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1.
Antimicrob Agents Chemother ; 60(8): 4684-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27216053

RESUMO

Recent observational studies have suggested possible reductions in mortality in patients receiving cefazolin versus antistaphylococcal penicillins. We examined 90-day mortality in patients receiving cefazolin compared to nafcillin for methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infection (BSI). We identified persons with MSSA BSI admitted to San Francisco General Hospital from January 2008 to July 2013 through a hospital-wide infection surveillance system and confirmed 90-day mortality using U.S. national vital registries. We included persons receiving cefazolin or nafcillin as the predominant intravenous antimicrobial agent; all participants received inpatient Infectious Diseases service consultation. We estimated the association between receipt of cefazolin and 90-day risk of death by multivariate logistic regression, including a propensity score for receiving cefazolin as the second predictor. Of 230 MSSA BSI cases, 30 received nafcillin and 70 received cefazolin as the predominant antimicrobial; 10 died within 90 days, 5 from each group. Unadjusted analysis showed substantial but not statistically significant reduced odds of death in those receiving cefazolin (odds ratio, 0.38; 95% confidence interval [CI], 0.10 to 1.44). Multivariate analysis with propensity scores found a similar adjusted odds ratio (0.40; 95% CI, 0.09 to 1.74; P = 0.22). We found a large reduction in 90-day mortality in those receiving cefazolin compared to nafcillin for MSSA BSI, but this finding was not statistically significant. The magnitude of effect seen in this and other studies justifies further study.


Assuntos
Bacteriemia/tratamento farmacológico , Cefazolina/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Meticilina/uso terapêutico , Nafcilina/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , California , Infecção Hospitalar/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Penicilinas/uso terapêutico , Centros de Atenção Terciária
2.
J Comp Physiol A ; 187(2): 91-103, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15523998

RESUMO

We have been exploring the role of serotonin in fighting behavior in lobsters using a specific model of agonistic behavior, the establishment of hierarchical relationships between pairs of socially naive juvenile lobsters. We selected this model because the behavior is easily evoked, readily quantifiable, and the effects of experience are eleminated by using socially naive animals. In these studies we injected a specific neurotoxin, 5,7-dihydroxytryptamine, into juvenile lobsters over a 4-week period and then measured the effects on fighting behavior. This treatment reduces the levels of serotonin in the nervous system and immunocytochemical studies show a dramatic reduction in neuropil staining for the amine. Control animals received vehicle injection alone. All injected animals were paired against larger or smaller non-injected opponents, and three successive 30-min fights were carried out and statistically analyzed. The results were surprising: As with elevations of serotonin, reduced levels of serotonin increased the amount of time animals engaged in fighting behavior. No significant effects were seen on who initiated encounters, who retreated first, or who the eventual winner would be. Thus, in this model, elevation or reduction of serotonergic function increases the tendency of animals to engage in agonistic encounters.


Assuntos
5,7-Di-Hidroxitriptamina/farmacologia , Agressão/fisiologia , Nephropidae/fisiologia , Serotoninérgicos/farmacologia , Serotonina/metabolismo , 5,7-Di-Hidroxitriptamina/administração & dosagem , Animais , Comportamento Animal , Serotoninérgicos/administração & dosagem
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