RESUMO
In this study, the efficacy of ceftaroline fosamil was compared with that of cefepime in an experimental rabbit meningitis model against two Gram-negative strains (Escherichia coli QK-9 and Klebsiella pneumoniae 1173687). The penetration of ceftaroline into inflamed and uninflamed meninges was also investigated. Both regimens were bactericidal, but ceftaroline fosamil was significantly superior to cefepime against K. pneumoniae and E. coli in this experimental rabbit meningitis model (P < 0.0007 against K. pneumoniae and P < 0.0016 against E. coli). The penetration of ceftaroline was approximately 15% into inflamed meninges and approximately 3% into uninflamed meninges.
Assuntos
Antibacterianos/farmacologia , Cefalosporinas/farmacologia , Infecções por Klebsiella/tratamento farmacológico , Meningite devida a Escherichia coli/tratamento farmacológico , Animais , Antibacterianos/líquido cefalorraquidiano , Antibacterianos/farmacocinética , Cefepima , Cefalosporinas/líquido cefalorraquidiano , Cefalosporinas/farmacocinética , Modelos Animais de Doenças , Escherichia coli/efeitos dos fármacos , Escherichia coli/fisiologia , Infecções por Klebsiella/líquido cefalorraquidiano , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/fisiologia , Meninges/efeitos dos fármacos , Meninges/metabolismo , Meninges/microbiologia , Meningite devida a Escherichia coli/líquido cefalorraquidiano , Meningite devida a Escherichia coli/microbiologia , Permeabilidade , Coelhos , Resultado do Tratamento , CeftarolinaRESUMO
Ceftaroline is a new cephalosporin with bactericidal activity against resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae, as well as common Gram-negative organisms. This study tested the prodrug, ceftaroline fosamil, against a penicillin-sensitive and a penicillin-resistant strain of S. pneumoniae in an experimental rabbit meningitis model. The penetration of ceftaroline into inflamed meninges was approximately 14%. Ceftaroline fosamil was slightly superior to ceftriaxone against the penicillin-sensitive strain and significantly superior to the combination of ceftriaxone and vancomycin against the penicillin-resistant strain.
Assuntos
Antibacterianos/farmacologia , Cefalosporinas/uso terapêutico , Meningite/tratamento farmacológico , Penicilinas/farmacologia , Streptococcus pneumoniae/patogenicidade , Animais , Resistência às Penicilinas , Coelhos , Streptococcus pneumoniae/efeitos dos fármacos , CeftarolinaRESUMO
We report the case of a 28-years-old woman with Turner's syndrome and iron deficiency anaemia. The faecal occult blood test was intermittently positive whereas earlier upper and lower endoscopy revealed no source of bleeding. Capsule endoscopy showed multiple vascular malformations on the jejunum and ileum. Our case report emphasizes the importance of capsule endoscopy in the localising occult bleedings in the small bowel. We discuss the different diagnostic modalities and possible treatments.
Assuntos
Anemia Ferropriva/etiologia , Hemorragia Gastrointestinal/diagnóstico , Síndrome de Turner/diagnóstico , Adulto , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/genética , Endoscopia por Cápsula , Diagnóstico Diferencial , Dilatação Patológica/diagnóstico , Feminino , Hemorragia Gastrointestinal/genética , Hemangioma/diagnóstico , Humanos , Íleo/irrigação sanguínea , Jejuno/irrigação sanguínea , Telangiectasia/diagnóstico , Síndrome de Turner/genética , Veias/patologiaRESUMO
We report the case of a 58-years-old soldier with a history of movement related neck pain, weight loss and exercise intolerance. Blood tests presented signs of an inflammatory syndrome. The CT-scan showed extended thickening of the aortic wall characteristic for aortitis. The diagnosis of giant cell arteritis could be histologically confirmed by biopsy of the temporal arteries. Our case report emphasizes the importance of the various imaging modalities. We discuss the different forms of disease evolution and the treatment regimen.
Assuntos
Fadiga/etiologia , Arterite de Células Gigantes/diagnóstico , Militares , Redução de Peso , Aortite/diagnóstico , Aortite/patologia , Biópsia , Arterite de Células Gigantes/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Artérias Temporais/patologiaRESUMO
Ceftobiprole medocaril, a new cephalosporin, is highly active against a broad spectrum of Gram-positive and Gram-negative clinical pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant pneumococci. In this study, we tested ceftobiprole against various Gram-negative pathogens in a rabbit meningitis model and determined its penetration into the cerebrospinal fluid (CSF). In this animal model, ceftobiprole produced an antibacterial activity similar to that of cefepime against an Escherichia coli strain, a Klebsiella pneumoniae strain, and a ß-lactamase-negative Haemophilus influenzae strain. Against a ß-lactamase-positive H. influenzae strain, ceftobiprole was significantly superior. The penetration of ceftobiprole through inflamed meninges reached about 16% of serum levels compared to about 2% of serum levels through uninflamed meninges.
Assuntos
Antibacterianos/administração & dosagem , Cefalosporinas/administração & dosagem , Modelos Animais de Doenças , Bactérias Gram-Negativas/efeitos dos fármacos , Meningites Bacterianas/tratamento farmacológico , beta-Lactamases/metabolismo , Animais , Antibacterianos/sangue , Antibacterianos/líquido cefalorraquidiano , Cefalosporinas/sangue , Cefalosporinas/líquido cefalorraquidiano , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Bactérias Gram-Negativas/enzimologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/microbiologia , Haemophilus influenzae/efeitos dos fármacos , Haemophilus influenzae/enzimologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Meningites Bacterianas/microbiologia , Testes de Sensibilidade Microbiana , Coelhos , Resultado do TratamentoRESUMO
We examined the cerebrospinal fluid penetration of daptomycin after the addition of dexamethasone and its bactericidal efficacy with and without ceftriaxone in an experimental rabbit model of pneumococcal meningitis. The combination of daptomycin with ceftriaxone was the most efficacious regimen for pneumococcal meningitis. The previous addition of dexamethasone affected the antibacterial activity of daptomycin only marginally, either as monotherapy or combined with ceftriaxone, although the penetration of daptomycin into inflamed meninges was significantly reduced from 6 to 2%. Daptomycin with ceftriaxone might be a potential candidate for the empirical therapy of bacterial meningitis, although the activity of this regimen against Listeria monocytogenes remains to be demonstrated.
Assuntos
Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Daptomicina/uso terapêutico , Dexametasona/uso terapêutico , Meningites Bacterianas/tratamento farmacológico , Vancomicina/uso terapêutico , Animais , Cromatografia Líquida de Alta Pressão , Quimioterapia Combinada , CoelhosRESUMO
From medical view the main problems of investigation and convicts are in particular in the range of the drugs and alcohol illnesses to see transferable diseases (HIV, hepatitis B - C and tuberculosis) and psychological illnesses. These complex diseases require a close meshed and intensive support of each individual patient and represent actually the main problem during an arrest. The development of the health service could address the new requirements making possible cost-conscious acting in handling with resources in the health service. In the canton Berne 957197 inhabitants live on a total area of 5959 km2. The police and military management operates the regional and district prisons as well as the transportation service for prisoners in the canton Berne for prisoners. The canton Berne has altogether 327 places. Since May 1971 persons from the regional and district prison and the penal institutions needing hospitalisation can be accepted. In the University hospital Berne on a specially equipped guard station and be cared for their medical problems. The prisoners profit in such a way from the entire range of the university facilities.
Assuntos
Atenção à Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração , Prisioneiros/estatística & dados numéricos , Prisões , Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/estatística & dados numéricos , Controle de Doenças Transmissíveis/organização & administração , Comorbidade , Estudos Transversais , Atenção à Saúde/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hospitalização/estatística & dados numéricos , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Medidas de Segurança/organização & administração , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , SuíçaAssuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Doenças do Colo/induzido quimicamente , Diclofenaco/efeitos adversos , Obstrução Intestinal/induzido quimicamente , Úlcera/induzido quimicamente , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Doenças do Colo/diagnóstico , Diagnóstico Diferencial , Diclofenaco/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Pessoa de Meia-Idade , Úlcera/diagnósticoAssuntos
Hipercalcemia/diagnóstico , Hiperparatireoidismo Primário/diagnóstico , Hipertensão/etiologia , Idoso , Animais , Diagnóstico Diferencial , Modelos Animais de Doenças , Feminino , Bócio Nodular/diagnóstico , Bócio Nodular/cirurgia , Humanos , Hipercalcemia/complicações , Hiperparatireoidismo Primário/complicações , Osteoporose/diagnóstico , Tireoidectomia , Resultado do TratamentoRESUMO
Daptomycin monotherapy was superior to ceftriaxone monotherapy and was highly efficacious in experimental pneumococcal meningitis, sterilizing the cerebrospinal fluid (CSF) of three of three rabbits after 4 to 6 h. With daptomycin therapy only a negligible release of [(3)H]choline as marker of cell wall lysis was detectable in the CSF, peaking around 250 cpm/min after 4 h, compared to a peak of around 2,400 cpm/min after 4 to 6 h for the ceftriaxone-treated rabbits.