 Nocardia sp. were isolated. Most patients were male (297, 61%) with a mean (IQR) age of 60 (51-75) and a median (IQR) Charlson Comorbidity Index of 4 (2-6). Of these, 239 (49%) patients were immunosuppressed. Organisms were most frequently isolated from sputum (174, 36%), and superficial swabs (102, 21%). Patients presented with pulmonary infections (165, 35%) and superficial skin and soft tissue infections (87, 18%) most commonly. One hundred (21%) isolates were deemed pulmonary colonisation and were not treated. Of the speciated organisms, N. nova complex was the most common (93, 19%), followed by N. farcinica complex (79, 16%). Organisms were reliably susceptible to linezolid (240/245, 98%), amikacin (455/470, 97%), and trimethoprim/sulfamethoxazole (459/476, 96%), but less so to imipenem (243/472, 51%) and ceftriaxone (261/448, 58%). This is the largest Australian description of Nocardia sp. to date. Given antimicrobials are often commenced prior to AST results and sometimes even speciation, characterisation of local species and antibiogram data is important to guide empiric choices and local guidelines.


Assuntos
Anti-Infecciosos , Nocardiose , Nocardia , Adulto , Humanos , Masculino , Feminino , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Queensland/epidemiologia , Nocardiose/tratamento farmacológico , Nocardiose/epidemiologia , Nocardiose/microbiologia , Austrália/epidemiologia , Anti-Infecciosos/uso terapêutico , Testes de Sensibilidade Microbiana
2.
J Neurooncol ; 153(1): 99-107, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33791952

RESUMO

PURPOSE: Glioblastoma prognosis is poor. Treatment options are limited at progression. Surgery may benefit, but no quality guidelines exist to inform patient selection. We sought to describe variations in surgical management at progression, highlight where further evidence is needed, and build towards a consensus strategy. METHODS: Current practice in selection of patients with progressive GBM for second surgery was surveyed online amongst specialists in the UK and Europe. We complemented this with an assessment of practice in a retrospective cohort study from six United Kingdom neurosurgical units. We used descriptive statistics to analyse the data. RESULTS: 234 questionnaire responses were received. Maintaining or improving patient quality of life was key to decision making, with variation as to whether patient age, performance status or intended extent of resection was relevant. MGMT methylation status was not important. Half considered no minimum time after first surgery. 288 patients were reported in the cohort analysis. Median time to second surgery from first surgery 390 days. Median overall survival 815 days, with no association between time to second surgery and time to death (p = 0.874). CONCLUSIONS: This is the most wide-ranging examination of contemporaneous practice in management of GBM progression. Without evidence-based guidelines, the variation is unsurprising. We propose consensus guidelines for consideration, to reduce heterogeneity in decision making, support data collection and analysis of factors influencing outcomes, and to inform clinical trials to establish whether second surgery improves patient outcomes, or simply selects to patients already performing well.


Assuntos
Glioblastoma , Tomada de Decisão Clínica , Estudos de Coortes , Glioblastoma/cirurgia , Humanos , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários
3.
Thorax ; 64(11): 926-31, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19574243

RESUMO

BACKGROUND: Pseudomonas aeruginosa is the most common bacterial pathogen in patients with cystic fibrosis (CF). Current infection control guidelines aim to prevent transmission via contact and respiratory droplet routes and do not consider the possibility of airborne transmission. It was hypothesised that subjects with CF produce viable respirable bacterial aerosols with coughing. METHODS: A cross-sectional study was undertaken of 15 children and 13 adults with CF, 26 chronically infected with P aeruginosa. A cough aerosol sampling system enabled fractioning of respiratory particles of different sizes and culture of viable Gram-negative non-fermentative bacteria. Cough aerosols were collected during 5 min of voluntary coughing and during a sputum induction procedure when tolerated. Standardised quantitative culture and genotyping techniques were used. RESULTS: P aeruginosa was isolated in cough aerosols of 25 subjects (89%), 22 of whom produced sputum samples. P aeruginosa from sputum and paired cough aerosols were indistinguishable by molecular typing. In four cases the same genotype was isolated from ambient room air. Approximately 70% of viable aerosols collected during voluntary coughing were of particles

Assuntos
Tosse/microbiologia , Fibrose Cística/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Adolescente , Adulto , Criança , Doença Crônica , Estudos Transversais , Feminino , Volume Expiratório Forçado , Infecções por Bactérias Gram-Negativas/transmissão , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade , Escarro/microbiologia , Adulto Jovem
4.
Science ; 159(3817): 888-9, 1968 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-5636330

RESUMO

The crystal structure of the triethylammonium salt of cyclic uridine-3',5'-phosphate was solved by use of the tangent formula to refine phase angles based upon the positions of six of the atoms. The two independent uracil rings are planar and in the keto form. The base-sugar torsion angles are in the anti range. The sugar puckering is C3'-endo, and the ribose conformation about the C5'-C4' bond is transgauche.


Assuntos
Nucleotídeos de Uracila , Fenômenos Químicos , Química , Cristalografia
5.
Science ; 201(4354): 415-20, 1978 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-663665

RESUMO

Continued progress in many areas of science depends on access to advanced modern instruments and the data they provide. Costly instruments have been shared in a number of disciplines for many years, and common patterns of shared usage have developed independently. The scientific and financial aspects of large instrument usage are discussed from the points of view of the instrument centers, the users, and the funding agencies. The instrument problem is not one problem but many, and coordinated solutions must be implemented with well-defined goals based on knowledge of the needs of the users and developers of instruments.


Assuntos
Equipamentos e Provisões , Pesquisa , Biofísica/instrumentação , Biologia Celular/instrumentação , Química/instrumentação , Computadores/provisão & distribuição , Órgãos Governamentais , Microscopia Eletrônica/instrumentação , Biologia Molecular/instrumentação , Aceleradores de Partículas/provisão & distribuição , Apoio à Pesquisa como Assunto , Análise Espectral/instrumentação , Estados Unidos
6.
Science ; 169(3950): 1097-8, 1970 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-5449320

RESUMO

Monoclinic crystals of the sodium salt of cytidine 2',3'-phosphate contain two anions in the asymmetric unit. Both bases are in the syn conformation, and the nucleotides are stacked together into an antiparallel stranded ribbon with the bases 3.3 angstroms apart. One ribose ring is planar, and the other has oxygen-1' puckered toward carbon-5'. The phosphorus atoms in the five-membered ester rings are puckered toward the sugars. The conformations about the carbon-4'-carbon-5' bonds are gauche-trans and gauche-gauche.


Assuntos
Nucleotídeos de Citosina/análise , Difração de Raios X
7.
Lab Anim ; 43(3): 232-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19116294

RESUMO

Reported analgesic use following experimental surgery is low in rodents and there has been little published information on the frequency of analgesic use in other laboratory species. A structured literature review was conducted to examine analgesic administration in larger laboratory animals. The Scirus search engine was used to identify studies published in peer-reviewed journals that reported carrying out experimental surgery on 'large' laboratory animals, specifically rabbits, pigs, sheep, dogs and non-human primates. Seventy-four studies between 2000 and 2001 and 75 studies between 2005 and 2006 were included in the review. There was an increase in the reported administration of systemic analgesics to these species from 50% in 2000-2001 to 63% in 2005-2006. When all agents with analgesic properties were considered (systemic analgesics, local anaesthetics and anaesthetics with analgesic components), the proportion of papers that reported some form of analgesic administration to 'large' laboratory animals increased from 86% in 2000-2001 to 89% in 2005-2006. Overall rabbits, pigs, sheep, dogs and non-human primates were more likely to receive analgesics following potentially painful experimental procedures than has been reported in laboratory rodents but analgesic administration to 'large' laboratory species is still not optimal.


Assuntos
Analgesia/veterinária , Analgésicos , Bem-Estar do Animal , Animais de Laboratório/cirurgia , Dor Pós-Operatória/veterinária , Cirurgia Veterinária/métodos , Analgesia/estatística & dados numéricos , Animais , Cães , Dor Pós-Operatória/prevenção & controle , Coelhos , Ovinos , Especificidade da Espécie , Suínos
8.
Public Health Action ; 9(Suppl 1): S12-S18, 2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-31579644

RESUMO

SETTING: Xpert® MTB/RIF was introduced in Papua New Guinea in 2012 for the diagnosis of tuberculosis (TB) and of rifampicin-resistant TB (RR-TB), a marker of multi-drug-resistant TB (MDR-TB). OBJECTIVE: To assess the concordance of Xpert with phenotypic drug susceptibility testing (DST) performed at the supranational reference laboratory and to describe the patterns of drug-resistant TB observed. DESIGN: This was a retrospective descriptive study of laboratory data collected from April 2012 to December 2017. RESULTS: In 69 months, 1408 specimens with Xpert results were sent for mycobacterial culture and DST; Mycobacterium tuberculosis was cultured from 63% (884/1408) and DST was completed in 99.4%. The concordance between Xpert and culture for M. tuberculosis detection was 98.6%. Of 760 RR-TB cases, 98.7% were detected using Xpert; 98.5% of 620 MDR-TB cases were identified using phenotypic DST. Phenotypic resistance to second-line drugs was detected in 59.4% (522/879) of specimens tested, including 29 with fluoroquinolone resistance; the majority were from the National Capital District and Daru Island. CONCLUSION: The high concordance between phenotypic DST and Xpert in identifying RR-TB cases supports the scale-up of initial Xpert testing in settings with high rates of drug resistance. However, rapid DST in addition to the detection of RR-TB is required.

9.
J Orthop Surg (Hong Kong) ; 16(3): 339-42, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19126902

RESUMO

PURPOSE: To classify the spectrum and antibiotic susceptibility of bacteria isolated from infected hip and knee arthroplasty specimens, and to recommend appropriate empiric peri-operative antibiotics. METHODS: From January 1999 to August 2006, specimens from revision hip and knee arthroplasties (with or without suspected infection) were routinely collected for identifying possible organisms and their susceptibility patterns. During the period, 147 patients had positive specimens yielding 248 micro-organisms (from 195 tissue specimens, 43 fluid specimens, and 10 swabs). 140 isolates were from hips and 108 from knees. RESULTS: Most isolates were Gram-positive; their distribution was similar in hip and knee specimens. Of the 248 micro-organisms isolated, Staphylococcus was the most common genus encountered (131, 53%), followed by Gram-negative isolates (24%). 88% of Gram-negative organisms were detected within 48 hours of inoculation and 94% of Gram-positive organisms within 96 hours. Overall, 46% of isolates were susceptible to cephalothin. Only 35% of coagulase-negative staphylococci were sensitive to cephalothin. No Gram-positive vancomycin resistance was encountered. CONCLUSION: Empiric prophylactic antibiotics for revision hip and knee arthroplasties should include vancomycin to cover Gram-positive organisms and gentamicin for most Gram-negative bacteria.


Assuntos
Antibioticoprofilaxia , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Infecções por Bactérias Gram-Negativas/prevenção & controle , Infecções por Bactérias Gram-Positivas/prevenção & controle , Infecção da Ferida Cirúrgica/microbiologia , Estudos de Coortes , Farmacorresistência Bacteriana , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Reoperação , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/tratamento farmacológico
10.
Int J Tuberc Lung Dis ; 22(2): 206-211, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29506618

RESUMO

SETTINGp: Multidrug-resistant tuberculosis (MDR-TB) is a growing concern worldwide. In Australia, although the incidence of MDR-TB remains low, Queensland is at an increased risk due to its proximity to Papua New Guinea (PNG). OBJECTIVE: To examine the epidemiology, clinical features and outcomes of MDR-TB in Queensland, with a comparison between cross-border PNG and non-cross-border patients. DESIGN: Retrospective case series of all MDR-TB patients in Queensland between 1 January 2000 and 31 December 2014. RESULTS: Ninety-six patients were diagnosed with MDR-TB in Queensland between 2000 and 2014. The majority were cross-border PNG nationals diagnosed within the Torres Straight Protected Zone (n = 73, 76%). Cross-border patients were younger (27.4 vs. 36.3 years, P = 0.02), had spent less time in Australia before diagnosis (<1 vs. 19 months, P < 0.01), had higher rates of smear positivity (67.1% vs. 40%, P = 0.04) and were less likely to have received a second-line injectable agent (45.8% vs. 71.4%, P = 0.05). Cross-border patients had significantly lower rates of treatment success than non-cross-border patients (47.9% vs. 85.7%; P < 0.01). CONCLUSION: MDR-TB cases in Queensland are largely a result of cross-border PNG nationals, with poorer outcomes seen in this cohort. Continued strengthening of the region's TB programmes, with a focus on cross-border patients, is required.


Assuntos
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Emigrantes e Imigrantes , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Papua Nova Guiné/etnologia , Queensland/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Tuberculose Resistente a Múltiplos Medicamentos/etnologia , Tuberculose Resistente a Múltiplos Medicamentos/prevenção & controle , Adulto Jovem
11.
J Hosp Infect ; 100(3): e77-e84, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30036634

RESUMO

BACKGROUND: The index case of Mycobacterium chimaera infection in a patient following open cardiac surgery in the state of Queensland, Australia prompted a centralized coordinated response to mitigate the risk. AIM: To describe the public health response to M. chimaera contamination of heater-cooler units (HCUs) and patient infection. METHODS: A public health sector strategy was developed with national and international consultation to respond to the threat of HCUs contaminated with M. chimaera. Data linkage of non-tuberculous mycobacterium notifications and selected procedures was undertaken where potential use of HCUs was identified through hospitalization records. Water sampling and testing protocols were standardized. Public disclosure and patient notification were undertaken. FINDINGS: A single case of disseminated M. chimaera infection in a patient has been diagnosed to date in Queensland, Australia. Ten of 12 (83%) LivaNova Stockert 3T HCUs from five hospitals tested positive for M. chimaera. In total, 5650 patients were notified by post of their potential risk of exposure. Use of the telehealth call centre was modest. M. chimaera was also found in extracorporeal membrane oxygenation heater units produced by two other device manufacturers, four of which tested positive prior to commissioning for use. CONCLUSIONS: Rapid international collaboration optimized the Queensland Health response to potential M. chimaera exposure during cardiac surgery. State-wide collaboration ensured a transparent, consistent approach to contacting patients and informing the public of the potential risk. A framework for ongoing risk management, clinical awareness and laboratory diagnosis was established. No further cases of M. chimaera infection have been identified in Queensland.


Assuntos
Contaminação de Equipamentos , Doença Iatrogênica/prevenção & controle , Controle de Infecções/organização & administração , Colaboração Intersetorial , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/prevenção & controle , Mycobacterium/isolamento & purificação , Humanos , Controle de Infecções/métodos , Queensland
12.
Int J Tuberc Lung Dis ; 22(3): 294-299, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29471907

RESUMO

OBJECTIVE: To describe the epidemiology and outcomes of multidrug-resistant tuberculosis (MDR-TB) diagnosed in Australia between 1998 and 2012. DESIGN: A retrospective review was undertaken involving all patients with laboratory-confirmed MDR-TB notified in Australia between 1998 and 2012 inclusive. Demographic, clinical and laboratory features are described. Clinical outcomes were defined according to World Health Organization definitions of treatment success (cure and treatment completion), treatment failure, death, loss to follow-up (including transfer out), or not evaluated at treatment completion. RESULTS: A total of 244 cases of MDR-TB were diagnosed in Australia during the study period, representing 1.4% of all TB cases notified. The majority were born outside Australia, including one third in Papua New Guinea. Of those with treatment outcome data available, treatment success was demonstrated in 81%. Treatment success was positively associated with use of a second-line injectable agent. Those born in Papua New Guinea were less likely to achieve treatment success. CONCLUSION: MDR-TB is uncommon in Australia. The large number of cases born in Papua New Guinea, and the poorer outcomes in this cohort, represent challenges with cross-border management of MDR-TB in the Torres Strait. Australia has an ongoing role in the prevention and management of MDR-TB locally and in the region.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Emigração e Imigração , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Falha de Tratamento , Adulto Jovem
13.
Endocrinology ; 148(11): 5424-32, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17702852

RESUMO

We investigated the effects of an intrafetal infusion of IGF-I on adrenal growth and expression of the adrenal steroidogenic and catecholamine-synthetic enzyme mRNAs in the sheep fetus during late gestation. Fetal sheep were infused for 10 d with either IGF-I (26 microg/kg.h; n = 14) or saline (n = 10) between 120 and 130 d gestation, and adrenal glands were collected for morphological analysis and determination of the mRNA expression of steroidogenic and catecholamine-synthetic enzymes. Fetal body weight was not altered by IGF-I infusion; however, adrenal weight was significantly increased by 145% after IGF-I infusion. The density of cell nuclei within the fetal adrenal cortex (the zona glomerulosa and zona fasciculata), and within the adrenaline synthesizing zone of the adrenal medulla, was significantly less in the IGF-I-infused fetuses compared with the saline-infused group. Thus, based on cell-density measurements, there was a significant increase in cell size in the zona glomerulosa and zona fasciculata of the adrenal cortex and in the adrenaline-synthesizing zone of the adrenal medulla. There was no effect of IGF-I infusion on the adrenal mRNA expression of the steroidogenic or catecholamine-synthetic enzymes or on fetal plasma cortisol concentrations. In summary, infusion of IGF-I in late gestation resulted in a marked hypertrophy of the steroidogenic and adrenaline-containing cells of the fetal adrenal in the absence of changes in the mRNA levels of adrenal steroidogenic or catecholamine-synthetic enzymes or in fetal plasma cortisol concentrations. Thus, IGF-I infusion results in a dissociation of adrenal growth and function during late gestation.


Assuntos
Glândulas Suprarrenais/efeitos dos fármacos , Feto/efeitos dos fármacos , Fator de Crescimento Insulin-Like I/administração & dosagem , Fator de Crescimento Insulin-Like I/farmacologia , Esteroides/metabolismo , Glândulas Suprarrenais/embriologia , Glândulas Suprarrenais/crescimento & desenvolvimento , Animais , Feminino , Sangue Fetal/química , Desenvolvimento Fetal/efeitos dos fármacos , Desenvolvimento Fetal/genética , Peso Fetal/efeitos dos fármacos , Feto/metabolismo , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Idade Gestacional , Hidrocortisona/sangue , Fator de Crescimento Insulin-Like I/análise , Tamanho do Órgão/efeitos dos fármacos , Gravidez , Ovinos
14.
Int J Tuberc Lung Dis ; 21(3): 263-269, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28225336

RESUMO

SETTING: Queensland, Australia. BACKGROUND: Understanding paediatric tuberculosis (TB) is important, as children with TB typically reflect recent community transmission. Children pose unique diagnostic challenges and are at risk of developing severe disseminated infection. OBJECTIVE: To describe the epidemiology, presentation and outcomes of children with TB disease in Queensland. DESIGN: This is a retrospective case series of children diagnosed with TB aged 0-16 years notified in 2005-2014. Data collected in the Queensland Notifiable Conditions System were extracted and analysed. RESULTS: Of 127 children diagnosed with TB, 16 were Australian-born (including 12 Indigenous Queenslanders), 41 were overseas-born permanent and temporary residents and 70 were cross-border Papua New Guinea (PNG) children; 88 children had pulmonary disease (with/without other sites) and 39 had extra-pulmonary disease only, with lymph node TB the predominant extra-pulmonary site; 70.1% of children had laboratory confirmation; and 14 cross-border children had multidrug-resistant TB. Treatment outcomes among children residing in Australia were good (100% among Australian-born and 97.2% among permanent and temporary residents), but they were less favourable among PNG children diagnosed in the Torres Strait Protected Zone (76.6%). CONCLUSION: Queensland has unique challenges in TB control, with a high proportion of cross-border diagnoses and over-representation of Indigenous children. Vigilance is needed given the wide spectrum of clinical presentation, particularly in high-risk communities.


Assuntos
Antituberculosos/administração & dosagem , Tuberculose dos Linfonodos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Criança , Pré-Escolar , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase , Queensland/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose dos Linfonodos/tratamento farmacológico , Tuberculose dos Linfonodos/etnologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/etnologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/etnologia
15.
Infect Control Hosp Epidemiol ; 27(2): 201-3, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16465641

RESUMO

Using pulsed-field gel electrophoresis, we genotyped 21 methicillin-resistant Staphylococcus aureus isolates from patients attending an adult cystic fibrosis unit. Eleven patients exhibited pulsotypes related to 2 locally endemic strains. Eleven chronically colonized patients were assessed over a period of up to 2 years, and all demonstrated a retention of strain type.


Assuntos
Fibrose Cística , Resistência a Meticilina , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Infecção Hospitalar/epidemiologia , Eletroforese em Gel de Campo Pulsado , Humanos , Queensland/epidemiologia , Staphylococcus aureus/patogenicidade
16.
Forensic Sci Int ; 164(2-3): 126-30, 2006 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-16423482

RESUMO

This article details the stability of Delta(9)-tetrahydrocannabinol (THC) in oral fluid during collection, extraction and storage. Oral fluid is being increasingly used as the specimen of choice for the detection of drug use in various applications. Studies to determine the extraction efficiency of THC from the collection buffer and stability under various laboratory storage conditions were carried out. THC was extracted from the collection pad and buffer with an average efficiency over 80% and was stable in Quantisal oral fluid extraction buffer when stored at refrigerated temperatures. Fluorescent lighting caused THC losses of over 50%, however the presence of the pad reduced the loss. In the dark, the loss of THC at room temperature was approximately 20% over 14 days. When stored with the serum separators in place, THC losses were significant. After 3 days, THC concentration was reduced by almost 30%, and after 14 days, 60% of the drug was lost and the losses were not concentration dependent.


Assuntos
Dronabinol/farmacocinética , Alucinógenos/farmacocinética , Saliva/química , Manejo de Espécimes/instrumentação , Soluções Tampão , Escuridão , Dronabinol/análise , Estabilidade de Medicamentos , Fluorescência , Toxicologia Forense , Alucinógenos/análise , Humanos , Detecção do Abuso de Substâncias , Temperatura
17.
Cancer Res ; 48(18): 5167-71, 1988 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-3409242

RESUMO

The 0-24-h urinary metabolic profile of cyclophosphamide was investigated in a series of 14 patients with various malignancies receiving combination chemotherapy including i.v. cyclophosphamide. This was accomplished using combined thin-layer chromatography-photography-densitometry, which can quantitate cyclophosphamide and its four principal urinary metabolites (4-ketocyclophosphamide, nor-nitrogen mustard, carboxyphosphamide, and phosphoramide mustard). Recovery of drug-related metabolites was 36.5 +/- 17.8% (SD) dose, the most abundant metabolites being phosphoramide mustard (18.5 +/- 16.1% dose) and unchanged cyclophosphamide (12.7 +/- 9.3% dose). The most variable metabolite was carboxyphosphamide, with five patients excreting 0.3% dose or less. These patients were termed low carboxylators (LC) and could be distinguished from high carboxylators (HC) by a carboxylation index (relative percentage as carboxyphosphamide multiplied by 10). Mean carboxylation indices for the LC and HC phenotypes were 3.4 +/- 2.6 and 151 +/- 115, respectively. There were no associations between patient age, sex, body weight, tumor type, or concomitant drug therapy and carboxylation phenotype. Neither 4-ketocyclophosphamide nor nor-nitrogen mustard excretion differed between LC and HC phenotypes; however, HC patients had a greater excretion of cyclophosphamide (46.4 +/- 15.5 relative percentage) than LC patients (19.4 +/- 12.6%). The DNA cross-linking cytotoxic metabolite phosphoramide mustard was elevated more than 2-fold in the LC (76.5 +/- 13.9%) compared with the HC (33.0 +/- 12.2%) phenotype. It is concluded that these data represent the first evidence of a defect in cyclophosphamide metabolism, and it is proposed that this arises from a hitherto unrecognized aldehyde dehydrogenase genotype.


Assuntos
Ciclofosfamida/farmacocinética , Neoplasias/urina , Mostardas de Fosforamida/urina , Adulto , Idoso , Cromatografia em Camada Fina , Ciclofosfamida/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Fenótipo
18.
J Cyst Fibros ; 4(3): 205-7, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16019268

RESUMO

Methicillin-resistant Staphylocosis aureus (MRSA) is an emerging infection in patients with cystic fibrosis (CF). MRSA may be a management dilemma for healthcare workers (HCWs) with CF. Eradication of MRSA with long-term rifampicin and fusidic acid can be achieved in patients with CF. We describe a case of recurrent MRSA infection in a HCW with CF. Molecular typing of the MRSA isolates supported re-infection rather than re-emergence of an earlier MRSA infection. Infection control advice for HCWs with CF who acquire MRSA remains controversial.


Assuntos
Antibacterianos/uso terapêutico , Fibrose Cística/microbiologia , Pessoal de Saúde , Resistência a Meticilina , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/isolamento & purificação , Adulto , Quimioterapia Combinada , Feminino , Seguimentos , Ácido Fusídico/uso terapêutico , Humanos , Rifampina/uso terapêutico , Escarro/microbiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos
20.
Endocrinology ; 139(12): 5144-50, 1998 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9832454

RESUMO

Previous studies in the primate fetal adrenal gland have indicated that the gland is comprised of three functional zones: 1) the inner fetal zone (FZ), which has the enzymes necessary for dehydroepiandrosterone sulfate (DHEAS) production beginning early in gestation; 2) the transitional zone (TZ), which possesses enzymes necessary for cortisol production; and 3) the outer, definitive zone (DZ), which appears to function as a reservoir of progenitor cells that may populate the remainder of the gland and does not acquire a steroidogenic phenotype with the capacity to produce mineralocorticoids until near term. The enzymes CYP21A2 (P450 21 hydroxylase, or P450c21), CYP11B1 (11beta hydroxylase or P450c11) and CYP11B2 (aldosterone synthase) are necessary for glucocorticoid and mineralocorticoid synthesis but have not been localized previously in an ontogenic manner in the primate fetal adrenal gland. Therefore, we used immunocytochemistry (ICC) to assess specific zonal localization and developmental regulation of CYP21A2 and CYP11B1/CYP11B2 in the human (13-24 weeks' gestation) and rhesus monkey (109 d-term) fetal adrenal gland. In the fetal rhesus, ICC was performed with and without metyrapone administration to the fetus to assess the effects of endogenously increased fetal ACTH. In the human fetal adrenal, CYP21A2 immunoreactivity (IR) was present in only a few isolated cells in the DZ but was detectable in almost all cells in the TZ and FZ. In the fetal rhesus, CYP21A2-IR was present in cells throughout the DZ and TZ and, to a lesser degree, in the FZ. Staining intensity increased with advancing gestational age and was up-regulated in the DZ and TZ, but not the FZ, of the metyrapone-treated fetuses. In the human fetal adrenal gland, CYP11B1/CYP11B2-IR was absent in the DZ but present in the TZ and FZ. In the fetal rhesus monkey adrenal, CYP11B1/CYP11B2-IR was present in all cells of the TZ and FZ but was absent from the DZ until near term. After metyrapone, CYP11B1/CYP11B2-IR was induced in the DZ and was up-regulated in the TZ and FZ. Taken together, these data indicate that in the primate fetal adrenal gland, the FZ has the capacity to synthesize DHEA and DHEAS beginning early in development, the TZ has the capacity to synthesize cortisol after midgestation, and the DZ has the capacity to synthesize mineralocorticoids, but not until near term. The spatial localization of steroid metabolizing enzymes and steroid products in the human and rhesus monkey fetal adrenal suggests analogies of the three functional zones of the fetus (DZ, TZ, and FZ) to their adult counterparts (zona glomerulosa, zona fasciculata, and zona reticularis) and their steroid products (mineralocorticoids, glucocorticoids and androgens, respectively), although the reason for the presence of CYP11B1/CYP11B2- and CYP21A2-IR in the FZ remains to be elucidated.


Assuntos
Glândulas Suprarrenais/embriologia , Citocromo P-450 CYP11B2/metabolismo , Primatas/embriologia , Esteroide 11-beta-Hidroxilase/metabolismo , Esteroide 21-Hidroxilase/metabolismo , Esteroides/biossíntese , Animais , Desenvolvimento Embrionário e Fetal/fisiologia , Humanos , Imuno-Histoquímica , Macaca mulatta , Fatores de Tempo , Distribuição Tecidual
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