STUDIES ON THE COMBINATION THERAPY OF FOSFOMYCIN AND DIBEKACIN IN COMPLICATED URINARY TRACT INFECTIONS

Clinical efficacy of combination therapy with fosfomycin (FOM) and dibekacin (DKB) was studied in patients with complicated urinary tract infection (UTI). Of the 55 patients accumulated from 7 urology institutes, 39 patients who had pyuria of 5 or more white blood cells per high power field, bacteriuria of 10[4] or more• bacteria per ml of urine and underlying urinary diseases were evaluated for clinical efficacy. Patients received 4g of intravenous FOM and 100 or 200mg of intramuscular DKB a day for 5 to 7 days. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee in Japan as excellent, moderate or poor. Of the 39 patients evaluated for clinical efficacy, 13 patients (33.3%) were infected with multiple organisms and 30 patients (76.9%) had indwelling catheters. The overall results of treatment were excellent in 17.9%, moderate in 64.1% and poor in 17.9%, overall effectiveness rate being 82. 1 %. Of the 52 strains isolated from 39 patients, 48 strains (92.3%) were eradicated and only 4 strains (7.7%) persisted. Side effects were recorded in all 55 patients including those excluded from the evaluation of clinical efficacy. Subjective side effects were not observed in any of the 55 patients. Drugrelated aggravations in laboratory test results were observed in 6 patients (10.9%) but most of them were slight and transient changes; the combination of FOM and DKB appeared to be well tolerated. From the results obtained in this study, combination therapy of FOM and DKB seemed useful in the treatment of complicated UTI, especially those due to multiple orgenisms and those associated with indwelling catheters

Observation results by the TAMA300 detector on gravitational wave bursts from stellar-core collapses

We present data-analysis schemes and results of observations with the TAMA300 gravitational-wave detector, targeting burst signals from stellar-core collapse events. In analyses for burst gravitational waves, the detection and fake-reduction schemes are different from well-investigated ones for a chirp-wave analysis, because precise waveform templates are not available. We used an excess-power filter for the extraction of gravitational-wave candidates, and developed two methods for the reduction of fake events caused by non-stationary noises of the detector. These analysis schemes were applied to real data from the TAMA300 interferometric gravitational wave detector. As a result, fake events were reduced by a factor of about 1000 in the best cases. The resultant event candidates were interpreted from an astronomical viewpoint. We set an upper limit of 2.2x10^3 events/sec on the burst gravitational-wave event rate in our Galaxy with a confidence level of 90%. This work sets a milestone and prospects on the search for burst gravitational waves, by establishing an analysis scheme for the observation data from an interferometric gravitational wave detector

Post-intensive care syndrome: its pathophysiology, prevention, and future directions

Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long-term prognoses. Post-intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long-term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS-p) and the mental status of their family (PICS-F). Intensive care unit-acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS. Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow-up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS