The dose at which neomycin and polymyxin B can be applied for selective decontamination of the digestive tract in mice

Oral treatment of mice with various doses of neomycin or polymyxin B was performed in order to determine which dose caused substantial suppression of aerobic gram-negative rods. In addition the effect of the various doses on Streptococcus faecalis and on other factors of the colonization resistance (CR) of the digestive tract were studied. It was found that polymyxin B was effective in suppressing sensitive gram-negative bacteria following daily doses of 3.2 mg/mouse, and that even extremely high daily doses of 9.7 mg/mouse did not affect the CR. Neomycin was effective in suppressing Enterobacteriaceae species following oral daily doses of 5.4 mg/mouse. With this dose, however, the CR was somewhat decreased which was also evidenced by the increased concentration of beta-aspartylglycine in the faeces and the increased size (weight) of the caecum in these animals. Suppression of Str. faecalis was seen from doses of 24 mg/mouse on

Early treatment of trans-tibial amputees: retrospective analysis of early fitting and elastic bandaging

This study investigates the effects of early fitting in trans-tibial amputees. The assumption is that compared to elastic bandaging, the use of a rigid dressing in early fitting will result in quicker wound healing and earlier ambulation. A retrospective file search was carried out in three different hospitals, analysing the time to first prosthesis, the incidence of local and general complications and the functional outcome after discharge from hospital. Each of the hospitals used a different method of postoperative care: elastic bandaging, immediate postoperative application of the plaster cast or delayed application of the plaster cast within one week post amputation. In comparison to the elastic bandaging method (N = 52), the use of a rigid dressing in the early fitting method (immediate and delayed, N = 97) resulted in a statistically significant shorter period from amputation to the delivery of a first regular prosthesis (110 days vs 50 days) and a decreased risk of knee flexion contracture. Although, differences in local complications were not observed, the risk of pressure sores in other places than the stump was increased in early fitting. Instead of further reducing the time to first prosthesis by immediate fitting, the use of delayed fitting resulted in a statistically significant shorter period from amputation to the delivery of a first regular prosthesis (56 vs 40 days). However, delayed fitting was associated with an increased risk for reamputation. In conclusion, this study indicates that early fitting by use of a rigid dressing after trans-tibial amputation is the treatment of choice. If it is possible to apply a plaster cast in the operating room, the authors would prefer the immediate fitting method

How Reproducible Are Transcranial Magnetic Stimulation-Induced MEPs in Subacute Stroke?

Methods: Eighteen patients with stroke and 8 healthy volunteers were tested twice within a 1-week period by 2 examiners using TMS to determine MEPs and TMCT for the abductor pollicis brevis muscle of their affected and unaffected hands. Results: The authors found moderate to perfect reliability of TMS-induced MEPs in healthy volunteers, noninfarcted hemispheres (perfect agreement), and infarcted hemispheres (Kappa's = 0.45-0.87). Reliability of TMCT was good to excellent in the volunteers (intraclass correlation coefficients = 0.77-0.97), excellent in the noninfarcted hemispheres (intraclass correlation coefficients = 0.97-1.00), and poor to excellent in the infarcted hemispheres (intraclass correlation coefficients = 0.44-0.90). Conclusions: The reliability of TMS-induced MEPs and TMCT measurements in healthy volunteers and the noninfarcted hemisphere of patients with stroke with an upper paretic limb was good to excellent. In contrast, TMS measurements in the infarcted hemisphere were less consistent. Based on the lower reproducibility of TMCT measurements in the infarcted hemisphere, we recommend to repeat the TMCT measurements to improve the reliability of tests. Purpose: Motor evoked potentials (MEPs) and total motor conduction time (TMCT) induced by transcranial magnetic stimulation (TMS) are used to make assumptions about the prognosis of motor outcome after stroke. Understanding the different sources of variability is fundamental to the concept of reliability. Reliability testing of TMS-MEPs and TMCTs within and between two independent examiners in healthy and stroke subjects is still an unexplored field in the clinical neurophysiology. Assessing the reproducibility of TMS measurements requires studies to investigate the test-retest reliability of TMS-induced MEPs and TMCT. The authors set out to test the reliability of these TMS measurements

How Do Fugl-Meyer Arm Motor Scores Relate to Dexterity According to the Action Research Arm Test at 6 Months Poststroke?

Objective To determine the optimal cutoff scores for the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) with regard to predicting no, poor, limited, notable, or full upper-limb capacity according to frequently used cutoff points for the Action Research Arm Test (ARAT) at 6 months poststroke. Design Prospective. Setting Rehabilitation center. Participants Patients (N=460) with a first-ever ischemic stroke at 6 months poststroke. Interventions Not applicable. Main Outcome Measures Based on the ARAT classification of poor to full upper-limb capacity, receiver operating characteristic curves were used to calculate the area under the curve, optimal cutoff points for the FMA-UE were determined, and a weighted kappa was used to assess the agreement. Results FMA-UE scores of 0 through 22 represent no upper-limb capacity (ARAT 0-10); scores of 23 through 31 represent poor capacity (ARAT 11-21); scores of 32 through 47 represent limited capacity (ARAT 22-42); scores of 48 through 52 represent notable capacity (ARAT 43-54); and scores of 53 through 66 represent full upper-limb capacity (ARAT 55-57). Overall, areas under the curve ranged from.916 (95% confidence interval [CI],.890-.943) to.988 (95% CI,.978-.998; P31 points correspond to no to poor arm-hand capacity (ie, ≤21 points) on the ARAT, whereas FMA-UE scores >31 correspond to limited to full arm-hand capacity (ie, >22 points) on the ARAT