Ceftazidime: pharmacokinetics in young volunteers versus elderly patients and therapeutic efficacy with complicated urinary tract infections

Thirty-six urological patients (21 male, 15 female) aged 21 to 83 years with complicated and/or hospital-acquired urinary tract infections due to sensitive bacteria were treated with ceftazidime intravenously with a daily dose of 2 g bd over 5 to 17 days. Twenty-seven patients were followed for 1 to 4 weeks after therapy. Cure was observed in 41%, reinfection in 33% and relapse in 26% of the patients. Eradication of the original pathogen occurred in 74%. Five patients showed minor side effects: diarrhoea (2), nausea (1), rash (1), headache (1). No signs of renal, hepatic or haematological toxicity were observed. A pharmacokinetic study was performed in 13 elderly patients aged 63 to 83 years on day 1 of treatment and in 6 volunteers aged 24 to 32 years following administration of 2 g of ceftazidime as short intravenous infusion. The mean serum half life in 12 patients 2.9 h significantly higher than in volunteers (1.75 h). Serum concentrations in patients on day 7 of treatment, however, showed no accumulation when treated with a dosage of 2 g bd

Analysis of total urinary catecholamines by liquid chromatography: methodology, routine experience and clinical interpretations of results

A simple routine method is described for simultaneous assay of total urinary adrenaline, noradrenaline and dopamine. The catecholamines are pre-purified on a small ion-exchange column, separated by reversed phase ion-pair liquid chromatography, and are quantitated by electrochemical detection. The method was routinely applied to 422 urines. Elevated values were found in four urine specimens obtained from patients with histologically proven phaeochromocytomas. Virtually no interference by endogenous or exogenous compounds was found. Values for urinary catecholamines determined by fluorimetric analysis agreed with those obtained by high pressure liquid chromatography with electrochemical detection. Within-day CVs for the compounds ranged from 5.2-11.9%, between-day CVs from 3.3-6.6%. The normal range (95% confidence level) was 20-230 micrograms/24 h for noradrenaline and 1-35 micrograms/24 h for adrenaline

Hypothermia, immune suppression and SDD: can we have our cake and eat it?

In vitro studies and clinical observations suggest that both accidental and controlled/therapeutic hypothermia have a strong immunosuppressive effect, and that hypothermia increases the risk of infections, especially wound infections and pneumonia. In the previous issue of Critical Care, Kamps and colleagues report that when hypothermia was used for prolonged periods in patients with severe traumatic brain injury in conjunction with selective decontamination of the digestive tract, the risks of infection were the same or lower in patients treated with therapeutic cooling. The risk of infection is widely regarded as the most important danger of therapeutic cooling. The findings of Kamps and colleagues need to be verified in prospective trials and in higher-resistance environments, but raise the possibility of cooling for prolonged periods with greatly reduced risk. We may be able to have our cake and eat it

Pharmacokinetics, in-vitro activity, therapeutic efficacy and clinical safety of aztreonam vs. cefotaxime in the treatment of complicated urinary tract infections

The minimal inhibitory concentrations (MICs) of aztreonam and cefotaxime were determined against 400 isolates from urological in-patients with complicated and/or hospital acquired urinary tract infections (UTI). Against the Gram-negative rods the activities of both antibiotics were comparable except for higher activity of aztreonam against Pseudomonas aeruginosa. The pharmacokinetic study in nine elderly patients showed a prolonged plasma half life of aztreonam (2.7 h) as compared to younger volunteers (1.6-1.9 h). In a prospective randomized study 39 urological patients with complicated and/or hospital acquired UTI were treated with 1 g aztreonam or cefotaxime iv twice daily for 4 to 15 days. Cure was obtained in 5 out of 18 patients in the aztreonam and 7 out of 20 patients in the cefotaxime group. There were 3 superinfections, 7 relapses and 3 reinfections in the aztreonam group and 1 failure, 1 superinfection, 6 relapses and 5 reinfections in the cefotaxime group. There was no significant difference in therapeutic efficacy between the two antibiotics. Both antibiotics were tolerated well and seem to be equally effective in the treatment of complicated UTI caused by sensitive organisms

Horticultural Households Profit Optimization and the Efficiency of Labour Contract Choice

In agriculture, the coexistence of different forms of land tenancy or labour contract has been explained so far by several theories related to Marshallian inefficiency, incentives, risk sharing, and transaction costs, including supervision costs. These theories and the empirical evidences have greatly contributed to explain the reasons behind land tenancy or labour contract choice. This study follows up on this. Moreover, it intends to take a further step by focusing particularly on the production technologies at plot level, and by designing and testing a theoretical model based on household profit optimization. This model will take into account the supervision costs of labour (i) to compare optimum profit derived from plots based on household labour, a sharecropping labour contract, and a wage labour contract, controlling for irrigation equipment (ii) to test the efficiency of the labour contract choice using data from Senegal’s horticultural zone. As expected, the production elasticity of labour decreases when improved irrigation equipment like a motor pump is used. The technology displays an increasing return to scale on plots without a motor pump and a constant return to scale on plots irrigated with a motor pump. While on plots without a motor pump the sharecropping contract is the efficient labour contract choice, leading to a higher optimum profit for the household, on plots irrigated with a motor pump, the wage contract is the best labour contract choice. Consequently, we can conclude from this finding that the use of a motor pump drives out the sharecropping contract in favour of household labour and the wage labour contract.land tenancy, labour, sharecropping, wage, contract, supervision, household, profit optimization, efficient, irrigation equipment, horticulture, Senegal, Agricultural Finance,

Biometrics for Emotion Detection (BED): Exploring the combination of Speech and ECG

The paradigm Biometrics for Emotion Detection (BED) is introduced, which enables unobtrusive emotion recognition, taking into account varying environments. It uses the electrocardiogram (ECG) and speech, as a powerful but rarely used combination to unravel people’s emotions. BED was applied in two environments (i.e., office and home-like) in which 40 people watched 6 film scenes. It is shown that both heart rate variability (derived from the ECG) and, when people’s gender is taken into account, the standard deviation of the fundamental frequency of speech indicate people’s experienced emotions. As such, these measures validate each other. Moreover, it is found that people’s environment can indeed of influence experienced emotions. These results indicate that BED might become an important paradigm for unobtrusive emotion detection

Lincoln Cathedral Library MS 182: Bede, "Homilies on the Gospels"

160. Lincoln Cathedral Library MS 182 Bede, "Homilies on the Gospels" [Ker 124, Gneuss 274] HISTORY: A late 10c or early 11c English manuscript. Its origin is disputed: Gneuss (no. 274), following Bishop (1967: 73-74), believes that it was written at Abingdon, a claim which is disputed by Dumville (1993: 58, n. 259; 1994: 185-86), while Marsden (1995: 381) mentions Canterbury as a place of origin. It contains Bede's homilies on the Gospels, written between 730 and 735, towards the end of his life, but before the "Historia ecclesiastica gentis Anglorum;' since he writes in HE 5.24 that his two books of Homilies have already been completed. The manuscript was listed as "Bedam xlix omeliarum'' in the 12c catalogue of the manuscripts of Lincoln Cathedral Library, and also occurs in a 15c catalogue of the same library (Ker, Cat., p. 158; 1964: 115; cf. Woolley 1927: v-xiv). The warrant for including this manuscript in the series is that on f. 27v there is an OE scribble, 'gepafa nu; glossing 'Sine modo', perhaps because of the potential ambiguity of the Latin phrase. At least two folios have been removed from the front of the book: the first folio of quire I and a 13c table of contents which is now f. 1 of Lincoln Cathedral Library 184. According to Thomson (1989: 147-48), the table of contents was still part of this manuscript in the 17c, but had been removed by ca. 1833, as indicated by Richard Garvey's manuscript catalogue

Cambridge University Library Ii. 4. 6.: Temporale selected from Ælfric, "Catholic Homilies" I & II, etc.

101. Cambridge University Library Ii. 4. 6. Temporale selected from Ælfric, "Catholic Homilies" I & II, etc. [Ker 21, Gneuss 18] HISTORY: A collection of homilies, mostly by Ælfric, copied in the middle of the 11c at New Minster in Winchester (Bishop 1971: xv). The manuscript, discussed by Pope (1967: 39-48), Godden (1979: xlv-xlvii), Clemoes (1997: 28-30), and Teresi (2007: 291-310), is known as "M" in the classification of Ælfrician manuscripts. At the beginning of the manuscript, "an indeterminable number of leaves" from more than one quire were lost (Pope 1967: 40), which suggests that several more items may once have been there. The homilies are for "Sundays and festivals, other than Saints' days, from the second Sunday after Epiphany to the first Sunday after Pentecost" (Ker, Cat., p. 31; cf. Godden 1979: xlv), and the manuscript was designed as a Temporale. Except for two homilies, for the Monday and Tuesday in Rogationtide, all contain material by Ælfric, and most belong to the two series of Catholic Homilies (Ker, Cat.: arts. 1-6, 8-10, 12-14, 16-24, 29-31, 33, 36-37; cf. Clemoes 1997: 30), ten complete homilies and several fragments from the First Series and twelve from the Second Series. The items which are not entirely by /Elfric are two composite homilies, added for the first time to the Ælfrician canon in this manuscript (Godden 1975). The collection in this manuscript is well organized and contains all the homilies from CH I and CH II relevant to the period, as well as the "Caput ieiunii" and the Prayer of Moses (Skeat 1881-1900: nos. xii and xiii) and additional homilies (Pope 1967-1968: nos. 4, 7-10, 12). Its organization and comprehensive nature make this manuscript important to the study of Ælfric's homilies. In the stemma of the First Series, this manuscript (M) forms part of the 8 line of transmission together with Cotton Faustina A. ix [192) (N) and CCCC 302 [48) (O). In the stemma of the Second Series, M belongs to an advanced stage of the first recension (Godden 1979: xlvi), sharing contamination with the earlier south-eastern MS CCCC 162 [33) (known as F), which entered both manuscripts from the immediate exemplar of M (Godden 1979: xlix). M, together with F, N, and 0, derives from a separate collection set up as "a series of homilies for occasions other than saints' days from Christmas to the Sunday after Pentecost;' to which later some other items were added, first in this manuscript (Clemoes 1997: 71-76; Godden 1979: lxiv-lxv). Whereas Clemoes and Godden believe that Ælfric himself may have been the compiler of this collection, Teresi (2007: 291-310) argues against this possibility, suggesting, instead, that it was made independent of Ælfric's direct influence. Glosses and additions coeval with the compilation of the MS, on ff. 23v-37r, as well as marginalia of the 13c/14c on ff. 132r and 146v show that the texts were studied through those times. Presumably, the manuscript stayed in Winchester, for in the 15c it belonged to the nearby Abbey of the Blessed Virgin Mary and Saint Rumonus in Tavistock in Devonshire (Ker 1964: no. 1988; Wanley 1705: 160), whence it was taken away according to an inscription on f. lr: 'hunc codice<m> cu<m> altero co<n>simili: reperit R. Ferro' seruus comit<is> Bedfordie | in Domo quonda<m> cenobio de Tavestocke in Devinshire, a<nno> 1566:. Robert Ferrar (d. 1572) was a member of parliament for Tavistock and a servant of Francis (Russell), second Earl of Bedford (d. 1585), inscription(s) on 7v, '1566: 'F. Bedford'. In 1567, the Earl gave the manuscript to Archbishop Matthew Parker (see inscription f. 308v), even before the Privy Council authorized Parker to actively 'collect' such books in the interest of the nation (Kleist 2007: 467). In 1574, Parker gave 25 manuscripts and many more printed books to Cambridge University Library, and this book is no. 9 in the list (Page 1993: 9; Ker, Cat., p. 35), inscription on f. 9v: 'Matthreus Cantuar: dedit. 1574'

Lincoln Cathedral Library 298, no. 2: OE "Heptateuch'' (fragment)

161. Lincoln Cathedral Library 298, no. 2 OE "Heptateuch'' (fragment) [Ker 125, Gneuss 276] HISTORY: A fragment consisting of the remains of one bifolium ( two onceconjugate leaves) containing part of the text of Numbers from what was probably a manuscript from the OE Heptateuch; it dates from the second half of the l lc. Wanley (1705: 305) mentioned that it was used as the cover of another manuscript. According to Crawford (1920: 1), the fragment was considered lost in the 19c, only to be rediscovered by R. M. Woolley in the process of his cataloguing the manuscripts of Lincoln Cathedral Chapter Library. It has the siglum "Ln" in Marsden's edition (2008), who gives a description (lxiii-1.xv), and discusses its textual tradition (clvii-clx). The fragment is now kept as item 'B' (no. 2) in an album containing a collection of fragments from the Library of Lincoln Cathedral

Brussels, Bibliotheque Royale 1650: Aldhelm, prose "De laude virginitatis" with glosses in Latin and OE

18. Brussels, Bibliotheque Royale 1650 (1520) Aldhelm, prose "De laude virginitatis" with glosses in Latin and OE [Ker 8, Gneuss 806] HISTORY: The manuscript dates from the 10c or early 11c, and was written in England. It has traditionally been associated with Abingdon (see Ker, Cat., p. 3; Gneuss; Goossens 1974: 7; Porter 1996: 164), but Gwara (1997: 365) has suggested Canterbury as a likely place of origin, on account of its "style IV Anglo-Caroline script;' and because some of its glosses were copied into what is now BL, MS Royal D.xxiv, a Canterbury manuscript, though almost certainly from Abingdon. The text of the prose "De laude virginitatis" is Ehwald's "B''. Ker believed on the basis of two identical glossing hands that, at the time, it formed one manuscript with Antwerp, Plantin Moretus Museum, MSS 16.2 (4] and 16.8 [5], and London, BL, MS Add. 32246 [164]. The Aldhelm glosses, above 5000, in four different hands, date from the first half of the 11 c. In an extensive discussion of the glosses, Gretsch ( 1999: 132-84) does not confirm an Abingdon provenance, but concludes that the corpus of glosses is the accumulation of layers of work by several generations of scholars, and of the OE glosses, the most important contribution is by that of the latest hand, which she calls "CD''. According to Goossens (1974: 7, 16-27) the glosses were indeed written at Abingdon; they were copied almost verbatim in what is now Oxford, Bodleian Library, Digby 146 (1747) (370], also an Abingdon manuscript which remained at the Abbey until the Dissolution. It is not known when the manuscript was shipped to the continent, but notes in MS Plantin 16.8 show that that manuscript was still in England in the 16c (Ker, Cat., p. 3). Notes on flyleaf ivr (2r) mentioning works by the 16c scholars Johannes Trithemius (1482-1516) and John Bale (1495-1563) suggest that humanists studied it in the middle of the 16c. It is known to have belonged to the Antwerp cartographer and scholar Abraham Ortelius (1527-1598) (van Langenhove 1941: 10; Goossens 1974: 8); afterwards, it ended up in the possession of the Antwerp Jesuits (f. lr 'Collegae soc. Jesu Antuerp' D.P.'). It was studied by the humanist Jesuit Andreas Schottus (1552-1629) (Ker, Cat., p. 7; Goossens 1974: 8), who mentions on the flyleaf (iii r) that the manuscript had been brought from England where it had escaped the iconoclasts' flames, and that he had put the quires in the right order. Marginalia from the later Middle Ages indicate that several quires had been misbound. Indeed, Ker holds that the four manuscripts mentioned above once formed one volume; they must have been separated sometime during the end of the 16c. Later this manuscript almost certainly formed part of the library of the Bollandists because in 1773 it passed to the Bibliotheque de Bourgogne in Brussels, which came to form part of the Royal Library in 1837. [Note: The manuscript contains a considerable number of annotations from the 16c and/or early 17c and some from the later Middle Ages: f.iiir a note by Andreas Schottus, 'Huius Aldelmi elogiumf [sic] exstat in catalogo Scriptorum | Britanniae Ballaei'; f. iiiv modern pencil scribbles; f. ivr a biblio-biographical note on Aldhelm, in a 16c hand, 'ALDELMVS BLADVINVS, Yna Visisaxonum seu Occidentalium Anglorum | regis: with Schottus writing at the top: 'Pone et Verba Trithemij. | Ex Joh. Baleo: and at the bottom: 'Exempla Beatus Aldhelmus Sanctorum Sanctorum [sic] | virginum colligit, & idque exemplo B. Ambrosii | lib. 8 de virginitate, et Eusebii Caesariens. | lib VIII Histor. Ecclesiasticae'; f. 1r mark of ownership of the Antwerp Jesuits: 'Collegii Soc. Jesu. Antuerp. | D<omus> P<rofessa>' (ed. Goossens 1974: 6). The text also contains miscellaneous 16c or early 17c additions and corrections, identifying the title, f. lr, and the chapters, e.g. f. lr 'cAP. ,:, f. 4r 'cAP. m'; identifying sources of the text, e.g. f. 2r 'Virg. VIII. lEn. ver. 596'; correcting medieval Latin idiosyncrasies, e.g. f. 14r/17 'supp<re>ma<m>' with the first p crossed out; f. 27/20 'BABILLO' has the last three letters expunged and replaced by 'LA'; titles of sections were sometimes added, e.g. on ff. 45v/2, 46r/ll, 46vl9, 48r/13. On ff. 8v, 16v, 32v notes in a late medieval hand indicate the correct order of the quires by referring to the first word of the following page, an indication that several quires were once misbound. On f. 8v this was later crossed out.