In Vitro Activities of Telavancin and Vancomycin against Biofilm-Producing Staphylococcus aureus, S. epidermidis, and Enterococcus faecalis Strains

We investigated the activities of telavancin and vancomycin against biofilm-producing Staphylococcus and Enterococcus strains. At clinically attainable concentrations, telavancin was active against bacteria embedded in biofilm (minimal biofilm eradication concentration [MBEC], 0.125 to 2 μg/ml) and inhibited biofilm formation at concentrations below the MIC. Vancomycin did not demonstrate the same activity (MBEC, ≥512 μg/ml) against Staphylococcus aureus and Enterococcus faecalis. Telavancin may have a unique role in biofilm-associated infections

La firme et l’environnement

Ce court texte vise à présenter les articles qui composent ce numéro spécial ayant pour thème la firme et l’environnement. Nous les présentons tout en les situant autour des deux grands axes de la littérature sur l’intervention gouvernementale en matière d’environnement : le « comment » de l’intervention et ses effets.This paper introduces the articles that are part of this special issue on the firm and the environment. The articles are presented along two important themes in the literature on government intervention and the environment: the means of intervention and their effects

A qualitative investigation of decision making during help-seeking for adult hearing loss

Objective: The Any Qualified Provider framework in the National Health Service has changed the way adult audiology services are offered in England. Under the new rules, patients are being offered a choice in geographical location and audiology provider. This study aimed to explore how choices in treatment are presented and to identify what information patients need when they are seeking help with hearing loss. Design: This study adopted qualitative methods of ethnographic observations and focus group interviews to identify information needed prior to, and during, help-seeking. Observational data and focus group data were analysed using the constant comparison method of grounded theory. Study sample: Participants were recruited from a community Health and Social Care Trust in the west of England. This service incorporates both an Audiology and a Hearing Therapy service. Twenty seven participants were involved in focus groups or interviews. Results: Participants receive little information beyond the detail of hearing aids. Participants report little information that was not directly related to uptake of hearing aids. Conclusions: Participant preferences were not explored and limited information resulted in decisions that were clinician-led. The gaps in information reflect previous data on clinician communication and highlight the need for consistent information on a range of interventions to manage hearing loss

La firme et l’environnement

This paper introduces the articles that are part of this special issue on the firm and the environment. The articles are presented along two important themes in the literature on government intervention and the environment: the means of intervention and their effects. Ce court texte vise à présenter les articles qui composent ce numéro spécial ayant pour thème la firme et l’environnement. Nous les présentons tout en les situant autour des deux grands axes de la littérature sur l’intervention gouvernementale en matière d’environnement : le « comment » de l’intervention et ses effets.

Universal Scaling of Wave Propagation Failure in Arrays of Coupled Nonlinear Cells

We study the onset of the propagation failure of wave fronts in systems of coupled cells. We introduce a new method to analyze the scaling of the critical external field at which fronts cease to propagate, as a function of intercellular coupling. We find the universal scaling of the field throughout the range of couplings, and show that the field becomes exponentially small for large couplings. Our method is generic and applicable to a wide class of cellular dynamics in chemical, biological, and engineering systems. We confirm our results by direct numerical simulations.Comment: 4 pages, 3 figures, RevTe

Comparison of Telavancin and Vancomycin Antibiotic Lock Solutions in the Eradication of Biofilm-Producing Staphylococci and Enterococci from Central Venous Catheters

Purpose: Results of a study of the activity of antibiotic lock solutions of vancomycin and telavancin against biofilm-forming strains of Staphylococcus epidermidis, Enterococcus faecalis, and Staphylococcus aureus are reported. Methods: An established in vitro central venous catheter model was used to evaluate lock solutions containing vancomycin (5 mg/mL) or telavancin (5 mg/mL), with and without preservative-containing heparin sodium (with 0.45% benzyl alcohol) 2500 units/mL, heparin, and 0.9% sodium chloride solution. Lock solutions were introduced after 24-hour bacterial growth in catheters incubated at 35 °C. After 72 hours of exposure to the lock solutions, catheters were drained, flushed, and cut into segments for quantification of colony-forming units. Results: Against S. epidermidis, vancomycin and telavancin (with or without heparin) had similar activity. Against E. faecalis, vancomycin alone was more active than telavancin alone (p \u3c 0.01). Against S. aureus, vancomycin plus heparin had activity than telavancin (p \u3c 0.02). The addition of heparin was associated with reduced activity of the vancomycin lock solution against S. epidermidis and E. faecalis (p \u3c 0.01). Telavancin activity was not significantly changed with the addition of heparin. Conclusion: In a central venous catheter model, vancomycin and telavancin activity was similar in reducing biofilm-producing S. epidermidis. However, vancomycin was more active than telavancin against E. faecalis and S. aureus. None of the tested agents eradicated biofilm-forming strains. The addition of preservative-containing heparin sodium 2500 units/mL to vancomycin was associated with reduced activity against S. epidermidis and E. faecalis

Survival Following Kidney Sparing Management of Upper Urinary Tract Transitional Cell Carcinoma is Adversely Affected By Prior History of Bladder Cancer

Objective: To evaluate oncological outcomes of Kidney Sparing Surgery (KSS) for upper urinary tract transitional cell carcinoma (UUT-TCC). Patients and Methods: We performed a retrospective review of patients who underwent segmental ureterectomy or endoscopic treatment (percutaneous nephroscopy or retrograde ureteroscopy) for UUT-TCC between 1991 and 2006 at our institution. We evaluated recurrence-free and overall survival rates following KSS. There were 40 renal units in 38 patients. Three patients had bilateral synchronous disease. Mean patient age (±SD) was 69.8±12.3 years. Eighteen (47%) patients had a prior history of bladder TCC. Sixteen (40%) segmental ureterectomies and 24 (60%) endoscopic treatments were performed. Six (16%) patients received adjuvant BCG. Grade distribution was 24 (60%) low-grade, 12 (30%) high-grade and 4 (10%) Gx. The mean follow-up was 47 months. Results: Recurrence rate was 32.5%. The three and five-year recurrence-free survivals were 59.5% and 42.4%. Tumor location was predictive for recurrence (p <0.03). The three and five-year overall survivals were 91.6% and 79.8%. Predictive variables for overall survival were tumor grade (p <0.008) and stage (p <0.018) and previous history of bladder TCC. There was a statistically significant correlation (r= 0.3539) between tumor grade and stage (p= 0.027). Conclusions: KSS offers good oncological outcomes in selected patients with UUT-TCC. The tumor biology rather than the surgical approach dictates prognosis. Patients with higher stage and grade disease may be better served with a more aggressive treatment approach.Key Words: Upper Urinary Tract, Transitional Cell Carcinoma, Endoscopic, Kidney Sparing Surgery, Ureteroscopy, Percutaneous, Survival, Recurrenc