Role of pathogenic oral flora in postoperative pneumonia following brain surgery

Background: Post-operative pulmonary infection often appears to result from aspiration of pathogens colonizing the oral cavity. It was hypothesized that impaired periodontal status and pathogenic oral bacteria significantly contribute to development of aspiration pneumonia following neurosurgical operations. Further, the prophylactic effects of a single dose preoperative cefazolin on the oral bacteria were investigated. Methods: A matched cohort of 18 patients without postoperative lung complications was compared to 5 patients who developed pneumonia within 48 hours after brain surgery. Patients waiting for elective operation of a single brain tumor underwent dental examination and saliva collection before surgery. Bacteria from saliva cultures were isolated and periodontal disease was scored according to type and severity. Patients received 15 mg/kg cefazolin intravenously at the beginning of surgery. Serum, saliva and bronchial secretion were collected promptly after the operation. The minimal inhibitory concentrations of cefazolin regarding the isolated bacteria were determined. The actual antibiotic concentrations in serum, saliva and bronchial secretion were measured by capillary electrophoresis upon completion of surgery. Bacteria were isolated again from the sputum of postoperative pneumonia patients. Results: The number and severity of coexisting periodontal diseases were significantly greater in patients with postoperative pneumonia in comparison to the control group (p = 0.031 and p = 0.002, respectively). The relative risk of developing postoperative pneumonia in high periodontal score patients was 3.5 greater than in patients who had low periodontal score (p < 0.0001). Cefazolin concentration in saliva and bronchial secretion remained below detectable levels in every patient. Conclusion: Presence of multiple periodontal diseases and pathogenic bacteria in the saliva are important predisposing factors of postoperative aspiration pneumonia in patients after brain surgery. The low penetration rate of cefazolin into the saliva indicates that its prophylactic administration may not be sufficient to prevent postoperative aspiration pneumonia. Our study suggests that dental examination may be warranted in order to identify patients at high risk of developing postoperative respiratory infections

High Enzyme Activity of a Binuclear Nickel Complex Formed with the Binding Loops of the NiSOD Enzyme

Detailed equilibrium, spectroscopic and superoxide dismutase (SOD) activity studies are reported on a nickel complex formed with a new metallopeptide bearing two nickel binding loops of NiSOD. The metallopeptide exhibits unique nickel binding ability and the binuclear complex is a major species with 2x(NH2,N-amide,S-,S-) donor set even in an equimolar solution of the metal ion and the ligand. Nickel(III) species were generated by oxidizing the Ni-II complexes with KO2 and the coordination modes were identified by EPR spectroscopy. The binuclear complex formed with the binding motifs exhibits superior SOD activity, in this respect it is an excellent model of the native NiSOD enzyme. A detailed kinetic model is postulated that incorporates spontaneous decomposition of the superoxide ion, the dismutation cycle and fast redox degradation of the binuclear complex. The latter process leads to the elimination of the SOD activity. A unique feature of this system is that the Ni-III form of the catalyst rapidly accumulates in the dismutation cycle and simultaneously the Ni-II form becomes a minor species

Mechanistic Explanation for Differences Between Catalytic Activities of Dissolved and Aerogel Immobilized Cu(II) Cyclen

The copper(II) complex of 1,4,7,10-tetraazacyclododecane [Cu(II)-cyclen] was covalently immobilized in mesoporous silica aerogel. This immobilization significantly alters the catalytic activity of Cu(II)-cyclen when referenced to the dissolved complex in the oxidation of phenol by H2O2 in aqueous solution. In order to understand this phenomenon, the functionalized aerogel was characterized by scanning electron microscopy (SEM), N2 porosimetry, small angle neutron scattering (SANS), infrared spectroscopy (IR) and electron paramagnetic resonance spectroscopy (EPR). Aerogel morphology is typical of mesoporous silica aerogels, and the coordination mode of Cu(II) in the immobilized complex is well-related but not identical to solution phase Cu(II)-cyclen. The mechanisms of the catalytic reactions involving dissolved and immobilized Cu(II)-cyclen were explored by fine kinetic experiments using capillary electrophoresis (CE) and on-line UV–vis spectrophotometry. Hydroquinone, pyrocatechol and the related benzoquinones were identified as the main intermediates in both reaction systems. A detailed kinetic model is postulated based on global data fitting, which clearly highlights the mechanistic differences in the two systems. Interestingly, the activation of the catalyst by H2O2 is more effective in the case of the aerogel, but the total conversion of phenol is slower due to hindered mass transport compared to using dissolved Cu(II)-cyclen

Role of pathogenic oral flora in postoperative pneumonia following brain surgery

<p>Abstract</p> <p>Background</p> <p>Post-operative pulmonary infection often appears to result from aspiration of pathogens colonizing the oral cavity. It was hypothesized that impaired periodontal status and pathogenic oral bacteria significantly contribute to development of aspiration pneumonia following neurosurgical operations. Further, the prophylactic effects of a single dose preoperative cefazolin on the oral bacteria were investigated.</p> <p>Methods</p> <p>A matched cohort of 18 patients without postoperative lung complications was compared to 5 patients who developed pneumonia within 48 hours after brain surgery. Patients waiting for elective operation of a single brain tumor underwent dental examination and saliva collection before surgery. Bacteria from saliva cultures were isolated and periodontal disease was scored according to type and severity. Patients received 15 mg/kg cefazolin intravenously at the beginning of surgery. Serum, saliva and bronchial secretion were collected promptly after the operation. The minimal inhibitory concentrations of cefazolin regarding the isolated bacteria were determined. The actual antibiotic concentrations in serum, saliva and bronchial secretion were measured by capillary electrophoresis upon completion of surgery. Bacteria were isolated again from the sputum of postoperative pneumonia patients.</p> <p>Results</p> <p>The number and severity of coexisting periodontal diseases were significantly greater in patients with postoperative pneumonia in comparison to the control group (p = 0.031 and p = 0.002, respectively). The relative risk of developing postoperative pneumonia in high periodontal score patients was 3.5 greater than in patients who had low periodontal score (p < 0.0001). Cefazolin concentration in saliva and bronchial secretion remained below detectable levels in every patient.</p> <p>Conclusion</p> <p>Presence of multiple periodontal diseases and pathogenic bacteria in the saliva are important predisposing factors of postoperative aspiration pneumonia in patients after brain surgery. The low penetration rate of cefazolin into the saliva indicates that its prophylactic administration may not be sufficient to prevent postoperative aspiration pneumonia. Our study suggests that dental examination may be warranted in order to identify patients at high risk of developing postoperative respiratory infections.</p

Determination of Cephalosporins Using Electrophoretic Techniques

Kefalosporinok vizsgálata elektroforetikus technikákkalDetermination of cephalosporins using electrophoretic technique

Analysis of cephalosporins in bronchial secretions by capillary electrophoresis after simple pretreatment

The applicability of capillary zone electrophoresis (CZE) for analysis of cephalosporin antibiotics has been studied in bronchial secretion as highly viscous, thick and non-homogeneous samples. The lyophilization was found to be a simple but effective pretreatment of these samples to bring them into a form which is suitable for injection to CE capillary. The obtained good recovery data prove that the lyophilization/dissolution of bronchial secretion samples can be reproducibly performed

Analysis of Rituximab, A Therapeutic Monoclonal Antibody by Capillary Zone Electrophoresis

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