RESUMO
Critically ill patients are frequently transported out of the intensive care unit (ICU) for diagnostic tests and procedures. Advanced diagnostic testing and increased patient acuity have influenced the level of nursing care required during intrahospital transport. Previous studies have documented deleterious patient outcomes during intrahospital transport, but none have evaluated twelve lead electrocardiograms (ECGs). Using a prospective design, this study sought to describe ECG changes during intrahospital transport. A secondary purpose was to describe the nursing implications of transporting the patients in this sample. A convenience sample of 29 critical care patients (14 cardiac, 8 neurological, 5 medical, 2 transplant) was selected from three ICUs at a university hospital. In addition to the standard, single bipolar lead monitor, patients were monitored with a portable, interpretative electrocardiograph with continuous 12 lead ST segment analysis. Results of this study indicate that cardiac events during intrahospital transport may go undetected because of current monitoring practices and the mechanics of transport.
Assuntos
Estado Terminal/enfermagem , Eletrocardiografia/enfermagem , Transporte de Pacientes , Adulto , Idoso , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/enfermagem , Eletrocardiografia/instrumentação , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
AIMS: High local control rates are achieved in stage I lung cancer using stereotactic ablative radiotherapy. Target delineation is commonly based on four-dimensional computed tomography (CT) scans. Target volumes defined by positron emission tomography/computed tomography (PET/CT) are compared with those defined by four-dimensional CT and conventional ('three-dimensional') (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT. MATERIALS AND METHODS: For 16 stage I non-small cell lung cancer tumours, six approaches for deriving PET target volumes were evaluated: manual contouring, standardised uptake value (SUV) absolute threshold of 2.5, 35% of maximum SUV (35%SUV(MAX)), 41% of SUV(MAX) (41%SUV(MAX)) and two different source to background ratio techniques (SBR-1 and SBR-2). PET-derived target volumes were compared with the internal target volume (ITV) from the modified maximum intensity projection (MIP(MOD) ITV). Volumetric and positional correlation was assessed using the Dice similarity coefficient (DSC). RESULTS: PET-based target volumes did not correspond to four-dimensional CT-based target volumes. The mean DSC relative to MIP(MOD) ITV were: PET manual = 0.64, SUV2.5 = 0.64, 35%SUV(MAX) = 0.63, 41%SUV(MAX) = 0.57. SBR-1 = 0.52, SBR-2 = 0.49. PET-based target volumes were smaller than corresponding MIP ITVs. CONCLUSIONS: Conventional three-dimensional (18)F-FDG PET-derived target volumes for lung stereotactic ablative radiotherapy did not correspond well with those derived from four-dimensional CT, including those in routine clinical use (MIP(MOD) ITV). Caution is required in using three-dimensional PET for motion encompassing target volume delineation.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Fluordesoxiglucose F18 , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Radiocirurgia/métodos , Carcinoma Pulmonar de Células não Pequenas/patologia , Tomografia Computadorizada Quadridimensional/métodos , Humanos , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons/métodosRESUMO
OBJECTIVE: Positron emission tomography (PET)/CT scans can improve target definition in radiotherapy for non-small cell lung cancer (NSCLC). As staging PET/CT scans are increasingly available, we evaluated different methods for co-registration of staging PET/CT data to radiotherapy simulation (RTP) scans. METHODS: 10 patients underwent staging PET/CT followed by RTP PET/CT. On both scans, gross tumour volumes (GTVs) were delineated using CT (GTV(CT)) and PET display settings. Four PET-based contours (manual delineation, two threshold methods and a source-to-background ratio method) were delineated. The CT component of the staging scan was co-registered using both rigid and deformable techniques to the CT component of RTP PET/CT. Subsequently rigid registration and deformation warps were used to transfer PET and CT contours from the staging scan to the RTP scan. Dice's similarity coefficient (DSC) was used to assess the registration accuracy of staging-based GTVs following both registration methods with the GTVs delineated on the RTP PET/CT scan. RESULTS: When the GTV(CT) delineated on the staging scan after both rigid registration and deformation was compared with the GTV(CT)on the RTP scan, a significant improvement in overlap (registration) using deformation was observed (mean DSC 0.66 for rigid registration and 0.82 for deformable registration, p = 0.008). A similar comparison for PET contours revealed no significant improvement in overlap with the use of deformable registration. CONCLUSIONS: No consistent improvements in similarity measures were observed when deformable registration was used for transferring PET-based contours from a staging PET/CT. This suggests that currently the use of rigid registration remains the most appropriate method for RTP in NSCLC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Simulação por Computador , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Masculino , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Planejamento da Radioterapia Assistida por Computador , Carga TumoralAssuntos
Lipopolissacarídeos/isolamento & purificação , Mycoplasmatales/metabolismo , Alcanos , Fracionamento Celular , Técnicas de Química Analítica , Cromatografia Gasosa , Cromatografia em Gel , Cromatografia por Troca Iônica , Cromatografia em Camada Fina , Éteres , Glucose , Glicerol , Glicosídeo Hidrolases , Hidrólise , Manose , Conformação Molecular , Peso Molecular , Oxirredução , Ácido Periódico , Dodecilsulfato de SódioRESUMO
The acquisition of radiotherapy planning scans on positron emission tomography (PET)-CT scanners requires the involvement of radiotherapy radiographers. This study assessed the radiation dose received by these radiographers during this process. Radiotherapy planning (18)F-fluorodeoxyglucose ((18)F-FDG) PET-CT scans were acquired for 28 non-small cell lung cancer patients. In order to minimise the radiation dose received, a two-stage process was used in which the most time-consuming part of the set-up was performed before the patient received their (18)F-FDG injection. Throughout this process, the radiographers wore electronic personal dosemeters and recorded the doses received at different stages of the process. The mean total radiation dose received by a radiotherapy radiographer was 5.1+/-2.6 microSv per patient. The use of the two-stage process reduced the time spent in close proximity to the patient by approximately a factor of four. The two-stage process was effective in keeping radiation dose to a minimum. The use of a pre-injection set-up session reduces the radiation dose to the radiotherapy radiographers because of their involvement in PET-CT radiotherapy treatment planning scans by approximately a factor of three.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Relação Dose-Resposta à Radiação , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/radioterapia , Compostos Radiofarmacêuticos , Tecnologia Radiológica , Tomografia Computadorizada de Emissão/métodos , Recursos HumanosRESUMO
The introduction of functional data into the radiotherapy treatment planning process is currently the focus of significant commercial, technical, scientific and clinical development. The potential of such data from positron emission tomography (PET) was recognized at an early stage and was integrated into the radiotherapy treatment planning process through the use of image fusion software. The combination of PET and CT in a single system (PET/CT) to form an inherently fused anatomical and functional dataset has provided an imaging modality which could be used as the prime tool in the delineation of tumour volumes and the preparation of patient treatment plans, especially when integrated with virtual simulation. PET imaging typically using 18F-Fluorodeoxyglucose (18F-FDG) can provide data on metabolically active tumour volumes. These functional data have the potential to modify treatment volumes and to guide treatment delivery to cells with particular metabolic characteristics. This paper reviews the current status of the integration of PET and PET/CT data into the radiotherapy treatment process. Consideration is given to the requirements of PET/CT data acquisition with reference to patient positioning aids and the limitations imposed by the PET/CT system. It also reviews the approaches being taken to the definition of functional/tumour volumes and the mechanisms available to measure and include physiological motion into the imaging process. The use of PET data must be based upon a clear understanding of the interpretation and limitations of the functional signal. Protocols for the implementation of this development remain to be defined, and outcomes data based upon clinical trials are still awaited.
Assuntos
Neoplasias/radioterapia , Planejamento de Assistência ao Paciente , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Humanos , Neoplasias/diagnóstico , Compostos Radiofarmacêuticos , Resultado do TratamentoRESUMO
OBJECTIVE: The occurrence of high signal abnormalities on T2 weighted images is strongly age related. The diagnostic value of these changes in a younger population with dementia is not currently known. We studied the potential of high signal changes on magnetic resonance imaging (MRI) in differentiating Alzheimer's disease (AD), frontotemporal dementia (FTD) and vascular dementia (VaD) in younger patients. METHODS: High signal abnormalities were rated, using a previously validated scale, from hard copies of T2 weighted axial images of 102 patients with AD (n=49), VaD (n=31), FTD (n=22) (mean ages 63-65 years). RESULTS: High signal abnormalities were widespread across AD, VaD and FTD. Although they were most frequent and most severe in the VaD group only lacunes and grade III deep white matter hyperintensities (DWMH) were specific for these patients. CONCLUSIONS: High signal changes on T2 weighted images on MRI are common across degenerative (AD and FTD) and vascular dementias. Although lacunes and grade III DWMH are specific for VaD, the low sensitivities (sensitivities: for lacunes, 0.32; for grade III DWMH, 0.16) limit their use as diagnostic markers for VaD. High signal changes on MRI should be interpreted with caution in dementias. Their presence, even in younger patients, should not deter one from diagnosing AD or FTD.
Assuntos
Doença de Alzheimer/diagnóstico , Demência Vascular/diagnóstico , Lobo Frontal/patologia , Imageamento por Ressonância Magnética , Lobo Temporal/patologia , Idoso , Gânglios da Base/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
OBJECTIVES: Alzheimer's disease (AD), frontotemporal dementia (FTD) and vascular dementia (VaD) are the three most common causes of young onset dementias. Most neuroimaging studies of these disorders have involved comparisons with normal controls. The aims of this study were to examine the clinical diagnostic value of magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) (in combination and in isolation) in the differentiation of one form of dementia from another from amongst a group of AD, FTD and VaD. METHODS: T1 weighted MRI images and 99mTc-HMPAO SPECT images were obtained from consecutive patients with FTD (n=21), AD (n=23) and VaD (n=20) and rated visually by experienced neuroradiologists and nuclear medicine physicians. RESULTS: Asymmetrical atrophy was seen only in FTD. Frontotemporal dementia patients were the most atrophic whereas severe atrophy was rarely observed in VaD. Severe frontal atrophy (unilaterally or bilaterally) and/or asymmetrical atrophy on MRI is highly diagnostic (sensitivity 0.71, specificity 0.93, LR 10.24) of FTD from within a group of FTD and non-FTD (AD, VaD) patients. Mild or severe parietal atrophy with severe reduction in parietal regional cerebral blood flow on SPECT is diagnostic (sensitivity 0.71, specificity 0.76, LR 3.02) of AD from within a group of AD and non-AD (VaD, FTD) patients. CONCLUSION: Anatomical (MRI) and functional (SPECT) imaging provide different information and a combination of these modalities improves diagnostic specificity.
Assuntos
Doença de Alzheimer/diagnóstico , Circulação Cerebrovascular , Demência Vascular/diagnóstico , Demência/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Atrofia , Demência/diagnóstico por imagem , Demência/fisiopatologia , Demência Vascular/diagnóstico por imagem , Demência Vascular/fisiopatologia , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Lobo Frontal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Lobo Parietal/fisiopatologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Lobo Temporal/fisiopatologiaRESUMO
Surface carbohydrate, presumably the lipopolysaccharide, of Thermoplasma acidophilum was visualized by means of the concanavalin A, horseradish peroxidase, and diaminobenzidine cytochemical staining procedure.
Assuntos
Lipopolissacarídeos/análise , Polissacarídeos Bacterianos/análise , Thermoplasma/análise , 3,3'-Diaminobenzidina , Membrana Celular/análise , Concanavalina A , Peroxidase do Rábano Silvestre , Thermoplasma/ultraestruturaRESUMO
When cells of both Staphylococcus aureus and Staphylococcus epidermidis are grown in batch culture in nutrient-rich media, their cell walls are regular in thickness, their cell size is within the normal range for each species, and their septation patterns are orderly. When cells of each of these species are examined directly in infected tissue in the rabbit tibia model infection, their cell wall thickness is often much increased and very irregular around the circumference of the cell, their cell size is often increased, and their septation patterns are often severely deranged. All of these alterations in cell wall structure occur in the absence of antibiotics, and we suggest that they may be an expression of phenotypic plasticity in response to altered environmental conditions such as specific nutrient limitations, the presence of antibacterial factors, and growth of the cells on hard surfaces such as rabbit bone or plastic catheters. Some of these specific cell wall alterations are also seen when staphylococcal cells are exposed, in vitro or in vivo, to antibiotics such as clindamycin, but we emphasize that growth in tissue alone is sufficient for their induction.
Assuntos
Osteomielite/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/ultraestrutura , Staphylococcus epidermidis/ultraestrutura , Animais , Parede Celular/ultraestrutura , Masculino , Microscopia Eletrônica , Coelhos , Staphylococcus aureus/crescimento & desenvolvimento , Staphylococcus epidermidis/crescimento & desenvolvimentoRESUMO
After induction of experimental osteomyelitis with Staphylococcus aureus in a rabbit tibia model, clindamycin phosphate (280 mg/kg/day) was used to treat the infected animals for 1, 2 and 3 week periods. Scanning electron microscopy of samples of infected bone tissue taken at necropsy revealed masses of coccoid profiles embedded in a matrix of condensed exopolysaccharide material which adhered to the bone in both infected control animals and in infected animals treated for 1 week with clindamycin phosphate. After 2 and 3 weeks of clindamycin phosphate treatment, the infecting bacteria could not be cultured from tissue samples, and scanning electron microscopy of these samples revealed few coccoid profiles adhering to the bone and marrow. Radiological, microbiological, clinical, histological and electron microscopic findings all indicated recovery from the diseased state with increased length of clindamycin phosphate treatment.
Assuntos
Osso e Ossos/microbiologia , Clindamicina/farmacologia , Glicoproteínas/biossíntese , Osteomielite/microbiologia , Polissacarídeos/biossíntese , Staphylococcus aureus/efeitos dos fármacos , Animais , Aderência Bacteriana/efeitos dos fármacos , Medula Óssea/microbiologia , Clindamicina/uso terapêutico , Masculino , Microscopia Eletrônica , Microscopia Eletrônica de Varredura , Osteomielite/tratamento farmacológico , Coelhos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/metabolismo , Staphylococcus aureus/fisiologia , TíbiaRESUMO
Experimental osteomyelitis was induced in the rabbit tibia with Staphylococcus epidermidis alone, with Bacteroides thetaiotaomicron alone, and with both bacteria as etiologic agents, in the presence or absence of a foreign-body implant. Animals were monitored by clinical observation and roentgenographic, microbiologic, histologic, immunofluorescent microscopic, and electron microscopic methods. Scanning and transmission electron microscopy showed masses of coccoid and rod-shaped bacteria embedded in a matrix of exopolysaccharide and adhered to bone, marrow, and the foreign-body implant (when present). Of the 58 rabbits receiving an implant, osteomyelitis developed in 48 (83%), and bacteria were recovered by culture from 56 (97%). Of the 31 animals without the implant, osteomyelitis developed in 18 (58%), but no bacteria were recovered by culture. Bacterial recovery appeared to be dependent on the presence of the implant. The rate of induction and the severity of osteomyelitis were enhanced by the presence of the foreign-body implant and by the polymicrobic infection.
Assuntos
Infecções por Bacteroides/microbiologia , Bacteroides , Osteomielite/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus epidermidis , Tíbia , Animais , Infecções por Bacteroides/complicações , Infecções por Bacteroides/patologia , Medula Óssea/microbiologia , Medula Óssea/ultraestrutura , Microscopia Eletrônica , Osteomielite/patologia , Próteses e Implantes , Coelhos , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/patologia , Tíbia/microbiologia , Tíbia/patologia , Tíbia/ultraestruturaRESUMO
The scanning electron microscope was utilized to observe the morphology of the thermophilic, acidophilic mycoplasma, Thermoplasma acidophilum. Upon examination of the surface morphology, the size and shape of this unusual mycoplasma revealed its similarity to the other mycoplasmas that have been investigated.
Assuntos
Mycoplasmatales/ultraestrutura , Ágar , Parede Celular/ultraestrutura , Temperatura Alta , Microscopia Eletrônica de Varredura , Mycoplasmatales/crescimento & desenvolvimentoRESUMO
Spiroplasma citri was examined by electron microscopy for morphological changes when maintained under a variety of conditions. PPLO serum fraction maintained spiral and helical morphology of S. citri at pH values of 8.0, 7.5, and 7.0, but only partially at pH 6.0 and 5.0. The absence of PPLO serum fraction resulted in round, deteriorated cells at all pH values tested. Bovine serum albumin (BSA), Phytone, soluble starch, potato starch, spermine, lipid-extracted PPLO serum fraction, and lipid-extracted BSA could substitute for PPLO serum fraction in maintaining spiral and helical morphology at pH 7.5. At pH 5.0, only BSA, lipid-extracted BSA, and lipid-extracted PPLO serum fraction were effective. Only BSA supported growth of S. citri for more than two transfers, whereas all other substitutes could not support growth longer than two transfers.
Assuntos
Spiroplasma/ultraestrutura , Sangue , Meios de Cultura , Concentração de Íons de Hidrogênio , Microscopia Eletrônica , Soroalbumina BovinaRESUMO
The fine structure of lipopolysaccharide isolated from Thermoplasma acidophilum was examined by electron microscopy. Negative staining of the lipopolysaccharide revealed long, ribbon-like structures with some branching. The average width of the lipopolysaccharide ribbons was 5 nm. Treatment of the lipopolysaccharide with 0.5% sodium dodecyl sulfate resulted in the dissociation of the ribbon-like structures to spherical- and vesicular-shaped particles and some short, rodlike structures. Results suggest that the lipopolysaccharide from T. acidophilum is morphologically similar to lipopolysaccharide isolated from gram-negative bacteria.
Assuntos
Lipopolissacarídeos , Mycoplasma/ultraestrutura , Polissacarídeos Bacterianos , Lipopolissacarídeos/isolamento & purificação , Microscopia Eletrônica , Ácido Fosfotúngstico , Polissacarídeos Bacterianos/isolamento & purificação , Dodecilsulfato de Sódio , Coloração e RotulagemRESUMO
Cells of five Bacteroides species were examined following treatment with homologous antisera and staining with ruthenium red. They were enveloped by glycocalyces and these extensive fibrous exopolysaccharide matrices were fully retained as an integral "capsule" by some cells, while other cells showed "capsule" as well as detached glycocalyx components forming an intercellular "slime.". These extensive glycocalyces collapsed during dehydration for electron microscopy and formed electron-dense accretions on cell surfaces and electron-dense reticula in intercellular spaces when the cells were treated with heterologous antiserum or when antibody stabilization was omitted. The glycocalyces of all strains, both stabilized and unstabilized, were observed outside the outer membranes of cell walls that showed the "classic" gram-negative structural organization. Appropriate modifications of the indirect fluorescent antibody test demonstrated an integral "capsule" on all strains examined; detached glycocalyx and varying amounts of slime were demonstrated after stabilization with homologous, but not heterologous, antiserum.
Assuntos
Bacteroides/ultraestrutura , Glicoproteínas/análise , Polissacarídeos/análise , Especificidade de Anticorpos , Bacteroides/análise , Bacteroides/patogenicidade , Imunofluorescência , Glicoproteínas/fisiologia , Histocitoquímica , Microscopia Eletrônica , Polissacarídeos/fisiologiaRESUMO
After induction of experimental polymicrobic osteomyelitis with Staphylococcus epidermidis and Bacteroides thetaiotaomicron (ciprofloxacin MIC, 0.5 micrograms/ml and 4.0 micrograms/ml, respectively), in the presence of a foreign body implant, in a rabbit tibia model, ciprofloxacin was administered to infected animals for 2- and 4-week periods. At necropsy, rabbits in the 2-weeks-treated group had mean ciprofloxacin levels of 5.94 micrograms/ml in serum, 3.63 micrograms/g in marrow, and 1.88 micrograms/g in bone. Rabbits in the 4-weeks-treated group had mean ciprofloxacin levels of 7.77 micrograms/ml in serum, 5.84 micrograms/g in marrow, and 2.01 micrograms/g in bone. Quantitative bacterial plate counts were conducted on weighed samples of infected bone, marrow, and the catheter implant, taken at necropsy from treated and control rabbits. Variable reduction of bacterial numbers was observed in samples from treated animals, as compared to untreated controls. Samples of infected bone, marrow and catheter, showed comparable evidence of osteomyelitis and bacterial colonization in both treated and control animals. Although relatively high tissue levels of ciprofloxacin were attained, little therapeutic effect was observed.
Assuntos
Infecções por Bacteroides/tratamento farmacológico , Ciprofloxacina/uso terapêutico , Osteomielite/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus epidermidis/efeitos dos fármacos , Animais , Bacteroides/efeitos dos fármacos , Infecções por Bacteroides/complicações , Medula Óssea/metabolismo , Medula Óssea/ultraestrutura , Osso e Ossos/metabolismo , Osso e Ossos/ultraestrutura , Cateteres de Demora , Ciprofloxacina/sangue , Ciprofloxacina/farmacocinética , Modelos Animais de Doenças , Masculino , Microscopia Eletrônica , Coelhos , Infecções Estafilocócicas/complicações , Tíbia , Distribuição TecidualRESUMO
Subcutaneous abscesses were induced in mice with Staphylococcus epidermidis strain G19-85 and a foreign body implant. The MIC of ciprofloxacin for this strain was 0.25 microgram/ml. The ciprofloxacin dosage, 120 mg/kg/day, was divided into three injections, administered to the mice subcutaneously at 8 h intervals. Serum concentration kinetics in normal mice (n = 50) were determined. The peak serum level of ciprofloxacin was 3.18 micrograms/ml at the 15 min sampling time; the trough level was 0.53 micrograms/ml at 8 h. Abscesses were found in 96% (n = 49) of the untreated, infected control mice. Three modes of treatment with ciprofloxacin were tested: (1) four prophylactic injections of ciprofloxacin prior to infection reduced abscess formation to 64% (p less than or equal to 0.0002, n = 50). (2) Eleven therapeutic injections, initiated 4 days after infection, reduced abscess formation to 86% (p less than or equal to 0.17, n = 49). (3) One prophylactic injection prior to surgery and five therapeutic injections after infection reduced abscess formation to 43% (p less than or equal to 0.0001, n = 49). Culture results correlated with the abscess formation rates.
Assuntos
Abscesso/tratamento farmacológico , Ciprofloxacina/uso terapêutico , Corpos Estranhos , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Abscesso/prevenção & controle , Animais , Ciprofloxacina/administração & dosagem , Ciprofloxacina/sangue , Modelos Animais de Doenças , Injeções Subcutâneas , Masculino , Camundongos , Infecções Cutâneas Estafilocócicas/prevenção & controle , Staphylococcus epidermidisRESUMO
Ciprofloxacin concentrations were determined in serum, bone and bone marrow of rabbits. Four experimental groups of animals were examined: group A (n = 6) received a dosage of 60 mg/kg/day intramuscularly for 4 weeks, groups B (n = 6), C (n = 15) and D (n = 15) received dosages of 120 mg/kg/day subcutaneously for 2 days, 2 weeks, and 4 weeks, respectively. In the kinetic portion of the study, peak serum concentrations of ciprofloxacin measured at the 15 min sampling time were: 2.61 +/- 0.27 micrograms/ml in the 60 mg/kg/day group (group A) and 3.24 +/- 0.78 micrograms/ml in the 120 mg/kg/day group (group B). At necropsy, rabbits in group A had mean ciprofloxacin concentrations of 3.60 +/- 2.27 micrograms/ml in serum, 2.24 +/- 1.19 micrograms/g in marrow and 1.19 +/- 0.44 micrograms/g in bone. Rabbits in group B achieved mean levels of 4.02 +/- 1.23 micrograms/ml in serum, 2.48 +/- 0.79 micrograms/g in marrow, and 1.35 +/- 0.40 micrograms/g in bone. Rabbits in group C achieved mean levels of 5.65 +/- 2.16 micrograms/ml in serum, 3.74 +/- 1.33 micrograms/g in marrow and 1.92 +/- 0.94 micrograms/g in bone. Rabbits in group D achieved mean levels of 7.24 +/- 2.50 micrograms/ml in serum, 4.48 +/- 1.68 micrograms/g in marrow, and 1.93 +/- 0.54 micrograms/g in bone. Differences between mean values for the four experimental groups were not statistically significant.