5,735 research outputs found
Synergism of Ampicillin and Gentamicin against Obstructive Pyelonephritis Due to Escherichia coli in Rats
Rats with obstructive pyelonephritis due to Escherichia coli were treated for different intervals with ampicillin and gentamicin either alone or in combination. The combination of ampicillin and gentamicin was synergistic in vitro and significantly more effective in vivo than was either drug alone. After treatment for 10 days, the combination of ampicillin and gentamicin was the only regimen that sterilized all of the pyelonephritic kidneys. The importance of achieving sterility was illustrated by the observation that severe infection and acute pyelonephritis recurred after religation of the ureter in 12 (71%) of 17 ampicillin-treated animals that had harbored as few as 46 organisms per kidney before ligation. A synergistic combination of antibiotics rapidly sterilizes obstructed pyelonephritic kidneys. In view of the particular risk of renal infection in the presence of urinary obstruction in humans, synergistic antibiotic combinations may be useful in the treatment of obstructive pyelonephritis in human
Extramedullary plasmacytoma of the pancreas as an uncommon cause of obstructive jaundice: a case report
Prevention of Pyelonephritis Due to Escherichia coli in Rats with Gentamicin Stored in Kidney Tissue
Although gentamicin is known to accumulate and persist in the kidneys after systemic administration, its antibacterial activity at this site has not been determined. In the present study the accumulation of gentamicin in rat kidneys before infection prevented obstructive pyelonephritis due to Escherichia coli despite heavy urinary tract infection in the obstructed pelvis; thus the kidneys were protected against infection in the absence of effective levels of gentamicin in the urine. Stored gentamicin also protected pyelonephritic rats from relapse after complete obstruction of the kidneys. The level of antimicrobial activity of gentamicin in whole kidney tissue was 95% less than that anticipated on the basis of levels measured after dilution of kidney tissue homogenates; this low level of activity apparently was due in part to high concentrations of solutes. In view of these results in rats, the possibility must be considered that despite reduced activity, gentamicin storage might be useful in the prophylaxis of kidney infection in patients with abnormalities of the urinary tract. In the treatment of established kidney infection, the dose of gentamicin could be reduced and the interval of its administration increased for minimal toxicit
Small Cages with Insect Couples Provide a Simple Method for a Preliminary Assessment of Mating Disruption
Mating disruption by sex pheromones is a sustainable, effective and widely used pest management scheme. A drawback of this technique is its challenging assessment of effectiveness in the field (e.g., spatial scale, pest density). The aim of this work was to facilitate the evaluation of field-deployed pheromone dispensers. We tested the suitability of small insect field cages for a pre-evaluation of the impact of sex pheromones on mating using the grape moths Eupoecilia ambiguella and Lobesia botrana, two major pests in vineyards. Cages consisted of a cubic metal frame of 35 cm sides, which was covered with a mosquito net of 1500 μm mesh size. Cages were installed in the centre of pheromone-treated and untreated vineyards. In several trials, 1 to 20 couples of grape moths per cage were released for one to three nights. The proportion of mated females was between 15 to 70% lower in pheromone-treated compared to untreated vineyards. Overall, the exposure of eight couples for one night was adequate for comparing different control schemes. Small cages may therefore provide a fast and cheap method to compare the effectiveness of pheromone dispensers under standardised semi-field conditions and may help predict the value of setting-up large-scale field trials
Profil et facteurs prédictifs de mortalité du traumatisé grave dans la ville de Kinshasa: Profile and predictive factors of mortality of severe trauma patients in Kinshasa city
Context and objective. Little is known about the prognosis of severe trauma in sub-Saharan Africa. Thestudy analyses epidemioclinical features and treatment of severe trauma patients in 4 hospitals of Kinshasa. Mortality determinants were assessed. Methods. A retrospective cohort analysis of epidemuioclinical and theurapeutical data from 195 severe trauma patents admitted from January 1st 2009 to December 31st 2014. Data related to the accident (rescue type, delay to reference, the lesional assessement, and hemodynamic state upon arrival, radiological findings, medical or surgical care provided within the first 48 hours, and the outcome were recorded. Uni-or multivariable analyses were applied as appropriate. To assess death determinants. Results. A total of 195 patients (mean age: 38.8+/-14.6 years; sex ratio F/M = 3/1) were enrolled. Road accidents (90.8%) was the main cause, and not any patient benefited of pre-hospital medical assistance.The time to admission was of 19.2 +/-3.6 H. Head (82.6%) and/or thoracic trauma (67.1%) were the prevalent lesions. Many patients were comatous (86.2%) with uni or bilateral mydriasis, and almost half (42.1%) had respiratory distress. One out of 3 had hemmoragic shock. Only 27 patients were intubated, and a large proportion was hemodynamicly unstable (63.1%; group A). The rate of mortality in ICU was 73.3%. Poor prognosis was linked to five independent predictive facors among which: age >/= 65 years and the RTS score < 10 emerged. The risk of death was most increased in patients with thoracic trauma than others. Conclusion. Excess mortality in this study has identified risk factors which can help developing accurate tagerted strategies.
Contexte et objectifs. Les données sur les pronostics des traumatisés graves (TG) en Afrique subsaharienne sont fragmentaires. L’étude analyse les données épidémio-cliniques et thérapeutiques des TG dans 4 hôpitaux de Kinshasa. Les s facteurs associés à la mortalité ont été recherchés. Méthodes. Une analyse de cohorte retrospective des données épidémiocliniques et du traitement des TG, admis entre le premier janvier 2009 et le 31 décembre 2014 a été entreprise. Les circonstances de l’accident données étudiées étaient: les caractéristiques démographiques, les circonstances de l’accident, le type de secours pré-hospitalier le délai de référence, le es données cliniques, le bilan radiologique et lésionnel, ainsi que le traitement médicochirurgical endéans les premières 48 heures ont été enregistré. Une analyse uni- et multivariée a été utilisée pour rechercher les facteurs associés au décès. Résultats. Au total, 195 patients (âge moyen : 38,8±14,6 ans ; sexe ratio F/H= 3/1) ont été inclus. Les accidents de voie publique (90,8%) ont été le principal motif d’admission et aucun patient n’a bénéficié d’une assistance médicale pré-hospitalière. Le délai de référence était en moyenne de 19,2 ± 3,6 h. les lésions céphaliques (82,6%) et thoraciques (67,1%) étaient les plus fréquentes. La majorité de patients étaient en coma (86,2%), et 57,9% avaient une mydriase uni ou bilatérale, tandis que 82 patients (42,1%) présentaient une détresse respiratoire et 35 (17,9%) étaient en choc hémorragique. Seulement 27 patients (13,8%) étaient intubés et la majorité avait un état hémodynamique instable. La mortalité en réanimation était de 73,3%. Cinq facteurs prédictifs indépendants associés à un mauvais pronostic ont été identifiés: parmi lesquels l’âge ≥ 65 ans, la saturation pulsée en oxygène < 90% le score RTS < 10. Le risque de décès était plus fréquent dans le groupe des traumatisés thoraciques que dans d’autres. Conclusion. La surmortalité dans cette enquête a permis d’identifier des facteurs pronostiques justifiant des stratégies ciblées de prise en charge
Offshore Oligo-Miocene volcanic fields within the Corsica-Liguria Basin: Magmatic diversity and slab evolution in the western Mediterranean Sea
International audienceThe European and Corsica-Sardinia margins of the Ligurian Sea (western Mediterranean) have been affected by a geochemically diverse igneous activity, offshore and onshore, since the Eocene. This magmatism occurred in a global subduction-related framework. On the European side, the oldest Tertiary magmatism dated at ca. 35 Ma was mainly calc-alkaline. It included the emplacement of plutonic bodies of adakitic affinity, such as the quartz microdiorite laccolith locally referred to as "esterellite". Younger magmatic events on-land within the whole Ligurian domain were mostly medium-K or K-rich calc-alkaline. Miocene volcanic activity was important in Sardinia, where andesites and ignimbrites were erupted during several magmatic cycles. In Corsica, it was minor although it emplaced lamprophyres near Sisco at 15 Ma. Dredging and diving cruises conducted in the Ligurian Sea during the last thirty years allowed us to collect a number of submarine samples. We discuss here their geochemistry (major and trace elements) and their whole-rock K-Ar ages and mineral 40Ar-39Ar plateau ages. Around 15 Ma, minor amounts of adakitic lavas were emplaced off southwestern Corsica, in the deepest part of the Liguria-Corsica Basin. They rested over the thinnest southwestern Corsica Hercynian continental crust. Closer to the coast, contemporaneous calc-alkaline rocks erupted on a less thinned crust. The adakitic events could be indicative of either the final stages of active subduction, or alternatively of a slab tearing linked to the southeastern retreat and steepening of the slab. The latter event could be connected with the end of the Corsica-Sardinia block drifting and its correlative eastern collision. Younger volcanic effusions, dated at 14-6 Ma, occurred mostly northwest and north of Corsica. K-rich calc-alkaline basalts, shoshonites and K-rich trachytes were emplaced during this period, and alkali basalts erupted as early as 12 Ma in Sardinia. In the Toulon area, alkali basalts dated at 7-6 Ma represent the last onshore activity just before the Messinian crisis, and the Pliocene alkali basaltic outpouring in Sardinia. We propose to link these latter volcanic events to the development of a slab window in a post-collisional tectonic framework
Treatment of initial allergic reactions to peanut inside and outside of health care facilities
Parenteral Nutrition Modeling and Research Advances
Parenteral nutrition (PN) provides nutritional support intravenously to individuals who have gastrointestinal (GI) failure or contraindication to enteral feeding. Since the initial development of PN, researchers have developed specialized formulas with complete macronutrients, micronutrients, vitamins, minerals, and electrolytes to support patients’ metabolic needs. These formulas prevent malnutrition and optimize patient health, especially under long-term feeding circumstances. Although PN is commonly used and essential in preterm and malnourished patients, complications associated with PN feeding include gastrointestinal defects, infection, and other metabolic abnormalities such as liver injury and brain related disorders. In this chapter, we highlight an overview of PN and its association with abnormalities of microbiome composition as well as with gastrointestinal (GI), immune, hepatic, and neuronal disfunction. Within the gut, PN influences the number and composition of gut-associated lymphoid tissue (GALT) cells, altering adaptive immune responses. PN also modulates intestinal epithelium cell turnover, secretions, and gut barrier function, as well as the composition of the intestinal microbiome leading to changes in gut permeability. Collectively, these changes result in increased susceptibility to infection and injury. Here, we highlight animal models used to examine parenteral nutrition, changes that occur to the major organ systems, and recent advancement in using enteric nervous system (ENS) neuropeptides or microbially derived products during PN, which may improve GI, immune cell, hepatic, and neuronal function
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