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Sample records for ciprofloxacine therapy compared

  1. Amodiaquine and Ciprofloxacin Combination in Plasmodiasis Therapy

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    Peace Mayen Edwin Ubulom

    2015-01-01

    Full Text Available Objective. The study was designed to determine the efficacy of combined Amodiaquine and Ciprofloxacin in plasmodiasis therapy. Method. The in vivo antiplasmodial effect of different dosage levels of Amodiaquine, Ciprofloxacin, and their combinations against Plasmodium berghei berghei was evaluated using Swiss albino mice. Results. Amodiaquine (a known antiplasmodial agent had a fairly significant antiplasmodial effect reducing the parasites for every 100 red blood cells (RBC from 66 to 16 (75.75% at the tolerable dosage level of 7.5 mg/kg body weight while Ciprofloxacin (an antibiotic known to have antimalarial effect showed an insignificant antiplasmodial effect reducing the parasites for every 100 RBC from 65 to 64 (1.53% at the tolerable dosage level of 10.7 mg/kg body weight. Conversely, the combination therapy of Amodiaquine and Ciprofloxacin had a significant antiplasmodial effect at all the doses administered. The combination of 7.5 mg/kg of Amodiaquine and 12.8 mg/kg of Ciprofloxacin, however, showed the most significant antiplasmodial effect of the doses used reducing the number of parasites per 100 RBC from 60 to 10 (83.33%. Conclusions. Appropriate Amodiaquine and Ciprofloxacin combination will be effective for the treatment of malaria and better than either Amodiaquine or Ciprofloxacin singly at their recommended dosage levels.

  2. Amodiaquine and Ciprofloxacin Combination in Plasmodiasis Therapy.

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    Ubulom, Peace Mayen Edwin; Udobi, Chinweizu Ejikeme; Madu, Mark Iheukwumere

    2015-01-01

    Objective. The study was designed to determine the efficacy of combined Amodiaquine and Ciprofloxacin in plasmodiasis therapy. Method. The in vivo antiplasmodial effect of different dosage levels of Amodiaquine, Ciprofloxacin, and their combinations against Plasmodium berghei berghei was evaluated using Swiss albino mice. Results. Amodiaquine (a known antiplasmodial agent) had a fairly significant antiplasmodial effect reducing the parasites for every 100 red blood cells (RBC) from 66 to 16 (75.75%) at the tolerable dosage level of 7.5 mg/kg body weight while Ciprofloxacin (an antibiotic known to have antimalarial effect) showed an insignificant antiplasmodial effect reducing the parasites for every 100 RBC from 65 to 64 (1.53%) at the tolerable dosage level of 10.7 mg/kg body weight. Conversely, the combination therapy of Amodiaquine and Ciprofloxacin had a significant antiplasmodial effect at all the doses administered. The combination of 7.5 mg/kg of Amodiaquine and 12.8 mg/kg of Ciprofloxacin, however, showed the most significant antiplasmodial effect of the doses used reducing the number of parasites per 100 RBC from 60 to 10 (83.33%). Conclusions. Appropriate Amodiaquine and Ciprofloxacin combination will be effective for the treatment of malaria and better than either Amodiaquine or Ciprofloxacin singly at their recommended dosage levels.

  3. Ciprofloxacin

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    ... tract infections, but should not be used for bronchitis and sinus infections, or certain types of urinary tract infections if there are other treatment options. Ciprofloxacin extended-release (long-acting) tablets are ...

  4. Quinolone therapy of Klebsiella pneumoniae sepsis following irradiation: Comparison of pefloxacin, ciprofloxacin, and ofloxacin

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    Brook, I.; Elliott, T.B.; Ledney, G.D. (Armed Forces Radiobiology Research Institute, Bethesda, MD (USA))

    1990-05-01

    Exposure to whole-body irradiation is associated with fatal gram-negative sepsis. The effect of oral therapy with three quinolones, pefloxacin, ciprofloxacin, and ofloxacin, for orally acquired Klebsiella pneumoniae infection was tested in B6D2F1 mice exposed to 8.0 Gy whole-body irradiation from bilaterally positioned 60Co sources. A dose of 10(8) organisms was given orally 2 days after irradiation, and therapy was started 1 day later. Quinolones reduced colonization of the ileum with K. pneumoniae: 16 of 28 (57%) untreated mice harbored the organisms, compared to only 12 of 90 (13%) mice treated with quinolones (P less than 0.005). K. pneumoniae was isolated from the livers of 6 of 28 untreated mice, compared to only 1 of 90 treated mice (P less than 0.001). Only 5 of 20 (25%) untreated mice survived for at least 30 days compared with 17 of 20 (85%) mice treated with ofloxacin, 15 of 20 (75%) mice treated with pefloxacin, and 14 of 20 (70%) treated with ciprofloxacin (P less than 0.05). These data illustrate the efficacy of quinolones for oral therapy of orally acquired K. pneumoniae infection in irradiated hosts.

  5. Wound Penetration of Cefazolin, Ciprofloxacin, Piperacillin, Tazobactam, and Vancomycin During Negative Pressure Wound Therapy

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    Rowan, Matthew P.; Niece, Krista L.; Rizzo, Julie A.; Akers, Kevin S.

    2017-01-01

    Objective: Negative pressure wound therapy (NPWT) uses subatmospheric pressure as a noninvasive adjunct to treat wounds and has demonstrated clinical efficacy by accelerating healing of a variety of acute and chronic wounds. NPWT may also play a role in preventing or treating wound infections, possibly by increasing wound penetration of antibiotics. However, clinical data in patients undergoing antibiotic and NPWT treatment are limited. Approach: To evaluate the wound penetration of antibiotics in NPWT patients, we conducted a prospective, observational study of burn and trauma patients treated with NPWT and systemic antibiotics. We evaluated the plasma pharmacokinetic profile of systemic vancomycin, ciprofloxacin, cefazolin, and piperacillin/tazobactam, as well as total and unbound antibiotic concentrations in wound exudate from the same patients. Results: Data from 32 patients with 37 wounds undergoing NPWT demonstrated that vancomycin, ciprofloxacin, and piperacillin/tazobactam all penetrated wounds with exudate to plasma concentration ratios more than 0.8. Cefazolin did not penetrate wounds in patients undergoing NPWT as effectively, with an average exudate to plasma concentration ratio of 0.51. Innovation: Clinical data on the wound penetration of antibiotics in patients undergoing NPWT are limited, but these data suggest that antibiotics have different capacities for wound penetration during NPWT that should be considered when making clinical decisions. Conclusion: This initial report suggests that (1) vancomycin, ciprofloxacin, and piperacillin/tazobactam effectively penetrate wounds during NPWT and (2) cefazolin as well as other antibiotics may not penetrate wounds during NPWT.

  6. Efficacy of ciprofloxacin-gentamicin combination therapy in murine bubonic plague.

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    Nadine Lemaître

    Full Text Available Potential benefits of combination antibiotic therapy for the treatment of plague have never been evaluated. We compared the efficacy of a ciprofloxacin (CIN and gentamicin (GEN combination therapy with that of each antibiotic administered alone (i against Yersinia pestis in vitro and (ii in a mouse model of bubonic plague in which animals were intravenously injected with antibiotics for five days, starting at two different times after infection (44 h and 56 h. In vitro, the CIN+GEN combination was synergistic at 0.5x the individual drugs' MICs and indifferent at 1x- or 2x MIC. In vivo, the survival rate for mice treated with CIN+GEN was similar to that observed with CIN alone and slightly higher than that observed for GEN alone 100, 100 and 85%, respectively when treatment was started 44 h post challenge. 100% of survivors were recorded in the CIN+GEN group vs 86 and 83% in the CIN and GEN groups, respectively when treatment was delayed to 56 h post-challenge. However, these differences were not statistically significant. Five days after the end of treatment, Y. pestis were observed in lymph nodes draining the inoculation site (but not in the spleen in surviving mice in each of the three groups. The median lymph node log(10 CFU recovered from persistently infected lymph nodes was significantly higher with GEN than with CIN (5.8 vs. 3.2, p = 0.04 or CIN+GEN (5.8 vs. 2.8, p = 0.01. Taken as the whole, our data show that CIN+GEN combination is as effective as CIN alone but, regimens containing CIN are more effective to eradicate Y. pestis from the draining lymph node than the recommended GEN monotherapy. Moreover, draining lymph nodes may serve as a reservoir for the continued release of Y. pestis into the blood - even after five days of intravenous antibiotic treatment.

  7. [Ciprofloxacin and therapy of urinary tract infections, including those due to Staphylococcus saprophyticus].

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    Ivanov, D V; Budanov, S V

    2006-01-01

    Staphylococcus saprophyticus is one of the main pathogens of cystitis in young women. The human biotopes are contaminated by the staphylococcus on direct contacts with domestic animals or after using not properly cooked food of animal origin. Young women are more susceptible to colonization of the urinary tract by S. saprophyticus vs. the other contingents. Sexual intercourse is conducive to the colonization and infection. Shifts in the urinary tract microflora due to the use of spermicide, as well as candidiasis promote colonization of the urinary tract by S. saprophyticus. At present fluoroquinolones are considered as a significant independent group of chemotherapeutics within the class of quinolones, inhibitors of DNA gyrase, characterized by high clinical efficacy in the treatment of urinary tract infections. Especially significant clinical experience with ciprofloxacin in the therapy of urinary tract infections is available.

  8. The potential of liposome–encapsulated ciprofloxacin as a tularemia therapy

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    Karleigh Ann Hamblin

    2014-06-01

    Full Text Available Liposome-encapsulation has been suggested as method to improve the efficacy of ciprofloxacin against the intracellular pathogen, Francisella tularensis. Early work with a prototype formulation, evaluated for use against the F. tularensis live vaccine strain, showed that a single dose of liposomal ciprofloxacin given by the intranasal or inhalational route could provide protection in a mouse model of pneumonic tularemia. Liposomal ciprofloxacin offered better protection than ciprofloxacin given by the same routes. Liposomal ciprofloxacin has been further developed by Aradigm Corporation for Pseudomonas aeruginosa infections in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis. This advanced development formulation is safe, effective and well tolerated in human clinical trials. Further evaluation of the advanced liposomal ciprofloxacin formulation against the highly virulent F. tularensis Schu S4 strain has shown that aerosolised CFI (Ciprofloxacin encapsulated in liposomes for inhalation provides significantly better protection than oral ciprofloxacin. Thus, liposomal ciprofloxacin is a promising treatment for tularemia and further research with the aim of enabling licensure under the animal rule is warranted.

  9. The potential of liposome-encapsulated ciprofloxacin as a tularemia therapy.

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    Hamblin, Karleigh A; Wong, Jonathan P; Blanchard, James D; Atkins, Helen S

    2014-01-01

    Liposome-encapsulation has been suggested as method to improve the efficacy of ciprofloxacin against the intracellular pathogen, Francisella tularensis. Early work with a prototype formulation, evaluated for use against the F. tularensis live vaccine strain, showed that a single dose of liposomal ciprofloxacin given by the intranasal or inhalational route could provide protection in a mouse model of pneumonic tularemia. Liposomal ciprofloxacin offered better protection than ciprofloxacin given by the same routes. Liposomal ciprofloxacin has been further developed by Aradigm Corporation for Pseudomonas aeruginosa infections in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis. This advanced development formulation is safe, effective and well tolerated in human clinical trials. Further evaluation of the advanced liposomal ciprofloxacin formulation against the highly virulent F. tularensis Schu S4 strain has shown that aerosolized CFI (Ciprofloxacin encapsulated in liposomes for inhalation) provides significantly better protection than oral ciprofloxacin. Thus, liposomal ciprofloxacin is a promising treatment for tularemia and further research with the aim of enabling licensure under the animal rule is warranted.

  10. Ciprofloxacin Injection

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    ... attack) . Ciprofloxacin may also be used to treat bronchitis and sinus infections, but should not be used for these conditions if there are other treatment options available. Ciprofloxacin injection is in a class ...

  11. Efficacy of Compound Therapy by Ginseng and Ciprofloxacin on Bacterial Prostatitis

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    Maryam Miri

    2016-04-01

    Full Text Available Objective: Genitourinary tract infections play a significant role in male infertility. Infections of reproductive sex glands, such as the prostate, impair function and indirectly affect male fertility. The general aim of this study is to investigate the protective effect of Korean red ginseng (KRG on prostatitis in male rats treated with ciprofloxacin (CIPX. Materials and Methods: In this experimental study, we randomly divided 72 two male Wistar rats into 9 groups. The groups were treated as follows for 10 days: i. Control (no medication, ii. Sham [(normal saline injection into the vas deferens and oral administration of phosphate-buffered saline (PBS], iii. Ginseng, iv. CPIX, v. CIPX+ginseng, vi. Uropathogenic Escherichia coli (E. coli (UPEC, vii. UPEC+ginseng, viii. UPEC+CIPX, and ix. UPEC+ginseng+CIPX. The rats were killed 14 days after the last injection and the prostate glands were removed. After sample preparation, routine histology was performed using hematoxylin and eosin staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL method was used to determine the presence of apoptotic cells. Results: The severity score for acinar changes and inflammatory cell infiltration in the UPEC+CIPX group did not significantly different from the UPEC group. However this score significantly decreased in the UPEC+CIPX+ginseng group compared to the UPEC group. Apoptotic index of all ginseng treated groups significantly decreased compared to the UPEC and CPIX groups. Conclusion: These results suggested that ginseng might be an effective adjunct in CIPX treatment of prostatitis. The combined use ginseng and CIPX was more effective than ginseng or CIPX alone.

  12. Comparison of Ciprofloxacin-Based Triple Therapy with Conventional Triple Regimen for Helicobacter pylori Eradication in Children.

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    Farahmand, Fatemeh; Mohammadi, Tayebeh; Najafi, Mehri; Fallahi, Gholamhosein; Khodadad, Ahmad; Motamed, Farzaneh; Mahdi Marashi, Sayed; Shoaran, Maryam; Nabavizadeh Rafsanjani, Raheleh

    2016-06-01

    Helicobacter pylori infection is a prevalent disease among Iranian children. The purpose of this study was to compare the effect of ciprofloxacin and furazolidone on eradicating helicobacter pylori in Iranian children in combination with amoxicillin and omeprazole. In this cohort study, helicobacter pylori infection was confirmed by gastroscopy, rapid urease test or pathologic assessments. A total of 66 children were randomly enrolled; based on the random number table, and were divided into two groups; first, a combination regimen consisting of ciprofloxacin, amoxicillin, and omeprazole; second, a three-medication regimen consisting of amoxicillin, furazolidone, and omeprazole. The effect of both medical regimens on the successful eradication of helicobacter pylori infection was assessed and compared. Chi-square test was used for evaluating the association between quantitative variables. All comparisons were made at the significance of Phelicobacter pylori infection was reported 87.9% (29/33) in the first group (CAO) and 60.6% (20.33) in the second group (FAO) (P=0.011). It appears that a major advantage of our proposed regimen over others is a lack of wide use of fluoroquinolones for treating children's diseases. Given FDA's recommendation about the possibility of prescribing ciprofloxacin for infected patients with multidrug resistance, we can use the regimen proposed in this study in patients with resistance to standard treatments.

  13. Susceptibility of conjunctival bacterial pathogens to fluoroquinolones. A comparative study of ciprofloxacin, norfloxacin and ofloxacin

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    Stella Odjimogho

    2003-10-01

    Full Text Available In order to determine the most common bacteria implicated in conjunctivitis, and the effectiveness of the antibiotic Fluoroquinolone for its treatment, a total of 50 subjects (100 eyes, between the ages of 1-30 years with mean age of 16.94 ± 8.06 years with infected eyes, were examined at the Lagos State University Teaching Hospital, Nigeria (LASUTH. Conjunctival swabs were collected and cultured in the laboratory to isolate the pathogens responsible for the infection. Sensitivity and antibiotic suscepticibility tests were carried out with discs impregnated with 0.3% concentration of ophthalmic topical solutions of chibroxin (Norfloxacin, ciloxan (Ciprofloxacin, and ocuflox (Ofloxacin, to ascertain the most sensitive of the three drugs. The results showed that the implicated bacteria in order of decreasing frequency were Staphylococcus aureus (34%, followed by Streptococcus pneumoniae (22%, Pseudomonas aeruginosa (14%, Klebsiella pneumoniae (12%, Hemophilus influenzae (9%, Escherichia coli (9%. All the isolated organisms were highly sensitive to the three drugs. However, a one way analysis of variance (ANOVA showed a significant difference in the sensitivity of the three drugs (p< 0.05. ANOVA Post Hoc located Ciprofloxacin as the source of the significance. In conclusion therefore, Ciprofloxacin is the most sensitive of the three drugs and, hence should be the first choice of the fluoroquinolones for the treatment of bacterial conjunctivitis.

  14. Inhaled Liposomal Ciprofloxacin Protects against a Lethal Infection in a Murine Model of Pneumonic Plague

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    Hamblin, Karleigh A.; Armstrong, Stuart J.; Barnes, Kay B.; Davies, Carwyn; Laws, Thomas; Blanchard, James D.; Harding, Sarah V.; Atkins, Helen S.

    2017-01-01

    Inhalation of Yersinia pestis can lead to pneumonic plague, which without treatment is inevitably fatal. Two novel formulations of liposome-encapsulated ciprofloxacin, ‘ciprofloxacin for inhalation’ (CFI, Lipoquin®) and ‘dual release ciprofloxacin for inhalation’ (DRCFI, Pulmaquin®) containing CFI and ciprofloxacin solution, are in development. These were evaluated as potential therapies for infection with Y. pestis. In a murine model of pneumonic plague, human-like doses of aerosolized CFI, aerosolized DRCFI or intraperitoneal (i.p.) ciprofloxacin were administered at 24 h (representing prophylaxis) or 42 h (representing treatment) post-challenge. All three therapies provided a high level of protection when administered 24 h post-challenge. A single dose of CFI, but not DRCFI, significantly improved survival compared to a single dose of ciprofloxacin. Furthermore, single doses of CFI and DRCFI reduced bacterial burden in lungs and spleens to below the detectable limit at 60 h post-challenge. When therapy was delayed until 42 h post-challenge, a single dose of CFI or DRCFI offered minimal protection. However, single doses of CFI or DRCFI were able to significantly reduce the bacterial burden in the spleen compared to empty liposomes. A three-day treatment regimen of ciprofloxacin, CFI, or DRCFI resulted in high levels of protection (90–100% survival). This study suggests that CFI and DRCFI may be useful therapies for Y. pestis infection, both as prophylaxis and for the treatment of plague. PMID:28220110

  15. Peroral ciprofloxacin therapy impairs the generation of a protective immune response in a mouse model for Salmonella enterica serovar Typhimurium diarrhea, while parenteral ceftriaxone therapy does not.

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    Endt, Kathrin; Maier, Lisa; Käppeli, Rina; Barthel, Manja; Misselwitz, Benjamin; Kremer, Marcus; Hardt, Wolf-Dietrich

    2012-05-01

    Nontyphoidal Salmonella (NTS) species cause self-limiting diarrhea and sometimes severe disease. Antibiotic treatment is considered only in severe cases and immune-compromised patients. The beneficial effects of antibiotic therapy and the consequences for adaptive immune responses are not well understood. We used a mouse model for Salmonella diarrhea to assess the effects of per os treatment with ciprofloxacin (15 mg/kg of body weight intragastrically 2 times/day, 5 days) or parenteral ceftriaxone (50 mg/kg intraperitoneally, 5 days), two common drugs used in human patients. The therapeutic and adverse effects were assessed with respect to generation of a protective adaptive immune response, fecal pathogen excretion, and the emergence of nonsymptomatic excreters. In the mouse model, both therapies reduced disease severity and reduced the level of fecal shedding. In line with clinical data, in most animals, a rebound of pathogen gut colonization/fecal shedding was observed 2 to 12 days after the end of the treatment. Yet, levels of pathogen shedding and frequency of appearance of nonsymptomatic excreters did not differ from those for untreated controls. Moreover, mice treated intraperitoneally with ceftriaxone developed an adaptive immunity protecting the mice from enteropathy in wild-type Salmonella enterica serovar Typhimurium challenge infections. In contrast, the mice treated intragastrically with ciprofloxacin were not protected. Thus, antibiotic treatment regimens can disrupt the adaptive immune response, but treatment regimens may be optimized in order to preserve the generation of protective immunity. It might be of interest to determine whether this also pertains to human patients. In this case, the mouse model might be a tool for further mechanistic studies.

  16. Ciprofloxacin: a novel therapeutic agent for iron overload?

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    Mitra Elmi

    2009-09-01

    Full Text Available Objective: Major thalassemia is one of the hematological diseases requiring multiple blood transfusions, which results in iron overload in the liver, heart and other organs. Current iron chelation therapy consists of intravenous (IV deferoxamine and oral deferasirox and deferiprone. Although these chelators are effective, many side effects are reported. In the present study, the iron-chelating effect of ciprofloxacin with good oral absorption was investigated. Material and Methods: Thirty male albino Wistar rats were used for the study. Ciprofloxacin (7 or 14 mg/kg per day was administered simultaneously with iron (0.03 g/kg per day or after one-month administration of iron. Ciprofloxacin effect on iron absorption in the liver and heart was studied carefully using atomic absorption. Results: A significant decrease in the liver and heart iron following the ciprofloxacin (14 mg/kg per day administration was observed, when compared with the control group. This ciprofloxacin-induced tissue iron depletion was more pronounced when it was administered simultaneously with iron, when it was administered for a longer duration (2 months rather than 1 month and when it was given in higher doses (14 mg/kg per day. Conclusion: Administration of ciprofloxacin may help to decrease the burden of parenteral administration, thereby improving compliance and also the life expectancy of thalassemic patients.

  17. Comparative studies for ciprofloxacin hydrochloride pre-formed gels and thermally triggered (in situ) gels: in vitro and in vivo appraisal using a bacterial keratitis model in rabbits.

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    Abdelkader, Hamdy; Mansour, Heba F

    2015-06-01

    This article reports on comparative in vitro characterization and in vivo evaluation of pre-formed cellulose-based gels, methylcellulose (MC) and carboxymethylcellulose sodium (CMC) and in situ gel-forming Pluronic F127 (PL) for ocular delivery of ciprofloxacin hydrochloride (Cipro) by using a bacterial keratitis model and histological corneal examination. Drug-polymer interactions were studied employing thermal analysis. Further, different concentrations (1-3% w/w or 10-30% w/w) of gels depending on the nature of the polymer used were prepared, characterized for clarity, pH, rheology and in vitro release. Selected gel formulations were evaluated for ocular delivery to Staphylococcus aureus-infected rabbit corneas; and ocular toxicity through histological examination of the cornea. The results demonstrated no Cipro-polymers physicochemical interactions and pseudoplastic flow for all gels used at 35 °C. Both polymer concentrations and drug solubility in the gels are dominantly the rate-determining factors for in vitro drug release. The corneal healing rate for all gel-based formulations was significantly faster (p < 0.05) than that for Cipro solution-treated rabbits. PL-based gel induced significant swelling/edema of the corneal stroma, compared with MC- and CMC-based gels. In conclusion, cellulose-based polymers have superior ocular tolerability/dramatically less irritant; and superior efficacy with more convenient administration compared with PL and Cipro solution, respectively.

  18. Killing curve activity of ciprofloxacin is comparable to synergistic effect of beta-lactam-tobramycin combinations against Haemophilus species endocarditis strains

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    Westh, H; Frimodt-Møller, N; Gutschik, E

    1992-01-01

    Nine Haemophilus species strains, all beta-lactamase negative, isolated from patients with endocarditis were tested in killing curve experiments. Antibiotics used were penicillin, amoxicillin, aztreonam alone and in combination with tobramycin, as well as ciprofloxacin alone. Synergism between beta......-lactams and tobramycin with reduction of colony counts to zero was seen after 24 h for H. influenzae, H. parainfluenzae and H. segnis strains. Ciprofloxacin was as effective as beta-lactam-tobramycin combinations. The H. aphrophilus strain was not killed as effectively as other strains by any of the antibiotics....

  19. Comparison of efficacy of ciprofloxacin and doxycycline against experimental melioidosis and glanders.

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    Russell, P; Eley, S M; Ellis, J; Green, M; Bell, D L; Kenny, D J; Titball, R W

    2000-06-01

    Melioidosis and glanders are caused by the closely related species Burkholderia pseudomallei and Burkholderia mallei, respectively. Whereas melioidosis is a significant cause of morbidity in south-east Asia, glanders is extremely rare. The efficacies of ciprofloxacin and doxycycline were assessed against a strain of B. pseudomallei and a strain of B. mallei which were susceptible to both antimicrobials in vitro. Porton outbred mice and Syrian hamsters were given 40 mg/kg of either doxycycline or ciprofloxacin twice daily by sc injection according to one of three regimens: dosing starting 48 h before challenge and continuing for 5 days postchallenge; 5 days' therapy starting immediately after challenge; 5 days' therapy starting 24 h after challenge. Mice were challenged ip with B. pseudomallei 4845 and hamsters were challenged ip with B. mallei 23344. Antimicrobial efficacy was determined by the shift in the median lethal dose (MLD). Ciprofloxacin prophylaxis and immediate therapy both raised the MLD of B. pseudomallei to 4 x 10(6) cfu from 19 cfu in untreated animals, but therapeutic ciprofloxacin only raised the MLD to 180 cfu. The results for doxycycline were similar. Ciprofloxacin prophylaxis raised the MLD of B. mallei 23344 to 4.6 x 10(5) cfu compared with 4 cfu in untreated controls. Immediate therapy raised the MLD to 7.0 x 10(4) cfu and therapy raised the MLD to 1.6 x 10(3) cfu. All regimens of doxycycline protected hamsters against challenges of up to 2 x 10(7) cfu. Despite using a susceptible strain of B. pseudomallei, neither antimicrobial was effective when used therapeutically. The timely administration of either antimicrobial, however, was effective in preventing symptomatic infection. Doxycycline was the superior of the two antimicrobials against experimental glanders although relapse did occur in treated animals approximately 4-5 weeks after challenge.

  20. Focus on oral ciprofloxacin; clinical and economic considerations.

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    Pastel, D

    1989-10-01

    Ciprofloxacin, a recently released oral fluorinated quinolone structurally related to nalidixic acid, joins norfloxacin as the second drug of this class to be released. Ciprofloxacin has a wide spectrum of antimicrobial activity and importantly demonstrates little cross resistance to non-quinolone drug classes (e.g. ureidopenicillins, cephalosporins, monobactams, carbapenems, aminoglycosides). Unlike other antibacterial classes such as the beta-lactams or aminoglycosides, ciprofloxacin does not suffer from transferable plasmid-mediated (i.e. R-factor) antibiotic resistance. Against gram-positive (including penicillin-resistant and methicillin-resistant staphylococci aureus) and gram-negative aerobic bacteria including Pseudomonas aeruginosa, ciprofloxacin demonstrates excellent activity. Ciprofloxacin is inactive against Trichomonas sp., treponemes, and fungi and anaerobes are considered resistant. Ciprofloxacin is rapidly absorbed from the gastrointestinal tract (i.e. 70-80% bioavailable), demonstrates extensive extravascular distribution, and its 3.5-5 hour half-life allows twice daily dosing. The bacteriologic and clinical efficacy of oral ciprofloxacin was shown to be comparable to third generation cephalosporins or aminoglycosides for osteomyelitis, cefotaxime for skin structure infections, and to a combination of tobramycin with azlocillin for pulmonary exacerbation of cystic fibrosis. Adverse events associated with ciprofloxacin are related mostly to gastrointestinal disturbance and consist of nausea/vomiting or diarrhea. Concomitant administration of ciprofloxacin and theophylline may lead to decreased theophylline clearance and necessitates periodic measurements of theophylline levels to avoid toxic levels. Treatment with oral ciprofloxacin should offer substantial cost savings over a variety of parenteral antimicrobial regimens (e.g. aminoglycoside + beta-lactams) for difficult to treat infections such as chronic pyelonephritis, osteomyelitis, and skin

  1. Evaluation of Ciprofloxacin as a Representative of Veterinary Fluoroquinolones in Susceptibility Testing

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    Riddle, Christa; Lemons, Carol L.; Papich, Mark G.; Altier, Craig

    2000-01-01

    Currently in veterinary medicine, ciprofloxacin is often used in susceptibility testing to represent the entire class of fluoroquinolone antimicrobials. Using quality control organisms as well as clinical isolates, we compared the MIC of ciprofloxacin to those of three other fluoroquinolones used in animals and found that ciprofloxacin is not an adequate representative of other members of this class.

  2. Ciprofloxacin Improves the Stemness of Human Dermal Papilla Cells

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    Chayanin Kiratipaiboon

    2016-01-01

    Full Text Available Improvement in the expansion method of adult stem cells may augment their use in regenerative therapy. Using human dermal papilla cell line as well as primary dermal papilla cells as model systems, the present study demonstrated that ciprofloxacin treatment could prevent the loss of stemness during culture. Clonogenicity and stem cell markers of dermal papilla cells were shown to gradually decrease in the culture in a time-dependent manner. Treatment of the cells with nontoxic concentrations of ciprofloxacin could maintain both stem cell morphology and clonogenicity, as well as all stem cells markers. We found that ciprofloxacin exerted its effect through ATP-dependent tyrosine kinase/glycogen synthase kinase3β dependent mechanism which in turn upregulated β-catenin. Besides, ciprofloxacin was shown to induce epithelial-mesenchymal transition in DPCs as the transcription factors ZEB1 and Snail were significantly increased. Furthermore, the self-renewal proteins of Wnt/β-catenin pathway, namely, Nanog and Oct-4 were significantly upregulated in the ciprofloxacin-treated cells. The effects of ciprofloxacin in preserving stem cell features were confirmed in the primary dermal papilla cells directly obtained from human hair follicles. Together, these results revealed a novel application of ciprofloxacin for stem cell maintenance and provided the underlying mechanisms that are responsible for the stemness in dermal papilla cells.

  3. Ciprofloxacin and Amlodipine Coadministration

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    Nicolas De Schryver

    2015-01-01

    Full Text Available Simvastatin is among the most commonly used prescription medications for cholesterol reduction and the most common statin-related adverse drug reaction is skeletal muscle toxicity. Multiple factors have been shown to influence simvastatin-induced myopathy. In addition to age, gender, ethnicity, genetic predisposition, and dose, drug-drug interactions play a major role. This is particularly true for drugs that are extensively metabolized by cytochrome P450 (CYP3A4. We describe a particularly severe case of rhabdomyolysis after the introduction of ciprofloxacin, a weak CYP3A4 inhibitor, in a patient who previously tolerated the simvastatin-amlodipine combination.

  4. Comparing Postoperative Radiation Therapies for Brain Metastases

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    In this clinical trial, patients with one to four brain metastases who have had at least one of the metastatic tumors removed surgically will be randomly assigned to undergo whole-brain radiation therapy or stereotactic radiosurgery.

  5. Biodegradation of ciprofloxacin in water and soil and its effects on the microbial communities

    Energy Technology Data Exchange (ETDEWEB)

    Girardi, Cristobal, E-mail: cristobal.girardi-lavin@ufz.de [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Biotechnology, Permoserstrasse 15, 04318 Leipzig (Germany); Greve, Josephine [Minnesota State University, Mankato, MN 56001 8400 (United States); Lamshoeft, Marc [Institute of Environmental Research (INFU), TU Dortmund University, Otto-Hahn-Str. 6, NRW 44221 Dortmund (Germany); Fetzer, Ingo [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Microbiology, Permoserstrasse 15, 04318 Leipzig (Germany); Miltner, Anja [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Biotechnology, Permoserstrasse 15, 04318 Leipzig (Germany); Schaeffer, Andreas [Department of Environmental Biology and Chemodynamics, Institute for Environmental Research (Biology V), RWTH Aachen University, Worringerweg 1, 52074 Aachen (Germany); Kaestner, Matthias [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Biotechnology, Permoserstrasse 15, 04318 Leipzig (Germany)

    2011-12-30

    Highlights: Black-Right-Pointing-Pointer Mineralisation of toxic pollutants can be higher in soil than in water. Black-Right-Pointing-Pointer Ciprofloxacin affects the microbial communities and activities in soil. Black-Right-Pointing-Pointer Toxicity of ciprofloxacin is reduced in soil due to sorption processes. Black-Right-Pointing-Pointer Despite the buffering capacity of soil, ciprofloxacin remains active. Black-Right-Pointing-Pointer Ciprofloxacin resistance can develop in soils contaminated with this antibiotic. - Abstract: While antibiotics are frequently found in the environment, their biodegradability and ecotoxicological effects are not well understood. Ciprofloxacin inhibits active and growing microorganisms and therefore can represent an important risk for the environment, especially for soil microbial ecology and microbial ecosystem services. We investigated the biodegradation of {sup 14}C-ciprofloxacin in water and soil following OECD tests (301B, 307) to compare its fate in both systems. Ciprofloxacin is recalcitrant to biodegradation and transformation in the aqueous system. However, some mineralisation was observed in soil. The lower bioavailability of ciprofloxacin seems to reduce the compound's toxicity against microorganisms and allows its biodegradation. Moreover, ciprofloxacin strongly inhibits the microbial activities in both systems. Higher inhibition was observed in water than in soil and although its antimicrobial potency is reduced by sorption and aging in soil, ciprofloxacin remains biologically active over time. Therefore sorption does not completely eliminate the effects of this compound.

  6. Minimum inhibitory concentration of ciprofloxacin in combination with hexahydroquinoline derivatives against Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    F Amin Harati

    2012-12-01

    Full Text Available Background: Staphylococcus aureus is the most common pathogen responsible for skin and soft tissue infections worldwide. Methicillin-resistant S. aureus is a major cause of both nosocomial and community acquired infections. The emergence of antimicrobial-resistant S. aureus is of global concern. Fluoroquinolone antimicrobials including ciprofloxacin, levofloxacin, and moxifloxacin are used to treat skin and soft tissue infections due to S. aureus. Emergence of ciprofloxacin resistance has increased in community acquired methicillin-resistant S. aureus strains. The aim of this study was to evaluate the minimum inhibitory concentration of ciprofloxacin and hexahydroquino-line derivatives against methicillin- and ciprofloxacin-resistant S. aureus.Methods: Identification of S. aureus was performed by routine microbiological tests in the Department of Pathobiology in Winter 2012. The susceptibility of S. aureus strains to both methicillin and ciprofloxacin was examined by the Kirby-Bauer disk-diffusion method. The minimum inhibitory concentration of ciprofloxacin, hexahydroquinoline derivatives and their combination were separately determined by broth microdilution method against methicillin- and ciprofloxacin-resistant S. aureus.Results: The minimum inhibitory concentration of ciprofloxacin decreased in the presence of hexahydroquinolinein derivatives in comparison with ciprofloxacin alone.Conclusion: This study showed that hexahydroquinoline derivatives enhance the antibacterial effect of ciprofloxacin against methicillin- and ciprofloxacin-resistant S. aureus. Therefore, these derivatives could be used as inhibitors of antibiotic resistance in combination therapies. This enhancement may be related to the inhibitory effect of hexahydroquinoline derivatives on the expression of antibiotic efflux pump in the bacteria. However, the structural features of a fluoroquinolone that determine whether it is affected by efflux transporters are not fully

  7. Evaluation of Ciprofloxacin Cytotoxic Effect in Rat Testis

    Directory of Open Access Journals (Sweden)

    A. Khaki

    2007-04-01

    Full Text Available Introduction & Objective: Ciprofloxacin is a synthetic antibacterial agent belonging to the family of fluoroquinolones with a very broad spectrum against microbial pathogens, especially Gram-negative infectious diseases, that has been approved in more than 100 countries world-wide. The aim of this study was to see histopathological and cytotoxic effects of ciprofloxacin after inducement in rat testis. Materials & Methods: The twenty male wistar rat were selected and randomly divided into two groups; control (n=10 and test (n=10. The test group was received 12.5mg/kg (PO ciprofloxacin daily for sixty day; however the control group just received plate. On sixtieth day the testis tissue of rat in both groups were removed and were prepared for light microscopy and cytotoxic studies. Results: Study about cytotoxic effects was indicated that absorption of radiation rate after five day in control group was increased when as compared with experimental group, (Control: 92.8±1.5 & Test: 65±6, P<0.05 and the studies of testis tissue slices of test group showed many changes such as necrosis in spermatocyt I cells plus diameter of nuclei in spermatocyt I, was increased, (P<0.01. Conclusion: Since in our study ciprofloxacin had cytotoxic side effect on spermatocyt I cells, and rate of cell death may be increased in this cells then consequently ciprofloxacin inducement is harmful for sperm health ability parameters and due decrease fertility rates in human.

  8. Ciprofloxacin induced fixed drug eruption

    Directory of Open Access Journals (Sweden)

    M. Ravishankar

    2014-12-01

    Full Text Available Fixed drug eruption (FDE is a clinical entity occurring in the same site or sites each time the drug is administered. Acute lesions appear as sharply marginated erythematous plaques, which are usually found on lips, genitalia, abdomen, and legs. The eruptions usually occur within hours of administration of the offending agent and resolves spontaneously without scarring after few weeks of onset. Most common drugs causing FDE are sulfonamides, tetracyclines, salicylates, barbiturates, doxycycline, fluconazole, clarithromycin, etc. Ciprofloxacin, a widely used fluoroquinolone antimicrobial, induces cutaneous adverse drug reactions (ADRs in about 1-2% of treated patients. Urticaria, angioedema, maculopapular exanthems, and photosensitivity are the most frequently documented cutaneous adverse reactions. In this case report, the patient soon after taking ciprofloxacin tablets, developed itching in the lips, palms and in scrotal region. On continuing the treatment, the next day he developed fluid filled lesions over palm, knuckle, and hyperpigmentation. He gives a history of severe itching and rashes in scrotal region. He gives a history of similar complaints in the previous month after taking ciprofloxacin medication. There was no history of intake of any other medication. On examination, bullous lesions and pustules in finger webs, hyperpigmentation on knuckles, and scrotal erosions were seen. In the present case report, the patient presented with FDE immediately after oral administration of ciprofloxacin and got completely cured after stopping the drug and taking adequate treatment. According to the Naranjo's ADR probability scale (score=8, this ADR is categorized as a and ldquo;probable and rdquo; reaction to the drug. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1096-1097

  9. Treatment of inflammatory bowel disease associated E. coli with ciprofloxacin and E. coli Nissle in the streptomycin-treated mouse intestine

    DEFF Research Database (Denmark)

    Petersen, Andreas Munk; Schjørring, Susanne; Gerstrøm, Sarah Choi

    2011-01-01

    E. coli belonging to the phylogenetic group B2 are linked to Inflammatory Bowel Disease (IBD). Studies have shown that antimicrobials have some effect in the treatment of IBD, and it has been demonstrated that E. coli Nissle has prophylactic abilities comparable to 5-aminosalicylic acid (5-ASA......) therapy in ulcerative colitis. The objective of this study was to test if ciprofloxacin and/or E. coli Nissle could eradicate IBD associated E. coli in the streptomycin-treated mouse intestine....

  10. Efficacy of a “Rescue” Ciprofloxacin-Based Regimen for Eradication of Helicobacter pylori Infection after Treatment Failures

    Directory of Open Access Journals (Sweden)

    Maria Pina Dore

    2012-01-01

    Full Text Available The aim of our study was to evaluate the efficacy and tolerability of a ciprofloxacin-based regimen for H. pylori eradication failures as an alternative to bismuth based quadruple therapy. Methods. Design: prospective single-center study. Patients in whom a first eradication trial with omeprazole/esomeprazole, clarithromycin plus amoxicillin or tinidazole/metronidazole had failed were included. H. pylori status: established by histology, rapide urease test and polymerase chain reaction. Intervention: esomeprazole 20 mg, ciprofloxacin 500 mg, and metronidazole 500 mg, administered together before breakfast and dinner for 10 days. Susceptibility testing was performed by the Epsilometer test. Ciprofloxacin resistance was defined as a MIC of ≥1 μg/mL. Eradication was established by a negative 13C-UBT and 4–6 weeks post-therapy. Efficacy and side effects were determined. Results. 34 patients were enrolled, 32 completed the study. Compliance was excellent (100%. Side effects were mild. Ciprofloxacin-based therapy cured 65% (22/34 of patients by intention to treat and 69% (22/32 per protocol analysis. The prevalence of ciprofloxacin resistance was 8%. Conclusions. The effectiveness of ciprofloxacin-based therapy was greatly reduced despite the high prevalence of ciprofloxacin sensitive H. pylori strains. Bismuth based quadruple therapy still remain the best choice as a “rescue” regimen in our region.

  11. Ciprofloxacin@SiO2: Fluorescent nanobubbles

    Indian Academy of Sciences (India)

    M J Rosemary; V Suryanarayanan; P Ganapati Reddy; Ian Maclaren; S Baskaran; T Pradeep

    2003-10-01

    We report a new nanomaterial in which ciprofloxacin molecules are incorporated inside silica nanobubbles, denoted as ciprofloxacin@SiO2. The material has been characterised using UV/Vis absorption spectroscopy, transmission electron microscopy, cyclic voltammetry, and emission spectroscopy. The material is stable and the freestanding particles can be precipitated and redispersed in several solvents. Confinement of the molecule is complete as leaching through the shell is minimal. The material behaves like free ciprofloxacin in solution; however, effects of confinement are manifested. Energy transfer reaction between ciprofloxacin@SiO2 and Tb3+ was monitored by emission spectroscopy. The emission intensity decreased with metal ion exposure indicating selective electronic interaction.

  12. Impairment of ciprofloxacin absorption by calcium polycarbophil.

    Science.gov (United States)

    Kato, Ryuji; Ueno, Kazuyuki; Imano, Hideki; Kawai, Masayuki; Kuwahara, Shiro; Tsuchishita, Yoshimasa; Yonezawa, Emi; Tanaka, Kazuhiko

    2002-07-01

    The effect of calcium polycarbophil on the absorption of ciprofloxacin, a broad-spectrum antibacterial agent, was evaluated in an in vitro and in vivo study. In the in vitro study, the release of ciprofloxacin from the cellulose membrane in the presence or absence of metal cations was measured using the dissolution test procedure. In the in vivo study, male ST Wistar rats and male volunteers were employed. First, 20 mg/kg of ciprofloxacin alone (Rat Study 1) or 20 mg/kg of ciprofloxacin in combination with 64 mg/kg of calcium chloride (Rat Study 2) was administered orally to 3 rats. Second, a volunteer study was employed and a randomized crossover design with twophases was used. In onephase, volunteers received 400 mg of ciprofloxacin alone (Study 1); in the other phase, they received 400 mg of ciprofloxacin and 1200 mg of fine calcium polycarbophil granules concomitantly (Study 2). The plasma and serum concentrations of ciprofloxacin were measured by high-performance liquid chromatography. The release of ciprofloxacin from the cellulose membrane in the presence of aluminum, calcium, or iron ions was slower than that in the absence of these metal ions. The AUC0-4 and Cmax in Rat Study 2 were lower than those respective values in Rat Study 1. AUC0-4 was approximately 60% lower in Rat Study 2 than Rat Study 1. In the volunteer study, the AUC0-12 and Cmax in Study 2 were lower than those respective values in Study 1. In particular, AUC0-12 was approximately 50% lowerin Study 2 than in Study 1. These findings suggest that when ciprofloxacin and calcium polycarbophil were coadministered concomitantly, a decrease of ciprofloxacin absorption was observed, and this action was caused by the formation of chelate complexes. Therefore, it seems clear that we should avoid the concomitant administration of ciprofloxacin and calcium polycarbophil.

  13. Heterogeneous catalytic ozonation of ciprofloxacin in water with carbon nanotube supported manganese oxides as catalyst

    Energy Technology Data Exchange (ETDEWEB)

    Sui, Minghao, E-mail: suiminghao.sui@gmail.com [State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Tongji University, 1239 Siping Road, Shanghai 200092 (China); Xing, Sichu; Sheng, Li; Huang, Shuhang; Guo, Hongguang [State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Tongji University, 1239 Siping Road, Shanghai 200092 (China)

    2012-08-15

    Highlights: Black-Right-Pointing-Pointer Ciprofloxacin in water was degraded by heterogeneous catalytic ozonation. Black-Right-Pointing-Pointer MnOx were supported on MWCNTs to serve as catalyst for ozonation. Black-Right-Pointing-Pointer MnOx/MWCNT exhibited highly catalytic activity on ozonation of ciprofloxacin in water. Black-Right-Pointing-Pointer MnOx/MWCNT resulted in effective antibacterial activity inhibition on ciprofloxacin. Black-Right-Pointing-Pointer MnOx/MWCNT promoted the generation of hydroxyl radicals. - Abstract: Carbon nanotube-supported manganese oxides (MnOx/MWCNT) were used as catalysts to assist ozone in degrading ciprofloxacin in water. Manganese oxides were successfully loaded on multi-walled carbon nanotube surfaces by simply impregnating the carbon nanotube with permanganate solution. The catalytic activities of MnOx/MWCNT in ciprofloxacin ozonation, including degradation, mineralization effectiveness, and antibacterial activity change, were investigated. The presence of MnOx/MWCNT significantly elevated the degradation and mineralization efficiency of ozone on ciprofloxacin. The microbiological assay with a reference Escherichia coli strain indicated that ozonation with MnOx/MWCNT results in more effective antibacterial activity inhibition of ciprofloxacin than that in ozonation alone. The effects of catalyst dose, initial ciprofloxacin concentration, and initial pH conditions on ciprofloxacin ozonation with MnOx/MWCNT were surveyed. Electron spin resonance trapping was applied to assess the role of MnOx/MWCNT in generating hydroxyl radicals (HO{center_dot}) during ozonation. Stronger 5,5-dimethyl-1-pyrroline-N-oxide-OH signals were observed in the ozonation with MnOx/MWCNT compared with those in ozonation alone, indicating that MnOx/MWCNT promoted the generation of hydroxyl radicals. The degradation of ciprofloxacin was studied in drinking water and wastewater process samples to gauge the potential effects of water background matrix on

  14. In vitro efficacy of the combination of ciprofloxacin and cefotaxime against nalidixic acid-resistant Salmonella enterica serotype Typhi.

    Science.gov (United States)

    Kim, Dong-Min; Neupane, Ganesh Prasad; Jang, Sook Jin; Kim, Sung Hun; Lee, Bok Kwon

    2010-08-01

    Typhoid fever is a systemic intracellular infection caused by Salmonellaenterica serotype Typhi. The emergence and spread of nalidixic acid-resistant S. Typhi (NARST) is challenging for clinicians in many countries owing to the lack of suitable treatment options. The aim of this study was to identify in vitro synergistic combinations of antibiotics against S. Typhi. In vitro time-kill studies were performed on three clinical NARST isolates and one type strain of nalidixic acid-susceptible S. Typhi (NASST) ATCC 9992 with ciprofloxacin, cefotaxime and azithromycin in various combinations. The combination of ciprofloxacin (0.012-0.375 microg/mL) and cefotaxime (0.063-0.125 microg/mL) against all three NARST strains and the NASST strain was significantly more effective in vitro in reducing bacterial counts by >or=3log(10) colony-forming units at 24h and showed synergistic effects. Combination therapy with ciprofloxacin and cefotaxime might be the treatment of choice for patients with typhoid fever. The combination of a fluoroquinolone and a beta-lactam, which are directed against different targets, may improve efficacy compared with a fluoroquinolone alone and may reduce the chance of fluoroquinolone-resistant mutants emerging in patients with severe typhoid fever.

  15. In vitro and ex vivo methods predict the enhanced lung residence time of liposomal ciprofloxacin formulations for nebulisation.

    Science.gov (United States)

    Ong, Hui Xin; Benaouda, Faiza; Traini, Daniela; Cipolla, David; Gonda, Igor; Bebawy, Mary; Forbes, Ben; Young, Paul M

    2014-01-01

    Liposomal ciprofloxacin formulations have been developed with the aim of enhancing lung residence time, thereby reducing the burden of inhaled antimicrobial therapy which requires multiple daily administration due to rapid absorptive clearance of antibiotics from the lungs. However, there is a lack of a predictive methodology available to assess controlled release inhalation delivery systems and their effect on drug disposition. In this study, three ciprofloxacin formulations were evaluated: a liposomal formulation, a solution formulation and a 1:1 combination of the two (mixture formulation). Different methodologies were utilised to study the release profiles of ciprofloxacin from these formulations: (i) membrane diffusion, (ii) air interface Calu-3 cells and (iii) isolated perfused rat lungs. The data from these models were compared to the performance of the formulations in vivo. The solution formulation provided the highest rate of absorptive transport followed by the mixture formulation, with the liposomal formulation providing substantially slower drug release. The rank order of drug release/transport from the different formulations was consistent across the in vitro and ex vivo methods, and this was predictive of the profiles in vivo. The use of complimentary in vitro and ex vivo methodologies provided a robust analysis of formulation behaviour, including mechanistic insights, and predicted in vivo pharmacokinetics.

  16. Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients

    Directory of Open Access Journals (Sweden)

    David Arroyo

    2014-01-01

    Full Text Available Background. BK virus (BKV infection is a common complication following kidney transplantation. Immunosuppression reduction is the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with the use of ciprofloxacin in patients with persistent BKV infection. Methods. Retrospective evaluation of the effect of a 30-day ciprofloxacin course (250 mg twice daily on BKV infection in kidney transplant recipients who had been diagnosed with BK viruria ≥106 copies/mL and viremia ≥500 copies/mL and in whom the infection did not resolve after immunosuppression reduction and/or treatment with other adjuvant agents. BKV in plasma and urine was evaluated after 3 months following treatment with ciprofloxacin. Results. Nine kidney transplant recipients received ciprofloxacin at a median of 130 days following the initial reduction in immunosuppression. Three patients showed complete viral clearance and another 3 had a ≥50% decrease in plasma viral load. No serious adverse events secondary to ciprofloxacin were reported and no grafts were lost due to BKV up to 1 year after treatment. Conclusion. Ciprofloxacin may be a useful therapy for persistent BKV infection despite conventional treatment. Randomized trials are required to evaluate the potential benefit of this adjuvant therapy.

  17. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  18. Clinicopharmacological comparative study of rizatriptan versus conventional therapy in migraine.

    Science.gov (United States)

    Kushwah, Anjali; Tomar, Akhilesh

    2014-01-01

    Migraine is a common neurological problem, which accounts for large morbidity and disability. Non-steroidal anti-inflammatory agents and triptans are mainly used to terminate the attack of moderate to severe migraine. This study compared the safety, efficacy and pharmaco-economics of rizatriptan (5HT(IB/ID) agonist) versus conventional therapy (paracetamol 500 mg + metoclopramide 10 mg + flunarizine 10 mg + alprazolam 0.5 mg). In this study, drug combinations used in conventional therapy was indigenously designed by the neurologist. Rizatriptan was found more efficacious than conventional therapy in terminating an attack of migraine and its' associated symptoms but looking into the contra-indications, side-effects and cost of the former there has been limitation in its prescription as well as the use.

  19. Group therapy compared with individual desensitization for dental anxiety

    DEFF Research Database (Denmark)

    Moore, R.; Brødsgaard, I.

    1994-01-01

    Results of group therapy (GT) for extreme dental anxiety were compared with individual treatment (IT). Scales used measured dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment which showed reduced dental anxiety and improved dental beliefs compared...... with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist...

  20. Toxicity of the fluoroquinolone antibiotics enrofloxacin and ciprofloxacin to photoautotrophic aquatic organisms.

    Science.gov (United States)

    Ebert, Ina; Bachmann, Jean; Kühnen, Ute; Küster, Anette; Kussatz, Carola; Maletzki, Dirk; Schlüter, Christoph

    2011-12-01

    The present study investigated the growth inhibition effect of the fluoroquinolone antibiotics enrofloxacin and ciprofloxacin on four photoautotrophic aquatic species: the freshwater microalga Desmodesmus subspicatus, the cyanobacterium Anabaena flos-aquae, the monocotyledonous macrophyte Lemna minor, and the dicotyledonous macrophyte Myriophyllum spicatum. Both antibiotics, which act by inhibiting the bacterial DNA gyrase, demonstrated high toxicity to A. flos-aquae and L. minor and moderate to slight toxicity to D. subspicatus and M. spicatum. The cyanobacterium was the most sensitive species with median effective concentration (EC50) values of 173 and 10.2 µg/L for enrofloxacin and ciprofloxacin, respectively. Lemna minor proved to be similarly sensitive, with EC50 values of 107 and 62.5 µg/L for enrofloxacin and ciprofloxacin, respectively. While enrofloxacin was more toxic to green algae, ciprofloxacin was more toxic to cyanobacteria. Calculated EC50s for D. subspicatus were 5,568 µg/L and >8,042 µg/L for enrofloxacin and ciprofloxacin, respectively. These data, as well as effect data from the literature, were compared with predicted and reported environmental concentrations. For two of the four species, a risk was identified at ciprofloxacin concentrations found in surface waters, sewage treatment plant influents and effluents, as well as in hospital effluents. For ciprofloxacin the results of the present study indicate a risk even at the predicted environmental concentration. In contrast, for enrofloxacin no risk was identified at predicted and measured concentrations.

  1. Simultaneous Quantification of Ciprofloxacin, Quinine and 3-hyrdoxyquinine in Human Plasma using a HPLC Method

    Directory of Open Access Journals (Sweden)

    Adebanjo J. Adegbola, Julius O. Soyinka , Babatunde A. Adeagbo

    2016-02-01

    Full Text Available Malaria has been shown to strongly predispose patients in areas of malaria endemicity to bacteremia with severe outcomes, thus justifying the use of antibiotics in combination with antimalarial therapy in patients with severe malaria. This study describes a High-Performance Liquid Chromatographic (HPLC method for simultaneous determinations of Ciprofloxacin (CPN, Quinine (QN, and its major metabolite, 3-Hydroxyquinine (3-HQN, in human plasma. Following a simple precipitation with acetonitrile, chromatographic separation was achieved on a reversed-phase Agilent Zorbax (CN column (5 µm, 150 X 4.6 mm i.d using a mobile phase consisting of acetonitrile: potassium dihydrogen phosphate (pH = 2.8; 0.02 M (42:58, v/v. Retention times for CPN, 3-HQN, IS and QN were 2.7, 3.3, 3.6 and 4.9 minutes respectively. The limits of detection and validated lower limits of quantitation were 30 and 70 ng/ml for both QN and 3-HQN while the corresponding values were 50 and 100 ng/ml for CPN, respectively. The new HPLC method here developed, when compared with previous methods for the analysis of either or both drugs is simple, rapid, selective, reproducible and costeffective. It is also suitable for conducting a simultaneous therapeutic monitoring of quinine and ciprofloxacin in patients when concomittantly administered as demonstrated in five healthy volunteers.

  2. Drug utilization review of ciprofloxacin in the outpatient department of Boru Meda Hospital, South Wollo Zone, Amhara Region, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tessema Tsehay Biru

    2014-02-01

    Conclusions: Due From the retrospective Drug Use Evaluation (DUE study, it was identified that there was inappropriate ciprofloxacin use in the outpatient department of Boru Meda hospital even though the drug’s use regarding indications was a better performance and dosing practices were almost appropriate as per the criteria used for the study (assuming that there were no dose adjustments. There was a great problem concerning the duration of ciprofloxacin drug therapy. Ciprofloxacin use along with potentially interacting drugs and against contraindications was also another problem indicated in the study. [Int J Basic Clin Pharmacol 2014; 3(1.000: 171-178

  3. Interaction between oral ciprofloxacin and caffeine in normal volunteers.

    OpenAIRE

    Healy, D P; Polk, R E; Kanawati, L; Rock, D T; Mooney, M L

    1989-01-01

    The influence of multiple doses of ciprofloxacin on the disposition of caffeine and its major metabolite, paraxanthine, was investigated in healthy volunteers. Ten xanthine-free, fasting males were given 100 mg of caffeine orally 24 h before being given ciprofloxacin and again with the third dose of ciprofloxacin (750 mg administered every 12 h). Blood samples were serially collected after both doses of caffeine and after the first and last doses of ciprofloxacin. Ciprofloxacin significantly ...

  4. Susceptibility of Pseudomonas isolates from the ears and skin of dogs to enrofloxacin, marbofloxacin, and ciprofloxacin.

    Science.gov (United States)

    Wildermuth, Brett Everett; Griffin, Craig E; Rosenkrantz, Wayne S; Boord, Mona J

    2007-01-01

    The purpose of this study was to compare susceptibilities of ear and skin Pseudomonas spp. isolates to enrofloxacin, marbofloxacin, and ciprofloxacin. Specimens were obtained from dogs examined in a veterinary dermatology referral hospital. Susceptibilities of ear isolates to enrofloxacin, marbofloxacin, and ciprofloxacin were 46.9%, 66.7%, and 75.0%, respectively. Susceptibilities of skin isolates to the same drugs were 76.2%, 81.0%, and 80.0%, respectively. Ear isolates were significantly less susceptible to enrofloxacin than to ciprofloxacin (P=0.021), and ear isolates were significantly less susceptible to enrofloxacin than were skin isolates (P=0.034). When fluoroquinolone resistance was present, ear isolates were significantly less susceptible to enrofloxacin than to ciprofloxacin (Pmarbofloxacin (P=0.014).

  5. Comparative Effectiveness of Injection Therapies in Lateral Epicondylitis

    DEFF Research Database (Denmark)

    Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell

    2012-01-01

    Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available.......Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available....

  6. Antibiotic combination therapy can select for broad-spectrum multidrug resistance in Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Vestergaard, Martin; Paulander, Wilhelm; Marvig, Rasmus L.

    2016-01-01

    Combination therapy with several antibiotics is one strategy that has been applied in order to limit the spread of antimicrobial resistance. We compared the de novo evolution of resistance during combination therapy with the β-lactam ceftazidime and the fluoroquinolone ciprofloxacin with the resi...

  7. EFFECT OF MANUAL THERAPY VERSUS CONVENTIONAL THERAPY IN PATIENTS WITH PLANTAR FASCIITIS – A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Shashwat Prakash

    2014-02-01

    Full Text Available Objective: To compare the effectiveness of manual therapy with conventional therapy on pain and disability in patients with plantar fasciitis. Background: There is limited evidence available which support that manual therapy can be used as an intervention in the management of plantar fasciitis. Study Design: experimental study and different subject design Methods: Patients diagnosed with plantar fasciitis underwent a standard evaluation and completed a self-report questionnaire including the Foot Function Index (FFI, and the Numeric Pain Rating Scale (NPRS. 30 patients were randomly divided in two groups, to be treated with either Conventional therapy or Manual therapy approach. Outcomes of treatment were captured on the 1st day and 21st day of the treatment session. Results: The data was analysed using unpaired‘t’ tests. NPRS was mean 6.53 versus 6.80 for pre-treatment in group A and group B respectively; t28=0.50, p=0.62 and mean 2.27 versus 1.00 for post-treatment in group A and group B respectively; t28=2.62, p=0.01 FFI was mean 41.01 versus 42.67 for pre-treatment in group A and group B respectively; t28=0.77, p=0.49 and mean 6.20 versus 4.16 for post-treatment in group A and group B respectively; t28=2.68, p=0.01 Conclusion: The results of this study provide evidence that manual therapy is a superior approach in improving pain and disability in individuals with plantar fasciitis and can be incorporated in the regular treatment regime of the same.

  8. Ciprofloxacin oxidation by UV-C activated peroxymonosulfate in wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Mahdi-Ahmed, Moussa; Chiron, Serge, E-mail: Serge.Chiron@msem.univ-montp2.fr

    2014-01-30

    Highlights: • UV/PMS more efficient than UV/H{sub 2}O{sub 2} for ciprofloxacin removal in wastewater. • PMS decomposition into sulfate radical was activated by bicarbonate ions. • CIP degradation pathways elucidation support sulfate radical attacks as a main route. • Sulfate radical generation allows for CIP antibacterial activity elimination. -- Abstract: This work aimed at demonstrating the advantages to use sulfate radical anion for eliminating ciprofloxacin residues from treated domestic wastewater by comparing three UV-254 nm based advanced oxidation processes: UV/persulfate (PDS), UV/peroxymonosulfate (PMS) and UV/H{sub 2}O{sub 2}. In distilled water, the order of efficiency was UV/PDS > UV/PMS > UV/H{sub 2}O{sub 2} while in wastewater, the most efficient process was UV/PMS followed by UV/PDS and UV/H{sub 2}O{sub 2} mainly because PMS decomposition into sulfate radical anion was activated by bicarbonate ions. CIP was fully degraded in wastewater at pH 7 in 60 min for a [PMS]/[CIP] molar ratio of 20. Nine transformation products were identified by liquid chromatography–high resolution-mass spectrometry allowing for the establishment of degradation pathways in the UV/PMS system. Sulfate radical anion attacks prompted transformations at the piperazinyl ring through a one electron oxidation mechanism as a major pathway while hydroxyl radical attacks were mainly responsible for quinolone moiety transformations as a minor pathway. Sulfate radical anion generation has made UV/PMS a kinetically effective process in removing ciprofloxacin from wastewater with the elimination of ciprofloxacin antibacterial activity.

  9. Toxic epidermal necrolysis and agranulocytosis: Rare adverse effects of ciprofloxacin

    Directory of Open Access Journals (Sweden)

    Upadya Gatha

    2009-10-01

    Full Text Available Ciprofloxacin is one of the most commonly used antibacterial agents with relatively few side effects. Serious adverse reactions reported with ciprofloxacin are rare with an incidence of 0.6%. Recently we came across two rare adverse effects of ciprofloxacin, viz. toxic epidermal necrolysis and agranulocytosis. To our knowledge, a total of seven cases have been reported in the literature documenting an association between oral ciprofloxacin administration and toxic epidermal necrolysis. One case of granulocytopenia, four of pancytopenia and fifteen of leucopenia worldwide have been reported. With the use of ciprofloxacin becoming more and more widespread, these two rare but fatal complications of ciprofloxacin should be borne in mind.

  10. Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

    Science.gov (United States)

    ... 1999 Spotlight on Research 2013 August 2013 (historical) Physical Therapy to Treat Torn Meniscus Comparable to Surgery for ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded by ...

  11. Isobolographic analysis of pharmacodynamic interactions between antifungal agents and ciprofloxacin against Candida albicans and Aspergillus fumigatus.

    Science.gov (United States)

    Stergiopoulou, Theodouli; Meletiadis, Joseph; Sein, Tin; Papaioannidou, Paraskevi; Tsiouris, Ioannis; Roilides, Emmanuel; Walsh, Thomas J

    2008-06-01

    Patients suffering from invasive mycoses often receive concomitant antifungal therapy and antibacterial agents. Assessment of pharmacodynamic interactions between antifungal and antibacterial agents is complicated by the absence of a common antifungal end point for both agents. Ciprofloxacin has no intrinsic antifungal activity but may interact with antifungal agents, since it inhibits DNA gyrase (topoisomerase II), which is abundant in fungi. We therefore employed isobolographic analysis adapted to incorporate a nonactive agent in order to analyze the potential in vitro interaction between the fluoroquinolone ciprofloxacin and several representative antifungal agents against Candida albicans and Aspergillus fumigatus strains by using a microdilution checkerboard technique. In agreement with earlier in vitro studies, conventional fractional inhibitory concentration index analysis was unable to detect interactions between ciprofloxacin and antifungal agents. However, isobolographic analysis revealed significant pharmacodynamic interactions between antifungal agents and ciprofloxacin against C. albicans and A. fumigatus strains. Amphotericin B demonstrated concentration-dependent interactions for both species, with synergy (interaction indices, 0.14 to 0.81) observed at ciprofloxacin concentrations of Isobolographic analysis may help to elucidate the pharmacodynamic interactions between antifungal and non-antifungal agents and to develop better management strategies against invasive candidiasis and aspergillosis.

  12. Variability of residue concentrations of ciprofloxacin in honey from treated hives.

    Science.gov (United States)

    Chan, Danny; Macarthur, Roy; Fussell, Richard J; Wilford, Jack; Budge, Giles

    2016-11-28

    Honey bees (Apis mellifera L.) were treated with a model veterinary drug compound (ciprofloxacin) in a 3-year study (2012-14) to investigate the variability of residue concentration in honey. Sucrose solution containing ciprofloxacin was administered to 45 hives (1 g of ciprofloxacin per hive) at the beginning of the honey flow in late May/mid-June 2012, 2013 and 2014. Buckfast honey bees (A. mellifera - hybrid) were used in years 2012 and 2013. Carniolan honey bees (A. mellifera carnica) were used instead of the Buckfast honey bees as a replacement due to unforeseen circumstances in the final year of the study (2014). Honey was collected over nine scheduled time points from May/June till late October each year. Up to five hives were removed and their honey analysed per time point. Honey samples were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine ciprofloxacin concentration. Statistical assessment of the data shows that the inter-hive variation of ciprofloxacin concentrations in 2012/13 is very different compared with that of 2014 with relative standard deviations (RSDs) of 138% and 61%, respectively. The average ciprofloxacin concentration for 2014 at the last time point was more than 10 times the concentration compared with samples from 2012/13 at the same time point. The difference between the 2012/13 data compared with the 2014 data is likely due to the different type of honey bees used in this study (2012/13 Buckfast versus 2014 Carniolan). Uncertainty estimates for honey with high ciprofloxacin concentration (upper 95th percentile) across all hives for 55-day withdrawal samples gave residual standard errors (RSEs) of 22%, 20% and 11% for 2012, 2013 and 2014, respectively. If the number of hives were to be reduced for future studies, RSEs were estimated to be 52% (2012), 54% (2013) and 26% (2014) for one hive per time point (nine total hives).

  13. The influence of ciprofloxacin on viability of A549, HepG2, A375.S2, B16 and C6 cell lines in vitro.

    Science.gov (United States)

    Kloskowski, Tomasz; Gurtowska, Natalia; Nowak, Monika; Joachimiak, Romana; Bajek, Anna; Olkowska, Joanna; Drewa, Tomasz

    2011-01-01

    Ciprofloxacin is a chemotherapeutic agent mainly used in the treatment of the pulmonary and urinary tract infections but is also known for its anticancer properties. The aim of these study was to check the anticancer effect of ciprofloxacin on selected five cell lines. Human non-small cell lung cancer line A549, human hepatocellular carcinoma line HepG2, human and mouse melanoma lines (A375.S2 and B16) and rat glioblastoma line C6 were used for evaluation of cytotoxic properties of ciprofloxacin (in concentration range: 10-1000 microg/mL). Viability was established using trypan blue assay and MTT. Ciprofloxacin induced morphological changes and decreased viability of A549 cells in a concentration and time dependent manner. In case of A375.S2 and B16 cell lines, cytotoxicyty of ciprofloxacin was observed but we were not able to eradicate all cells from A375.S2 and B16 cultures. HepG2 line was sensitive to ciprofloxacin, but this effect was independent from concentration and incubation time. The C6 cells were insensitive to ciprofloxacin. Our results showed that ciprofloxacin can be potentially used for the experimental adjunctive therapy of lung cancer.

  14. Synthesis, Physicochemical Properties, and Antimicrobial Studies of Iron (III Complexes of Ciprofloxacin, Cloxacillin, and Amoxicillin

    Directory of Open Access Journals (Sweden)

    Fabian I. Eze

    2014-01-01

    Full Text Available Iron (III complexes of ciprofloxacin, amoxicillin, and cloxacillin were synthesized and their aqueous solubility profiles, relative stabilities, and antimicrobial properties were evaluated. The complexes showed improved aqueous solubility when compared to the corresponding ligands. Relative thermal and acid stabilities were determined spectrophotometrically and the results showed that the complexes have enhanced thermal and acid stabilities when compared to the pure ligands. Antimicrobial studies showed that the complexes have decreased activities against most of the tested microorganisms. Ciprofloxacin complex, however, showed almost the same activity as the corresponding ligand. Job’s method of continuous variation suggested 1 : 2 metals to ligand stoichiometry for ciprofloxacin complex but 1 : 1 for cloxacillin complex.

  15. Intraventricular ciprofloxacin usage in treatment of multidrug-resistant central nervous system infections: report of four cases

    Directory of Open Access Journals (Sweden)

    Ayse Karaaslan

    2014-12-01

    Full Text Available In recent years, multidrug-resistant microorganisms appear as important nosocomial pathogens which treatment is quite difficult. As sufficient drug levels could not be achieved in cerebrospinal fluid during intravenous antibiotic therapy for central nervous system infections and due to multidrug-resistance treatment alternatives are limited. In this study, four cases of central nervous system infections due to multidrug-resistant microorganisms who were successfully treated with removal of the devices and intraventricular ciprofloxacin are presented. In conclusion, intraventricular ciprofloxacin can be used for treatment of central nervous system infections if the causative microorganism is sensitive to the drug and no other alternative therapy is available.

  16. Quercetin protection against ciprofloxacin induced liver damage in rats.

    Science.gov (United States)

    Taslidere, E; Dogan, Z; Elbe, H; Vardi, N; Cetin, A; Turkoz, Y

    2016-01-01

    Ciprofloxacin is a common, broad spectrum antibacterial agent; however, evidence is accumulating that ciprofloxacin may cause liver damage. Quercetin is a free radical scavenger and antioxidant. We investigated histological changes in hepatic tissue of rats caused by ciprofloxacin and the effects of quercetin on these changes using histochemical and biochemical methods. We divided 28 adult female Wistar albino rats into four equal groups: control, quercetin treated, ciprofloxacin treated, and ciprofloxacin + quercetin treated. At the end of the experiment, liver samples were processed for light microscopic examination and biochemical measurements. Sections were prepared and stained with hematoxylin and eosin, and a histopathologic damage score was calculated. The sections from the control group appeared normal. Hemorrhage, inflammatory cell infiltration and intracellular vacuolization were observed in the ciprofloxacin group. The histopathological findings were reduced in the group treated with quercetin. Significant differences were found between the control and ciprofloxacin groups, and between the ciprofloxacin and ciprofloxacin + quercetin groups. Quercetin administration reduced liver injury caused by ciprofloxacin in rats. We suggest that quercetin may be useful for preventing ciprofloxacin induced liver damage.

  17. Antibacterial antagonism between fusidic acid and ciprofloxacin.

    Science.gov (United States)

    Uri, J V

    1993-01-01

    A routine laboratory disk susceptibility testing of a resistant Staphylococcus aureus strain showed that around the ciprofloxacin disk, placed by chance in proximity to a fusidic acid disk, the inhibition zone was truncated. Follow-up of this observation by a planned disk approximation method showed that there is a real antagonism between these two antibacterial agents. The antagonism was observed while testing S. aureus isolates including the standard ATCC 25923 strain, with Bacillus subtilis ATCC 6633 spores and also with a mutant Escherichia coli made fusidic acid susceptible. The antagonistic property was found structure-specific, only associated with those fluoroquinolones containing the cyclopropyl substituent at the N1-position: ciprofloxacin, enrofloxacin, sparfloxacin and WIN 57273. Fluoroquinolones without this substituent such as enoxacin, norfloxacin, pefloxacin and ofloxacin were not antagonized by fusidic acid, the steroidal Gram-positive active antibiotic.

  18. Ciprofloxacin induced acute generallised exanthematous pustulosis

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    Caterina Foti

    2017-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. We describe a case of AGEP in a 61-year-old woman that was hospitalized for the acute onset of fever, erythroderma, and pustulosis. Clinical history revealed that she had been treating a bacterial inguinal intertrigo for 4 days with ciprofloxacin 500 mg tablets twice daily and desloratadine 5 mg tablet once daily. To the best of our knowledge, this is the third reported case of AGEP caused by ciprofloxacin, supporting two other previous reports.

  19. Onychomadesis Secondary Erythroderma Exfoliative due to Ciprofloxacin

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    Patricia Chang

    2014-01-01

    Full Text Available Female patient 63 years old who was hospitalized due to erythroderma exfoliative (Fig. 1 after taking ciprofloxacin by urinary tract infection, 4 weeks later we began to observe the detachment of the finger and toenails from the proximal nail fold predominantly on the thumbs (Fig. 2, and the diagnosis of onychomadesis was done. Nail diseases are common but no all people and doctors know about nail changes due to drug reaction or systemic diseases.

  20. Ciprofloxacin induced erythema multiforme: a case report

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    K. M. Narasimhamurthy

    2015-06-01

    Full Text Available Erythema multiforme (EM is an acute, self-limited, and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers like flavorings and preservatives, such as benzoic acid and cinnamon, immunologic disorders, such as transient selective C4 deficiency of infancy, collagen diseases, vasculitides, sarcoidosis, non-Hodgkin lymphoma, leukemia, multiple myeloma, myeloid metaplasia, and polycythemia, physical or mechanical factors, such as tattooing, radiotherapy, cold, and sunlight, foods, including salmon berries and margarine, malignancy, and hormonal. EM may be present within a wide spectrum of severity. EM minor represents a localized eruption of the skin with minimal or no mucosal involvement. According to a consensus definition, Stevens-Johnson syndrome (SJS was separated from the EM spectrum and added to toxic epidermal necrolysis (TEN. The two spectra are now divided into the following: (1 EM consisting of erythema minor and major and (2 SJS/TEN. Ciprofloxacin is a second generation fluoroquinolone. Fluoroquinolones are rapidly bactericidal in vitro and are considerably potent against Escherichia coli and various species of Salmonella, Shigella, Enterobacter, Campylobacter, and Neisseria. Mainly used in urinary tract infections, prostatitis, sexually transmitted diseases, gastrointestinal and abdominal infections, respiratory tract infections, bone-joint and soft tissue infections. Metronidazole is a nitroimidazole antimicrobial medication used particularly for anaerobic bacteria and protozoa. It is on the World Health Organizations list of essential medicines, a list of the most important medications needed in a basic health system. Here we report the case of a 39-year-old male patient who presented with EM to the dermatology outpatient department, Adichunchanagiri Hospital and Research Centre. The patient gave a history of taking

  1. Isobolographic Analysis of Pharmacodynamic Interactions between Antifungal Agents and Ciprofloxacin against Candida albicans and Aspergillus fumigatus▿

    OpenAIRE

    Stergiopoulou, Theodouli; Meletiadis, Joseph; Sein, Tin; Papaioannidou, Paraskevi; Tsiouris, Ioannis; Roilides, Emmanuel; Walsh, Thomas J.

    2008-01-01

    Patients suffering from invasive mycoses often receive concomitant antifungal therapy and antibacterial agents. Assessment of pharmacodynamic interactions between antifungal and antibacterial agents is complicated by the absence of a common antifungal end point for both agents. Ciprofloxacin has no intrinsic antifungal activity but may interact with antifungal agents, since it inhibits DNA gyrase (topoisomerase II), which is abundant in fungi. We therefore employed isobolographic analysis ada...

  2. Effects of low-level ciprofloxacin challenge in the in vitro development of ciprofloxacin resistance in Campylobacter jejuni.

    Science.gov (United States)

    Hannula, Minna; Hänninen, Marja-Liisa

    2008-09-01

    The effects on MIC values and the selection of different base substitutions in the quinolone resistance determining region (QRDR) of gyrA were studied on initially ciprofloxacin-susceptible Campylobacter jejuni strains by challenging them to 0.125 mg/L of ciprofloxacin. This ciprofloxacin challenge selected variants with ciprofloxacin MIC levels up to 32 mg/L. Repeated experiments under identical conditions resulted in different responses in MIC levels and alterations in the QRDR of gyrA. A characteristic outcome to ciprofloxacin challenges was the appearance of double peaks in the sequencing chromatograms of QRDR. This finding suggested the coexistence of subpopulations possessing Thr86 --> Ile and/or Asp90 --> Asn mutations alongside the unmutated parent population. In some cases, bacterial variants expressing ciprofloxacin-resistant phenotypes possessed no mutations in their QRDR. These variants were prone to regain susceptibility to ciprofloxacin rapidly after the removal of the selection pressure, whereas the QRDR-mutated variants persisted over several subcultivations in a medium without ciprofloxacin. In conclusion, a low ciprofloxacin concentration of 0.125 mg/L selects a variety of QRDR mutations and also a QRDR-independent resistance mechanism, which may coexist with each other in a C. jejuni population. Persistent ciprofloxacin challenge selects Thr86 --> Ile and/or Asp90 --> Asn mutants.

  3. A Comparative Effectiveness of Acceptance and Commitment Therapy and Group Cognitive Therapy for Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Shima Tamannaeifar

    2014-08-01

    Full Text Available Background: Acceptance and commitment therapy (ACT is a new method of psychotherapy for major depressive disorder (MDD. The aim of this experimental study is evaluating the effectiveness of acceptance and commitment therapy and cognitive therapy. Materials and Methods: In this randomized clinical trial, 19 depressive out-patients were randomly divided into 2 groups (acceptance and commitment therapy and cognitive therapy. Twelve therapeutic sessions administered in consulting center of Tehran University twice a week. All the subjects were tested by Beck Depression Inventory (BDI-II and the Ruminative Response Scale (RRS before and after the treatments. Data were analyzed by multivariate analysis of covariance (MANCOVA. Results: The results show no significant differences between the two groups in terms of the variables of depression and rumination. Conclusion: Overall, the results suggest that ACT is an effective treatment, the effectiveness of which appears equivalent to that of CT.

  4. A novel and rapid microbiological assay for ciprofloxacin hydrochloride

    Institute of Scientific and Technical Information of China (English)

    Edith Cristina Laignier Cazedey; Hérida Regina Nunes Salgado

    2013-01-01

    The present work reports a simple, fast and sensitive microbiological assay applying the turbidimetric method for the determination of ciprofloxacin hydrochloride (CIPRO HCl) in ophthalmic solutions. The validation method yielded good results and included excellent linearity, precision, accuracy and specificity. The bioassay is based on the inhibitory effect of CIPRO HCl upon the strain of Staphylococcus epidermidis ATCC 12228 used as the test microorganism. The results were treated statistically by analysis of variance (ANOVA) and were found to be linear (r¼0.9994, in the range of 14.0-56.0 mg/mL), precise (intraday RSD%¼2.06;interday RSD%¼2.30) and accurate (recovery ¼ 99.7%). The turbidimetric assay was compared to the UV spectrophotometric and HPLC methods for the same drug. The turbidimetric bioassay described on this paper for determination of ciprofloxacin hydrochloride in ophthalmic solution is an alternative to the physicochemical methods disclosed in the literature and can be used in quality control routine.

  5. Effect of chloroquine on the urinary excretion of ciprofloxacin.

    Science.gov (United States)

    Ilo, Cajetan E; Ezejiofor, Ndidi A; Agbakoba, Nneka; Brown, Sinye A; Maduagwuna, Chinonye A; Agbasi, Patrick U; Orisakwe, Orish E; Orisakweph, Orish E

    2008-01-01

    Ciprofloxacin is an inexpensive antibacterial, whereas chloroquine is an inexpensive antimalarial. The coadministration of chloroquine and ciprofloxacin is easily encountered because both drugs are commonly prescribed to patients in the tropics. Five healthy male volunteers aged 19 to 31 years who were not taking any of the prescribed medications and who had no sensitivity to either ciprofloxacin or chloroquine each received 500 mg ciprofloxacin orally with 250 mL of water, and after a 2-week washout period, 500 mg ciprofloxacin plus 600 mg chloroquine was administered orally with 250 mL of water after providing informed consent. A urine sample (7 mL) was collected just before taking the drug at 8:00 AM representing 0 hour and continued afterward at 1, 2, 4, 8, 12, and 24 hours the next day. The samples were stored at -20 degrees C until analyzed. The minimum inhibitory concentrations by diffusion through agar technique were used for the assay of urine ciprofloxacin. The rate of ciprofloxacin excretion and cumulative urine ciprofloxacin were significantly increased. The coadministration of chloroquine increased the cumulative urinary concentration and excretion rate of ciprofloxacin.

  6. COMPARATIVE STUDY OF PULSE THERAPY WITH DAILY IMMUNOSUPPRESSIVE THERAPY IN STEROID RESPONSIVE DERMATOSIS

    OpenAIRE

    Naseem Begum , SwathiBurla, Bhavika

    2015-01-01

    Background: Pemphigus, scleroderma and SLE are diseases of unknown etiology for which no specific treatment is effective. The introduction of corticosteroids and immunosuppressive drugs reduced the mortality rate. Objectives: To correlate signs and symptoms and incidence of adverse effects in patients with steroid responsive dermatosis before and during DCP therapy and daily immunosuppressive therapy. Material and Methods: 100 patients were enrolled in this study. They are divided into 2 grou...

  7. Ciprofloxacin induced acute generallised exanthematous pustulosis

    OpenAIRE

    Caterina Foti; Paolo Romita; Giovanni Zanframundo; Mario Mastrolonardo; Gianni Angelini; Gianfranco Calogiuri; Eustacchio Nettis; Domenico Bonamonte

    2017-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. We describe a case of AGEP in a 61-year-old woman that was hospitalized for the acute onset of fever, erythroderma, and pustulosis. Clinical history revealed that she had been treating a bacterial inguinal intertrigo for 4 days with ciprofloxacin 500 mg table...

  8. Teicoplanin plus ciprofloxacin versus gentamicin plus piperacillin in the treatment of febrile neutropenic patients.

    Science.gov (United States)

    Kelsey, S M; Weinhardt, B; Collins, P W; Newland, A C

    1992-06-01

    Teicoplanin plus ciprofloxacin was compared with gentamicin plus piperacillin for the empirical treatment of fever in 80 neutropenic patients. A favourable response was seen in 78% of patients receiving teicoplanin plus ciprofloxacin and in 49% receiving gentamicin plus piperacillin (p less than 0.05). When microbiologically documented episodes were analysed separately, the response to teicoplanin plus ciprofloxacin was favourable in 81% of patients whereas only 35% responded favourably to gentamicin plus piperacillin (p = 0.034). Gram-positive organisms accounted for 76% of bacterial isolates, Staphylococcus epidermidis being the most common pathogen. Ten of 12 (83%) Staphylococcus epidermidis infections resolved when treated with teicoplanin plus ciprofloxacin as compared with 2 of 8 (25%) treated with gentamicin plus piperacillin. Teicoplanin is at least as effective as gentamicin plus piperacillin in the empirical treatment of febrile neutropenic patients and may be more effective in situations where gram-positive organisms are prevalent. The high incidence of gram-positive infections in our unit justifies the use of an agent with specific activity against gram-positive organisms in the first-line antibiotic regimen.

  9. Ciprofloxacin susceptibility of Pseudomonas aeruginosa isolates from keratitis

    DEFF Research Database (Denmark)

    Lomholt, JA; Kilian, Mogens

    2003-01-01

    AIM: To examine the ciprofloxacin susceptibility of 106 Pseudomonas aeruginosa eye isolates from the United Kingdom, Denmark, India, the United States, and Australia, and to determine the molecular mechanisms of resistance. METHODS: Ciprofloxacin susceptibility was tested by an agar dilution meth...

  10. Specific and ultrasensitive ciprofloxacin detection by responsive photonic crystal sensor.

    Science.gov (United States)

    Zhang, Rong; Wang, Yong; Yu, Li-Ping

    2014-09-15

    A new approach for specific and ultrasensitive measurement of ciprofloxacin has been developed by integrating ternary complexes into responsive photonic crystal (RPC). Tryptophan was first immobilized within the polyacrylamide hydrogel substrates of RPC. The determination of ciprofloxacin was via the existence of zinc(II) ions that function as a 'bridge' to form specific tryptophan-zinc(II)-ciprofloxacin complexes step by step, which resulted in a stepwise red-shift of the diffraction wavelength. A maximum wavelength shift from 798 to 870 nm for ciprofloxacin was observed when the RPC film was immersed in 10(-4)M ciprofloxacin. A linear relationship has been obtained between the Δλ of diffraction peak and logarithm of ciprofloxacin concentration at pH 5.0 in the range of 10(-10) to 10(-4)M. And the least detectable concentration in present work is about 5 × 10(-11)M. The results demonstrated that the as-designed ternary complexes-based RPC sensor exhibited high sensitivity, satisfactory specificity and excellent recoverability for sensing of ciprofloxacin in aqueous media and were validated by detecting ciprofloxacin in the eye-drop sample.

  11. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad spect

  12. Ciprofloxacin susceptibility reduction of Salmonella strains isolated from outbreaks

    Directory of Open Access Journals (Sweden)

    Roberta B. Souza

    2010-06-01

    Full Text Available The antimicrobial susceptibility of 212 Salmonella strains isolated from patients and foods was evaluated and 45% were found to be resistant to nalidixic acid. Nalidixic acid resistant strains showed a higher minimal inhibitory concentration for ciprofloxacin than sensitive strains. During the study an increase of strains with reduced susceptibility to ciprofloxacin was also observed.

  13. Excretion of ciprofloxacin in sweat and multiresistant Staphylococcus epidermidis

    DEFF Research Database (Denmark)

    Høiby, N; Jarløv, J O; Kemp, M;

    1997-01-01

    BACKGROUND: Staphylococcus epidermidis develops resistance to ciprofloxacin rapidly. That this antibiotic is excreted in apocrine and eccrine sweat of healthy individuals might be the reason for the development of such resistance. We assessed whether S epidermidis isolated from the axilla and nasal...... flora of healthy people could develop resistance to ciprofloxacin after a 1-week course of this antibiotic. METHODS: The concentration of ciprofloxacin in sweat was measured in seven volunteers after oral administration of 750 mg ciprofloxacin twice daily for 7 days, and the development of resistance...... in S epidermidis from axilla and nostrils was monitored during and 2 months after the treatment. Genotyping of S epidermidis was done by restriction fragment length polymorphism. FINDINGS: The mean concentration of ciprofloxacin in sweat increased during the 7 days of treatment-from 2.2 micrograms/mL 2...

  14. Combined anti-tumor necrosis factor-α therapy and DMARD therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD therapy alone

    Directory of Open Access Journals (Sweden)

    Carl K Edwards

    2012-12-01

    Full Text Available Periodic assessment of gene expression for diagnosis and monitoring in rheumatoid arthritis (RA may provide a readily available and useful method to detect subclinical disease progression and follow responses to therapy with disease modifying anti-rheumatic agents (DMARDs or anti-TNF-α therapy. We used quantitative real-time PCR to compare peripheral blood gene expression profiles in active ("unstable" RA patients on DMARDs, stable RA patients on DMARDs, and stable RA patients treated with a combination of a DMARD and an anti-TNF-α agent (infliximab or etanercept to healthy human controls. The expression of 48 inflammatory genes were compared between healthy controls (N=122, unstable DMARD patients (N=18, stable DMARD patients (N=26, and stable patients on combination therapy (N=20. Expression of 13 genes was very low or undetectable in all study groups. Compared to healthy controls, patients with unstable RA on DMARDs exhibited increased expression of 25 genes, stable DMARD patients exhibited increased expression of 14 genes and decreased expression of five genes, and combined therapy patients exhibited increased expression of six genes and decreased expression of 10 genes. These findings demonstrate that active RA is associated with increased expression of circulating inflammatory markers whereas increases in inflammatory gene expression are diminished in patients with stable disease on either DMARD or anti-TNF-α therapy. Furthermore, combination DMARD and anti-TNF-α therapy is associated with greater reductions in circulating inflammatory gene expression compared to DMARD therapy alone. These results suggest that assessment of peripheral blood gene expression may prove useful to monitor disease progression and response to therapy.

  15. Cooperation between prokaryotic (Lde) and eukaryotic (MRP) efflux transporters in J774 macrophages infected with Listeria monocytogenes: studies with ciprofloxacin and moxifloxacin.

    Science.gov (United States)

    Lismond, Ann; Tulkens, Paul M; Mingeot-Leclercq, Marie-Paule; Courvalin, Patrice; Van Bambeke, Françoise

    2008-09-01

    Antibiotic efflux is observed in both eukaryotic and prokaryotic cells, modulating accumulation and resistance. The present study examines whether eukaryotic and prokaryotic fluoroquinolone transporters can cooperate in the context of an intracellular infection. We have used (i) J774 macrophages (comparing a ciprofloxacin-resistant cell line overexpressing an MRP-like transporter with wild-type cells with basal expression), (ii) Listeria monocytogenes (comparing a clinical isolate [CLIP21369] displaying ciprofloxacin resistance associated with overexpression of the Lde efflux system with a wild-type strain [EGD]), (iii) ciprofloxacin (substrate of both Lde and MRP) and moxifloxacin (nonsubstrate), and (iv) probenecid and reserpine (preferential inhibitors of MRP and Lde, respectively). The ciprofloxacin MICs for EGD were unaffected by reserpine, while those for CLIP21369 were decreased approximately fourfold (and made similar to those of EGD). Neither probenecid nor reserpine affected the moxifloxacin MICs against EGD or CLIP21369. In dose-response studies (0.01x to 100x MIC) in broth, reserpine fully restored the susceptibility of CLIP21369 to ciprofloxacin (no effect on EGD) but did not influence the activity of moxifloxacin. In studies with intracellular bacteria, reserpine, probenecid, and their combination increased the activity of ciprofloxacin in wild-type and ciprofloxacin-resistant macrophages in parallel with an increase in ciprofloxacin accumulation in macrophages for EGD and an increase in accumulation and decrease in MIC (in broth) for CLIP21369. Moxifloxacin accumulation and intracellular activity were consistently not affected by the inhibitors. A bacterial efflux pump may thus actively cooperate with a eukaryotic efflux transporter to reduce the activity of a common substrate (ciprofloxacin) toward an intracellular bacterial target.

  16. Development of antimicrobial resistance in the normal anaerobic microbiota during one year after administration of clindamycin or ciprofloxacin.

    Science.gov (United States)

    Rashid, Mamun-Ur; Weintraub, Andrej; Nord, Carl Erik

    2015-02-01

    Thirty healthy subjects (15 males and 15 females) were randomly assigned in three groups and clindamycin (150 mg qid) or ciprofloxacin (500 mg bid) or placebo was given for a 10-day period. Skin, nasal, saliva, faeces samples were collected at day - 1, day 11, 1 month, 2 months, 4 months and 12 months post administration for microbiological analysis. Ciprofloxacin or clindamycin had no impact on the anaerobic skin microbiota and the proportions of antibiotic resistant anaerobic bacteria were similar as in the placebo group. Ciprofloxacin had impact on the Propionibacterium acnes in the nasal microbiota that normalized after 1 month, however, ciprofloxacin-resistant P. acnes strains increased at month 2 and month 12. Clindamycin had no impact on the nasal microbiota. In the oropharyngeal microbiota, a higher proportion of ciprofloxacin resistant Veillonella was found, it lasting up to 12 months post dosing. In the clindamycin group, clindamycin-resistant Prevotella spp. were found in increased proportions compared to placebo at various time points except month 4 in the saliva samples. The relative proportion of ciprofloxacin-resistant Bifidobacteria increased in the faecal samples on day 11, 1 month, 4 months and 12 months post dosing compared to placebo. The proportion of clindamycin-resistant Bacteroides spp. increased at 1, 2, 4 and 12 months post dosing compared to placebo in the faecal samples. No Clostridium difficile was recovered from any of the samples from any of the volunteers at any visit. The concentrations of ciprofloxacin or clindamycin in the faeces were higher than the MICs for most of the organisms present in the normal microbiota. No obvious correlation between the groups in resistant patterns for anaerobic bacteria was observed. In conclusion, based on the microbiological data of the microbiota as well as the results of the bioassays for ciprofloxacin and clindamycin concentrations in the faecal samples, oral administration of ciprofloxacin

  17. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    Science.gov (United States)

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P videogames were equally effective as traditional therapy for overall ROM gains and resulted in quicker recovery of motion with less pain experienced. Such videogames are a useful adjunct to therapy and should be considered as part of a holistic approach to rehabilitation within the hospital and at home after discharge in pediatric patients recovering from burn injury.

  18. Effects of sub-minimum inhibitory concentrations of ciprofloxacin on enteroaggregative Escherichia coli and the role of the surface protein dispersin

    Energy Technology Data Exchange (ETDEWEB)

    Fowlkes, Jason Davidson [ORNL; Doktycz, Mitchel John [ORNL; Allison, David Post [ORNL

    2011-01-01

    Enteroaggregative Escherichia coli (EAEC) are bacterial pathogens that cause watery diarrhoea, which is often persistent and can be inflammatory. The antibiotic ciprofloxacin is used to treat EAEC infections, but a full understanding of the antimicrobial effects of ciprofloxacin is needed for more efficient treatment of bacterial infections. In this study, it was found that sub-minimum inhibitory concentrations (sub-MICs) of ciprofloxacin had an inhibitory effect on EAEC adhesion to glass and mammalian HEp-2 cells. It was also observed that bacterial surface properties play an important role in bacterial sensitivity to ciprofloxacin. In an EAEC mutant strain where the hydrophobic positively charged surface protein dispersin was absent, sensitivity to ciprofloxacin was reduced compared with the wild-type strain. Identified here are several antimicrobial effects of ciprofloxacin at sub-MIC concentrations indicating that bacterial surface hydrophobicity affects the response to ciprofloxacin. Investigating the effects of sub-MIC doses of antibiotics on targeted bacteria could help to further our understanding of bacterial pathogenicity and elucidate future antibiotic treatment modalities.

  19. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Kyung; Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of); Yoon, Min Ki [Good Samaritan Hospital, Pohang (Korea, Republic of); Choe, Won Sick [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  20. RENAL CLEARANCE AND URINARY EXCRETION OF CIPROFLOXACIN IN GOATS

    Directory of Open Access Journals (Sweden)

    Z. IQBAL, I. JAVED, B. ASLAM, F. MUHAMMAD AND I. U. JAN

    2007-10-01

    Full Text Available The renal clearance and urinary excretion of ciprofloxacin were investigated in eight healthy female goats. In each animal, ciprofloxacin was administered intramuscularly at the rate of 5 mg/kg body weight. Following drug administration, blood and urine samples were collected at different time intervals and analyzed for ciprofloxacin and creatinine. High performance liquid chromatography (HPLC was used to determine the drug concentration in the plasma and urine. The value of diuresis after single administration of ciprofloxacin was 0.073 ± 0.014 ml/min/kg. Mean (± SE values for renal clearance of creatinine and ciprofloxacin were 1.870 ± 0.385 and 0.982 ± 0.166 ml/min/kg, respectively. The ratio between the renal clearance of ciprofloxacin and that of creatinine remained less than one, which was indicative of back diffusion. The mean (± SE value for the cumulative percent of ciprofloxacin dose excreted at 10 hours following its intramuscular administration was 13.03 ± 2.07. Based on these results, it was evident that besides glomerular filtration, renal handling of drug involved back diffusion also. It was concluded that in local goats glomerular filtration rate (GFR was lower than that reported for their foreign counterparts.

  1. Ciprofloxacin-Ceftriaxone Combination Prophylaxis for Prostate Biopsy; Infective Complications

    Directory of Open Access Journals (Sweden)

    Alper Ozorak

    2014-03-01

    Full Text Available Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3% 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended- spectrum %u03B2-lactamase-producing (ESBL Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy.

  2. In vitro synergism of ciprofloxacin and cefotaxime against nalidixic acid-resistant Salmonella enterica serotypes Paratyphi A and Paratyphi B.

    Science.gov (United States)

    Neupane, Ganesh Prasad; Kim, Dong-Min; Kim, Sung Hun; Lee, Bok Kwon

    2010-09-01

    Paratyphoid fever is considered an emerging systemic intracellular infection caused by Salmonella enterica serotypes Paratyphi A, B, and C. We performed in vitro time-kill studies on three clinical isolates of nalidixic acid-resistant Salmonella serotype Paratyphi (NARSP) with different concentrations of ciprofloxacin and cefotaxime to identify combinations of antibiotics with synergistic activity against paratyphoid fever. Furthermore, we identify the frequency of mutations to ciprofloxacin, cefotaxime, and rifampin resistance and also sequenced the gyrA, gyrB, parC, and parE genes to identify the cause of resistance in NARSP. When the activity of ciprofloxacin at 0.75x MIC (0.012 to 0.38 microg/ml) with cefotaxime at the MIC (0.125 to 0.25 microg/ml) against all three NARSP isolates was investigated, synergy was observed at 24 h, and the bacterial counts were reduced by >3 log(10) CFU/ml. This synergy was elongated for up to 72 h in two out of three isolates. When ciprofloxacin at 0.75x MIC (0.012 to 0.38 microg/ml) was combined with cefotaxime at 2x MIC (0.25 to 0.50 microg/ml), synergy was prolonged for up to 72 h in all three isolates. Both Salmonella serotype Paratyphi A isolates carried single mutations in codon 83 of the gyrA gene and codon 84 of the parC gene that were responsible for their reduced susceptibility to ciprofloxacin, while no mutations were found in the gyrB or parE gene. The ciprofloxacin-plus-cefotaxime regimen was very effective in reducing the bacterial counts at 24 h for all three isolates, and this combination therapy may be helpful in reducing the chance of the emergence of fluoroquinolone-resistant mutants in patients with severe paratyphoid fever.

  3. The comparative effectiveness of statin therapy in selected chronic diseases compared with the remaining population

    Directory of Open Access Journals (Sweden)

    Sheng Xia

    2012-08-01

    Full Text Available Abstract Background Total cholesterol (TC concentration is the most commonly used measure of statin efficacy in the UK. This study aimed to evaluate the effectiveness of statins in lowering TC, cardiovascular events (CV and mortality five common chronic diseases (chronic obstructive pulmonary disease (COPD, osteoarthritis (OA, rheumatoid arthritis (RA, chronic kidney disease (CKD, and diabetes mellitus (DM and to compare effectiveness with the rest of the population not recorded as having these diseases. Methods A population-based cohort study was conducted in Tayside population who had at least two TC measurements between 1993 and 2007. There were 12,140 patients with chronic diseases and 9,481 patients in the rest of the population not recorded as having these chronic diseases. The main outcomes were TC change from baseline, CV events and all-cause mortality. Results Statin-associated TC reductions varied from 15% to 28% with baseline value of between 5.1 and 5.9 mmol/L in the primary prevention (PP and from 7% to 23% with baseline value of 4.5 to 5.2 mmol/L in the secondary prevention (SP among chronic diseases patients. In the rest of the population, TC reductions with statins were 31% in PP and 28% in SP with baselines of 6.3 mmol/L and 5.3 mmol/L, respectively (test of heterogeneity with chronic disease groups: p  0.05. Conclusions The effectiveness of statins in common chronic diseases varied. With the exception of diabetes, statins tends to be less effective in patients with the chronic diseases compared with the rest of the study population. Changes in TC with statins appear not to correlate well with the changes in cardiovascular events and all-cause mortality.

  4. Ciprofloxacin resistant osteomyelitis following typhoid fever.

    Science.gov (United States)

    Ayeni, Itunuayo V; Calver, Graeme

    2012-07-13

    Salmonella typi is a rare cause of chronic osteomyelitis in a non-sickle cell patient. The authors report the case of a 25-year-old gentleman with a history of typhoid fever and an infected skin nodule on his left forearm 5 years prior to the diagnosis. He was referred to our orthopaedic colleagues with chronic osteomyelitis and underwent debridement of the bone for which samples grew Salmonella typhi. He was commenced on intravenous ceftriaxone 2 g once daily for 6 weeks followed by oral azithromycin 500 mg once daily for a further 6 weeks. The purpose of this case report is to consider the possible mode for antibiotic resistance. In this patient, the authors believe that partial treatment of the typhoid fever 5 years prior to diagnosis of osteomyelitis enabled antibiotic resistance to ciprofloxacin. Furthermore, the authors believe that the infected nodule was the result of direct inoculation with the Salmonella organism which then acted as a focus for further infections.

  5. The Effect of Ciprofloxacin Injection on Genetically Absence Prone (WAG/Rij Rats Electroencephalogram Characteristics

    Directory of Open Access Journals (Sweden)

    Ali Moghimi

    2013-01-01

    Full Text Available   Introduction: Ciprofloxacin which was used in this study is a Fluoroquinolone (FQ. This kind of drug may cause epileptic seizures probably because of the inhibition of GABA binding to its receptors. Wag/Rij rats (an animal model for generalized absence epilepsy, were used as experimental subjects.   Methods: For EEG study, electrodes were inserted into the cortex of animals according to paxinos coordinates. After and before ciprofloxacin injection, EEG was recorded and their SWDs were compared with each others.   Results: Findings showed a significant increase in the mean number of seizures during recording period. But the mean number of SWDs during seizures did not show any significant differences between groups.   Conclusion: These results may be due to involvement of GABA antagonistic effects of FQs and/or Mg2+ linked blockade of NMDA receptors. More researches are going to determine physiopathology of SWDs and find new effective substance against this kind of epilepsy.

  6. [Post-antibiotic effect of imipenem, amikacin and ciprofloxacin against various strains of Serratia marcescens].

    Science.gov (United States)

    Bollet, C; Mallet, M N; Bouchemal, H; de Micco, P

    1990-05-01

    The authors compared the post-antibiotic effect (PAE) of imipenem, amikacin, ciprofloxacin, and latamoxef against Serratia marcescens ATCC 13880 (type strain) and against 12 clinical strains belonging to Grimont's most frequent biotypes: A2a, A3a, A3b, A4a, A4b, A5, A6a, A8a, A8b, A8c, TT, TCT. PAE was determined by measuring bacterial growth kinetics after one hour exposure to concentration of 2 x MIC of 10(6) CFUs in Mueller-Hinton broth. Drug removal was by 10-3 dilution of the exposed culture. A PAE was consistently present with imipenem (range 0.8-2.9 hrs), amikacin (range 1.0-4.9 hrs), ciprofloxacin (range 1.4-2.8 hrs). The duration of PAE did not correlate with MIC or Grimont's biotypes.

  7. Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness

    Institute of Scientific and Technical Information of China (English)

    Shi Xuehui; Wei Wenbin; Zhang Cong

    2014-01-01

    Background Photodynamic therapy (PDT) has been recommended as a main treatment for idiopathic choroidal neovascularization (I-CNV).But the visual results of PDT were inconsistent and variable,and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries.In recent years,intravitreal ranibizumab therapy,showing favorable visual outcomes,has developed as an advanced treatment for choroidal neovascularization (CNV).Although both methods have been reported to be effective in treating I-CNV,there is no detailed comparative report between the two methods.This study aimed to compare visual outcomes,retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV,and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.Methods Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT.The best corrected visual acuity (BCVA) was recorded before and at each follow-up visit after treatments (IogMAR).Enhanced-depth imaging optical coherence tomography (EDI-OCT) was used to evaluate the retinal structural changes,and to measure central retinal thickness (CRT) and central choroidal thickness (CCT).Results Mean BCVA was 0.64±0.27 in PDT group and 0.69±0.22 in ranibizumab group at baseline (P=0.55).When compared with the baseline,mean BCVA in PDT group was improved significantly at 3-month after PDT (0.41±0.16,P=0.002),then changed little (0.42±0.25 at 12-month,P=0.88).Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit.It improved much more obviously in the first month and then remained stable.The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT (P <0.05).When compared with the baseline,mean CRT in PDT group decreased significantly since 3-month visit

  8. Characterization of Ciprofloxacin-Resistant and Ciprofloxacin-Susceptible Uropathogenic Escherichia coli Obtained from Patients with Gynecological Cancer.

    Science.gov (United States)

    Capett, Muniqui S; Vollú-Silva, Patricia; Melchiades, Vanessa A; Bokehi, Luciana C; Araújo, Fernanda M; Martins, Ianick Souto; Neves, Felipe P G; Gonzalez, Alice G M; Oswald, Eric; de Paula, Geraldo R; Teixeira, Lenise A

    2016-11-01

    The objective of this work was to assess the genetic characteristics of uropathogenic Escherichia coli, ciprofloxacin resistance or susceptibility, obtained from patients with gynecological cancer and urinary tract infection (UTI). Seventy-seven E. coli ciprofloxacin-resistant isolates and 38 ciprofloxacin-susceptible were analyzed by polymerase chain reaction (PCR) to determine the phylogenetic groups, virulence factors as iucC, fyuA, hlyC, cnf1 genes, and pks pathogenicity island. The presence of genes related to ciprofloxacin resistance such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA, and the sequencing of DNA gyrase genes and topoisomerase IV were determined. The genetic profile of the isolates was determined by pulsed-field gel electrophoresis (PFGE). Statistical analysis was performed using Fisher's exact test and Chi-square test. Phylogenetic group B2 was the most prevalent although a great genetic diversity was observed by PFGE. Only genes associated to siderophores were found in ciprofloxacin-resistant isolates; however, in ciprofloxacin-susceptible isolates, genes related to siderophores and toxin, were detected. Additionally qnrB was detected in both populations, ciprofloxacin resistant and susceptible. DNA mutations in gyrA were Ser-83-Leu and Asp-87-Asn and in parC were Ser-80-Ile and Glu-84-Val, Glu-84-Lys. In conclusion, it was observed a high prevalence of qnrB in the population studied; in addition, it was the first time the pks island was observed only in ciprofloxacin-susceptible isolates.

  9. Dynamics of quinolone resistance in fecal Escherichia coli of finishing pigs after ciprofloxacin administration.

    Science.gov (United States)

    Huang, Kang; Xu, Chang-Wen; Zeng, Bo; Xia, Qing-Qing; Zhang, An-Yun; Lei, Chang-Wei; Guan, Zhong-Bin; Cheng, Han; Wang, Hong-Ning

    2014-09-01

    Escherichia coli resistance to quinolones has now become a serious issue in large-scale pig farms of China. It is necessary to study the dynamics of quinolone resistance in fecal Escherichia coli of pigs after antimicrobial administration. Here, we present the hypothesis that the emergence of resistance in pigs requires drug accumulation for 7 days or more. To test this hypothesis, 26 pigs (90 days old, about 30 kg) not fed any antimicrobial after weaning were selected and divided into 2 equal groups: the experimental (EP) group and control (CP) group. Pigs in the EP group were orally treated daily with 5 mg ciprofloxacin/kg of body weight for 30 days, and pigs in the CP group were fed a normal diet. Fresh feces were collected at 16 time points from day 0 to day 61. At each time point, ten E. coli clones were tested for susceptibility to quinolones and mutations of gyrA and parC. The results showed that the minimal inhibitory concentration (MIC) for ciprofloxacin increased 16-fold compared with the initial MIC (0.5 µg/ml) after ciprofloxacin administration for 3 days and decreased 256-fold compared with the initial MIC (0.5 µg/ml) after ciprofloxacin withdrawal for 26 days. GyrA (S83L, D87N/ D87Y) and parC (S80I) substitutions were observed in all quinolone-resistant E. coli (QREC) clones with an MIC ≥8 µg/ml. This study provides scientific theoretical guidance for the rational use of antimicrobials and the control of bacterial resistance.

  10. Comparative study of 99Tcm-ciprofloxacin scintigraphy, 18F-FDG PET and diffusion weighted imaging for detecting secondary infection associated with severe acute pancreatitis%99Tcm-环丙沙星SPECT和18F-FDG PET及MRI弥散加权显像检测重症胰腺炎继发感染灶的比较

    Institute of Scientific and Technical Information of China (English)

    汪建华; 孙高峰; 张建; 邵成伟; 潘桂霞; 彭烨; 茅娟莉; 郑建明; 左长京

    2013-01-01

    Objective To compare the diagnostic values of 99Tcm-ciprofloxacin SPECT,18F-FDG PET and MR diffusion weighted imaging (DWI) for detecting secondary infection associated with severe acute pancreatitis (SAP) in swine.Methods Swine models were constructed and grouped,including control group (normal swine,n =6),non-infected SAP group (inoculated with inactivative Escherichia coli,n =6)and infected SAP group (inoculated with Escherichia coli,n=16).At 7 d after inoculation,a series of 99Tcmciprofloxacin SPECT,18 F-FDG PET and MR DWI scans were performed.The imaging findings were visually evaluated and semi-quantitative analyzed.Lesion-background radioactive counts ratio (L/B),SUVmax and the apparent diffusion coefficient (ADC) were calculated.The image results were compared with histopathological and bacteriological results,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated.Bonferroni test,the least significant difference t test and x2 test were used for statistical data analysis.Results (1) The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 99Tcm-ciprofloxacin SPECT via visual analysis were 93.8% (15/16),5/6,90.9%(20/22),93.8%(15/16) and 5/6,whereas 81.2%(13/16),2/6,68.2%(15/22),76.5%(13/17) and 2/5 for 18F-FDG PET,and 15.4%(2/13),5/6,36.8%(7/19),2/3 and 31.3%(5/16) for MRI DWI respectively.Both 99Tcm-ciprofloxacin SPECT and 18F-FDG PET had higher sensitivities (both P>0.05),but the specificity of 18 F-FDG PET was lower.(2)99Tcm-ciprofloxacin imaging showed the changes of L/B for the infected SAP swine were significantly different from those of the non-infected and normal swine (F=95.66,P<0.001).18F-FDG PET early-phase images showed SUVmax was not significantly different between infected SAP (2.61±1.07) and non-infected SAP (1.87±0.76) groups (P>0.05),but the SUVmax of infected SAP group was higher than that of non-infected SAP group on

  11. Comparing Two Cooperative Small Group Formats Used with Physical Therapy and Medical Students

    Science.gov (United States)

    D'Eon, Marcel; Proctor, Peggy; Reeder, Bruce

    2007-01-01

    This study compared "Structured Controversy" (a semi-formal debate like small group activity) with a traditional open discussion format for medical and physical therapy students. We found that those students who had participated in Structured Controversy changed their personal opinion on the topic more than those who were in the Open Discussion…

  12. Hypnosis compared with group therapy and individual desensitization for dental anxiety

    DEFF Research Database (Denmark)

    Moore, Rod; Abrahamsen, Randi; Brødsgaard, I

    1996-01-01

    Effects of hypnotherapy (HT) and self-hypnosis training on extreme dental anxiety in adults aged 19-65 years were compared with group therapy (GT) and individual desensitization (SD) using scales of dental anxiety, dental beliefs, and fear of a next dentist (after specialist treatment). All...

  13. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    NARCIS (Netherlands)

    Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and pro

  14. Brief Cognitive Behavioural Therapy compared to optimised general practitioners’ care for depression : A randomised trial

    NARCIS (Netherlands)

    Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and pro

  15. The phenotypic evolution of Pseudomonas aeruginosa populations changes in the presence of subinhibitory concentrations of ciprofloxacin

    DEFF Research Database (Denmark)

    Wassermann, Tina; Meinike Jørgensen, Karin; Ivanyshyn, Karolina;

    2016-01-01

    populations compared to unexposed populations. Three replicate populations of P. aeruginosa PAO1 and its hypermutable mutant ΔmutS were cultured aerobically for approximately 940 generations by daily passages in LB medium with and without subinhibitory concentration of ciprofloxacin and aliquots...

  16. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gunther, Jillian R. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sato, Mariko; Chintagumpala, Murali [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Ketonen, Leena [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Jeremy Y. [Department of Pediatric Radiology, Texas Children' s Hospital, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Okcu, M. Fatih; Su, Jack M. [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Weinberg, Jeffrey [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Boehling, Nicholas S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Khatua, Soumen [Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adesina, Adekunle [Department of Pathology, Baylor College of Medicine, Texas Children' s Hospital, Houston, Texas (United States); Dauser, Robert; Whitehead, William E. [Department of Neurosurgery, Texas Children' s Hospital, Houston, Texas (United States); Mahajan, Anita, E-mail: amahajan@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem.

  17. Ciprofloxacin residue and antibiotic-resistant biofilm bacteria in hospital effluent.

    Science.gov (United States)

    Ory, Jérôme; Bricheux, Geneviève; Togola, Anne; Bonnet, Jean Louis; Donnadieu-Bernard, Florence; Nakusi, Laurence; Forestier, Christiane; Traore, Ousmane

    2016-07-01

    Discharge of antimicrobial residues and resistant bacteria in hospital effluents is supposed to have strong impacts on the spread of antibiotic resistant bacteria in the environment. This study aimed to characterize the effluents of the Gabriel Montpied teaching hospital, Clermont-Ferrand, France, by simultaneously measuring the concentration of ciprofloxacin and of biological indicators resistant to this molecule in biofilms formed in the hospital effluent and by comparing these data to ciprofloxacin consumption and resistant bacterial isolates of the hospital. Determination of the measured environmental concentration of ciprofloxacin by spot sampling and polar organic chemical integrative (POCIS) sampling over 2 weeks, and comparison with predicted environmental concentrations produced a hazard quotient >1, indicating a potential ecotoxicological risk. A negative impact was also observed with whole hospital effluent samples using the Tetrahymena pyriformis biological model. During the same period, biofilms were formed within the hospital effluent, and analysis of ciprofloxacin-resistant isolates indicated that Gamma-Proteobacteria were numerous, predominantly Aeromonadaceae (69.56%) and Enterobacteriaceae (22.61%). Among the 115 isolates collected, plasmid-mediated fluoroquinolone-resistant genes were detected, with mostly aac(6')-lb-cr and qnrS. In addition, 60% of the isolates were resistant to up to six antibiotics, including molecules mostly used in the hospital (aminosides and third-generation cephalosporins). In parallel, 1247 bacteria isolated from hospitalized patients and resistant to at least one of the fluoroquinolones were collected. Only 5 of the 14 species identified in the effluent biofilm were also found in the clinical isolates, but PFGE typing of the Gram-negative isolates found in both compartments showed there was no clonality among the strains. Altogether, these data confirm the role of hospital loads as sources of pollution for wastewater

  18. Tc-99m ciprofloxacin imaging in diagnosis of chronic bacterial prostatitis

    Institute of Scientific and Technical Information of China (English)

    Ji-KanRyu; Seong-MinLee; Do-WhanSeong; Jun-KyuSuh; SungeunKim; WonsickChoe; YeonsookMoon; Soo-HwanPai

    2003-01-01

    Aim:To investigate the value of Tc-99m ciprofloxacin imaging in the differential diagnosis of chronic bacterial prostatitis. Methods: The study included 4 normal subjects as the negative controls, 2 patients with acute prostatitis or cystourethritis as the positive controls and 59 patients diagnosed as chronic bacterial prostatitis or chronic pelvic pain syndrome by traditional laboratory tests. In every subject, the single photon emission computer-ized tomography images were obtained 3 h after intravenous injection of Tc-99m Ciprofloxacin. The results of the imaging were compared with those of laboratory tests. Results: On the images, negative uptake was observed in all normal subjects, while strong hot uptake, in the whole prostate of acute prostatitis patients and in the whole urethra of acute cystourethritis patients. In 13 (68 %) of 19 patients categorized as chronic bacterial prostatitis by standard laboratory tests, hot uptake with less intensity than that of acute prostatitis was observed in the prostate area around the prostatic urethra. Negative uptake in the prostate was observed in 6 of 19 patients (32 %) categorized as chronic bacterial prostatitis. Interestingly, hot uptake in the prostate was exhibited in 28 (70 %) of the 40 patients categorized as chronic pelvic pain syndrome. Conclusion: Tc-99m ciprofloxacin imaging is helpful in the differential diagnosis of prostatitis syndrome. (Asian J Androl 2003 Sep; 5:179-183 )

  19. The efficacy of maggot debridement therapy - a review of comparative clinical trials

    DEFF Research Database (Denmark)

    Zarchi, K.; Jemec, G.B.

    2012-01-01

    Over the last decade, maggot debridement therapy (MDT) has been recognized by many clinicians as a potential adjunct to conventional therapy, and many patients with non healing, chronic ulcers have been treated. Numerous case reports and case series have described the successful use of MDT...... in a variety of ulcers. However, comparative clinical trials and in particular randomized controlled trials investigating the efficacy of MDT are sparse. A systematic search in the literature showed three randomized clinical trials and five non randomized studies evaluating the efficacy of sterile Lucilia...... sericata applied on ulcers with various aetiologies. Of these, seven studies had debridement and/or healing as an outcome variable. When evaluating maggots as debriding agents, the studies report MDT as being significantly more effective than hydrogel or a mixture of conventional therapy modalities...

  20. Ciprofloxacin-induced tendinopathy of the gluteal tendons.

    Science.gov (United States)

    Shimatsu, Kaumakaokalani; Subramaniam, Somasundaram; Sim, Helen; Aronowitz, Paul

    2014-11-01

    Fluoroquinolone-induced tendinopathy most commonly affects the Achilles tendon; however, involvement of several other tendons has been described. This is a case report of ciprofloxacin-induced tendinopathy of the gluteal tendons with MRI findings. An obese 25-year-old woman with no significant past medical history was diagnosed with acute pyelonephritis and was treated with intravenous ciprofloxacin. Shortly after her first dose of ciprofloxacin, she developed severe left hip pain and decreased range of motion. MRI of the hips showed bilateral tendinopathy of the gluteal muscle insertion. A diagnosis of ciprofloxacin-induced tendinopathy was made based on her MRI and a Naranjo score of 7. Ciprofloxacin was stopped and her pain quickly resolved. Fluoroquinolones cause tendinopathy in 0.14 % to 0.4 % of patients using these agents. Fluoroquinolone-associated tendinopathy is a serious adverse reaction that can affect many tendons and should be considered in any patient presenting with new musculoskeletal complaints and in whom there is a history of fluoroquinolone use within the preceding 6 months.

  1. RESISTANCE TO AMOXICILLIN, CLARITHROMYCIN AND CIPROFLOXACIN OF Helicobacter pylori ISOLATED FROM SOUTHERN BRAZIL PATIENTS

    Directory of Open Access Journals (Sweden)

    Simone Ulrich Picoli

    2014-06-01

    Full Text Available Introduction: Helicobacter pylori is a bacteria which infects half the world population and is an important cause of gastric cancer. The eradication therapy is not always effective because resistance to antimicrobials may occur. The aim of this study was to determine the susceptibility profile of H. pylori to amoxicillin, clarithromycin and ciprofloxacin in the population of Southern Brazil. Material and methods: Fifty four samples of H. pylori were evaluated. The antibiotics susceptibility was determined according to the guidelines of the British Society for Antimicrobial Chemotherapy and the Comité de l'Antibiogramme de la Société Française de Microbiologie. Results: Six (11.1% H. pylori isolates were resistant to clarithromycin, one (1.9% to amoxicillin and three (5.5% to ciprofloxacin. These indices of resistance are considered satisfactory and show that all of these antibiotics can be used in the empirical therapy. Conclusion: The antibiotics amoxicillin and clarithromycin are still a good option for first line anti-H. pylori treatment in the population of Southern Brazil.

  2. Comparative Study of Multimodal and Pharmacological Therapy in Treating School Aged Children with ADHD

    Directory of Open Access Journals (Sweden)

    Susana Bogdana MILEA

    2012-09-01

    Full Text Available The attention deficit hyperactivity disorder (ADHD, one of the most commonly diagnosed psychiatric disorders among school aged children, continues to create disputes between specialists, upon the best treatment to be used. The herby study aims to bring forward some differences that may exist between the efficacy of the multimodal treatment compared to the drug treatment of ADHD. The novelty component of this study, unfolded February 2010-July 2012, is that the children, their parents and also their teachers were included in the multimodality treatment. The children included in this research (n=63, aged 6-14 and ADHD diagnosed, were randomly assigned in two groups. In the medication (Med group (n=32 the children only received the specific pharmacological treatment (Atomoxetine or Methylphenidate, and for the multimodality (MM group (n=31 the therapy included psychosocial interventions besides the drug therapy. All children were evaluated, both pre and post intervention, with the Achenbach System of Empirically Based Assessment – ASEBA, for the 6-18 aged category. We have compared the influence of therapy on the core symptoms, on the adaptive functionality and academic performance and on the competences and social functioning of the children in the two groups. The multimodal intervention proved to be more effective (p<0.05 than medication alone, firstly in ameliorating the child’s social behavior in both family and school environment, than in what concerns the main ADHD symptoms. The children’s academic performance was little impacted by either of the two therapies.

  3. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    OpenAIRE

    Schene, A.H.; Baas, K.D.; Koeter, M; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K. F.; van Weert, H.C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and protocolised according to current evidence based guidelines for depression. So far this has not been the case. We studied whether a protocolised 8 session CBT is more effective than optimised and prot...

  4. Comparing Linguistic Complexity and Efficiency in Conversations from Stimulation and Conversation Therapy in Aphasia

    Science.gov (United States)

    Savage, Meghan C.; Donovan, Neila J.

    2017-01-01

    Background: Efficacy studies have demonstrated the benefit of group conversation therapy for a person with aphasia (PWA). However, a PWA typically participates in individual therapy prior to group therapy. Stimulation therapy (ST) is the most common type of individual aphasia therapy. Ultimately, the outcome of therapy is to enable the PWA to…

  5. Comparative Effectiveness of Single versus Combination Antibiotic Prophylaxis for Infections after Transrectal Prostate Biopsy.

    Science.gov (United States)

    Marino, Kaylee; Parlee, Anne; Orlando, Ralph; Lerner, Lori; Strymish, Judith; Gupta, Kalpana

    2015-12-01

    An increase in fluoroquinolone resistance and transrectal ultrasound-guided prostate (TRUS) biopsy infections has prompted the need for alternative effective antibiotic prophylaxis. We aimed to compare ciprofloxacin and other single-agent therapies to combination therapy for efficacy and adverse effects. Men who underwent a TRUS biopsy within the VA Boston health care system with documented receipt of prophylactic antibiotics periprocedure were eligible for inclusion. Postprocedure infections within 30 days were ascertained by chart review from electronic records, including any inpatient, outpatient, or urgent-care visits. Among 455 evaluable men over a 3-year period, there were 25 infections (5.49%), with sepsis occurring in 2.4%, urinary tract infections (UTI) in 1.54%, and bacteremia in 0.44% of patients. Escherichia coli was the most common urine (89%) and blood (92%) pathogen, with fluoroquinolone resistance rates of 88% and 91%, respectively. Ciprofloxacin alone was associated with significantly more infections than ciprofloxacin plus an additional agent (P = 0.014). Intramuscular gentamicin alone was also significantly associated with a higher infection rate obtained with all other regimens (P = 0.004). Any single-agent regimen, including ciprofloxacin, ceftriaxone, or gentamicin, was associated with significantly higher infection rates than any combination regimen (odds ratio [OR], 4; 95% confidence interval [CI], 1.47, 10.85; P = 0.004). Diabetes, immunosuppressive condition or medication, hospitalization within the previous year, and UTI within the previous 6 months were not associated with infection risk. Clostridium difficile infections were similar. These findings suggest that ciprofloxacin, ceftriaxone, and gentamicin alone are inferior to a combination regimen. Institutions with high failure rates of prophylaxis for TRUS biopsies should consider combination regimens derived from their local data.

  6. Comparison of Infection and Urosepsis Rates of Ciprofloxacin and Ceftriaxone Prophylaxis before Percutaneous Nephrolithotomy: A Prospective and Randomised Study

    Directory of Open Access Journals (Sweden)

    Abdullah Demirtas

    2012-01-01

    Full Text Available This study aimed at determining the choice and administration duration of ideal antibiotic prophylaxis before percutaneous nephrolithotomy (PNL operation, a treatment modality for nephrolithiasis. The study included 90 patients who had no internal problem, yet had a negative urine culture and underwent a PNL operation. We compared infection rates between ciprofloxacin and ceftriaxone groups and their subgroups. The results showed no statistical difference between ciprofloxacin and ceftriaxone groups in terms of systemic inflammatory response syndrome (SIRS (CIPP=0.306, CTX P=0.334. As a result of this study no statistical difference was observed between ciprofloxacin and ceftriaxone in terms of SIRS. It seems, however, reasonable to choose ceftriaxone, considering antibiotic sensitivity of microorganisms and detection of three cases accepted as urosepsis in the ciprofloxacin group. As there is no difference between short, and long-term prophylactic use of these antibiotics, preference of short-term prophylaxis for patients with no risk of infection will be important to avoid inappropriate antibiotic usage.

  7. Comparison of infection and urosepsis rates of ciprofloxacin and ceftriaxone prophylaxis before percutaneous nephrolithotomy: a prospective and randomised study.

    Science.gov (United States)

    Demirtas, Abdullah; Yildirim, Yunus Emre; Sofikerim, Mustafa; Kaya, Esma Gunduz; Akinsal, Emre Can; Tombul, Sevket Tolga; Ekmekcioglu, Oguz; Gulmez, Ibrahim

    2012-01-01

    This study aimed at determining the choice and administration duration of ideal antibiotic prophylaxis before percutaneous nephrolithotomy (PNL) operation, a treatment modality for nephrolithiasis. The study included 90 patients who had no internal problem, yet had a negative urine culture and underwent a PNL operation. We compared infection rates between ciprofloxacin and ceftriaxone groups and their subgroups. The results showed no statistical difference between ciprofloxacin and ceftriaxone groups in terms of systemic inflammatory response syndrome (SIRS) (CIP(P) = 0.306,  CTX P = 0.334. As a result of this study no statistical difference was observed between ciprofloxacin and ceftriaxone in terms of SIRS. It seems, however, reasonable to choose ceftriaxone, considering antibiotic sensitivity of microorganisms and detection of three cases accepted as urosepsis in the ciprofloxacin group. As there is no difference between short, and long-term prophylactic use of these antibiotics, preference of short-term prophylaxis for patients with no risk of infection will be important to avoid inappropriate antibiotic usage.

  8. Ciprofloxacin versus colistin prophylaxis during neutropenia in acute myeloid leukemia: two parallel patient cohorts treated in a single center

    Science.gov (United States)

    Pohlen, Michele; Marx, Julia; Mellmann, Alexander; Becker, Karsten; Mesters, Rolf M.; Mikesch, Jan-Henrik; Schliemann, Christoph; Lenz, Georg; Müller-Tidow, Carsten; Büchner, Thomas; Krug, Utz; Stelljes, Matthias; Karch, Helge; Peters, Georg; Gerth, Hans U.; Görlich, Dennis; Berdel, Wolfgang E.

    2016-01-01

    Patients undergoing intensive chemotherapy for acute myeloid leukemia are at high risk for bacterial infections during therapy-related neutropenia. However, the use of specific antibiotic regimens for prophylaxis in afebrile neutropenic acute myeloid leukemia patients is controversial. We report a retrospective evaluation of 172 acute myeloid leukemia patients who received 322 courses of myelosuppressive chemotherapy and had an expected duration of neutropenia of more than seven days. The patients were allocated to antibiotic prophylaxis groups and treated with colistin or ciprofloxacin through 2 different hematologic services at our hospital, as available. The infection rate was reduced from 88.6% to 74.2% through antibiotic prophylaxis (vs. without prophylaxis; P=0.04). A comparison of both antibiotic drugs revealed a trend towards fewer infections associated with ciprofloxacin prophylaxis (69.2% vs. 79.5% in the colistin group; P=0.07), as determined by univariate analysis. This result was confirmed through multivariate analysis (OR: 0.475, 95%CI: 0.236–0.958; P=0.041). The prophylactic agents did not differ with regard to the microbiological findings (P=0.6, not significant). Of note, the use of ciprofloxacin was significantly associated with an increased rate of infections with pathogens that are resistant to the antibiotic used for prophylaxis (79.5% vs. 9.5% in the colistin group; P<0.0001). The risk factors for higher infection rates were the presence of a central venous catheter (P<0.0001), mucositis grade III/IV (P=0.0039), and induction/relapse courses (vs. consolidation; P<0.0001). In conclusion, ciprofloxacin prophylaxis appears to be of particular benefit during induction and relapse chemotherapy for acute myeloid leukemia. To prevent and control drug resistance, it may be safely replaced by colistin during consolidation cycles of acute myeloid leukemia therapy. PMID:27470601

  9. A Comparative Study of Oral Cyclosporine and Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata

    Science.gov (United States)

    Jang, Yong Hyun; Kim, Sang Lim; Lee, Kyou Chae; Kim, Min Ji; Park, Kyung Hea; Lee, Weon Ju; Lee, Seok-Jong

    2016-01-01

    Background Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. Objective To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. Methods Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. Results The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. Conclusion Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety. PMID:27746635

  10. Impact of Spores on the Comparative Efficacies of Five Antibiotics for Treatment of Bacillus anthracis in an In Vitro Hollow Fiber Pharmacodynamic Model

    OpenAIRE

    2012-01-01

    Bacillus anthracis, the bacterium that causes anthrax, is an agent of bioterrorism. The most effective antimicrobial therapy for B. anthracis infections is unknown. An in vitro pharmacodynamic model of B. anthracis was used to compare the efficacies of simulated clinically prescribed regimens of moxifloxacin, linezolid, and meropenem with the “gold standards,” doxycycline and ciprofloxacin. Treatment outcomes for isogenic spore-forming and non-spore-forming strains of B. anthracis were compar...

  11. Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

    Science.gov (United States)

    Sakurai, Kouichi; Suda, Hiroko; Ido, Yumi; Takeichi, Takayuki; Okuda, Ayako; Hasuda, Kiwamu; Hattori, Masahiro

    2017-01-01

    AIM To compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)-based therapies to treat Helicobacter pylori (H. pylori). METHODS We retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori -positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan. The primary endpoint was the eradication rate, which was assessed with a full analysis set. The secondary endpoints were adverse events and related factors. RESULTS After the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%), 71.6% (95%CI: 67.5%-75.5%), 62.9% (95%CI: 52.0%-72.9%), and 57.3% (95%CI: 50.4%-64.1%), respectively. The vonoprazan eradication rate was significantly higher than that of the PPIs (P pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013). The incidence of adverse events in the vonoprazan group was not different from the PPI group (P = 0.054), although the vonoprazan group exhibited a wider range of adverse events. Vonoprazan-based triple therapy was highly effective as a second-line treatment, with an eradication rate similar to that of PPI-based therapy. CONCLUSION Vonoprazan might be superior to PPIs in first-line H. pylori therapy, particularly for smokers. However, caution is required due to possible adverse events. PMID:28216974

  12. Comparison of the effectiveness and safety of cefpodoxime and ciprofloxacin in acute exacerbation of chronic suppurative otitis media: A randomized, open-labeled, phase IV clinical trial

    Directory of Open Access Journals (Sweden)

    Arijit Ghosh

    2012-01-01

    Full Text Available Objective : To compare the effectiveness and safety of cefpodoxime and ciprofloxacin for the treatment of mild to moderate cases of acute exacerbation of chronic suppurative otitis media (AECSOM. Materials and Methods : Adult patients diagnosed with AECSOM were screened and patients fulfilling the inclusion criteria were randomized to receive either cefpodoxime 200 mg twice daily or ciprofloxacin 500 mg twice daily orally for 7 days. The primary outcome of this randomized, open-labeled, phase IV clinical trial (Registration Number - CTRI/2011/10/002079 was clinical success rate at day 14 visit and the secondary outcome was incidence of adverse events (AEs. Forty-six patients were enrolled: 23 in the cefpodoxime group and 23 in the ciprofloxacin group. Results : The clinical success rates were 95.6% in the cefpodoxime group versus 90.9% in the ciprofloxacin group. These rates are comparable, but no statistically significant difference was observed between the groups. Few mild and self-limiting AEs were observed and the tolerability of both the drugs was also good. Conclusion : The results of this randomized, open-labeled phase IV clinical trial showed that a 7-day course of cefpodoxime is therapeutically comparable to ciprofloxacin in terms of both clinical effectiveness and safety for the treatment of patients with AECSOM.

  13. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome.

    Science.gov (United States)

    Kaya, Erkan; Zinnuroglu, Murat; Tugcu, Ilknur

    2011-02-01

    The purpose of this study was to determine and compare the efficacy of kinesio tape and physical therapy modalities in patients with shoulder impingement syndrome. Patients (n = 55) were treated with kinesio tape (n = 30) three times by intervals of 3 days or a daily program of local modalities (n = 25) for 2 weeks. Response to treatment was evaluated with the Disability of Arm, Shoulder, and Hand scale. Patients were questioned for the night pain, daily pain, and pain with motion. Outcome measures except for the Disability of Arm, Shoulder, and Hand scale were assessed at baseline, first, and second weeks of the treatment. Disability of Arm, Shoulder, and Hand scale was evaluated only before and after the treatment. Disability of Arm, Shoulder, and Hand scale and visual analog scale scores decreased significantly in both treatment groups as compared with the baseline levels. The rest, night, and movement median pain scores of the kinesio taping (20, 40, and 50, respectively) group were statistically significantly lower (p values were 0.001, 0.01, and 0.001, respectively) at the first week examination as compared with the physical therapy group (50, 70, and 70, respectively). However, there was no significant difference in the same parameters between two groups at the second week (0.109, 0.07, and 0.218 for rest, night, and movement median pain scores, respectively). Disability of Arm, Shoulder, and Hand scale scores of the kinesio taping group were significantly lower at the second week as compared with the physical therapy group. No side effects were observed. Kinesio tape has been found to be more effective than the local modalities at the first week and was similarly effective at the second week of the treatment. Kinesio taping may be an alternative treatment option in the treatment of shoulder impingement syndrome especially when an immediate effect is needed.

  14. Successful treatment of Bacillus cereus infection with ciprofloxacin.

    OpenAIRE

    Gascoigne, A.D.; Richards, J.; Gould, K.; Gibson, G. J.

    1991-01-01

    Bacillus cereus is rarely a pulmonary pathogen but may cause pneumonia in immunocompromised patients. A patient with bronchiectasis and no recognisable immunodeficiency had this organism isolated during two infective exacerbations, once from respiratory secretions and once by blood culture. Ciprofloxacin treatment was effective on both occasions.

  15. Identifikasi Bakteri Dan Tes Sensitifitas Terhadap Ciprofloxacin Pada Periodontitis Kronis

    OpenAIRE

    Irene Edith Riuwpassa, Dr.drg. M.Si

    2011-01-01

    Berdasarkan hasil penelitian diperoleh distribusi kuman sebagai berikut: Porhyromonas gingivalis(52), Streptococcus(47), Actinobacillus actinomycetemcomitans(31), Pseudomonas(9), Staphylococcus(11), Klebsiela pneumonia(5), Escherichia colli(2), Alkaigines fascialis(2) dan Enternobacter aerogenus(2) Terdapat P.AERUGINOSA YANG RESISTEN TERHADAP CIPROFLOXACIN SEBESAR 50% (4) DARI 8 SAMPEL. Periodontitis adalah tipe umum penyakit periodontal yang disebabkan oleh perluasan radang tahap awal pad...

  16. Prediction of pharmacokinetics and drug-drug interaction potential using physiologically based pharmacokinetic (PBPK) modeling approach: A case study of caffeine and ciprofloxacin

    Science.gov (United States)

    Park, Min-Ho; Shin, Seok-Ho; Byeon, Jin-Ju; Lee, Gwan-Ho; Yu, Byung-Yong

    2017-01-01

    Over the last decade, physiologically based pharmacokinetics (PBPK) application has been extended significantly not only to predicting preclinical/human PK but also to evaluating the drug-drug interaction (DDI) liability at the drug discovery or development stage. Herein, we describe a case study to illustrate the use of PBPK approach in predicting human PK as well as DDI using in silico, in vivo and in vitro derived parameters. This case was composed of five steps such as: simulation, verification, understanding of parameter sensitivity, optimization of the parameter and final evaluation. Caffeine and ciprofloxacin were used as tool compounds to demonstrate the “fit for purpose” application of PBPK modeling and simulation for this study. Compared to caffeine, the PBPK modeling for ciprofloxacin was challenging due to several factors including solubility, permeability, clearance and tissue distribution etc. Therefore, intensive parameter sensitivity analysis (PSA) was conducted to optimize the PBPK model for ciprofloxacin. Overall, the increase in Cmax of caffeine by ciprofloxacin was not significant. However, the increase in AUC was observed and was proportional to the administered dose of ciprofloxacin. The predicted DDI and PK results were comparable to observed clinical data published in the literatures. This approach would be helpful in identifying potential key factors that could lead to significant impact on PBPK modeling and simulation for challenging compounds. PMID:28066147

  17. Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... and Music (GIM), another group received 50 hours of outpatient trauma therapy with Psychodynamic Imaginative Trauma Therapy (PITT). The third group was a waiting-list control group of women who had to wait at least nine months for therapy. The participants filled out questionnaires measuring symptoms....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy....

  18. EFFECT OF COGNITIVE BEHAVIOR THERAPY AS COMPARED TO MYOFASCIAL RELEASE TECHNIQUE IN FIBROMYALGIA SYNDROME

    Directory of Open Access Journals (Sweden)

    Kaur kusumpreet

    2013-10-01

    Full Text Available Background and introduction:Fibromyalgia or fibromyalgic syndrome is a common form of non-articularrheumatism characterized by variety of non-specific symptoms including diffuse widespread musculoskeletalaching associated with fatigue, morning stiffness and sleep disturbances (Bennett, 1997. The current study willcompare the beneficial effects of Cognitive behavior therapy (CBT and Myofascial release (MFR along withconventional treatment. This study tries to find out new effective method for reducing the problemsof pain,anxiety and sleep disturbance in fibromyalgia.Method:24 subjects selected according to the inclusion andexclusion criteria were randomly divided in to three groups: Conventional group, Myofascial releasealong withconventional treatment and Cognitive behavior therapy along with conventional treatment. Pre and post readingsat 0 day, 7thday and 14thday were recorded for Fibromyalgia Impact Questionnaire (FIQ, Epworth SleepinessScale (ESS and State Trait Anxiety Inventory (STAI.Results:After two week protocol it was found that all threetreatment approaches were effective in reducing the problem of pain, anxiety and sleep disturbance to someextent. However on comparing three treatment approaches , CBT is the most effective in reducing theaboveparameters. (p<0.05Conclusion:Cognitive behavior therapy is more effective than Myofascial release tehniquesin reducing fibromyalgia symptoms.

  19. Different susceptibility of coagulase-positive and coagulase-negative staphylococci to ciprofloxacin.

    Science.gov (United States)

    Utili, R; Tripodi, M F; Rosario, P; Andreana, A; Locatelli, A; Rambaldi, A; Florio, A

    1996-10-01

    Ciprofloxacin susceptibility was evaluated in 573 clinical staphylococcal isolates (Staphylococcus aureus 230, methicillin-resistant (MR) 36%; coagulase-negative strains 343, MR 66%) collected from 1989 to 1995. Resistance to ciprofloxacin for MR Staphylococcus aureus was 25% until 1991 when ciprofloxacin was introduced into the hospital formulary, and rose progressively to 90% in 1994-1995. MR Staphylococcus haemolyticus showed a ciprofloxacin resistance of 46% until 1991 and of 73% from 1992 to 1995. In contrast MR Staphylococcus epidermidis and other coagulase-negative strains showed a constant susceptibility to this agent (80%). Ciprofloxacin has limited usefulness against MR Staphylococcus aureus but can be still used to treat Staphylococcus epidermidis infections.

  20. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Directory of Open Access Journals (Sweden)

    Saeed Imani

    2015-11-01

    Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  1. A pilot study of myofascial release therapy compared to Swedish massage in fibromyalgia.

    Science.gov (United States)

    Liptan, Ginevra; Mist, Scott; Wright, Cheryl; Arzt, Anna; Jones, Kim Dupree

    2013-07-01

    Fibromyalgia (FM) is characterized by widespread muscle pain and soft tissue tenderness. However, a lack of definitive muscle pathology has made FM both a diagnostic and a treatment puzzle. Much of the evidence for pathology in FM lies in the central nervous system - in particular abnormal amplification of pain signals in the spinal cord - a manifestation of central sensitization. An emerging body of evidence posits that peripheral pain generated from the muscles and fascia may trigger and maintain central sensitization in FM. Since FM patients so frequently seek manual therapy to relieve muscle symptoms, the present study compared two different manual therapy techniques in a parallel study of women with FM. Eight subjects received myofascial release (MFR) while four subjects received Swedish massage, 90 min weekly for four weeks. Overall symptom burden and physical function were assessed by the Fibromyalgia Impact Questionnaire Revised (FIQ-R). A unique challenge for the manual therapist in treating conditions involving central sensitization is to determine if localized pain reduction can be achieved with targeted therapy in the context of ongoing widespread pain. Localized pain improvement was measured by a novel questionnaire developed for this study, the modified Nordic Musculoskeletal Questionnaire (NMQ). Between-group differences in FIQ-R did not reach statistical significance, but the total change scores on FIQ-R for the MFR group (mean = 10.14, SD = 16.2) trended in the hypothesized and positive direction compared to the Swedish massage group (mean = 0.33, SD = 4.93) yielding a positive Aikin separation test. Although overall modified NMQ scores improved in both groups there were no consistent focal areas of improvement for the Swedish massage group. In contrast, the MFR group reported consistent pain reductions in the neck and upper back regions on the NMQ. These data support the need for larger randomized controlled trials of MFR versus other

  2. Comparing the Effectiveness of the Attachment-based Therapy, Dietary Therapy, and Combined Treatment Method on Weight Loss in Obese Adolescents of Yasuj High Schools

    Directory of Open Access Journals (Sweden)

    M Chorami

    2014-10-01

    Full Text Available Background & aim: At the present time, obesity as one of the most important public health problems which has widely prevailed throughout the world. The aim of this study was to compare the effectiveness of the attachment-based therapy, dietary-therapy, and the combined treatment method on weight (body mass index loss in obese high school adolescents of Yasuj city. Methods: This clinical trial study was conducted on sixty female high school students of Yasuj, Iran, diagnosed with overweight and obesity. Subjects were randomly selected and divided into four equal groups, and their body mass indexes were assessed. Three intervention groups were exposed to the attachment-based therapy, dietary-therapy, and combined treatment method. The fourth group (control did not receive any intervention. Following the treatment period, body mass indexes of the four groups were assessed. The data were analyzed by implementing Univariate analysis of covariance and LSD post hoc tests. Results: All three intervention methods of weight loss significantly increased compared with the control group (p < 0.001. However, the combination therapy was more effective. Conclusions: According to the findings of this study, it was concluded that although interventional techniques such as attachment-based therapy and dietary therapy are effective for weight loss, the combination of these two methods were more effective for weight loss.

  3. Rupture of adductor longus tendon due to ciprofloxacin.

    Science.gov (United States)

    Mouzopoulos, George; Stamatakos, Mihalis; Vasiliadis, George; Skandalakis, Panagiotis

    2005-12-01

    We present a rare case of spontaneous rupture of the adductor longus tendon induced by ciprofloxacin. A 35-year-old man was diagnosed with pneumonia and was recommended ciprofloxacin 500 mg iv twice a day for 7 days. Three days after receiving the initial dose, he developed discomfort in his left medial thigh, and pain and swelling in the same area followed ten days later. He consulted us when he noted a palpable mass on the medial side of his left thigh, and MRI study revealed adductor longus tendon rupture. There was no obvious underlying disease or other factor causing fragility of his adductor longus tendon. We review the pathophysiological mechanisms leading to fluoroquinolone-related tendon rupture as well as the risk factors and discuss proper management.

  4. Comparative evaluation of antioxidant drug influence on a radio therapy efficiency and oxidative status in mice

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    Alexander V. Siprov

    2013-09-01

    Full Text Available The aim of the study is a comparative analysis of the effect of melatonin (Melaxen and 3-hydroxypyridine (Mexidol on antitumor and antimetastatic influence of chemoradiotherapy and oxidative status at mice with Lewis lung carcinoma. Material — Experiments have been organized on 95 mice of C57Bl/6 line and of 20–22 g in weight. Cyclophosphan has been abdominally administered two times in a dosage of 60 mg/kg within the interval of 120 hours — 20-30 min before radiotherapy. It has been located on the area of initial tumor in a dosage of 2 g at the same time as cyclophosphan injection. Melaxen and Mexidol have been intramuscularly injecting in the dosage of 45 and 50 mg/ kg for 14 days. Antitumor and antimetastatic effect of the applied therapy and changes in the oxidative status of the animals have been estimated. Results — Melaxen and Mexidol do not decrease antitumour and antimetastatic effects of radiotherapy and prevent the activation of free radical processes at animals with tumors. Mexidol was more effective than Melaxen in correction of superoxide dismutase activity in liver. The drugs under the study do not decrease radiotherapy-induced lipid peroxidation in the initial tumor. Conclusion — Melaxen and Mexidol do not decrease the radio therapy efficiency and oxidative status at mice with tumor (on the background of antitumor treatment.

  5. Comparative outcomes for three-dimensional conformal versus intensity-modulated radiation therapy for esophageal cancer.

    Science.gov (United States)

    Freilich, J; Hoffe, S E; Almhanna, K; Dinwoodie, W; Yue, B; Fulp, W; Meredith, K L; Shridhar, R

    2015-01-01

    Emerging data suggests a benefit for using intensity modulated radiation therapy (IMRT) for the management of esophageal cancer. We retrospectively reviewed patients treated at our institution who received definitive or preoperative chemoradiation with either IMRT or 3D conformal radiation therapy (3DCRT) between October 2000 and January 2012. Kaplan Meier analysis and the Cox proportional hazard model were used to evaluate survival outcomes. We evaluated a total of 232 patients (138 IMRT, 94 3DCRT) who received a median dose of 50.4 Gy (range, 44-64.8) to gross disease. Median follow up for all patients, IMRT patients alone, and 3DCRT patients alone was 18.5 (range, 2.5-124.2), 16.5 (range, 3-59), and 25.9 months (range, 2.5-124.2), respectively. We observed no significant difference based on radiation technique (3DCRT vs. IMRT) with respect to median overall survival (OS) (median 29 vs. 32 months; P = 0.74) or median relapse free survival (median 20 vs. 25 months; P = 0.66). On multivariable analysis (MVA), surgical resection resulted in improved OS (HR 0.444; P 20% weight loss (OR 0.51; P = 0.050). Our data suggest that while IMRT-based chemoradiation for esophageal cancer does not impact survival there was significantly less toxicity. In the IMRT group there was significant decrease in weight loss and grade ≥3 toxicity compared to 3DCRT.

  6. Serum sickness-like illness associated with ciprofloxacin.

    Science.gov (United States)

    Slama, T G

    1990-05-01

    Serum sickness is a systemic hypersensitivity reaction initially reported in children receiving horse serum. Drugs such as penicillins, cephalosporins, and sulfonamides are now noted to be the most common etiologic agents of serum sickness-like reactions. This case report describes a serum sickness-like reaction temporally related to ciprofloxacin, a previously unreported adverse effect of this drug or any of the other quinolones.

  7. Fixed drug eruptions to ciprofloxacin - a case report

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    Rama R. Bhosale

    2012-06-01

    Full Text Available Fixed drug eruptions (FDE are common adverse drug reactions and they recur at the same site with each exposure to a particular drug. Drugs inducing FDE are usually those taken intermittently. Most common drugs causing fixed drug eruptions are antibiotics and analgesics. Here, we report a case of FDE to ciprofloxacin which was used in treatment of upper respiratory tract infection. [Int J Basic Clin Pharmacol 2012; 1(3.000: 221-222

  8. Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction

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    Jonathan M. Meyer

    2016-01-01

    Full Text Available Objective. Clozapine provides a 50%–60% response rate in refractory schizophrenia but has a narrow therapeutic index and is susceptible to pharmacokinetic interactions, particularly with strong inhibitors or inducers of cytochrome P450 (CYP 1A2. Case Report. We report the case of a 28-year-old nonsmoking female with intellectual disability who was maintained for 3 years on clozapine 100 mg orally twice daily. The patient was treated for presumptive urinary tract infection with ciprofloxacin 500 mg orally twice daily and two days later collapsed and died despite resuscitation efforts. The postmortem femoral clozapine plasma level was dramatically elevated at 2900 ng/mL, and the cause of death was listed as acute clozapine toxicity. Conclusion. Given the potentially fatal pharmacokinetic interaction between clozapine and ciprofloxacin, clinicians are advised to monitor baseline clozapine levels prior to adding strong CYP450 1A2 inhibitors, reduce the clozapine dose by at least two-thirds if adding a 1A2 inhibitor such as ciprofloxacin, check subsequent steady state clozapine levels, and adjust the clozapine dose to maintain levels close to those obtained at baseline.

  9. A COMPARATIVE STUDY BETWEEN THE EFFICACIES OF ULTRASOUND THERAPY WITH CRYOKINETICS VERSUS ULTRASOUND THERAPY WITH SOFT TISSUE MASSAGE (DEEP FRICTION MASSAGE IN ACUTE SUPRASPINATUS TENDINITIS

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    Shivakumar

    2014-04-01

    Full Text Available BACKGROUND: Supraspinatus tendinitis is the non-traumatic, inflammatory and degenerative changes of tendon. This condition is common in athletes involving repetitive overhead activities like bowling, swimming, and javelin throw etc. and even in persons involving these repetitive overhead activities at their work places. The pain and discomfort associated with this condition have a dramatic impact on physical mobility and function. This study was done to assess the effectiveness of ultrasound and cryokinetics versus ultrasound and soft tissue massage (deep friction massage in patients suffering from acute supraspinatus tendinitis. AIMS: To compare the efficacy of ultrasound therapy with cryokinetics versus ultrasound therapy with soft tissue massage (deep fiction massage in acute supraspinatus tendinitis. METHODS AND MATERIALS: It is a comparative experimental study dividing in to two groups. 60 subjects aged between 30-60 years 30 in each group. Group A: (n=30:- Treated with ultrasound therapy and cryokinetics Group B: (n=30:- Treated with ultrasound therapy and soft tissue massage (deep friction massage. Analysis was based on VAS scores and Shoulder Pain and Disability Index (SPADI.Treatment was given for 6 days a week for 2 weeks. The following outcome measures were measured at baseline, day 7 and day14 with 1 week follow up. VAS Score, and Shoulder pain and disability index (SPADI. The baseline measurements were compared to data at the end of 2nd week. RESULTS: The VAS, SPADI percentage across baseline, day 7 and day 14 follow up showed a significant improvement statistically in their mean scores within Group A and Group B (P<0.001. Statistically significant greater changes in score were found in ultrasound therapy and soft tissue massage (deep friction massage in (Group B for VAS, and SPADI as compared to ultrasound therapy and cryokinetics (Group A. CONCLUSION: The results indicate that ultrasound therapy with cryokinetics (Group A and

  10. Oral pharmacological chaperone migalastat compared with enzyme replacement therapy in Fabry disease

    DEFF Research Database (Denmark)

    Hughes, Derralynn A; Nicholls, Kathleen; Shankar, Suma P

    2017-01-01

    therapy (ERT), stabilises specific mutant (amenable) forms of α-Gal to facilitate normal lysosomal trafficking. METHODS: The main objective of the 18-month, randomised, active-controlled ATTRACT study was to assess the effects of migalastat on renal function in patients with Fabry disease previously...... ventricular mass index decreased significantly with migalastat treatment (-6.6 g/m(2) (-11.0 to -2.2)); there was no significant change with ERT. Predefined renal, cardiac or cerebrovascular events occurred in 29% and 44% of patients in the migalastat and ERT groups, respectively. Plasma...... globotriaosylsphingosine remained low and stable following the switch from ERT to migalastat. PROs were comparable between groups. Migalastat was generally safe and well tolerated. CONCLUSIONS: Migalastat offers promise as a first-in-class oral monotherapy alternative treatment to intravenous ERT for patients with Fabry...

  11. Comparative study of conventional therapy and additional yogasanas for knee rehabilitation after total knee arthroplasty

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    Nilima Bedekar

    2012-01-01

    Full Text Available Background: Amongst various modalities of post operative rehabilitation in a total knee replacement (TKR surgery, this study focuses on evaluating the effect of additional yoga therapy on functional outcome of TKR patients. Materials and Methods: A comparative study was done to compare the effects of conventional physiotherapy and additional yoga asanas, on 56 patients undergoing total knee arthroplasty due to osteoarthritis. After obtaining written informed consent, the patients were alternately assigned to two groups: Conventional and experimental. Baseline WOMAC scores for pain and stiffness were taken on third post operative day. The subjects in conventional group received physiotherapy rehabilitation program of Sancheti Institute where the study was conducted, the experimental group received additional modified yoga asanas once daily by the therapist. After discharge from the hospital, patients were provided with written instructions and photographs of the asanas, two sets of WOMAC questionnaire with stamped and addressed envelopes and were instructed to perform yoga asanas 3 days/week. Subjects filled the questionnaire after 6 weeks and 3 months from the day of surgery and mailed back. The primary outcome measure was WOMAC questionnaire which consists of 24 questions, each corresponding to a visual analog scale, designed to measure patient′s perception of pain, stiffness and function. Results: The results suggest that there was a significant change (P<0.05 for all the groups for pain, stiffness and function subscales of WOMAC scale. The pain and stiffness was found to be less in experimental group receiving additional yoga therapy than in conventional group on 3 rd post operative day, 6 weeks and 3 months after the surgery. Conclusion: A combination of physiotherapy and yoga asana protocol works better than only physiotherapy protocol. Larger and blinded study is needed.

  12. Patient-reported benefits of rizatriptan compared with usual non-triptan therapy for migraine in a primary care setting.

    Science.gov (United States)

    Baos, V; Serrano, A; Torrecilla, M; Bertral, C; Caloto, M T; Nocea, G; Gerth, W C

    2003-11-01

    The purpose of this open-label study was to compare rizatriptan with usual non-triptan therapy for migraine in patients who had never received a triptan. Patient-reported outcomes were examined for a prestudy migraine attack and after three consecutive study attacks, the first and third treated with rizatriptan 10 mg wafer and the second with usual non-triptan therapy. A total of 97 patients (83% women; mean age 39 years) completed the study. Two-thirds of patients reported severe or total disability during migraine attacks. All comparisons between rizatriptan therapy and usual non-triptan therapy significantly favoured rizatriptan (p rizatriptan and by 46-48% of patients after usual therapy; 41-47% and 12-18%, respectively, were pain free at 2 hours. Patient satisfaction and migraine-specific quality-of-life scores were also significantly better for attacks treated with rizatriptan. At study end, 62% and 17% of patients were very or completely satisfied with rizatriptan and usual non-triptan therapy, respectively. Among those patients who worked for pay, therapy with rizatriptan significantly reduced absenteeism and improved the amount and quality of time at work compared with usual non-triptan therapy. Allowing patients to have experience with rizatriptan may improve the level of medical care for migraine attacks.

  13. Laser Therapy After Repair of the Distal Half of the Median Nerve; a Comparative Study

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    Seyed Forootan

    2015-05-01

    Full Text Available Background Nerve injuries resulting from major or minor trauma often cause some disabilities for patients. Neurotmesis, characterized by complete anatomical rupture of the nerve, is the most severe form of the injury which will not recover without reconstructive surgery and nowadays such neural damages are improved by microsurgical procedures. Some studies have used low power laser for nerve cell growth in order to improve the rehabilitation results of peripheral nerves. Low power laser can complement the reformation of postsurgical nerve injuries. Objectives The current study aimed to assess the effects of laser therapy after repair of median nerve rupture in the distal third of the forearm and to compare the results with that of the standard method. Patients and Methods The current study was a case-control clinical trial of 36 patients with volar surface rupture of the distal third of forearm admitted to the emergency ward of Hazrat-e-Fatemeh Hospital within 72 hours of injury, they had anesthesia in the first, second, and third fingers as a result of Median Nerve Injury. Patients were divided into two groups. The first group included subjects treated with standard methods and the second group included those treated with low power laser therapy (LT along with the standard method. The same surgeon operated the subjects in the two groups. The second group underwent 10 sessions of LT every other day. Clinical Examination, Electromyography and Nerve Conduction Velocity (NCV were done after six months and the results were compared. Results In the two -point discrimination- test, there was no significant difference between the two groups in the thumbs but a significant improvement was observed in the index finger of the LT group. Improvement of muscular examinations such as opposition and thumb abduction supported the usage of laser in the second group. Regarding electromyography and NCV, significant statistical difference was observed in the motor

  14. Prevalence of Multidrug Efflux Pump Requiring Ciprofloxacin, Ofloxacin and Pefloxacin as Substrates, Among Clinical Isolates of Pseudomonas aeruginosa

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    Omoregie, R.

    2007-01-01

    Full Text Available Forty two consecutive clinical isolates of Pseudomonas aeruginosa were screened for the presence of reserpine inhibited multidrug (MDR efflux pump, utilizing ciprofloxacin ofloxacin and/or pefloxacin as substrates, by determining the minimum inhibitory concentration in the presence and absence of 100 mg/L reserpine. The result showed that 50% of the Pseudomonas aeruginosa isolates possessed reserpine inhibited MDR efflux pump. MDR efflux pump requiring ofloxacin (40.48% were significantly (p<0.01 more among the isolates when compared with those requiring ciprofloxacin (16.67% or pefloxacin (11.90%. Only one isolate possessed reserpine inhibited MDR efflux pumps that utilize all three fluiroquinolones. Research into suitable combination of antibacterials and appropriate pump mactivators or antibacterials that are less likely to be substrate for MDR pumps is advocated.

  15. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius

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    Parisa Taheri

    2016-01-01

    Results: One man and 19 women, age group of 45.3 ± 7.7 years, were assigned into laser therapy group. Two men and 24 women, average age group of 42.3 ± 10.4 were assigned into shock wave therapy group. A significant difference was found among our study groups before treatment and after starting treatment for VAS, NDI, and SPDI indices, that is, two methods of treatments were effective (P < 0.001. However, among these two treatment methods, laser therapy provided higher effect on VAS and NDI as compared to the radial shock wave method (P < 0.05 in 2 weeks from starting the treatment (consequent to treatment. Conclusion: According to this study results, we can conclude that shock wave and laser therapy results on similar effect in long-term for relieve of pain and eliminating symptoms in patients with myofascial but laser provides a faster optimal results.

  16. Intensity modulated radiotherapy versus volumetric modulated arc therapy in breast cancer: A comparative dosimetric analysis

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    KR Muralidhar

    2015-01-01

    Full Text Available Purpose: Intensity modulated radiotherapy (IMRT and volumetric modulated arc therapy (VMAT has the capacity to optimize the dose distribution. We analyzed the dosimetric differences of plans in treatment planning system (TPS between VMAT and IMRT in treating breast cancer. Methods: Fourteen patients were simulated, planned, and treated with VMAT using single, double or partial arcs. IMRT treatments were generated using 4 to 5 tangential IMRT fields for the same patients. All treatment plans were planned for 50 Gy in 25 fractions. The VMAT and IMRT plans were compared using the planning target volume (PTV dose and doses to the other organs at risk (OARs. Results: For the PTV, comparable minimum, mean, maximum, median, and modal dose as well equivalent sphere diameter of the structure (Equis were observed between VMAT and IMRT plans and found that these values were significantly equal in both techniques. The right lung mean and modal doses were considerably higher in VMAT plans while maximum value was considerably lower when compared with IMRT plans. The left lung mean and modal doses were higher with VMAT while maximum doses were higher in IMRT plans. The mean dose to the heart and maximum dose to the spinal cord was lower with IMRT. The mean dose to the body was higher in VMAT plans while the maximum dose was higher in IMRT plans. Conclusion: Four field tangential IMRT delivered comparable PTV dose with generally less dose to normal tissues in our breast cancer treatment study. The IMRT plans typically had more favourable dose characteristics to the lung, heart, and spinal cord and body dose when compared with VMAT. The only minor advantage of VMAT for breast cases was slightly better PTV coverage.

  17. Combined anti-tumor necrosis factor-alpha therapy and DMARD therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD therapy alone

    NARCIS (Netherlands)

    Edwards, C.K., 3rd; Green, J.S.; Volk, H.D.; Schiff, M.; Kotzin, B.L.; Mitsuya, H.; Kawaguchi, T.; Sakata, K.M.; Cheronis, J.; Trollinger, D.; Bankaitis-Davis, D.; Dinarello, C.A.; Norris, D.A.; Bevilacqua, M.P.; Fujita, M.; Burmester, G.R.

    2012-01-01

    Periodic assessment of gene expression for diagnosis and monitoring in rheumatoid arthritis (RA) may provide a readily available and useful method to detect subclinical disease progression and follow responses to therapy with disease modifying anti-rheumatic agents (DMARDs) or anti-TNF-alpha therapy

  18. Ciprofloxacin containing Mannich base and its copper complex induce antitumor activity via different mechanism of action.

    Science.gov (United States)

    Fu, Yun; Yang, Yingli; Zhou, Sufeng; Liu, Youxun; Yuan, Yanbin; Li, Shaoshan; Li, Changzheng

    2014-11-01

    The Mannich base containing ciprofloxacin and kojic acid structural units was prepared and evaluated in antitumor activity. The enhancement in antitumor activity was observed both from the Mannich base (IC(50): 103.3±5.0 µM for HepG2, 87.9±8.0 µM for HCT-116 cell) and its copper complex (IC(50): 11.5±1.8 µM for HepG2, 44.4±2.5 µM for HCT-116 cell) compared to the ciprofloxacin and kojic acid. The mechanistic studies via RT-PCR, cell cycle analysis, mitochondrial membrane potential measurement, inhibition of topoisomerase and molecular docking indicated that there is a different molecular mechanism between the Mannich base and its copper complex. The cytotoxicity of the Mannich base was involved in apoptosis, cell cycle arrest, depolarization of mitochondrial membrane and weaker topoisomerase II inhibition, but the copper complex exerted its cytotoxicity mainly through dual topoisomerase inhibition, especially stabilizing the intermediate of cleavage DNA-topoisomerase complex.

  19. Robust Synthesis of Ciprofloxacin-Capped Metallic Nanoparticles and Their Urease Inhibitory Assay

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    Muhammad Nisar

    2016-03-01

    Full Text Available The fluoroquinolone antibacterial drug ciprofloxacin (cip has been used to cap metallic (silver and gold nanoparticles by a robust one pot synthetic method under optimized conditions, using NaBH4 as a mild reducing agent. Metallic nanoparticles (MNPs showed constancy against variations in pH, table salt (NaCl solution, and heat. Capping with metal ions (Ag/Au-cip has significant implications for the solubility, pharmacokinetics and bioavailability of fluoroquinolone molecules. The metallic nanoparticles were characterized by several techniques such as ultraviolet visible spectroscopy (UV, atomic force microscopy (AFM, Fourier transform infrared spectroscopy (FTIR, scanning electron microscopy (SEM and energy dispersive X-ray (EDX methods. The nanoparticles synthesized using silver and gold were subjected to energy dispersive X-ray tests in order to show their metallic composition. The NH moiety of the piperazine group capped the Ag/Au surfaces, as revealed by spectroscopic studies. The synthesized nanoparticles were also assessed for urease inhibition potential. Fascinatingly, both Ag-cip and Au-cip NPs exhibited significant urease enzyme inhibitory potential, with IC50 = 1.181 ± 0.02 µg/mL and 52.55 ± 2.3 µg/mL, compared to ciprofloxacin (IC50 = 82.95 ± 1.62 µg/mL. MNPs also exhibited significant antibacterial activity against selected bacterial strains.

  20. Robust Synthesis of Ciprofloxacin-Capped Metallic Nanoparticles and Their Urease Inhibitory Assay.

    Science.gov (United States)

    Nisar, Muhammad; Khan, Shujaat Ali; Qayum, Mughal; Khan, Ajmal; Farooq, Umar; Jaafar, Hawa Z E; Zia-Ul-Haq, Muhammad; Ali, Rashid

    2016-03-25

    The fluoroquinolone antibacterial drug ciprofloxacin (cip) has been used to cap metallic (silver and gold) nanoparticles by a robust one pot synthetic method under optimized conditions, using NaBH₄ as a mild reducing agent. Metallic nanoparticles (MNPs) showed constancy against variations in pH, table salt (NaCl) solution, and heat. Capping with metal ions (Ag/Au-cip) has significant implications for the solubility, pharmacokinetics and bioavailability of fluoroquinolone molecules. The metallic nanoparticles were characterized by several techniques such as ultraviolet visible spectroscopy (UV), atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) methods. The nanoparticles synthesized using silver and gold were subjected to energy dispersive X-ray tests in order to show their metallic composition. The NH moiety of the piperazine group capped the Ag/Au surfaces, as revealed by spectroscopic studies. The synthesized nanoparticles were also assessed for urease inhibition potential. Fascinatingly, both Ag-cip and Au-cip NPs exhibited significant urease enzyme inhibitory potential, with IC50 = 1.181 ± 0.02 µg/mL and 52.55 ± 2.3 µg/mL, compared to ciprofloxacin (IC50 = 82.95 ± 1.62 µg/mL). MNPs also exhibited significant antibacterial activity against selected bacterial strains.

  1. An indirect atomic absorption spectrometric determination of ciprofloxacin, amoxycillin and diclofenac sodium in pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    MAHMOUD MOHAMED ISSA

    2008-05-01

    Full Text Available A highly sensitive indirect atomic absorption spectrophotometric (AAS method has been developed for the determination of very low concentrations of ciprofloxacin, amoxycillin and diclofenac sodium. The method is based on the oxidation of these drugs with iron(III. The excess of iron(III was extracted into diethyl ether and then the iron(II in the aqueous layer was aspirated into an air–acetylene flame and determined by AAS. The linear concentration ranges were 25–400, 50–500 and 60–600 ng ml-1 for ciprofloxacin, amoxycillin and diclofenac sodium, respectively. The results were statistically compared with the official method using t- and f-test at p < 0.05. There were insignificant interferences from most of the excipients present. The intra- and inter-day assay coefficients of variation were less than 6.1 % and the recoveries ranged from 95 to 103 %. The method was applied for the analysis of these drug substances in their commercial pharmaceutical formulations.

  2. Rapid change in the ciprofloxacin resistance pattern among Neisseria gonorrhoeae strains in Nuuk, Greenland: time to reconsider preventive and treatment strategies

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    Anne Skjerbæk Rolskov

    2015-05-01

    Full Text Available Objectives: Sexually transmitted infections (STIs, including infections with Neisseria gonorrhoeae (GC, are highly incident in Greenland. Since January 2011, GC testing has been performed on urine with nucleic acid amplification tests (NAATs by strand displacement amplification (Becton Dickinson ProbeTec. Monitoring of GC antibiotic susceptibility by culture was introduced in Nuuk in 2012. Until 2014, no cases of ciprofloxacin-resistant GC strains were reported. In this paper, we report the finding of ciprofloxacin-resistant GC and describe the most recent incidence of GC infections in Greenland. Methods: The number of urine NAATs and culture-positive swabs from January to October 2014 were obtained from the Central Laboratory at Queens Ingrid's Hospital in Nuuk and stratified on gender, place and period of testing. Incidence rates were estimated as number of urine NAAT * (12/10 per 100,000 inhabitants. Men in Nuuk with a positive NAAT for GC were encouraged to provide a urethral swab for culture and susceptibility testing. Results: From January to October 2014, a total of 5,436 urine GC NAATs were performed on patients from Nuuk and 9,031 from the rest of Greenland. Of these, 422 (8% and 820 (9% were positive, respectively. From January to August, 6 (15% cultures from Nuuk were ciprofloxacin resistant while in September and October, 26 (59% were ciprofloxacin resistant (p<0.01. In total, 35 (40% of 88 culture-positive isolates showed ciprofloxacin resistance. GC incidence in Nuuk was 3,017 per 100,000 inhabitants per year, compared to 2,491 per 100,000 inhabitants per year in the rest of Greenland. Conclusion: Within a short period, a rapid and dramatic change in ciprofloxacin susceptibility among GC strains isolated in Nuuk was documented and recommendation for first line treatments has changed. Continued monitoring and rethinking of primary and secondary preventive initiatives is highly recommended in this high GC incidence setting.

  3. Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Edeline, Julien [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Inserm UMR991, Rennes (France); Crouzet, Laurence; Pracht, Marc; Boucher, Eveline [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Campillo-Gimenez, Boris [Centre Eugene Marquis, Clinical Research Department, Rennes (France); Rolland, Yan; Rohou, Tanguy [Centre Eugene Marquis, Imaging Department, Rennes (France); Guillygomarc' h, Anne [CHU Pontchaillou, Hepatology Department, Rennes (France); Boudjema, Karim [CHU Pontchaillou, Hepatobiliary Surgery, Rennes (France); Lenoir, Laurence [Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France); Adhoute, Xavier [Hopital Saint-Joseph, Hepato-Gastroenterology Department, Marseille (France); Clement, Bruno [Inserm UMR991, Rennes (France); Blanc, Jean-Frederic [Hopital Saint-Andre, Hepato-Gastroenterology Department, Bordeaux (France); Garin, Etienne [Inserm UMR991, Rennes (France); Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France)

    2016-04-15

    Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or {sup 90}Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population. We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model. A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39-0.97] (p = 0.037) and 0.40 (95 % CI 0.19-0.82) (p = 0.013), respectively. SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials. (orig.)

  4. COMPARATIVE ANALYSIS OF THE RESULTS OF CONTINUOUS AND INTERMITTENT HORMONE THERAPY FOR DISSEMINATED PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    E. R. Babaev

    2014-07-01

    Full Text Available Objective: to compare the results of continuous and intermittent hormone therapy (HT in unselected patients with disseminated prostate cancer (PC.Subjects and methods. The study enrolled 113 patients with verified stage cT2b–4N0–1M0–1 PC. The median age of the patients was 70 ± 7.3 years. The median pretreatment concentration of prostate-specific antigen (PSA was 309.8 ng/ml. The cT2 category was diagnosed in 12 (10.6 % patients, сТ3 in 85 (75.2 %, сТ4 in 16 (14.2 %, сN+ in 32 (28.3 %, and М+ in 74 (65.5 %. At baseline, the median Gleason grade was (3.0 ± 0.8 + (4.0 ± 0.9 = 7.0 ± 1.7. All the patients received immediate HT: castration therapy was performed in 2 (1.8 % patients, maximal androgen blockade in 96 (85 %, and antiandrogen monotherapy in 15 (13.3 %. Continuous and intermittent treatment regimens were used in 100 (70.8 % and 33 (29.2 % cases, respectively. The median follow-up was 31.9 ± 17.7 months.Results. The intermittent HT regimen was associated with a significant increase in overall survival versus that during continuous treatment (medians 57.8 ± 11.6 and 25.2 ± 2.8 months, respectively; p = 0.031. Overall survival benefit remained in the poor prognosis (bone pain and/or a PSA of  100 ng/ml and/or сТ4 and/or М+ group. The HT regimen failed to affect survival in the good prognosis (no bone pain, a PSA of < 100 ng/ml, сТ < T4, М0 group. Impotence was less common during intermittent treatment than during continuous ablation (68.2 and 96.2 %, respectively; p = 0.002. No relationship was found between the incidence of other complications and the HT regimen. There was no significant difference between the groups in quality-of-life indicators before and during treatment. The average cost of an intermittent course of therapy per year was significantly lower than that of a continuous course (50586.7 and 72996.0 rubles, respectively; p < 0.0001.Conclusions. Intermittent HT fails to result in a clinically relevant

  5. Increasing Ciprofloxacin Resistance Among Prevalent Urinary Tract Bacterial Isolates in Gaza Strip, Palestine

    Directory of Open Access Journals (Sweden)

    Zakaria El Astal

    2005-01-01

    Full Text Available This article presents the incidence of ciprofloxacin resistance among 480 clinical isolates obtained from patients with urinary tract infection (UTI during January to June 2004 in Gaza Strip, Palestine. The resistance rates observed were 15.0% to ciprofloxacin, 82.5% to amoxycillin, 64.4% to cotrimoxazole, 63.1% to doxycycline, 32.5% to cephalexin, 31.9% to nalidixic acid, and 10.0% to amikacin. High resistance to ciprofloxacin was detected among Acinetobacter haemolyticus (28.6%, Staphylococcus saprophyticus (25.0%,Pseudomonas aeruginosa (20.0%, Klebsiella pneumonia (17.6%, and Escherichia coli (12.0%. Minimal inhibitory concentration (MIC of ciprofloxacin evenly ranged from 4 to 32 μg/mL with a mean of 25.0 μg/mL. This study indicates emerging ciprofloxacin resistance among urinary tract infection isolates. Increasing resistance against ciprofloxacin demands coordinated monitoring of its activity and rational use of the antibiotics.

  6. COMPARATIVE EFFICACY AND SAFETY OF HYPOLIPIDEMIC THERAPY WITH GENERIC AND ORIGINAL MEDICINAL PRODUCTS OF SIMVASTATIN

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    E. I. Tarlovskaya

    2011-01-01

    Full Text Available Aim. To compare efficacy , safety and pharmacoeconomical characteristics of generic and original medicinal products of simvastatin in achievement of cholesterol and low density lipoprotein target levels. Material and methods. 38 patients with arterial hypertension accompanied by type 2 diabetes with dyslipidemia were included into the study. They had no clinically obvious ischemic heart disease and did not receive hypolipidemic pharmacotherapy for a month before the study start. The patients were randomized into group A or group B. Patients of group A (n=18 received original simvastatin, patients of group B (n=20 received generic simvastatin. Initial simvastatin dose was 20 mg daily. Lipid plasma profile, liver enzymes, creatine phosphokinase were evaluated every 4 weeks. Cost-effectiveness ratio was calculated. Results. 11 patients (61% in group A and only 5 patients (25% in group B (χ2=5.05; р<0.05 achieved cholesterol target level with simvastatin in dose of 20 mg daily in 3 months of the treatment. Creatine phosphokinase blood level did not increase significantly. Achievement of cholesterol target level cost 814 and 952 RUB per patient in groups A and B, respectively , in 1 month of simvastatin treatment. These costs were 643 and 417 RUB per patient in groups A and B, respectively , in 3 months of treatment. Conclusion. The original simvastatin in comparison with generic one has advantages in hypolipidemic effect. Safety profile is similar for both medications. Original simvastatin therapy has lower cost than this for generic simvastatin therapy in achievement of cholesterol target level in 1 month of treatment. In 3 months the cost of treatment per patient is 227 RUB higher for original medication in comparison with this for generic medication.

  7. Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review

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    Mitchell Matthew D

    2012-05-01

    Full Text Available Abstract Background Insomnia is common in primary care, can persist after co-morbid conditions are treated, and may require long-term medication treatment. A potential alternative to medications is cognitive behavioral therapy for insomnia (CBT-I. Methods In accordance with PRISMA guidelines, we systematically reviewed MEDLINE, EMBASE, the Cochrane Central Register, and PsycINFO for randomized controlled trials (RCTs comparing CBT-I to any prescription or non-prescription medication in patients with primary or comorbid insomnia. Trials had to report quantitative sleep outcomes (e.g. sleep latency in order to be included in the analysis. Extracted results included quantitative sleep outcomes, as well as psychological outcomes and adverse effects when available. Evidence base quality was assessed using GRADE. Results Five studies met criteria for analysis. Low to moderate grade evidence suggests CBT-I has superior effectiveness to benzodiazepine and non-benzodiazepine drugs in the long term, while very low grade evidence suggests benzodiazepines are more effective in the short term. Very low grade evidence supports use of CBT-I to improve psychological outcomes. Conclusions CBT-I is effective for treating insomnia when compared with medications, and its effects may be more durable than medications. Primary care providers should consider CBT-I as a first-line treatment option for insomnia.

  8. Iron Oxide Nanospheres and Nanocubes for Magnetic Hyperthermia Therapy: A Comparative Study

    Science.gov (United States)

    Nemati, Z.; Das, R.; Alonso, J.; Clements, E.; Phan, M. H.; Srikanth, H.

    2017-02-01

    Improving the heating capacity of magnetic nanoparticles (MNPs) for hyperthermia therapy is an important but challenging task. Through a comparative study of the inductive heating properties of spherical and cubic Fe3O4 MNPs with two distinct average volumes (˜7000 nm3 and 80,000 nm3), we demonstrate that, for small size (˜7000 nm3), the cubic MNPs heat better compared with the spherical MNPs. However, the opposite trend is observed for larger size (˜80,000 nm3). The improvement in heating efficiency in cubic small-sized MNPs (˜7000 nm3) can be attributed to enhanced anisotropy and the formation of chain-like aggregates, whereas the decrease of the heating efficiency in cubic large-sized MNPs (˜80,000 nm3) has been attributed to stronger aggregation of particles. Physical motion is shown to contribute more to the heating efficiency in case of spherical than cubic MNPs, when dispersed in water. These findings are of crucial importance in understanding the role of shape anisotropy and optimizing the heating response of magnetic nano-structures for advanced hyperthermia.

  9. Hydro-galvanic and rising - temperature bath therapy for chronic elbow epicondylitis: a comparative study

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    C. Mucha

    2004-02-01

    Full Text Available The efficacy of two different regimens of physiotherapy for epicondylitis was compared. A combination treatment with hydrogalvanic four-cell bath and arm bath with rising temperature, which had showed good effects in treatment of tennis elbow in an earlier observational study (Mucha 1987, was compared with the analgesic interference current treatment often recommended in the literature (Sadil and Sadil 1994, Noteboom et al 1994, Becker and Reuter 1982. For this study, 60 patients with epicondylitis that was resistant to conservative treatment were randomized into two groups for comparison. In group 1, interference currents were administered twice a day for six weeks and group 2 received combination treatment with the hydrogalvanic four-cell bath and rising- temperature arm bath once a day for six weeks. Criteria for inclusion, control and appraisal were laid down prospectively. Several parameters were used, recorded and statistically evaluated as outcome measures.  These were active joint range of movement of the elbow, grip strength, pain provocation with muscle contraction, palpation pain and pain with functional activities.  The results showed a significant superiority of combination treatment over therapy with interference current. It is therefore recommended that hydrogalvanic four-cell bath and arm bath with rising temperature should be carried out before considering surgical treatment for chronic epicondylitis.

  10. Faster T-cell development following gene therapy compared with haploidentical HSCT in the treatment of SCID-X1.

    Science.gov (United States)

    Touzot, Fabien; Moshous, Despina; Creidy, Rita; Neven, Bénédicte; Frange, Pierre; Cros, Guilhem; Caccavelli, Laure; Blondeau, Johanna; Magnani, Alessandra; Luby, Jean-Marc; Ternaux, Brigitte; Picard, Capucine; Blanche, Stéphane; Fischer, Alain; Hacein-Bey-Abina, Salima; Cavazzana, Marina

    2015-06-04

    During the last decade, gene therapy via ex vivo gene transfer into autologous hematopoietic stem cells has emerged as a convincing therapy for severe combined immunodeficiency caused by ILR2G mutation (SCID-X1) despite the occurrence of genotoxicity caused by the integration of first-generation retroviral vectors. However, the place of gene therapy among the therapeutic armamentarium remains to be defined. We retrospectively analyze and compare clinical outcomes and immune reconstitution in 13 consecutive SCID-X1 patients having undergone haploidentical hematopoietic stem cell transplantation (HSCT) and 14 SCID-X1 patients treated with gene therapy over the same period at a single center level: the Necker Children's Hospital (Paris, France). Our results show a clear advantage in terms of T-cell development of gene therapy over HSCT with a mismatched donor. Patients treated with gene therapy display a faster T-cell reconstitution and a better long-term thymic output. Interestingly, this advantage of gene therapy vs haploidentical HSCT seems to be independent of the existence of clinical graft-versus-host disease in the latter condition. If data of safety are confirmed over the long term, gene therapy for SCID-X1 appears to be an equal, if not superior, alternative to haploidentical HSCT.

  11. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius

    Science.gov (United States)

    Taheri, Parisa; Vahdatpour, Babak; Andalib, Somayeh

    2016-01-01

    Background: The aim of this study is to compare the effects of laser therapy and shock wave therapy for symptoms treatment among patients with MPS in the upper trapezius muscle. Materials and Methods: In a clinical trial study, 46 patients were selected based on the clinical criteria and physiathrist diagnosis. Subjects were randomized into two groups as follows: Twenty individuals were assigned to exercise-medication-laser therapy group, and 26 to exercise-medication-shock wave therapy group. The pain was assessed based on visual analog scale (VAS), neck disability index (NDI), and SPADI in three stages: Before treatment, subsequently after treatment, and a month after treatment. Results: One man and 19 women, age group of 45.3 ± 7.7 years, were assigned into laser therapy group. Two men and 24 women, average age group of 42.3 ± 10.4 were assigned into shock wave therapy group. A significant difference was found among our study groups before treatment and after starting treatment for VAS, NDI, and SPDI indices, that is, two methods of treatments were effective (P myofascial but laser provides a faster optimal results. PMID:27656607

  12. TO COMPARE THE EFFICACY OF ULTRASOUND THERAPY WITH EXERCISES VERSUS LASER THERAPY WITH EXERCISES IN THE TREATMENT OF SUBACROMIAL IMPINGEMENT SYNDROME

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    Somashekhar

    2014-09-01

    Full Text Available OBJECTIVES: To compare and measure the effectiveness of Ultrasound therapy with exercises versus Laser therapy with exercises on affected shoulder in reducing pain which can be measured by Visual Analogue Scale in case of SAIS. To compare and measure the effectiveness of Ultrasound therapy with exercises versus Laser therapy with exercises in evaluating the active range of motion using Universal Goniometer. BACKGROUND: Sub acromial impingement syndrome (SAIS is a painful condition resulting from the entrapment of anatomical structures between the antero inferior corner of the acromion and the greater tuberosity of the humerus. Van der Windt et al.,(1995 and Vecchio et al.,(1995 have postulated that Sub acromial impingement syndrome (SAIS of the shoulder is the most common disorder of the shoulder, accounting for 44-65% of all complaints of shoulder pain. Shoulder Impingement syndrome is usually treated conservatively, but sometimes it is treated with arthroscopic surgery or open surgery. Conservative treatment includes rest, cessation of painful activity, ultrasound therapy, laser therapy and physiotherapy focused at maintaining range of movement and avoids shoulder stiffness. NSAID‟s and ice packs may be used for pain relief. Therapeutic injections of corticosteroid and local anaesthetic may be used for persistent impingement syndrome. In this study the researcher would like to compare and see the effectiveness of ultrasound with exercises and laser therapy with exercises on SAIS. METHODS: For this study 60 patients with acute SAIS of both the sex were taken. Patients were randomly divided into group A and group B. Group A were treated with US therapy for 5 minutes along with shoulder exercises and Group B were treated with LLLT of Ga-As for 5-6 minutes along with shoulder exercises to maintain ROM within available pain free range. Both the groups were treated 5 times per week for 2 weeks. Patients were evaluated with VAS and ROM on every 3rd

  13. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy

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    Nagarik Amit

    2010-01-01

    Full Text Available Systemic heparinization during continuous renal replacement therapy (CRRT is associated with disadvantage of risk of bleeding. This study analyses the efficacy of frequent saline flushes compared with heparin anticoagulation to maintain filter life. From January 2004 to November 2007, 65 critically ill patients with acute renal failure underwent CRRT. Continuous venovenous hemodialfiltration (CVVHDF was performed using Diapact Braun CRRT machine. 1.7% P.D. fluid was used as dialysate. 0.9% NS with addition of 10% Ca Gluconate, Magnesium Sulphate, Soda bicarbonate and Potassium Chloride added sequentially in separate units were used for replacement, carefully monitoring their levels. Anticoagulation of extracorporeal circuit was achieved with unfractionated heparin (250-500 units alternate hour in 35 patients targeting aPTT of 45-55 seconds. No anticoagulation was used in 30 patients with baseline APTT > 55 seconds and extracorporeal circuit was maintained with saline flushes at 30 min interval. 65 pa-tients including 42 males. Co-morbidities were comparable in both groups. HMARF was signifi-cantly more common in heparin group while Sepsis was comparable in both the groups. CRRT parameters were similar in both groups. Average filter life in heparin group was 26 ± 6.4 hours while it was 24.5 ± 6.36 hours in heparin free group ( P=NS. Patients receiving heparin had 16 bleeding episodes (0.45/patient while only four bleeding episodes occurred in heparin free group (0.13/patient, P< 0.05. Mortality was 71% in heparin group and 67% in heparin free group. Frequent saline flushes is an effective mode of maintainance of extracorporeal circuit in CRRT when aPTT is already on the higher side, with significantly decreased bleeding episodes.

  14. Trends in antimicrobial susceptibility among isolates of Campylobacter species in Ireland and the emergence of resistance to ciprofloxacin.

    LENUS (Irish Health Repository)

    Lucey, B

    2012-02-03

    Measurements were made of the susceptibility to six commonly prescribed antibiotics, including erythromycin, tetracycline and ciprofloxacin, of 130 isolates of Campylobacterjejuni and 15 isolates of Campylobacter coli cultured from human and poultry sources during 2000. The results were compared with the results from a collection of strains isolated between 1996 and 1998. The levels of resistance to erythromycin remained low, 2 per cent and 4.4 per cent for the human and poultry isolates, respectively. Resistance to tetracycline had increased to 31 per cent and 24.4 per cent from 13.9 per cent and 18.8 per cent for the human and poultry isolates, respectively. However, the resistance to ciprofloxacin of the strains isolated during 2000 had increased to 30 per cent, whereas between 1996 and 1998 there had been no resistance to this agent among human isolates, and only 3.1 per cent resistance among poultry isolates. The molecular basis for this resistance has been shown to be the result of a single amino acid substitution, Thr-86-Ile, in the gyrA subunit of DNA gyrase in Cjejuni. A subset of 59 isolates was tested by molecular methods and all of the 25 phenotypically resistant isolates possessed this substitution. None of the human isolates had been treated with ciprofloxacin before their laboratory isolation.

  15. Aqueous and vitreous penetration of ciprofloxacin following different modes of systemic administration.

    Science.gov (United States)

    Madu, A A; Mayers, M; Perkins, R; Liu, W; Drusano, G L; Aswani, R; Madu, C N; Miller, M H

    1996-08-01

    The overall importance of the peak or the mean serum concentrations as predictors of ocular drug penetration is unknown. To address this fundamental question with an agent which shows promise as adjunctive therapy in the treatment of endophthalmitis, we studied the penetration of ciprofloxacin into the aqueous and vitreous humors following three different modes of systemic administration. New Zealand white rabbits received either a single bolus dose (40 mg kg-1), three intermittent doses of 13.33 mg kg-1 evenly spaced over an 8 hr period, or a continuous infusion of 40 mg kg-1 over an 8 hr period. Pharmacokinetic analysis was performed using RSTRIP II, a non-linear, least square regression model analysis program. The serum area under the concentration-time curve (AUC) values for each mode of drug administration were similar: 32.9 micrograms hr ml-1 for single dose, 31.9 micrograms hr ml-1 for intermittent dose, and 33.8 micrograms hr ml-1 for continuous infusion modes. The percentage penetration into the aqueous and vitreous were also similar; 30.5% and 6.5% for a single dose, 31.6% and 7.4% for intermittent doses and 30.0% and 7.5% for continuous infusion. The penetration into the aqueous and vitreous humors was not influenced by mode of administration. As with other quinolones we have studied, elimination rates were similar for the central and peripheral compartments in the post-distributive phase. Vitreous humor ciprofloxacin concentrations achieved were below that which inhibits most Staphylococcus epidermidis, the most common isolate in patients with post-operative endophthalmitis.

  16. Modelling the fate of ciprofloxacin in activated sludge systems - The relevance of the sorption process

    DEFF Research Database (Denmark)

    Polesel, Fabio; Lehnberg, Kai; Dott, Wolfgang

    experiments were performed to estimate sorption model parameters using Freundlich isotherms under specific pH and iron salt dosing (used for chemical phosphorus removal) conditions. We used the previously tested activated sludge framework model for xenobiotic trace chemicals (ASM-X) to assess the fate...... was statistically evaluated in the two cases by comparing the model output with measured data. Batch experiments showed that maximum sorption capacity occurred at pH=7.4, corresponding to the isoelectric point of ciprofloxacin. A pH increase resulted in a significant reduction of sorption capacity as compared...... to the effect of the pH decrease applied in the experiment. Additionally, iron salt dosing was found to enhance sorption under both aerobic and anoxic conditions. Using the extended ASM-X model, results obtained in scenario simulations – based on the batch experimental Freundlich parameters – suggest that pH...

  17. Revised ciprofloxacin breakpoints for Salmonella Typhi: its implications in India.

    Science.gov (United States)

    Balaji, V; Sharma, A; Ranjan, P; Kapil, A

    2014-01-01

    The rise of multidrug resistant strains of Salmonella Typhi in the last decade of the previous century led to the use of fluoroquinolones as the drug of choice. However, over the past few years fluoroquinolone resistance has been increasingly reported. In accordance with the revised Clinical and Laboratory Standards Institute (CLSI) breakpoints, only 3% of the isolates were susceptible to ciprofloxacin in comparison to 95% as per the earlier guidelines when 488 isolates collected between 2010 and 2012 were re-interpreted. Interestingly, re-emergence of strains susceptible to chloramphenicol, ampicillin and cotrimoxazole is being seen. Amidst the changing susceptibility profile, azithromycin remains a promising alternative.

  18. Comparative Psychotherapy: Rational-Emotive Therapy Versus Systematic Desensitization in the Treatment of Stuttering

    Science.gov (United States)

    Moleski, Richard; Tosi, Donald J.

    1976-01-01

    The present study examined the efficacy of rational-emotive psychotherapy and systematic desensitization in the treatment of stuttering. Both therapies, making extensive use of in vivo behavioral assignments, were examined under the presence and absence of in vivo tasks. Results show that rational-emotive therapy was more effective in reducing…

  19. Investigation of comparative efficacy of eugenol and benzyl benzoate in therapy of sheep mange

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    Jezdimirović Milanka

    2010-01-01

    Full Text Available The acaricide efficacy, tolerance and safety of eugenol (10 and 20 % in the treatment of sarcoptic mange in sheep have been investigated. The results were compared with those corresponding for benzyl benzoate (25 %, which was applied to sheep in the same way. The treatment was applied on sheep three times in one-week intervals. Skin scrapings were sampled seven days after each treatment, as well as twenty-eight days following the third one. The changes on the skin were quantified and the mean recovery response (MRR was calculated. The clinical efficacy was assessed according to the MRR and the number of mites in the samples. Following the first treatment 10%eugenol was not significantly less efficacious in comparison with the higher concentration. Having been applied twice 20% eugenol was significantly more efficacious when compared to the lower concentration, which remained the same seven and twenty-eight days after the third application. The efficacy of 10% eugenol in the therapy of mange was significantly higher in comparison with benzyl benzoate following one, two or three administrations. The efficacy of benzyl benzoate four weeks after the third treatment was still significantly lower in comparison with 10% eugenol. The efficacy of 20% eugenol was significantly higher in comparison with its lower concentration as well as that of benzyl benzoate, following the second, and seven and twenty-eight days after the third one. No signs of local or systemic intolerance were observed in sheep treated with either 10 or 20% eugenol, or 25 % benzyl benzoate. .

  20. Comparative Effectiveness of Replacement Therapy with L-thyroxine in Women with Postoperative and Autoimmune Hypothyroidism

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    M Sch Madiyarova

    2014-03-01

    Full Text Available Objective. To compare the lipid profile, psychoemotional features, cognitive function, quality of life in women receiving adequate replacement therapy with levothyroxine for postoperative hypothyroidism and autoimmune (Hashimoto's hypothyroidism.Methods. 121 women (18-45 y.o. with primary hypothyroidism receiving levothyroxine for more than one year participated in the study. 66 women with autoimmune hypothyroidism, 55 - with hypothyroidism after subtotal thyroidectomy for Graves' disease. The scores for the Short-Form 36, Hospital Anxiety and Depression Scale, symptoms of hypothyroidism, Inventory of memory and attention, TSH, free T3, free T4 and lipid profiles were analyzed. Results. There were no significant differences between groups in the age, BMI, TSH, fT3, fT4 levels. The total cholesterol was higher in patients with postoperative hypothyroidism in comparison to autoimmune hypothyroidism ( р = 0,041. The levels of social functioning and mental health that reflect mental component of health were lower in patients with autoimmune hypothyroidism than with postoperative hypothyroidism ( p = 0,038, p = 0,019, respectively. The anxiety was higher in the same group ( p = 0,004. There was no difference in memory and attention levels. The anxiety level was higher in autoimmune hypothyroidism and “low-normal” TSH (0,4 - 2 µU/L than in postoperative hypothyroidism and the same TSH ( p = 0,016. Also in the group with postoperative hypothyroidism and “low-normal” TSH the cholesterol and prevalence of hypercholesterolemia were higher than in autoimmune hypothyroidism ( p = 0,017; р = 0,013. Conclusion. In young women with compensated autoimmune hypothyroidism the mental component of health is lower and the anxiety - higher than in postoperative hypothyroidism. Even in stable compensation of postoperative hypothyroidism the cholesterol level is higher comparing to the patients with autoimmune thyroiditis. And even in “low-normal” TSH

  1. Modified Sequential Therapy Regimen versus Conventional Triple Therapy for Helicobacter pylori Eradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

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    Ying-Qun Zhou

    2012-01-01

    Full Text Available Objective. Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. To observe the effect of eradicating Helicobacter pylori (H. pylori and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy. Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy and H. pylori positive confirmed by rapid urease test, serum anti-H. pylori antibody (ELASE, or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases and group B (70 cases were provided 10-day modified sequential therapy; group C (70 cases was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily. H. pylori eradication rate was checked four to eight weeks after taking the medicine by using a 13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously. Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that the H. pylori eradication rate of each group was as follows: group A 92.5% (62/67, group B 86.8% (59/68, and group C 78.8% (52/66. The H. pylori

  2. A randomized, comparative study of dual therapy (doxycycline–rifampin versus triple therapy (doxycycline–rifampin–levofloxacin for treating acute/subacute brucellosis

    Directory of Open Access Journals (Sweden)

    Ahmad Hasanain

    Full Text Available Abstract Aim The aim of this study was to compare both the efficacy and safety profile of the WHO-recommended, dual therapy (doxycycline–rifampin to a quinolone-based, triple therapy (doxycycline–rifampin–levofloxacin for treating acute/subacute brucellosis. Patients and methods We studied 107 consecutive, naïve patients with acute/subacute brucellosis admitted to Assiut University Hospital. Patients were randomly allocated to receive the dual therapy of doxycycline–rifampin (group-A or to receive the triple therapy of doxycycline–rifampin–levofloxacin (group-B. Acute/subacute brucellosis was diagnosed based on the presence of: (1 contact with animals or fresh animal products, (2 suggestive clinical manifestations of less than one-year duration, and (3 positive antibody titer (1:160 by standard tube agglutination test. Results There was no significant difference between the two groups regarding their demographic data. Fever was the most frequent manifestation (96.3%. Epigastric pain was the most frequent adverse effect of treatment (12.1%. Group-A patients had a significantly higher relapse rate compared to group-B patients (22.6% versus 9.3%, p-value = 0.01. The rate of treatment adverse effects was higher among group-B patients, although not reaching statistical significance (20.4% versus 11.3%, p-value = 0.059. Conclusions Adding levofloxacin to the dual therapy for acute/subacute brucellosis (doxycycline–rifampin may increase its efficacy in terms of lowering the relapse rate of the disease. Further, larger scale studies are needed before considering modifying the standard, dual therapy for brucellosis.

  3. Randomized clinical trial comparing affect regulation and supportive group therapies for victimization-related PTSD with incarcerated women.

    Science.gov (United States)

    Ford, Julian D; Chang, Rocío; Levine, Joan; Zhang, Wanli

    2013-06-01

    Traumatic victimization and associated problems with posttraumatic stress disorder (PTSD) and affect dysregulation are prevalent among incarcerated women, but there is limited evidence to support psychotherapeutic interventions for these problems in this underserved population. A group psychotherapy designed to enhance affect regulation without trauma memory processing-Trauma Affect Regulation: Guide for Education and Therapy (TARGET)-was compared to a supportive group therapy (SGT) in a randomized clinical trial with 72 incarcerated women with full or partial PTSD. Both interventions achieved statistically significant reductions in PTSD and associated symptom severity and increased self-efficacy. Dropout rates for both interventions were low (PTSD and associated symptoms. Experiential-focused supportive group therapy also may reduce victimization-related PTSD and associated symptoms. Both group therapy approaches warrant further study with this vulnerable population.

  4. Efficacy of combination therapy for systolic blood pressure in patients with severe systolic hypertension: the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study.

    Science.gov (United States)

    Neutel, Joel M; Smith, David H G; Weber, Michael A; Schofield, Lesley; Purkayastha, Das; Gatlin, Marjorie

    2005-11-01

    Systolic hypertension is predominant among patients over 50 years of age, is a more important cardiovascular risk factor than diastolic blood pressure, and is more difficult to control than diastolic blood pressure. Consequently, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends combination therapy as first-line treatment for patients with stage 2 hypertension. In the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study, 24-hour ambulatory blood pressure monitoring was used to identify patients with systolic hypertension and to determine the impact of 8 weeks of treatment with either amlodipine besylate/benazepril HCl 5/20 mg combination therapy (n=149), amlodipine besylate 5 mg (n=146), or benazepril HCl 20 mg (n=148). Combination therapy was significantly more effective in reducing systolic blood pressure and pulse pressure than either monotherapy (pamlodipine-treated group. The combination of amlodipine besylate/benazepril HCl given to patients with stage 2 systolic hypertension resulted in significantly greater reductions in blood pressure and pulse pressure than those seen with monotherapy and was at least as well tolerated as the separate components. This data supports the recommendation of the JNC 7 for the use of combination therapy in patients with stage 2 hypertension.

  5. Effectiveness of Cognitive Behavioral Therapy a long with Conventional Treatment in Asthma Patients Compared with Solely Conventional Therapy

    Directory of Open Access Journals (Sweden)

    Maryam Jamalimotlagh

    2012-09-01

    Full Text Available Background: While origin of Asthma is allergy and infection, mental stresses can also indicate asthma attacks. Most people with asthma argue that the reason of asthma attacks is mental- psychological problems such as stress. Aim & objective: Asthma is a chronic and recurrent disease. High levels of stress in this disease are associated with increased hospitalization and mortality, so this research aims to use cognitive behavioral therapy in order to control stress among patients with Asthma. Method/Study Design: Present study is a field and Quasi-experimental whose statistical society includes all patients with Asthma who have referred to Khatamol-Anbia Hospital for treatment. A total of 48 individuals were tested and controlled by purposive sampling procedure. 8 individual CBT sessions were conducted in experimental group during intervention period then the number of asthma attacks in the pre-test and post-test periods was evaluated Results/Finding: After analyzing data with SPSS software, results show that there exists significant difference between experimental and control group in post-test in ACQ, ASES and AQLQ questionnaires which is significant between two groups by a difference of ρ<0.001 but this difference wasn’t significant in pre-test. Conclusion: The results suggest that cognitive behavioral therapy along with conventional treatment in asthma patients can be effective on reduction of asthma attacks. Individual management improvement is based on such behavioral factors as daily scanning on symptoms and adherence to treatment which is affected by Asthma Self-Efficacy (ASE. This issue suggests the trust to ability in performing necessary behaviors on personal management for disease symptoms and prevention of recurrence.

  6. A multicenter comparative study of cefepime versus broad-spectrum antibacterial therapy in moderate and severe bacterial infections

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    Badaró Roberto

    2002-01-01

    Full Text Available The safety and efficacy of cefepime empiric monotherapy compared with standard broad-spectrum combination therapy for hospitalized adult patients with moderate to severe community-acquired bacterial infections were evaluated. In an open-label, multicenter study, 317 patients with an Acute Physiology and Chronic Health Evaluation (APACHE II score ranging from >5 to =19 were enrolled with documented pneumonia (n=196, urinary tract infection (n=65, intra-abdominal infection (n=38, or sepsis (n=18. Patients were randomly assigned 1:1 to receive cefepime 1 to 2 g IV twice daily or three times a day or IV ampicillin, cephalothin, or ceftriaxone ± aminoglycoside therapy for 3 to 21 days. For both treatment groups, metronidazole, vancomycin, or macrolide therapy was added as deemed necessary. The primary efficacy variable was clinical response at the end of therapy. Two hundred ninety-six (93% patients met evaluation criteria and were included in the efficacy analysis. Diagnoses included the following: 180 pneumonias (90 cefepime, 90 comparator, 62 urinary tract infections (29 cefepime, 33 comparator, 37 intra-abdominal infections (19 cefepime, 18 comparator, and 17 sepses (8 cefepime, 9 comparator. At the end of therapy, overall clinical success rates were 131/146 (90% for patients treated with cefepime vs 125/150 (83% for those treated with comparator (95% confidence interval [CI]: - 2.6% to 16.3%. The clinical success rate for patients with community-acquired pneumonia, the most frequent infection, was 86% for both treatment groups. Among the patients clinically evaluated, 162 pathogens were isolated and identified before therapy. The most commonly isolated pathogens were Escherichia coli (n=49, Streptococcus pneumoniae (n=29, Haemophilus influenzae (n=14, and Staphylococcus aureus (n=11. Bacteriologic eradication/presumed eradication was 97% for cefepime vs 94% for comparator-treated patients. Drug-related adverse events were reported in 16% of

  7. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial

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    Mohammad Dehghani Firoozabadi

    2014-01-01

    Full Text Available Background: Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. Materials and Methods: This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients and conventional treatment group (30 patients. An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months. Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Results: Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6 and 32.6 (±12.7 years, respectively (P = 0.45. After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80, frequency of migraine attacks (P = 0.63 and duration of attacks per hours (P = 0.48 were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P < 0.001. Conclusion: There was no significant difference between cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

  8. Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

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    Lens, Eelco, E-mail: e.lens@amc.uva.nl; Horst, Astrid van der; Versteijne, Eva; Tienhoven, Geertjan van; Bel, Arjan

    2015-07-01

    Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V{sub 95%} >98%. In addition, the change in PTV size and the changes in V{sub 10Gy}, V{sub 20Gy}, V{sub 30Gy}, V{sub 40Gy}, D{sub mean} and D{sub 2cc} for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D{sub 2cc} of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors.

  9. COMPARATIVE EFFICIENCY AND TOLERABILITY OF CURRENT THERAPIES FOR EARLY RHEUMATOID ARTHRITIS

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    E. V. Fedorenko

    2015-01-01

    Full Text Available Objective: to compare the efficiency and safety of four treatment regimens using methotrexate (MT,  leflunomide (LEF,  and a combination  of MT and glucocorticoids  (GC  for early rheumatoid  arthritis (RA (disease duration <2 years.Subjects and methods. 141 patients with early RA (of them there were 122 women; mean age 51 years; mean disease duration  7.8 months;  mean DAS28 6.0 were randomized  to 4 treatment groups: 1 MT 10–20 mg/week (n = 35; 2 MT 10–20 mg/week + oral GC equivalent to 10 mg/day of prednisolone  (n = 34; 3 MT 10–20 mg/week + oral CG + single intravenous administration of methylprednisolone (MP 1000 mg at baseline (n = 35; 4 LEF 20 mg/day (n = 37. The patients were matched for main clinical and demographic  characteristics. The duration of treatment was 1 year. Its efficiency was evaluated according to the European  League Against Rheumatism (EULAR  criteria.Results. 125 patients completed one-year treatment. At this time, 11.4% of the patients achieved remission (DAS28 <2.6 in the MT group, 37.5% in the MT+GC group, 29.4% in the MT+GC+MP group, and 16.2% in the LEF group. Adverse events, mainly of mild intensity, were recorded in 9 patients in each MT group. A total of 7 patients had to discontinue treatment because of its inefficiency.Conclusion. All the four therapy regimens demonstrated a significant efficiency in patients with early RA; the total remission rate was 24%. The combination  of MT and GC produced the most pronounced effect. The tolerability of treatment was good in all groups.

  10. A comparative evaluation of teaching methods in an introductory neuroscience course for physical therapy students

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    Willett, Gilbert M.

    Background and purpose. Use of computer based instruction (CBI) in physical therapy (P.T.) education is growing. P.T. educators have reported few studies regarding the effectiveness of CBI compared to lecture based instruction, and none have specifically addressed the area of neuroscience. The purpose of this study was to determine whether CBI would be a better alternative than lecture for teaching introductory neuroscience information to first year P.T. students. Subjects. This study was conducted over two years, with 28 participants in 2003 and 34 in 2004. Methods. A randomized, cross-over design was employed for this investigation. The course in which the study took place was divided into two sections with an exam after each. Both sections included 5 one hour lectures (or 5 equivalent CBI modules) and a two hour laboratory experience. Exams consisted of 30 multiple choice questions. Students in one group participated in CBI during the first half of the course and lecture during the second half. The order of participation was reversed for students in the other group. A review exam (60 multiple choice questions) was also taken by participants six months post-participation in the course. Exam scores, study time, course development costs, and student opinions regarding teaching methods were collected after each section of the course and analyzed using quantitative and qualitative methods. Results. There were no statistically significant differences in "within course" or review exam scores between participant groups based on instructional method, however, CBI taught students spent less time studying. Student opinions did not distinguish a major preference for either instruction method. Many students preferred that CBI be used as a complimentary rather than mutually exclusive instructional method. Lecture based instruction was clearly more cost effective than CBI. Conclusion. In this study, lecture based instruction was clearly the better choice of teaching method in

  11. Role of ciprofloxacin in patients with cholestasis after endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Thawee Ratanachu-ek; Pitchaya Prajanphanit; Kawin Leelawat; Suchart Chantawibul; Sukij Panpimanmas; Somboon Subwongcharoen; Jerasak Wannaprasert

    2007-01-01

    AIM: To determine the role of ciprofloxacin in reducing cholangitis in cholestatic patients with adequate biliary drainage after endoscopic retrograde cholangiopancreatography (ERCP).METHODS: A randomized, controlled trial was performed in 48 cholestatic patients at Rajavithi Hospital (Tertiary Referral Center for ERCP: 600 cases per year). All the 48 patients received 200 mg ciprofloxacin intravenous injection for 30 min before starting any procedures, and then were randomly divided in two groups. Twenty-two patients in study group continually received ciprofloxacin until 48 h after ERCP. Causes of biliary obstruction, bacteriology of bile and blood (in cholangitis) and clinical cholangitis were recorded.RESULTS: Forty-eight patients were enrolled and divided into continuous ciprofloxacin treatment group (n = 22) and discontinuous ciprofloxacin treatment group (n = 26). During ERCP, stones were found in 22 patients,malignant diseases in 24 patients and other pathologic lesions in 5 patients. One (4.5%) of the 22 patients who received ciprofloxacin and 2 (6.3%) of the 26 patients who discontinued ciprofloxacin after ERCP developed cholangitis (relative risk = 0.71; 95% CI = 0.14-3.65;P = 0.88). Bacterobilia was found in 27 (56.3%) out of 48 patients. E. coli and Streptococcus viridans were the most common organisms.CONCLUSION: Continual use of ciprofloxacin in patients with cholestasis after adequate biliary drainage procedures plays no role in reducing cholangitis.

  12. Effect of Leflunomide, Cidofovir and Ciprofloxacin on replication of BKPyV in a salivary gland in vitro culture system.

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    Jeffers-Francis, Liesl K; Burger-Calderon, Raquel; Webster-Cyriaque, Jennifer

    2015-06-01

    BK polyomavirus (BKPyV) is a known kidney tropic virus that has been detected at high levels in HIV-associated salivary gland disease (HIV-SGD), one of the most important AIDS associated oral lesions. BKPyV has been detected in HIV-SGD patient saliva and replicates in salivary gland cells in vitro. BKPyV antivirals are currently in wide use to guard against BKPyV mediated organ rejection in kidney transplant recipients. The goal of this study was to investigate the inhibitory effects of three such antiviral agents, Ciprofloxacin, Cidofovir, and Leflunomide in BKPyV infected salivary gland cells. Human salivary gland cells, and Vero cells, were infected with BKPyV, treated with antiviral drugs and assessed for BKPyV gene expression and viral replication for up to 5 days post infection. The kinetics of BKPyV replication were different in salivary gland cells compared to kidney cells. Ciprofloxacin and Cidofovir had minimal effect on metabolic activity and host cell DNA replication, however, cell toxicity was detected at the protein level with Leflunomide treatment. Ciprofloxacin decreased BKV T Ag and VP1 mRNA expression by at least 50% in both cell types, and decreased T Ag protein expression at days 3 and 4 post infection. A 2.5-4 log decrease in intracellular DNA replication and a 2-3 log decrease in progeny release were detected with Ciprofloxacin treatment. Cidofovir and Leflunomide also inhibited BKPyV gene expression and DNA replication. The three drugs diminished progeny release by 30-90% and 2- to 6-fold decreases in infectious virus were detected post drug treatment by fluorescence focus assay. Additionally, three clinical BKPyV isolates were assessed for their responses to these agents in vitro. Cidofovir and Leflunomide, but not Ciprofloxacin treatment resulted in statistically significant inhibition of BKPyV progeny release from salivary gland cells infected with HIVSGD BKPyV isolates. All three drugs decreased progeny release from cells infected with a

  13. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review

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    Diederik C Bervoets

    2015-07-01

    Full Text Available Question: Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Design: Systematic review of randomised clinical trials. Participants: People with musculoskeletal disorders. Interventions: Massage therapy (manual manipulation of the soft tissues as a stand-alone intervention. Outcome: The primary outcomes were pain and function. Results: The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579 per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. Conclusions: Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident. [Bervoets DC, Luijsterburg PAJ, Alessie JJN, Buijs MJ, Verhagen AP (2015 Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. Journal of Physiotherapy 61: 106–116

  14. A PROSPECTIVE STUDY COMPARING TAMSULOSIN AND SILODOSIN IN MEDICAL EXPULSIVE THERAPY FOR LOWER URETERIC STONES

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    Sreedhar Reddy

    2016-07-01

    Full Text Available The urinary stone disease is one of the most common afflictions of the modern society and it has been described since antiquity with the westernization of global culture. The efficacy of mini-invasive therapies, such as Extracorporeal Shock Wave Lithotripsy [ESWL] and ureteroscopy are not risk free, are problematic and are quite expensive. Recently, the use of watchful waiting approach has been extended by using Pharmacotherapy. This can reduce symptoms and facilitate stone expulsion. MATERIALS AND METHODS This prospective randomised study was conducted between September 2015 and May 2016 at Rajarajeshwari Medical College and Hospital, Bangalore. The cohort comprised 100 adult patients (54 men and 46 women who presented with a symptomatic, unilateral, single, uncomplicated lower ureteric stone of ≤ 10 mm. Patients were randomized into two equal groups, 50 (50% patients received a daily single dose of tamsulosin 0.4 mg for 28 days and 50 (50% patients received a daily single dose of silodosin 8 mg for 28 days. Both groups were compared in terms of patient’s demographics, socioeconomic status, stone size and side, type of MET, stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use and incidence of side effects. Subgroup analysis was performed according to stone size ≤ or > 5 mm. RESULTS No significant differences among the two groups for patient’s age, gender, stone side and stone size. Spontaneous stone expulsion rate within 28 days was observed in 44 (88% patients in the tamsulosin group and in 45 (90% patients in the silodosin group without statistically significant differences. There were no statistically significant differences observed in terms of mean expulsion time, mean number of pain episodes and need for analgesics. Retrograde ejaculation was significantly higher in the silodosin arm, while the incidence of side effects related to peripheral vasodilation were higher in the tamsulosin arm

  15. Comparing Physical Therapy Accompanying Exercise with Only Exercise Treatments in Patients with Chronic Mechanical Low Back Pain

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    Özlem Yılmaz

    2015-08-01

    Full Text Available Objective: Investigating and comparing the effects of exercise and physical therapy accompanying exercise treatments in patients with chronic low back pain. Materials and Methods: Twenty three patients with mechanical type low back existing more than 3 months were included one of the exercise or the physical therapy+exercise groups according to their application sequence. Both of the groups performed lumbar flexion and extension exercises, strengthening of the lumbar and abdominal muscle exercises and iliopsoas, hamstring and quadriceps stretching exercises two times a day for 14 days. The physical therapy group was given hot pack+therapeutic ultrasound+ interferential current for 10 days additionally. Degree of the low back pain was evaluated with visual analog scale (VAS, range of joint motion was evaluated with hand finger floor distance (HFFD and Modified Schober test, functional status was evaluated with Modified Oswestry Low Back Pain Scale and quality of life was evaluated with Short form-36 (SF-36 before and a month after the treatments. Results: In both groups (exercise group: average age 59 years, 21 females, 2 males; physical therapy group: average age 60 years, 20 females, 3 males pain intensity and HFFD decreased and Modified Schober increased, functionality recovered, pain and physical functions of SF-36 improved after the treatments. SF-36-physical role difficulty also improved in the exercise group. Decrease in pain, increase in HFFD andimproving of the functional status were all significantly more in the physical therapy group. There were no difference between the groups in terms of Modified Schober measurement and changes of the quality of life. Conclusions: Exercises and exercise+physical therapy are both effective in chronic low back pain. Successful results can be taken by addition of the physical therapy in patients who do not benefit sufficiently from exercise therapy. (Turkish Journal of Osteoporosis 2015;21: 73-8

  16. Ciprofloxacin Loaded Bovine Serum Albumin Microspheres: Prepa-ration and Drug Release Characterization In Vitro

    Institute of Scientific and Technical Information of China (English)

    LiFengqian; HuJinhong; LuBin; ZhuQuangang; SunHuajun

    2001-01-01

    Ciprofloxacin loaded microspheres were prepared by spray drying technique, with bovine serum albumin as the natural biodegradable wall materials. The obtained microspheres, using aqueous system, were organic solvent-free. The diameters of the spherical microspheres were in the range of 1-5 1:4. The drug entrapment of microspheres, formulated with different ciprofloxacin/albumin ratios as 1:1, 1:2 and 1:4, were 46.93%, 32.96% and 20.56% (n=3). And the encapsulation efflciencies for ciprofloxacin during spray drying were higher than 90%. Thermal denaturation programs at different temperatures (100-120℃) for different time intervals (3-6-12 h) were further processed to stabilize the spray-dried microspheres. The higher the extent for thermal denaturation, the slower the rate of ciprofloxacin released from microspheres in vitro. So the release rate of ciprofloxacin from microspheres can be controlled by modifing the conditions of thermal denaturation.

  17. Pilot study comparing multi-family therapy to single family therapy for adults with anorexia nervosa in an intensive eating disorder program.

    Science.gov (United States)

    Dimitropoulos, Gina; Farquhar, Jamie C; Freeman, Victoria Emily; Colton, Patricia Anne; Olmsted, Marion Patricia

    2015-07-01

    Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN.

  18. Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India.

    Science.gov (United States)

    Gupta, Devanand; Batra, Renu; Mahajan, Shveta; Bhaskar, Dara John; Jain, Ankita; Shiju, Mohammed; Yadav, Ankit; Chaturvedi, Mudita; Gill, Shruti; Verma, Renuka; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

    2014-10-01

    Musculoskeletal problems have become a significant issue in the profession of dentistry. There are currently no recommended effective disease-preventing and modifying remedies. High prevalence rates for musculoskeletal disorders (MSDs) among dentists have been reported in the literature. Complementary and alternative medicine can be helpful in managing and preventing the MSDs. The purpose of this study was to determine if dentists in the western part of India are using complementary and alternative medicine therapies for MSDs, and also to find if those who use complementary and alternative medicine therapies have greater job/career satisfaction compared to conventional therapy (CT) users. Dentists of western India registered under the Dental Council of India (N = 2166) were recruited for the study. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 73% (n = 1581) was obtained, of which 79% (n = 1249) was suffering from MSDs. The use of complementary and alternative medicine or CT was reported by 90% (n = 1124) of dentists with MSDs. Dentists using complementary and alternative medicine reported greater health (P alternative medicine therapies may improve the quality of life and enhance job satisfaction for a dentist who suffers from MSDs.

  19. Manufacturing models permitting roll out/scale out of clinically led autologous cell therapies: regulatory and scientific challenges for comparability.

    Science.gov (United States)

    Hourd, Paul; Ginty, Patrick; Chandra, Amit; Williams, David J

    2014-08-01

    Manufacturing of more-than-minimally manipulated autologous cell therapies presents a number of unique challenges driven by complex supply logistics and the need to scale out production to multiple manufacturing sites or near the patient within hospital settings. The existing regulatory structure in Europe and the United States imposes a requirement to establish and maintain comparability between sites. Under a single market authorization, this is likely to become an unsurmountable burden beyond two or three sites. Unless alternative manufacturing approaches can be found to bridge the regulatory challenge of comparability, realizing a sustainable and investable business model for affordable autologous cell therapy supply is likely to be extremely demanding. Without a proactive approach by the regulators to close this "translational gap," these products may not progress down the development pipeline, threatening patient accessibility to an increasing number of clinician-led autologous cellular therapies that are already demonstrating patient benefits. We propose three prospective manufacturing models for the scale out/roll out of more-than-minimally manipulated clinically led autologous cell therapy products and test their prospects for addressing the challenge of product comparability with a selected expert reference panel of US and UK thought leaders. This paper presents the perspectives and insights of the panel and identifies where operational, technological and scientific improvements should be prioritized. The main purpose of this report is to solicit feedback and seek input from key stakeholders active in the field of autologous cell therapy in establishing a consensus-based manufacturing approach that may permit the roll out of clinically led autologous cell therapies.

  20. The Effectiveness of Fissure Sealant Therapy Placed by Professional Complementary to Dentistry Compared with Dentists

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    F Nilchian

    2005-10-01

    Full Text Available Background: Dental caries is a process that may take place on any tooth surface in the oral cavity where a microbial biofilm (dental plaque is allowed to develop over a period. From the public health perspective, the prevention of caries is still a major challenge. The development of dental caries within the mouth follows a fixed hierarchy indicating that tooth surfaces vary in caries susceptibility. The most susceptible surfaces are the buccal pits and occlusal-fissured surfaces of the first molar teeth. Since the 1960`s many trials have investigated the effectiveness of using sealants on pit and fissure surfaces. However, the cost effectiveness of sealants is an important issue considered by many studies noted that cost-effectiveness of sealants would be enhanced by using trained auxiliaries to apply them. The changes in dentistry and oral health reveal a need to review the roles of dental auxiliaries in order to deliver quality care cost-effectively. There were number of studies conducted on the effectiveness of dental auxiliaries around the world. According to the purpose of this project, studies evaluated the effectiveness of Professional complementary to dentistry (PCDs and different type of dental auxiliaries in carrying out complete restorations and in the preventive therapies, fissure sealants, traumatic restorative treatment were evaluated in literature review. The aim of the present study is to review the literature and assess whether PCDs can perform pit and fissure sealants as effectively as dentist through investigation of the caries preventive effect of sealant placed by dentist relative to sealant placed by PCDs. Method: Electronic databases were searched till January 2005. The databases which were used are: Medline via Ovid, Cochrane databases of systematic review , DARE (Database of Abstracts of Reviews of Effectiveness, CCTR (Clinical Controlled Trials Register Cochrane Library, Dissertation Abstracts International database

  1. Clinical Comparative Study on Massage Therapy and Cisapride in Treating Functional Dyspepsia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jia-fu; LIN Qiang; LIU Hong-bo; ZHOU Ping; XIAO Yuan-chun

    2007-01-01

    To observe the clinical efficacy of massage therapy and Cisapride in the treatment of functional dyspepsia (FD).Methods:Eighty subjects were randomized into two groups:treatment group in which 40 cases were treated by massage therapy and control group in which 40 cases were treated by Cisapride,with a course of 4 weeks;meanwhile,another 40 healthy people were taken as normal group.Abdominal fullness,acid regurgitation,diminished appetite and anorexia,nausea and vomiting and health survey were observed;symptom scores were recorded.Results:These two treatment methods were effective for FD.Conclusion:Mental disorder is one cause of FD;massage therapy is quite effective for it.

  2. Comparative cost-effectiveness of stereotactic body radiation therapy versus intensity-modulated and proton radiation therapy for localized prostate cancer.

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    Anju eParthan

    2012-08-01

    Full Text Available Objective. To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer.Methods. A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publically available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY gained between treatments. Analyses were conducted from both a payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed.Results. Compared to intensity modulated radiation therapy (IMRT and proton beam therapy (PT, stereotactic body radiation therapy (SBRT was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost effective in 75%, and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75%, and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusions. Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

  3. [Pharmaco-economic evaluation of antibiotic therapy in a ward for infections diseases

    Science.gov (United States)

    Sabbatani, S.; Cannella, B.; Fulgaro, C.; Pipitone, E.; Cesari, R.

    2000-01-01

    For all hospitalized patients admitted in the first six months of 1999, we recorded the data relative to antibiotic therapy (TA) administered, establishing the period of treatment in days and the dosage, including any variations during the period in question. We calculated the prescribed daily dose (PDD) and were thus able to establish the expense incurred in antibiotic therapy, comparing the real overall cost per product used. For all patients, the discharge diagnosis was reported, and the whole case-study was aggregated into homogeneous groups. PDD was compared with DDD (defined daily doses). The Pareto curve was used to highlight the antibiotics with higher overall cost. Besides cotrimoxazole, ceftriaxone and ciprofloxacin were the antibiotics most frequently prescribed, while ceftriaxone, imipenem-cilastatine and vancomycin were the antibiotics incurring the greatest expense. With reference to the average duration of the treatment cycle, ceftriaxone (9.75 dd) and ciprofloxacin tbl (6.75 dd) were the only antibiotics (in monotherapy) used for less than 10 treatment days. Special attention was paid to analysing the TA costs in treating pneumonia, which accounted for the highest percentage of cases (50 cases). Ceftriaxone, especially pulmonary infections, was the most commonly used drug. In hospitalized subjects treated who show good therapeutic response, we recommend early discharge and continuation of the therapy at home (switch therapy). This strategy will allow the patient to return to his/her family in good time, also thereby reducing hospital management costs.

  4. Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial

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    Beurskens Anna J

    2007-10-01

    Full Text Available Abstract Background Mental practice as an additional cognitive therapy is getting increased attention in stroke rehabilitation. A systematic review shows some evidence that several techniques in which movements are rehearsed mentally might be effective but not enough to be certain. This trial investigates whether mental practice can contribute to a quicker and/or better recovery of stroke in two Dutch nursing homes. The objective is to investigate the therapeutic potential of mental practice embedded in daily therapy to improve individually chosen daily activities of adult stroke patients compared to therapy as usual. In addition, we will investigate prognostic variables and feasibility (process evaluation. Methods A randomised, controlled, observer masked prospective trial will be conducted with adult stroke patients in the (subacute phase of stroke recovery. Over a six weeks intervention period the control group will receive multi professional therapy as usual. Patients in the experimental group will be instructed how to perform mental practice, and will receive care as usual in which mental practice is embedded in physical, occupation and speech therapy sessions. Outcome will be assessed at six weeks and six months. The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale. Secondary outcomes are: Motricity Index, Nine Hole Peg Test, Barthel Index, Timed up and Go, 10 metres walking test, Rivermead Mobility Index. A sample size of the patients group and all therapists will be interviewed on their opinion of the experimental program to assess feasibility. All patients are asked to keep a log to determine unguided training intensity. Discussion Advantages and disadvantages of several aspects of the chosen design are discussed. Trial registration ISRCTN27582267

  5. Transarterial chemoembolization alone and in combination with other therapies: a comparative study in an animal HCC model

    Energy Technology Data Exchange (ETDEWEB)

    Maataoui, A.; Qian, J.; Vossoughi, D.; Khan, M.F.; Vogl, T.J. [Johann Wolfgang Goethe University, Institute for Diagnostic and Interventional Radiology, Frankfurt/Main (Germany); Oppermann, E.; Bechstein, W.O. [Johann Wolfgang Goethe University, Department of Visceral Surgery, Frankfurt/Main (Germany)

    2005-01-01

    The purpose of this study is to compare transarterial chemoembolization (TACE) alone and in combination with other therapies in an animal model. Subcapsular implantation of a solid Morris hepatoma 3924A in the liver was carried out in 50 male ACI rats (day 0). Tumor volume (V1) was measured by MRI (day 13). After laparotomy and retrograde placement of a catheter into the gastroduodenal artery (day 14), the following protocols of the interventional procedure were applied: TACE (mitomycin C + lipiodol) + immunotherapy (group A: TNF{alpha} + IL-2, group B: OK-432 + IL-2); TACE + antiangiogenesis therapy (group C: TNP-470, group D: endostatin); TACE alone in group E (control group). Tumor volume (V2) was assessed by MRI and the mean ratio of x(V2/V1) was calculated. Data were analyzed using Dunnett's ttest (comparing therapeutic groups with the control group) and the Student-Newman-Keuls test (comparing significant therapeutic groups). Multivariate analysis showed a significant reduction in the tumor growth rate (P<0.05) in groups B (x=6.53) and C (x=4.01) compared to the mean ratio of the control group E (x=9.14). Significant results were observed in group C (P<0.05) in comparison with the other therapeutic groups. TACE combined with immunotherapy (OK-432) and antiangiogenesis therapy (TNP-470) retards tumor growth compared with TACE alone in an HCC animal model. (orig.)

  6. Assessment of altered binding specificity of bacteriophage for ciprofloxacin-induced antibiotic-resistant Salmonella Typhimurium.

    Science.gov (United States)

    Kim, Jeongjin; Jo, Ara; Ding, Tian; Lee, Hyeon-Yong; Ahn, Juhee

    2016-08-01

    This study describes a new effort toward understanding the interaction mechanisms between antibiotic-resistant Salmonella Typhimurium and phages. The antibiotic susceptibility, β-lactamase activity, bacterial motility, gene expression, and lytic activity were evaluated in ciprofloxacin-induced antibiotic-sensitive Salmonella Typhimurium (ASST(CIP)) and ciprofloxacin-induced antibiotic-resistant S. Typhimurium (ARST(CIP)), which were compared to the wild-type strains (ASST(WT) and ARST(WT)). The MIC values of ampicillin, norfloxacin, chloramphenicol, and tetracycline were significantly increased to > 512, 16, 16, and 256 μg/ml, respectively, in the ARST(CIP). The lowest and highest extracellular lactamase activities were observed in ASST(WT) (6.85 μmol/min/ml) and ARST(CIP) (48.83 μmol/min/ml), respectively. The acrA, lpfE, and hilA genes were significantly upregulated by more than tenfold in both ASST(CIP) and ARST(CIP). The induction of multiple antibiotic resistance resulted from the increased efflux pump activity (AcrAB-TolC). The highest phage adsorption rates were more than 95 % for ASST(WT), ASST(CIP), and ARST(WT), while the lowest adsorption rate was 52 % for ARST(CIP) at 15 min of infection. The least lytic activity of phage was 20 % against the ARST(CIP), followed by ASST(CIP) (30 %). The adsorption rate of phage against ARST(CIP) was 52 % at 15 min of infection, which resulted in the decrease in lytic activity (12 %). Understanding the interaction of phage and bacteria is essential for the practical application of phage to control and detect antibiotic-resistant bacteria. The results provide useful information for understanding the binding specificity of phages for multiple antibiotic-resistant pathogens.

  7. A comparison between doxycycline-rifampin and ciprofloxacin-rifampin regimens in the treatment of acute Brucellosis

    Directory of Open Access Journals (Sweden)

    Majid Reza Erfanian Taghvaee

    2011-01-01

    Full Text Available Introduction: Brucellosis, a serious zoonosis, is a widespread disease in many countries, especially the developing ones, with an annual report of 500,000 new cases to the World Health Organization (WHO. Although successful results have been achieved by the combination therapies recommended by the WHO, their relapse rates have been high, and therefore, the most effective agents with least side-effects are still undetermined. Materials and Methods: An observational study has been prospectively carried out from 2007 to 2010 in the Infectious Clinics of Hashemi-nejad and Imam Reza Hospitals, Mashhad, Iran. In this study, among the patients of brucellosis, whose diseases were recently diagnosed, 50 patients, receiving one of the two common authentic regimens of doxycycline plus rifampin for eight weeks or ciprofloxacin plus rifampin for six weeks, were selected. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis, including a positive Wright and 2ME tests, with titers equal to or more than 1/160 and 1/40 respectively. Results: The cure rate was the same for the groups (P=0.55. However, the relapse rate was much more for the latter (P= 0.02. Conclusion: Doxycycline plus rifampin was considered better than ciprofloxacin plus rifampin for the treatment of acute brucellosis.

  8. Comparative Kinetic Methods used for the Therapy of Idiopathic Scoliosis in Adolescents

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    Elena AMARICĂI

    2013-12-01

    Full Text Available Scoliosis is one of the most common axial deviations of the spine. Because of its incidence and the fact that, with the evolution of technology, adolescents spend increasingly more time sitting at desk, adopting positions often incorrect, this paper aims to study the evolution of adolescent patients diagnosed with scoliosis using different kinetic methods of treatment. Another objective is to highlight the most effective method of treatment in terms of overall rehabilitation period, the time spent by the patient in the rehabilitation centre and the preservation of scoliosis correction. 9 adolescents patients (aged between 14 and 17 years with idiopathic scoliosis were divided into three groups based on the followed kinetic method. Three patients underwent a physical therapy program based on the conventional Klapp and Cotrel method, three patients performed Schroth method, and the other three patients performed Vojta method. All patients were monitored for 6 months. They followed a certain rehabilitation therapy in a specialized centre under the guidance of specialized therapist. Height, weight and scoliosis curvature (measured by the Cobb angle were assessed at the beginning of the program and after 6 months of kinetic program. The small number of patients in each group could not issue conclusions regarding the statistical efficiency of the three methods of therapy. However, besides the conventional therapy, both Schroth method and Vojta method represent possibilities to treat the adolescent patients with idiopathic scoliosis.

  9. Development of Liposomal Ciprofloxacin to Treat Lung Infections

    Directory of Open Access Journals (Sweden)

    David Cipolla

    2016-03-01

    Full Text Available Except for management of Pseudomonas aeruginosa (PA in cystic fibrosis, there are no approved inhaled antibiotic treatments for any other diseases or for infections from other pathogenic microorganisms such as tuberculosis, non-tuberculous mycobacteria, fungal infections or potential inhaled biowarfare agents including Francisella tularensis, Yersinia pestis and Coxiella burnetii (which cause pneumonic tularemia, plague and Q fever, respectively. Delivery of an antibiotic formulation via the inhalation route has the potential to provide high concentrations at the site of infection with reduced systemic exposure to limit side effects. A liposomal formulation may improve tolerability, increase compliance by reducing the dosing frequency, and enhance penetration of biofilms and treatment of intracellular infections. Two liposomal ciprofloxacin formulations (Lipoquin® and Pulmaquin® that are in development by Aradigm Corporation are described here.

  10. Formulation and evaluation of ciprofloxacin suspension using natural suspending agent

    Directory of Open Access Journals (Sweden)

    Sameer J. Nadaf

    2014-03-01

    Full Text Available The aim of the present study is to formulate and evaluate ciprofloxacin suspension using natural suspending agent. Trigonella foenum graecum Mucilage was used as natural suspending agent. Total 9 batches (C1-C9 were prepared by varying concentration of suspending agent from 0.5-2% and propylene glycol. Prepared suspension were evaluated by studying different parameters like pH, sedimentation volume, redispersibility, Flow rate (F, viscosity, degree of flocculation, effect of temperature etc. batches C6, C7 and C8 were found to be stable throughout the study. As the concentration of suspending agent increased viscosity also get increased which reduces the sedimentation and contributes to the stability of suspension. Increase in viscosity avoids the particle aggregation so particles remain in a flocculated state.

  11. Magnetic fields suppress Pseudomonas aeruginosa biofilms and enhance ciprofloxacin activity.

    Science.gov (United States)

    Bandara, H M H N; Nguyen, D; Mogarala, S; Osiñski, M; Smyth, H D C

    2015-01-01

    Due to the refractory nature of pathogenic microbial biofilms, innovative biofilm eradication strategies are constantly being sought. Thus, this study addresses a novel approach to eradicate Pseudomonas aeruginosa biofilms. Magnetic nanoparticles (MNP), ciprofloxacin (Cipro), and magnetic fields were systematically evaluated in vitro for their relative anti-biofilm contributions. Twenty-four-hour biofilms exposed to aerosolized MNPs, Cipro, or a combination of both, were assessed in the presence or absence of magnetic fields (Static one-sided, Static switched, Oscillating, Static + oscillating) using changes in bacterial metabolism, biofilm biomass, and biofilm imaging. The biofilms exposed to magnetic fields alone exhibited significant metabolic and biomass reductions (p biofilms were treated with a MNP/Cipro combination, the most significant metabolic and biomass reductions were observed when exposed to static switched magnetic fields (p biofilms to a static switched magnetic field alone, or co-administration with MNP/Cipro/MNP + Cipro appears to be a promising approach to eradicate biofilms of this bacterium.

  12. COMPARATIVE EFFICIENCY OF THE COMBINED THERAPY IN PATIENT’S WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. V. Shchekotov

    2014-07-01

    Full Text Available Objective — to assess influence of the combined therapy on a functional condition endothelium, the central haemodynamics and geometry of heart in patients with hypertensive disease.Subjects and methods. The volume of supervision has made 40 patients with arterial hypertension grade II hypertension, moderate — highrisk. Patients of the first group received the combined therapy lisinopril — 20 mg and hydrochlortiazid — 12.5 mg (iruzid — “Belupo”, Croatia, patients of the second group — therapy trandolapril and verapamil (tarka — “Ebbot”, Germany — 2 and 180 mg accordingly.Results. The combined therapy trandolapril and verapamil renders more expressed antihypertension effect, than lisinopril and hydrochlortiazid.Appointment of the combined therapy promoted normalization morphofunctional heart indicators: in group of tarka ejection fraction(EF has authentically increased by 4.34 % (р = 0,02, the thickness to a back wall of the left ventricle has decreased for 5.8 % (р = 0,03 in group of iruzid. Also in both groups optimization functional a condition endothelium vessels as on level desquamation endotheliocytes, a function indicator endothelium and on a level of a factor of Willebrand was marked. Authentically more expressed positive influence on endothelium tarka in comparison with iruzid has been noticed.Conclusion. At comparison of combinations fat-soluble ACE inhibitor with verapamil (tarka and water-soluble ACE inhibitor in a combination with hydrochlortiazid (iruzid the insignificant superiority of the first combination over the second for level of positive influence on endothelium of vessels has been revealed, more expressed antihypertensive effect and ability authentically to increase EF.

  13. COMPARATIVE EFFICIENCY OF THE COMBINED THERAPY IN PATIENT’S WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. V. Shchekotov

    2011-01-01

    Full Text Available Objective — to assess influence of the combined therapy on a functional condition endothelium, the central haemodynamics and geometry of heart in patients with hypertensive disease.Subjects and methods. The volume of supervision has made 40 patients with arterial hypertension grade II hypertension, moderate — highrisk. Patients of the first group received the combined therapy lisinopril — 20 mg and hydrochlortiazid — 12.5 mg (iruzid — “Belupo”, Croatia, patients of the second group — therapy trandolapril and verapamil (tarka — “Ebbot”, Germany — 2 and 180 mg accordingly.Results. The combined therapy trandolapril and verapamil renders more expressed antihypertension effect, than lisinopril and hydrochlortiazid.Appointment of the combined therapy promoted normalization morphofunctional heart indicators: in group of tarka ejection fraction(EF has authentically increased by 4.34 % (р = 0,02, the thickness to a back wall of the left ventricle has decreased for 5.8 % (р = 0,03 in group of iruzid. Also in both groups optimization functional a condition endothelium vessels as on level desquamation endotheliocytes, a function indicator endothelium and on a level of a factor of Willebrand was marked. Authentically more expressed positive influence on endothelium tarka in comparison with iruzid has been noticed.Conclusion. At comparison of combinations fat-soluble ACE inhibitor with verapamil (tarka and water-soluble ACE inhibitor in a combination with hydrochlortiazid (iruzid the insignificant superiority of the first combination over the second for level of positive influence on endothelium of vessels has been revealed, more expressed antihypertensive effect and ability authentically to increase EF.

  14. Topical adapalene in the treatment of plantar warts; Randomized comparative open trial in comparison with cryo-therapy

    Directory of Open Access Journals (Sweden)

    Ramji Gupta

    2015-01-01

    Full Text Available Background: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. Aims: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. Materials and Methods: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. Result: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47 days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11 days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. Conclusion: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy.

  15. Comparative effects of chiropractic adjustment versus chiropractic adjustment combined with static magnetic field therapy on acupuncture points for the treatment of mechanical neck pain

    OpenAIRE

    2012-01-01

    M.Tech. Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was hypothesised t...

  16. Comparative effects of chiropractic adjustment versus chiropractic adjustment combined with static magnetic field therapy on acupuncture points for the treatment of mechanical neck pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was...

  17. Monotherapy of androgen deprivation therapy versus radical prostatectomy among veterans with localized prostate cancer: comparative effectiveness analysis of retrospective cohorts

    Directory of Open Access Journals (Sweden)

    Liu J

    2012-05-01

    Full Text Available Jinan Liu1,2, Lizheng Shi1,2,3, Oliver Sartor31Tulane University, School of Public Health and Tropical Medicine, 2Southeast Louisiana Veterans Health Care System, Tulane University, 3School of Medicine and Tulane Cancer Center, New Orleans, LA, USABackground: This retrospective cohort study aimed to examine the comparative effectiveness of monotherapy of primary androgen deprivation therapy or radical prostatectomy.Methods: Male patients with localized prostate cancer (T1-T2, N0, M0 were identified in the Veterans Affairs Veterans Integrated Service Network 16 data warehouse (January 2003 to June 2006, with one-year baseline and at least three-year follow-up data (until June 2009. Patients were required to be 18–75 years old and without other recorded cancer history. The initiation of primary androgen deprivation therapy or monotherapy of radical prostatectomy within six months after the first diagnosis of prostate cancer was used as the index date. Primary androgen deprivation therapy patients were matched to the radical prostatectomy patients via propensity score, which was predicted from a logistic regression of treatment selection (primary androgen deprivation therapy versus radical prostatectomy on age, race, marital status, insurance type, cancer stage, Charlson comorbidity index, and alcohol and tobacco use. The overall survival from initiation of index treatment was then analyzed using the Kaplan–Meier and Cox proportional hazards model.Results: The two cohorts were well matched at baseline (all P > 0.05. During a median follow-up of 4.3 years, the cumulative incidence of death was 13 (10.57% among 123 primary androgen deprivation therapy patients and four (3.25% among 123 radical prostatectomy patients (P < 0.05. The overall three-year survival rate was 92.68% for primary androgen deprivation therapy and 98.37% for radical prostatectomy (P < 0.05. Patients who received primary androgen deprivation therapy had almost three times as

  18. Adherence to antihypertensive therapy with fixed-dose amlodipine besylate/benazepril HCl versus comparable component-based therapy.

    Science.gov (United States)

    Taylor, Addison A; Shoheiber, Omar

    2003-01-01

    Adhering to medication regimens has the potential to significantly improve clinical outcomes for persons with high blood pressure. A patient-related factor likely to affect adherence to treatment is the convenience of the prescribed drug regimen. The authors hypothesized that medication adherence would be superior and cost benefits would accrue in subjects who receive a once-daily, single-capsule, fixed-dose combination product for blood pressure control, compared with subjects who receive a similar regimen of separate components. A managed care organization that provides benefits for members enrolled in various health plans provided the data for this retrospective analysis. The database was used to assess medication adherence patterns for two groups of hypertensive subjects. Group 1 included subjects who had been prescribed the single-capsule, fixed-dose combination of amlodipine besylate/benazepril HCl. Group 2 comprised subjects who had been prescribed a regimen including an angiotensin-converting enzyme inhibitor and a dihydropyridine calcium channel blocker as separate drugs. Adherence was measured by the medication possession ratio, and medical resource utilization by the two groups was assessed during the study period. Group 1 (n=2754) and Group 2 (n=2978) were balanced with regard to age (mean, 53 years; range, 18-64 years) and sex (men, 50%; women, 50%). The overall medication possession ratio for Group 1 was significantly higher than that for Group 2 (80.8% vs. 73.8%; pamlodipine/benazepril HCl demonstrated significantly better medication adherence and required fewer medical resources than did subjects receiving an angiotensin-converting enzyme inhibitor and a dihydropyridine calcium channel blocker as separate components.

  19. Comparing Virtual Reality Exposure Therapy to Prolonged Exposure in the Treatment of Soldiers with PTSD

    Science.gov (United States)

    2014-06-01

    Hodges LF: The use of virtual reality exposure in the treatment of anxiety disorders . Behav Modif 1999; 23(4):507-25 4. Difede J, Cukor J, Ivy P, Giosan C...RD: Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder . J Clin Psychiatry 2001; 62(8):617-22 3. Rothbaum BO...Hoffman H: The Application of Virtual Reality to the Treatment of PTSD Following the WTC Attack, in Psychobiology of Posttraumatic Stress Disorders

  20. EFFECT OF COGNITIVE BEHAVIOR THERAPY AS COMPARED TO MYOFASCIAL RELEASE TECHNIQUE IN FIBROMYALGIA SYNDROME

    OpenAIRE

    Kaur kusumpreet; Armugam Narkeesh; Khurana Sonia

    2013-01-01

    Background and introduction:Fibromyalgia or fibromyalgic syndrome is a common form of non-articularrheumatism characterized by variety of non-specific symptoms including diffuse widespread musculoskeletalaching associated with fatigue, morning stiffness and sleep disturbances (Bennett, 1997). The current study willcompare the beneficial effects of Cognitive behavior therapy (CBT) and Myofascial release (MFR) along withconventional treatment. This study tries to find out new effective method f...

  1. Comparing Cognitive, Metacognitive, and Acceptance and Commitment Therapy Models of Depression: a Longitudinal Study Survey.

    Science.gov (United States)

    Ruiz, Francisco J; Odriozola-González, Paula

    2015-06-16

    This study analyzed the interrelationships between key constructs of cognitive therapy (CT; depressogenic schemas), metacognitive therapy (MCT; dysfunctional metacognitive beliefs), and acceptance and commitment therapy (ACT; psychological inflexibility) in the prediction of depressive symptoms. With a lapse of nine months, 106 nonclinical participants responded twice to an anonymous online survey containing the following questionnaires: the Depression subscale of the Depression Anxiety and Stress Scales (DASS), the Dysfunctional Attitude Scale Revised (DAS-R), the Positive beliefs, Negative beliefs and Need to control subscales of the Metacognitions Questionnaire-30 (MCQ-30), and the Acceptance and Action Questionnaire - II (AAQ-II). Results showed that when controlling for baseline levels of depressive symptoms and demographic variables, psychological inflexibility longitudinally mediated the effect of depressogenic schemas (path ab = .023, SE = .010; 95% BC CI [.008, .048]) and dysfunctional metacognitive beliefs on depressive symptoms (positive metacognitive beliefs: path ab = .052, SE = .031; 95% BC CI [.005, .134]; negative metacognitive beliefs: path ab = .087, SE = .049; 95% BC CI [.016, .214]; need to control: path ab = .087, SE = .051; 95% BC CI [.013, .220]). Results are discussed emphasizing the role of psychological inflexibility in the CT and MCT models of depression.

  2. Five-year comparative study on conventional and laser-assisted therapy of periimplantitis and periodontitis

    Science.gov (United States)

    Bach, Georg; Neckel, Claus P.

    2000-03-01

    Numerous groups have recommended the use of the diode laser to decontaminate infected root and implant surfaces. The aim of this study was to show the outcome after laser assisted and conventional therapy of periimplantitis and periodontitis administering approved treatment protocols. Between 1994 and 1999 a total of 50 patients with periimplantitis (20) and periodontitis (30) were treated in two groups each. Clinical, microbiological and radiographic evaluation was performed before and 6, 12, 24, 36, 48 and 60 months after treatment. In addition to the conventional treatment protocol, flap surgery, the tooth or implant surface was decontaminated with a 810 nm diode laser using 1 Watt output for 20 sec (CW mode). All accessible surfaces were decontaminated at the follow up dates. In the periimplantitis group recurrence of the marker bacteria was higher and faster over time for the conventionally operated patients. Also the clinical and radiographic reevaluation showed significantly better results. The laser group of the periodontitis patients also showed significantly better outcome in terms of clinical evaluation, microbiological counts, radiographic evaluation and tooth loss. In comparison to other long term studies our results for the conventional therapy were adequate, the laser assisted therapy brought up significantly better and reproducible results.

  3. Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, Leena-Maija, E-mail: leena-maija.aaltonen@hus.fi [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Rautiainen, Noora; Sellman, Jaana [Institute of Behavioural Sciences, University of Helsinki, Helsinki (Finland); Saarilahti, Kauko [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Mäkitie, Antti; Rihkanen, Heikki [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Laranne, Jussi; Kleemola, Leenamaija [Department of Otorhinolaryngology–Head and Neck Surgery, Tampere University Hospital, and University of Tampere, Tampere (Finland); Wigren, Tuija [Department of Oncology, Tampere University Hospital, and University of Tampere, Tampere (Finland); Sala, Eeva [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Lindholm, Paula [Department of Oncology, Turku University Hospital, and University of Turku, Turku (Finland); Grenman, Reidar [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland)

    2014-10-01

    Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.

  4. Comparative study of two collagen membranes for guided tissue regeneration therapy in periodontal intrabony defects: a randomized clinical trial

    OpenAIRE

    Chung, Young-Mi; Lee, Jue-Yeon; Jeong, Seong-Nyum

    2014-01-01

    Purpose The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive contro...

  5. Beneficial effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin in rats: A histological and biochemical study.

    Science.gov (United States)

    Elbe, H; Dogan, Z; Taslidere, E; Cetin, A; Turkoz, Y

    2016-03-01

    Ciprofloxacin is a broad-spectrum quinolone antibiotic commonly used in clinical practice. Quercetin is an antioxidant belongs to flavonoid group. It inhibits the production of superoxide anion. In this study, we aimed to evaluate the effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin. Twenty-eight female Wistar albino rats were divided into four groups: control, quercetin (20 mg kg(-1) day(-1) gavage for 21 days), ciprofloxacin (20 mg kg(-1) twice a day intraperitoneally for 10 days), and ciprofloxacin + quercetin. Samples were processed for histological and biochemical evaluations. Malondialdehyde (MDA) and glutathione (GSH) levels, superoxide dismutase (SOD), and catalase (CAT) activities were measured in kidney tissue. The ciprofloxacin group showed histopathological changes such as infiltration, dilatation in tubules, tubular atrophy, reduction of Bowman's space, congestion, hemorrhage, and necrosis. In the ciprofloxacin + quercetin group, these histopathological changes markedly reduced. MDA levels increased in the ciprofloxacin group and decreased in the ciptofloxacin + quercetin group. SOD and CAT activities and GSH levels significantly decreased in the ciprofloxacin group. On the other hand, in the ciprofloxacin + quercetin group, SOD and CAT activities and GSH levels significantly increased with regard to the ciprofloxacin group. We concluded that quercetin has antioxidative and therapeutic effects on renal injury and oxidative stress caused by ciprofloxacin in rats.

  6. Listeria monocytogenes Strains Selected on Ciprofloxacin or the Disinfectant Benzalkonium Chloride Exhibit Reduced Susceptibility to Ciprofloxacin, Gentamicin, Benzalkonium Chloride, and Other Toxic Compounds▿

    Science.gov (United States)

    Rakic-Martinez, Mira; Drevets, Douglas A.; Dutta, Vikrant; Katic, Vera; Kathariou, Sophia

    2011-01-01

    Listeria monocytogenes is a leading agent for severe food-borne illness and death in the United States and other nations. Even though drug resistance has not yet threatened therapeutic interventions for listeriosis, selective pressure associated with exposure to antibiotics and disinfectants may result in reduced susceptibility to these agents. In this study, selection of several L. monocytogenes strains on either ciprofloxacin (2 μg/ml) or the quaternary ammonium disinfectant benzalkonium chloride (BC; 10 μg/ml) led to derivatives with increased MICs not only to these agents but also to several other toxic compounds, including gentamicin, the dye ethidium bromide, and the chemotherapeutic drug tetraphenylphosphonium chloride. The spectrum of compounds to which these derivatives exhibited reduced susceptibility was the same regardless of whether they were selected on ciprofloxacin or on BC. Inclusion of strains harboring the large plasmid pLM80 revealed that MICs to ciprofloxacin and gentamicin did not differ between the parental and plasmid-cured strains. However, ciprofloxacin-selected derivatives of pLM80-harboring strains had higher MICs than those derived from the plasmid-cured strains. Susceptibility to the antimicrobials was partially restored in the presence of the potent efflux inhibitor reserpine. Taken together, these data suggest that mutations in efflux systems are responsible for the multidrug resistance phenotype of strains selected on ciprofloxacin or BC. PMID:22003016

  7. Antibiotic combination therapy can select for broad-spectrum multidrug resistance in Pseudomonas aeruginosa.

    Science.gov (United States)

    Vestergaard, Martin; Paulander, Wilhelm; Marvig, Rasmus L; Clasen, Julie; Jochumsen, Nicholas; Molin, Søren; Jelsbak, Lars; Ingmer, Hanne; Folkesson, Anders

    2016-01-01

    Combination therapy with several antibiotics is one strategy that has been applied in order to limit the spread of antimicrobial resistance. We compared the de novo evolution of resistance during combination therapy with the β-lactam ceftazidime and the fluoroquinolone ciprofloxacin with the resistance evolved after single-drug exposure. Combination therapy selected for mutants that displayed broad-spectrum resistance, and a major resistance mechanism was mutational inactivation of the repressor gene mexR that regulates the multidrug efflux operon mexAB-oprM. Deregulation of this operon led to a broad-spectrum resistance phenotype that decreased susceptibility to the combination of drugs applied during selection as well as to unrelated antibiotic classes. Mutants isolated after single-drug exposure displayed narrow-spectrum resistance and carried mutations in the MexCD-OprJ efflux pump regulator gene nfxB conferring ciprofloxacin resistance, or in the gene encoding the non-essential penicillin-binding protein DacB conferring ceftazidime resistance. Reconstruction of resistance mutations by allelic replacement and in vitro fitness assays revealed that in contrast to single antibiotic use, combination therapy consistently selected for mutants with enhanced fitness expressing broad-spectrum resistance mechanisms.

  8. A Population-Based Comparative Effectiveness Study of Radiation Therapy Techniques in Stage III Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Jeremy P. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Murphy, James D. [Department of Radiation Medicine and Applied Science, University of California– San Diego, Moores Cancer Center, La Jolla, California (United States); Hanlon, Alexandra L. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W., E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian, E-mail: diehn@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States)

    2014-03-15

    Purpose: Concerns have been raised about the potential for worse treatment outcomes because of dosimetric inaccuracies related to tumor motion and increased toxicity caused by the spread of low-dose radiation to normal tissues in patients with locally advanced non-small cell lung cancer (NSCLC) treated with intensity modulated radiation therapy (IMRT). We therefore performed a population-based comparative effectiveness analysis of IMRT, conventional 3-dimensional conformal radiation therapy (3D-CRT), and 2-dimensional radiation therapy (2D-RT) in stage III NSCLC. Methods and Materials: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify a cohort of patients diagnosed with stage III NSCLC from 2002 to 2009 treated with IMRT, 3D-CRT, or 2D-RT. Using Cox regression and propensity score matching, we compared survival and toxicities of these treatments. Results: The proportion of patients treated with IMRT increased from 2% in 2002 to 25% in 2009, and the use of 2D-RT decreased from 32% to 3%. In univariate analysis, IMRT was associated with improved overall survival (OS) (hazard ratio [HR] 0.90, P=.02) and cancer-specific survival (CSS) (HR 0.89, P=.02). After controlling for confounders, IMRT was associated with similar OS (HR 0.94, P=.23) and CSS (HR 0.94, P=.28) compared with 3D-CRT. Both techniques had superior OS compared with 2D-RT. IMRT was associated with similar toxicity risks on multivariate analysis compared with 3D-CRT. Propensity score matched model results were similar to those from adjusted models. Conclusions: In this population-based analysis, IMRT for stage III NSCLC was associated with similar OS and CSS and maintained similar toxicity risks compared with 3D-CRT.

  9. Comparing the effects of minimal handling protocols on the physiological parameters of preterm infants receiving exogenous surfactant therapy

    Directory of Open Access Journals (Sweden)

    Laura A. Cabral

    2014-04-01

    Full Text Available BACKGROUND: The practice of minimal handling is recommended for preterm infants (PTIs. However, few studies have investigated the effects of this practice among these infants or the time needed to ensure greater physiological stability, especially after exogenous surfactant treatments. OBJECTIVE: The current study compared the effects of two protocols of minimal handling on the physiological variables of PTIs after surfactant therapy. METHOD : An exploratory prospective observational study was performed with 40 PTIs weighing less than 1,500 g. The infants were divided into two groups and monitored for 72 hours. One group received the standard minimal handling procedure during the first 12 hours after surfactant therapy; the other group (i.e., the modified group received minimal handling within 72 hours after surfactant therapy. Infant heart rate (HR, oxygen saturation, body temperature, and the adverse events associated with changes to these variables were monitored every 10 minutes. RESULTS : Significant between-group differences were not found with regard to the occurrence of the adverse events associated with physiological changes (p>0.05. CONCLUSION: The practice of minimal handling among very low birth weight infants did not alter their physiological stability when performed either 12 or 72 hours after surfactant therapy.

  10. Students of physical therapy. A comparative study of student profiles at a college and university in Israel

    Directory of Open Access Journals (Sweden)

    Nitza Davidovitch

    2006-01-01

    Full Text Available This study focuses on the attributes of students of physical therapy in order to compare the profiles of students of physical therapy (PT in two institutions of higher learning in Israel: Ben Gurion University (BGU and the Academic College of Judea and Samaria (ACJS. This study focuses on a department where studies have an occupational/applicative/practical orientation and high status in the higher education system. Findings of this study indicate broad similarities in the profiles of students at both institutions in relation to their age, family status, country of origin, number of siblings, parental education, and financial status of student family of origin. On the other hand, students at both institutions differed in terms of gender composition, students' employment status, the source of payment for tuition, and in their academic attainments prior to admission. Specifically, students of physical therapy at ACJS had lower academic achievements prior to their admission and reported having been rejected by other physical therapy programs. Students at ACJS placed higher importance on factors relating to the quality of instruction including teacher involvement, competitiveness, organization, control, and orientation to the study material. Students at BGU attributed greater importance to teachers' support. Findings support a thesis of a converging system of higher education in Israel, traditionally dominated by national universities and regional colleges, a relatively recent phenomenon.

  11. Efficacy of Selected Electrical Therapies on Chronic Low Back Pain: A Comparative Clinical Pilot Study

    Science.gov (United States)

    Rajfur, Joanna; Pasternok, Małgorzata; Rajfur, Katarzyna; Walewicz, Karolina; Fras, Beata; Bolach, Bartosz; Dymarek, Robert; Rosinczuk, Joanna; Halski, Tomasz; Taradaj, Jakub

    2017-01-01

    Background In the currently available research publications on electrical therapy of low back pain, generally no control groups or detailed randomization were used, and such studies were often conducted with relatively small groups of patients, based solely on subjective questionnaires and pain assessment scales (lacking measurement methods to objectify the therapeutic progress). The available literature also lacks a comprehensive and large-scale clinical study. The purpose of this study was to assess the effects of treating low back pain using selected electrotherapy methods. The study assesses the influence of individual electrotherapeutic treatments on reduction of pain, improvement of the range of movement in lower section of the spine, and improvement of motor functions and mobility. Material/Methods The 127 patients qualified for the therapy (ultimately, 123 patients completed the study) and assigned to 6 comparison groups: A – conventional TENS, B – acupuncture-like TENS, C – high-voltage electrical stimulation, D – interferential current stimulation, E – diadynamic current, and F – control group. Results The research showed that using electrical stimulation with interferential current penetrating deeper into the tissues results in a significant and more efficient elimination of pain, and an improvement of functional ability of patients suffering from low back pain on the basis of an analysis of both subjective and objective parameters. The TENS currents and high voltage were helpful, but not as effective. The use of diadynamic currents appears to be useless. Conclusions Selected electrical therapies (interferential current, TENS, and high voltage) appear to be effective in treating chronic low back pain. PMID:28062862

  12. A randomized trial comparing bladder volume consistency during fractionated prostate radiation therapy

    LENUS (Irish Health Repository)

    Mullaney, L.

    2014-01-10

    Organ motion is a contributory factor to the variation in location of the prostate and organs at risk during a course of fractionated prostate radiation therapy (RT). A prospective randomized controlled trial was designed with the primary endpoint to provide evidence-based bladder-filling instructions to achieve a consistent bladder volume (BV) and thus reduce the bladder-related organ motion. The secondary endpoints were to assess the incidence of acute and late genitourinary (GU) and gastrointestinal (GI) toxicity for patients and patients’ satisfaction with the bladder-filling instructions.

  13. Early rheumatoid arthritis therapy: comparative characteristic of delagil, sulphasalazine and methotrexate

    Directory of Open Access Journals (Sweden)

    T S Salnikova

    2003-01-01

    Full Text Available Objective. To assess early administration and efficacy of 3 disease modifying antirheumatic drugs. Material and methods. 92 pts with rheumatoid arthritis (RA aged 17 to 45 years (mean age 34,9±8,5 years were included. Disease duration did not exceed 6 months (mean 3,5±1,9 months. All had 2-3 activity degree and did not received glucocorticoid therapy (systemic or local and did not have severe concomitant diseases of internal organs. Results. Diagnosis of RA was confirmed during follow up in 90 pts. In 2 pts after 6 months diagnosis was changed to systemic lupus erythematosus. 30 pts received delagil for 3 months without improvement. Treatment with sulphasalazine for 3 months was not effective in 23 from 30 pts. 7 pts had subjective improvement during first 3 months but at 6 month effect was lost. Methotrexate administration provided improvement (DAS change 1,6. Clinical and laboratory remission was achieved in 6 pts. Number of bone erosions in pts treated with methotrexate was significantly less and depended on time of therapy beginning and features of disease onset. Conclusion. Methotrexate was most effective from the 3 drugs in early RA particularly when administered during first 3 months of the disease.

  14. Susceptibility of Mexican brucella isolates to moxifloxacin, ciprofloxacin and other antimicrobials used in the treatment of human brucellosis.

    Science.gov (United States)

    López-Merino, Ahidé; Contreras-Rodríguez, Araceli; Migranas-Ortiz, Roberto; Orrantia-Gradín, Rubén; Hernández-Oliva, Gerardo M; Gutiérrez-Rubio, Arturo Torres Y; Cardeñosa, Oscar

    2004-01-01

    Brucellosis is a disease of domestic and wild animals that is transmitted to humans and exists worldwide. We assessed the in vitro activity of moxifloxacin, ciprofloxacin, tetracycline, doxicycline, rifampin, streptomycin and trimethoprim-sulfamethoxazole (TMP/SMX) against 97 Brucella strains isolated from clinical samples, animals and dairy products in Mexico. Fluoroquinolones showed an antibacterial activity similar to that of tetracyclines (MIC(90) 0.5). Other drugs commonly used against brucellosis were less active, such as rifampin (MIC(90) 2.0 microg/ml) and streptomycin (MIC(90) 4.0 microg/ml). TMP/SMX showed the poorest activity (MIC(90) 8.0 microg/ml). Fluoroquinolones, either first-generation or the newer 8-methoxi derivatives, might be useful in the therapy of brucellosis, which remains to be assessed in clinical trials.

  15. A Meta-analysis of Randomized Trials Comparing Surgery versus Endovascular Therapy for Thrombosed Arteriovenous Fistulas and Grafts in Hemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Kuhan, G., E-mail: gkuhan@nhs.net; Antoniou, G. A. [Central Manchester University Hospital Foundation Trust, Regional Vascular and Endovascular Unit (United Kingdom); Nikam, M.; Mitra, S. [Central Manchester University Hospital Foundation Trust, Department of Renal Medicine (United Kingdom); Farquharson, F. [Central Manchester University Hospital Foundation Trust, Department of Radiology (United Kingdom); Brittenden, J. [University of Aberdeen (United Kingdom); Chalmers, N. [Central Manchester University Hospital Foundation Trust, Department of Radiology (United Kingdom)

    2013-06-15

    Purpose. To carry out a systematic review of randomized trials comparing surgery vs. endovascular therapy for occluded fistulas and grafts. Methods. All randomized trials which compared surgery and endovascular therapy for occluded fistulas and grafts were retrieved from 1990 onwards. The following search terms were used: 'haemodialysis,' 'thrombosis,' 'arteriovenous fistula,' 'arteriovenous shunt,' 'end stage renal failure' on Medline and PubMed. The results of the pooled data were analysed by a fixed-effect model. Results. There were no randomized trials comparing surgery vs. endovascular therapy for native fistulas and vein grafts. Six randomized studies reporting on 573 occluded grafts were identified. Technical success, need for access line and primary patency at 30 days were similar between the two groups (odds ratio [OR] 1.40, 95 % confidence interval [CI] 0.91-2.14; OR 0.77, 95 % CI 0.44-1.34; and OR 1.15, 95 % CI 0.79-1.68, respectively). There was no significant difference in morbidity at 30 days between groups (OR 1.12, 95 % CI 0.67-1.86). There were no statistical difference between the two groups for 1 year primary patency (OR 2.08, 95 % CI 0.97-4.45). Primary assisted patency at 1 year was better with surgery (OR 3.03, 95 % CI 1.12-8.18) in a single study. Conclusion. Comparable results to surgery have been achieved with endovascular techniques for occluded prosthetic grafts for dialysis access. Long-term data comparing the two groups were lacking. Further trials designed to encompass variation in methods are warranted in order to obtain the best available evidence particularly for native fistulas.

  16. A man who wanted to commit suicide by hanging himself : an adverse effect of ciprofloxacin.

    NARCIS (Netherlands)

    Ahmed, A.I.A.; Heijden, F.M.M.A. van der; Berkmortel, H. van den; Kramers, K.

    2011-01-01

    In this case report, we describe a man who developed recurrent depression and suicidal ideation with a serious plan to commit suicide as definite adverse effect of ciprofloxacin, which had been prescribed for recurrent prostatitis.

  17. Biowaiver monographs for immediate release solid oral dosage forms: ciprofloxacin hydrochloride.

    Science.gov (United States)

    Olivera, M E; Manzo, R H; Junginger, H E; Midha, K K; Shah, V P; Stavchansky, S; Dressman, J B; Barends, D M

    2011-01-01

    Literature data relevant to the decision to allow a waiver of in vivo bioequivalence (BE) testing for the approval of new multisource and reformulated immediate release (IR) solid oral dosage forms containing ciprofloxacin hydrochloride as the only active pharmaceutical ingredient (API) are reviewed. Ciprofloxacin hydrochloride's solubility and permeability, its therapeutic use and index, pharmacokinetics, excipient interactions and reported BE/bioavailability (BA) problems were taken into consideration. Solubility and BA data indicate that ciprofloxacin hydrochloride is a BCS Class IV drug. Therefore, a biowaiver based approval of ciprofloxacin hydrochloride containing IR solid oral dosage forms cannot be recommended for either new multisource drug products or for major scale-up and postapproval changes (variations) to existing drug products.

  18. Comparative clinical study using laser and LED-therapy for orofacial pain relief: dentin hypersensitivity and cervicogenic headache

    Science.gov (United States)

    Lizarelli, Rosane F. Z.; Pizzo, Renata C. A.; Florez, Fernando L. E.; Grecco, Clovis; Speciali, Jose G.; Bagnato, Vanderlei S.

    2015-06-01

    Considering several clinical situations, low intensity laser therapy has been widely applied in pain relief or analgesia mechanism. With the advent of new LED-based (light emitting diode) light sources, the need of further clinical experiments aiming to compare the effectiveness among them is paramount. The LED system therapeutic use can be denominated as LEDT - Light Emitting Diode Therapy. This study proposed two clinical evaluations of pain relief effect: to dentin hypersensitivity and to cervicogenic headache using different sources of lasers (low and high intensity) and light emitting diodes (LEDs), one emitting at the spectral band of red (630+/- 5nm) and the other one at infrared band (880+/- 5nm). Two different clinical studies were performed and presented interesting results. Considering dentin hypersensitivity, red and infrared led were so effective than the control group (high intensity laser system); by the other side, considering cervicogenic headache, control group (infrared laser) was the best treatment in comparison to red and infrared led system.

  19. Minimum inhibitory concentration of ciprofloxacin in combination with hexahydroquinoline derivatives against Staphylococcus aureus

    OpenAIRE

    F Amin Harati; M Amini; Shahverdi AR; Pourmand, MR; Yousefi, M.

    2012-01-01

    Background: Staphylococcus aureus is the most common pathogen responsible for skin and soft tissue infections worldwide. Methicillin-resistant S. aureus is a major cause of both nosocomial and community acquired infections. The emergence of antimicrobial-resistant S. aureus is of global concern. Fluoroquinolone antimicrobials including ciprofloxacin, levofloxacin, and moxifloxacin are used to treat skin and soft tissue infections due to S. aureus. Emergence of ciprofloxacin resistance has inc...

  20. Comparative study of oral and topical ketoconazole therapy in pityriasis versicolor

    Directory of Open Access Journals (Sweden)

    Nagpal V

    2003-07-01

    Full Text Available Introduction: Both topical and systemic ketoconazole are reported to be effective against pityriasis versicolor. Material and Methods: Forty patients suffering from pityriasis versicolor were treated either with oral ketoconazole 200 mg per day or 2% ketoconazole cream topically once daily for 2 weeks. Results: On global assessment, after 2 weeks of start of therapy, 18 (90% out of 20 patients treated with oral ketoconazole were cured while 2 patients had considerable residual disease. In the ketoconazole cream group, 16 (80% out of 20 patients were cured and 4 patients had considerable residual disease. Conclusion: No significant difference was observed in the response rates in the two groups. Relapse occurred in two patients of the systemic ketoconazole group and six patients of the topical ketoconazole group during the follow-up period of three months.

  1. Which T category of nasopharyngeal carcinoma may benefit most from volumetric modulated arc therapy compared with step and shoot intensity modulated radiation therapy.

    Directory of Open Access Journals (Sweden)

    Ying Sun

    Full Text Available BACKGROUND: To compare volumetric modulated arc therapy (VMAT with conventional step and shoot intensity modulated radiation therapy (s-IMRT in nasopharyngeal carcinoma (NPC patients, and identify which T category patient gains the maximum benefit from VMAT. METHODS: Fifty-two patients that randomly selected from 205 patients received VMAT at a single center were retrospectively replanned with s-IMRT. For a fair comparison, the planning target volume (PTV coverage of the 2 plans was normalized to the same level. A standard planning constraint set was used; the constraints for the organs at risk (OARs were individually adapted. The calculated doses to the PTV and OARs were compared for s-IMRT and VMAT plans generated using the Monaco treatment planning system. RESULTS: VMAT and s-IMRT plans had similar PTV coverage and OAR sparing within all T categories. However, in stratified analysis, VMAT plans lead to better or similar sparing of the OARs in early T category patients; and lead to poorer sparing of the OARs in advanced T category patients (P<0.05. VMAT shows significant advantages for low dose burden (P<0.05 compared with s-IMRT. The delivery time per fraction for VMAT (424±64 s was shorter than s-IMRT (778 ± 126 s, p<0.01. CONCLUSIONS: VMAT provides similar dose coverage of the PTVs and similar/better normal tissue sparing in early T category NPC, and poorer OARs sparing in advanced T category NPC. And VMAT shows significant advantages for low dose burden and delivery time.

  2. Comparative dosimetry of volumetric modulated arc therapy and limited-angle static intensity-modulated radiation therapy for early-stage larynx cancer

    Energy Technology Data Exchange (ETDEWEB)

    Riegel, Adam C.; Antone, Jeffrey [Department of Radiation Medicine, North Shore–LIJ Health System, New Hyde, Park, NY (United States); Schwartz, David L., E-mail: dschwartz3@nshs.edu [Department of Radiation Medicine, North Shore–LIJ Health System, New Hyde, Park, NY (United States); Hofstra–NSLIJ School of Medicine, Hempstead, NY (United States)

    2013-04-01

    To compare relative carotid and normal tissue sparing using volumetric-modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) for early-stage larynx cancer. Seven treatment plans were retrospectively created on 2 commercial treatment planning systems for 11 consecutive patients with T1-2N0 larynx cancer. Conventional plans consisted of opposed-wedged fields. IMRT planning used an anterior 3-field beam arrangement. Two VMAT plans were created, a full 360° arc and an anterior 180° arc. Given planning target volume (PTV) coverage of 95% total volume at 95% of 6300 cGy and maximum spinal cord dose below 2500 cGy, mean carotid artery dose was pushed as low as possible for each plan. Deliverability was assessed by comparing measured and planned planar dose with the gamma (γ) index. Full-arc planning provided the most effective carotid sparing but yielded the highest mean normal tissue dose (where normal tissue was defined as all soft tissue minus PTV). Static IMRT produced next-best carotid sparing with lower normal tissue dose. The anterior half-arc produced the highest carotid artery dose, in some cases comparable with conventional opposed fields. On the whole, carotid sparing was inversely related to normal tissue dose sparing. Mean γ indexes were much less than 1, consistent with accurate delivery of planned treatment. Full-arc VMAT yields greater carotid sparing than half-arc VMAT. Limited-angle IMRT remains a reasonable alternative to full-arc VMAT, given its ability to mediate the competing demands of carotid and normal tissue dose constraints. The respective clinical significance of carotid and normal tissue sparing will require prospective evaluation.

  3. Effect of Amniotic Membrane Combined with Ciprofloxacin in Curing the Primary Stages of Pseudomonal Keratitis

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Sharifi Yazdi

    2012-03-01

    Full Text Available Background: Keratitis caused by Pseudomonas aeruginosa is often resulted in severe corneal ulcers and perforation, which leads to losses of vision. Human amniotic membrane (HAM forms the inner wall of the membranous sac which surrounds and protects the embryo during gestation. The purpose of this study was to evaluate the effectiveness of the amniotic membrane's healing in rabbits with pseudomonas keratitis.Methods: In total 14 rabbits divided in 2 groups of: 1 as Control and 2 as experimental amniotic membrane combined with ciprofloxacin. A 0.05 ml suspension of Pseudomonas aeruginosa ATCC 27853 was injected into rabbit’s corneal stroma, with no interference in control group. In the second group, the amniotic membrane in pieces of 1.5 × 1.5 cm transplanted to the entire corneal surface by eight interrupted 10.0 nylon sutures. In the first day ciprofloxacin drop was injected to the second group every 30 minutes and through second to seventh days every 2 hours. The results of perforation in cornea and the amount of infiltration were registered.Results: The results showed that amniotic membrane transplantation (AMT + ciprofloxacin group had 0% perforation and the control group 85.6%. Average infiltrations were 5 mm in AMT + ciprofloxacin groups and 23.75 mm in control.Conclusion: The use of amniotic membrane with ciprofloxacin was effective in prevention of cornea perforation and controlling the process of pseudomonal keratitis remission. The improvement of inflammation rapidly happened in ciprofloxacin + AMT group.

  4. Study of the role of efflux pump in ciprofloxacin resistance in Salmonella enterica serotype Typhi

    Directory of Open Access Journals (Sweden)

    V Sharma

    2013-01-01

    Full Text Available Purpose: There are increasing reports on failure of clinical response to ciprofloxacin in typhoid fever despite the strain being sensitive to drug in in-vitro using standard guidelines and showing mutations in DNA gyrase. But this increased MIC and clinical failures with ciprofloxacin are not always co-related with mutations presently identified in gyrA and parC genes. This shows that there may be other mechanisms such as an active drug efflux pump responsible as has been shown in other Enterobacteriaceae. This study was carried out to determine the role of efflux pump in Salmonella Typhi isolates. Materials and Methods : Total 25 already characterized nalidixic acid sensitive and nalidixic acid resistant S. Typhi strains with different range of ciprofloxacin MIC were included to study the role of efflux pump in the presence of CCCP (efflux pump inhibitor. For genotypic characterization, the entire acrR gene was sequenced to confirm the presence of any mutation in the gene. Results: The MIC of ciprofloxacin remained same in the presence and absence of CCCP in the studied strains and no significant mutations were found in the acrR gene in any of the isolates studied. Conclusions: No role of efflux pump in ciprofloxacin resistance was found in strains studied. There is a need to explore further mechanism of ciprofloxacin resistance in Salmonella Typhi.

  5. Effect of experimentally induced Escherichia coli epididymo-orchitis and ciprofloxacin treatment on rat spermatogenesis.

    Science.gov (United States)

    Demir, Aslan; Türker, Polat; Onol, Fikret Fatih; Sirvanci, Serap; Findik, Ayfer; Tarcan, Tufan

    2007-03-01

    We investigated the effects of epididymo-orchitis and ciprofloxacin on rat testicular histology and spermatogenesis. The control group underwent left orchiectomy. The second group received oral ciprofloxacin (150 mg/kg/day) for 10 days. Escherichia coli (10(6) cfu/mL, 0.1 mL) was injected into the proximal right ductus deferens in the third group. The fourth group received ciprofloxacin treatment 48 h after E. coli inoculation. In groups 3 and 4, bilateral orchiectomy was performed 14 days after the challenge. In healthy rats, ciprofloxacin caused recognizable histological damage associated with a mild decrease in testicular volume and sperm concentration. Infected testicles in groups 3 and 4 revealed severe histological damage associated with severe testicular atrophy and impaired spermatogenesis that were more significant in infected rats which received ciprofloxacin treatment. Contralateral testicles in these animals showed similar histopathological changes to a lesser extent. The results of our study suggest a gonadotoxic potential for ciprofloxacin and this potential in humans should be addressed with further studies.

  6. CIPROFLOXACIN RESISTANCE PATTERN AMONG BACTERIA ISOLATED FROM PATIENTS WITH COMMUNITY-ACQUIRED URINARY TRACT INFECTION

    Directory of Open Access Journals (Sweden)

    Ana Carolina Costa REIS

    2016-01-01

    Full Text Available SUMMARY Objective: To identify the main bacterial species associated with community-acquired urinary tract infection (UTI and to assess the pattern of ciprofloxacin susceptibility among bacteria isolated from urine cultures. Methods: We conducted a retrospective study in all the patients with community-acquired UTI seen in Santa Helena Laboratory, Camaçari, Bahia, Brazil during five years (2010-2014. All individuals who had a positive urine culture result were included in this study. Results: A total of 1,641 individuals met the inclusion criteria. Despite the fact that participants were female, we observed a higher rate of resistance to ciprofloxacin in males. The most frequent pathogens identified in urine samples were Escherichia coli, Klebsiella pneumoniae and Staphylococcus saprophyticus. Antimicrobial resistance has been observed mainly for ampicillin, sulfamethoxazole + trimethoprim and ciprofloxacin. Moreover, E. coli has shown the highest rate of ciprofloxacin resistance, reaching 36% of ciprofloxacin resistant strains in 2014. Conclusion: The rate of bacterial resistance to ciprofloxacin observed in the studied population is much higher than expected, prompting the need for rational use of this antibiotic, especially in infections caused by E. coli. Prevention of bacterial resistance can be performed through control measures to limit the spread of resistant microorganisms and a rational use of antimicrobial policy.

  7. CIPROFLOXACIN RESISTANCE PATTERN AMONG BACTERIA ISOLATED FROM PATIENTS WITH COMMUNITY-ACQUIRED URINARY TRACT INFECTION

    Science.gov (United States)

    REIS, Ana Carolina Costa; SANTOS, Susana Regia da Silva; de SOUZA, Siane Campos; SALDANHA, Milena Góes; PITANGA, Thassila Nogueira; OLIVEIRA, Ricardo Riccio

    2016-01-01

    SUMMARY Objective: To identify the main bacterial species associated with community-acquired urinary tract infection (UTI) and to assess the pattern of ciprofloxacin susceptibility among bacteria isolated from urine cultures. Methods: We conducted a retrospective study in all the patients with community-acquired UTI seen in Santa Helena Laboratory, Camaçari, Bahia, Brazil during five years (2010-2014). All individuals who had a positive urine culture result were included in this study. Results: A total of 1,641 individuals met the inclusion criteria. Despite the fact that participants were female, we observed a higher rate of resistance to ciprofloxacin in males. The most frequent pathogens identified in urine samples were Escherichia coli, Klebsiella pneumoniae and Staphylococcus saprophyticus. Antimicrobial resistance has been observed mainly for ampicillin, sulfamethoxazole + trimethoprim and ciprofloxacin. Moreover, E. coli has shown the highest rate of ciprofloxacin resistance, reaching 36% of ciprofloxacin resistant strains in 2014. Conclusion: The rate of bacterial resistance to ciprofloxacin observed in the studied population is much higher than expected, prompting the need for rational use of this antibiotic, especially in infections caused by E. coli. Prevention of bacterial resistance can be performed through control measures to limit the spread of resistant microorganisms and a rational use of antimicrobial policy. PMID:27410913

  8. Modification of a magnetic carbon composite for ciprofloxacin adsorption.

    Science.gov (United States)

    Mao, Haixin; Wang, Shikui; Lin, Jian-Ying; Wang, Zengshuang; Ren, Jun

    2016-11-01

    A magnetic carbon composite, Fe3O4/C composite, was fabricated by one-step hydrothermal synthesis, modified by heat treatment under an inert atmosphere (N2), and then used as an adsorbent for ciprofloxacin (CIP) removal. Conditions for the modification were optimized according to the rate of CIP removal. The adsorbent was characterized by Fourier transform infrared spectroscopy, X-ray diffraction measurements, vibrating-sample magnetometry, scanning electron microscopy, transmission electron microscopy, and N2 adsorption/desorption isotherm measurements. The results indicate that the modified adsorbent has substantial magnetism and has a large specific area, which favor CIP adsorption. The effects of solution pH, adsorbent dose, contact time, initial CIP concentration, ion strength, humic acid and solution temperature on CIP removal were also studied. Our results show that all of the above factors influence CIP removal. The Langmuir adsorption isotherm fits the adsorption process well, with the pseudo second-order model describing the adsorption kinetics accurately. The thermodynamic parameters indicate that adsorption is mainly physical adsorption. Recycling experiments revealed that the behavior of adsorbent is maintained after recycling for five times. Overall, the modified magnetic carbon composite is an efficient adsorbent for wastewater treatment.

  9. Ciprofloxacin release using natural rubber latex membranes as carrier.

    Science.gov (United States)

    Dias Murbach, Heitor; Jaques Ogawa, Guilherme; Azevedo Borges, Felipe; Romeiro Miranda, Matheus Carlos; Lopes, Rute; Roberto de Barros, Natan; Guedes Mazalli, Alexandre Vinicius; Gonçalves da Silva, Rosângela; Ferreira Cinman, José Luiz; de Camargo Drago, Bruno; Donizetti Herculano, Rondinelli

    2014-01-01

    Natural rubber latex (NRL) from Hevea brasiliensis is easily manipulated, low cost, is of can stimulate natural angiogenesis and cellular adhesion, is a biocompatible, material and presents high mechanical resistance. Ciprofloxacin (CIP) is a synthetic antibiotic (fluoroquinolone) used in the treatment of infection at external fixation screws sites and remote infections, and this use is increasingly frequent in medical practice. The aim of this study was to develop a novel sustained delivery system for CIP based on NRL membranes and to study its delivery system behavior. CIP was found to be adsorbed on the NRL membrane, according to results of energy dispersive X-ray spectroscopy. Results show that the membrane can release CIP for up to 59.08% in 312 hours and the mechanism is due to super case II (non-Fickian). The kinetics of the drug release could be fitted with double exponential function X-ray diffraction and Fourier transform infrared (FTIR) spectroscopy shows some interaction by hydrogen bound, which influences its mechanical behavior.

  10. Adsorption of ciprofloxacin on surface-modified carbon materials.

    Science.gov (United States)

    Carabineiro, S A C; Thavorn-Amornsri, T; Pereira, M F R; Figueiredo, J L

    2011-10-01

    The adsorption capacity of ciprofloxacin (CPX) was determined on three types of carbon-based materials: activated carbon (commercial sample), carbon nanotubes (commercial multi-walled carbon nanotubes) and carbon xerogel (prepared by the resorcinol/formaldehyde approach at pH 6.0). These materials were used as received/prepared and functionalised through oxidation with nitric acid. The oxidised materials were then heat treated under inert atmosphere (N2) at different temperatures (between 350 and 900°C). The obtained samples were characterised by adsorption of N2 at -196 °C, determination of the point of zero charge and by temperature programmed desorption. High adsorption capacities ranging from approximately 60 to 300 mgCPxgC(-1) were obtained (for oxidised carbon xerogel, and oxidised thermally treated activated carbon Norit ROX 8.0, respectively). In general, it was found that the nitric acid treatment of samples has a detrimental effect in adsorption capacity, whereas thermal treatments, especially at 900 °C after oxidation, enhance adsorption performance. This is due to the positive effect of the surface basicity. The kinetic curves obtained were fitted using 1st or 2nd order models, and the Langmuir and Freundlich models were used to describe the equilibrium isotherms obtained. The 2nd order and the Langmuir models, respectively, were shown to present the best fittings.

  11. Traditional Therapies Used to Manage Diabetes and Related Complications in Mauritius: A Comparative Ethnoreligious Study

    Science.gov (United States)

    Mahomoodally, M. Fawzi; Mootoosamy, A.; Wambugu, S.

    2016-01-01

    Religious communities from Mauritius still rely on traditional therapies (TT) for primary healthcare. Nonetheless, there is still a dearth of scientific information on TT used by the different religious groups to manage diabetes and related complications (DRC). This study aimed to gather ethnomedicinal knowledge on TT used by the different religious groups against DRC. Diabetic patients (n = 95) and traditional healers (n = 5) were interviewed. Fifty-two plant species belonging to 33 families and 26 polyherbal formulations were documented to manage DRC. The most reported DRC was hypertension (n = 36). Leaves (45.2%) and juice (36%) were the most cited mode of preparation of herbal recipes. Plants which scored high relative frequency of citation were Citrus aurantifolia (0.55) and Morinda citrifolia (0.54). The cultural importance index showed that Ocimum tenuiflorum, Cardiospermum halicacabum, Camellia sinensis, and Ophiopogon japonicas were the most culturally important plants among Hindu, Muslim, Christian, and Buddhist community, respectively. Hindu and Muslim community showed the highest similarity of medicinal plants usage (Jaccard index = 95.8). Seven animal species distributed over 4 classes were recorded for the management of DRC. Plants and animals recorded as TT should be submitted to scientific studies to confirm safety and efficacy in clinical practice and to identify pharmacologically active metabolites. PMID:27200100

  12. Traditional Therapies Used to Manage Diabetes and Related Complications in Mauritius: A Comparative Ethnoreligious Study

    Directory of Open Access Journals (Sweden)

    M. Fawzi Mahomoodally

    2016-01-01

    Full Text Available Religious communities from Mauritius still rely on traditional therapies (TT for primary healthcare. Nonetheless, there is still a dearth of scientific information on TT used by the different religious groups to manage diabetes and related complications (DRC. This study aimed to gather ethnomedicinal knowledge on TT used by the different religious groups against DRC. Diabetic patients (n=95 and traditional healers (n=5 were interviewed. Fifty-two plant species belonging to 33 families and 26 polyherbal formulations were documented to manage DRC. The most reported DRC was hypertension (n=36. Leaves (45.2% and juice (36% were the most cited mode of preparation of herbal recipes. Plants which scored high relative frequency of citation were Citrus aurantifolia (0.55 and Morinda citrifolia (0.54. The cultural importance index showed that Ocimum tenuiflorum, Cardiospermum halicacabum, Camellia sinensis, and Ophiopogon japonicas were the most culturally important plants among Hindu, Muslim, Christian, and Buddhist community, respectively. Hindu and Muslim community showed the highest similarity of medicinal plants usage (Jaccard index = 95.8. Seven animal species distributed over 4 classes were recorded for the management of DRC. Plants and animals recorded as TT should be submitted to scientific studies to confirm safety and efficacy in clinical practice and to identify pharmacologically active metabolites.

  13. Comparative pharmacokinetics of oral and intravenous ifosfamide/mesna/methylene blue therapy.

    Science.gov (United States)

    Aeschlimann, C; Küpfer, A; Schefer, H; Cerny, T

    1998-09-01

    Oral treatment with ifosfamide results in dose-limiting encephalopathy. Methylene blue is effective in reversal and prophylaxis of this side effect. In the present study, the pharmacokinetics of ifosfamide after iv and po therapy in combination with prophylactic administration of methylene blue were investigated. Nine patients with metastatic non-small cell lung cancer were treated by a combination of ifosfamide (3 days), sodium 2-mercaptoethane sulfonate (4 days), and etoposide (8 days). Cycles were repeated every 28 days. Ifosfamide was administered orally, with the exception of one of the first two cycles, when it was administered as a short infusion (randomly assigned). The patients received methylene blue in doses of 50 mg po 3 times daily; an initial dose of 50 mg was given the evening before chemotherapy. Urine samples were collected over the entire treatment period, and concentrations of ifosfamide and its major metabolite, 2-chloroethylamine, were measured by gas liquid chromatography. By the same technique, 2- and 3-dechloroethylifosfamide were determined in plasma and urine. Overall alkylating activity in urine was assayed by reaction of the alkylating metabolites with 4-(4'-nitrobenzyl)-pyridine. The chemotherapeutic regimen was well-tolerated by all of the patients studied. There was no evidence of a shift in the metabolic pattern dependent on the route of administration. From the data, we conclude that methylene blue has a neuroprotective effect and that the pharmacokinetics of ifosfamide are not influenced by its comedication.

  14. Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

    Directory of Open Access Journals (Sweden)

    L Nithya

    2014-01-01

    Full Text Available The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC intensity modulated radiation therapy (IMRT plans with volumetric modulated arc therapy (VMAT plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI and the conformity index (CI of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases.

  15. Individualized Positron Emission Tomography–Based Isotoxic Accelerated Radiation Therapy Is Cost-Effective Compared With Conventional Radiation Therapy: A Model-Based Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bongers, Mathilda L., E-mail: ml.bongers@vumc.nl [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Coupé, Veerle M.H. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); De Ruysscher, Dirk [Radiation Oncology University Hospitals Leuven/KU Leuven, Leuven (Belgium); Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Oberije, Cary; Lambin, Philippe [Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Uyl-de Groot, Cornelia A. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam (Netherlands)

    2015-03-15

    Purpose: To evaluate long-term health effects, costs, and cost-effectiveness of positron emission tomography (PET)-based isotoxic accelerated radiation therapy treatment (PET-ART) compared with conventional fixed-dose CT-based radiation therapy treatment (CRT) in non-small cell lung cancer (NSCLC). Methods and Materials: Our analysis uses a validated decision model, based on data of 200 NSCLC patients with inoperable stage I-IIIB. Clinical outcomes, resource use, costs, and utilities were obtained from the Maastro Clinic and the literature. Primary model outcomes were the difference in life-years (LYs), quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness and cost/utility ratio (ICER and ICUR) of PET-ART versus CRT. Model outcomes were obtained from averaging the predictions for 50,000 simulated patients. A probabilistic sensitivity analysis and scenario analyses were carried out. Results: The average incremental costs per patient of PET-ART were €569 (95% confidence interval [CI] €−5327-€6936) for 0.42 incremental LYs (95% CI 0.19-0.61) and 0.33 QALYs gained (95% CI 0.13-0.49). The base-case scenario resulted in an ICER of €1360 per LY gained and an ICUR of €1744 per QALY gained. The probabilistic analysis gave a 36% probability that PET-ART improves health outcomes at reduced costs and a 64% probability that PET-ART is more effective at slightly higher costs. Conclusion: On the basis of the available data, individualized PET-ART for NSCLC seems to be cost-effective compared with CRT.

  16. Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict's Rehabilitation Process: A Randomized Controlled Trial.

    Science.gov (United States)

    Azkhosh, Manoochehr; Farhoudianm, Ali; Saadati, Hemn; Shoaee, Fateme; Lashani, Leila

    2016-10-01

    Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance. Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (Pacceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility. Conclusion: The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

  17. Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

    Directory of Open Access Journals (Sweden)

    J Charles Henry

    2008-10-01

    Full Text Available J Charles Henry1, James H Peace2, Jeanette A Stewart3,4, William C Stewart3,41Little Rock Eye Clinic, Little Rock, AR, USA; 2Diabetic Eye Medical Clinic, Inglewood, CA, USA; 3PRN Pharmaceutical Research Network, LLC, Dallas,TX, USA; 4Carolina Eye Institute, University of South Carolina, School of Medicine, Columbia, SC, USAPurpose: To evaluate the efficacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension.Design: Prospective, multi-center, historical control study.Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later.Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p < 0.0001. Patients having any baseline OSD symptoms (n = 235 demonstrated significant improvement after switching to travoprost BAK-free (p < 0.0001. In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP was significantly decreased (p < 0.0001. Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy. Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p < 0.0001.Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically significant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.Keywords: glaucoma, prostaglandin analog, travoprost, latanoprost, bimatoprost, preservative, benzalkonium chloride

  18. A COMPARATIVE STUDY ON HYPOTHALAMIC MECHANISMS OF ANALGESIA INDUCED BY FOUR KINDS OF ACUPUNCTURE THERAPIES IN ADJUVANT ARTHRITIS RATS

    Institute of Scientific and Technical Information of China (English)

    FU Yi; LIANG Fan-rong; TAO Qiao-lin

    2005-01-01

    Objective: To compare the mechanisms of analgesia induced by four kinds of acupuncture therapies at the hypothalamic level in adjuvant arthritic rats. Methods: Forty-eight SD rats were randomized into normal, model, electroacupuncture (EA), filiform needle (FN), pricking blood-letting (BL) and point injection (PI) groups, with 8 cases in each. EA (20-100 Hz, 2-4 V and duration of 20 min), FN, BL PI were respectively applied to "Kunlun" (昆仑BL 60). Arthritis model was established by injecting complete Freund's adjuvant (0.1 mL) into the rat's right foot pad. Behavioral reactions, pain threshold (latency of tail flick to heat stimulation) and local swelling severity (foot volume) were detected; the contents of β-endorphin (β-EP) and adrenocorticotropin (ACTH) were assayed with radioimmunoassay; and the expression of pro-opi-omelanocortin (POMC) mRNA in hypothalamus were determined with hybridization method. Results: The pain threshold was significantly enhanced by all the four kinds of acupuncture therapies, and the effects of EA and PI were more obvious (P0.05). The content of β-EP in the hypothalamus was obviously elevated by EA and FN (P0.05). The content of ACTH in hypothalamus was considerably elevated by PI (P<0.05), but not by the other three therapies. The expression of POMCmRNA in hypothalamus was significantly strengthened by EA and FN (P<0.01), but not by the other two therapies. Conclusion: EA, filiform needle, blood-letting and point-injection all can produce analgesic effect in adjuvant arthritis rats, the effect of EA and filiform needle may be related to their resultant increase of hypothalamic β-EP, and that of point-injection related to the increase of hypothalamic ACTH level.

  19. Nootropic efficacy of Satvavajaya Chikitsaand Ayurvedic drug therapy: A comparative clinical exposition

    Directory of Open Access Journals (Sweden)

    Hetal Amin

    2015-01-01

    Full Text Available Introduction: Ayurveda is known for philosophical basis, and its approach to psychological ailments is quite different from conventional system of management. Satvavajaya Chikitsa (Ayurvedic psychotherapy is a nonpharmacological approach aimed at control of mind and restraining it from unwholesome Artha (objects or stressors. Withdrawal of the mind from unwholesome objects is known as Sattvavajaya Chikitsa or it is a treatment by Self Control. Charaka defines it as a mind controlling therapy in which a stress has been laid on restraining of mind from unwholesome objects. Thus, it includes all the methods of Manonigraha and Astanga Yoga (Yogic techniques too. Indian philosophy portrays Astanga Yoga as a primary tool to control mind; hence it can be used as Satvavajaya Chikitsa. Aims and Objectives: To evaluate efficacy of Satvavajaya Chikitsa and Aushadhiya Medhya Chikitsa for improving Smriti in young healthy volunteers. Materials and Methods: Totally, 102 physically healthy volunteers between age group 16 and 25 years were divided into two groups. In Group A, Satvavajaya Chikitsa was adopted in form of Yogic procedures such as Asana, Pranayama, Chanting etc., with counseling and placebo. Group B was Shankhapushpi tablets made with whole part of Shankhpushpi plant was used as standard control. The Weschler′s memory scale (WMS was adopted to collect data before and after intervention period of 2 months. Paired and Unpaired t-test were used for analysis the data in Sigmastat Software. Results: Group A (Satvavajaya + placebo with counseling showed statistically highly significant result (P < 0.001 in verbal retention for similar pair, verbal retention for dissimilar pair and visual immediate tests; while Group B (Shankhapushpi tablets showed significant result (P < 0.01 in auditory delayed, visual delayed, auditory recognition and visual recognition tests. Conclusion: Satvavajaya Chikitsa shows better results in immediate recollection in terms of

  20. Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease

    NARCIS (Netherlands)

    Pitt, B; Waters, D; Brown, WV; van Boven, AJ; Schwartz, L; Title, LM; Eisenberg, D; Shurzinske, L; McCormick, LS

    1999-01-01

    Background Percutaneous coronary revascularization is widely used in improving symptoms and exercise performance in patients with ischemic heart disease and stable angina pectoris. In this study, we compared percutaneous coronary revascularization with lipid-lowerin Methods We studied 341 patients w

  1. Pharmacodynamics of Finafloxacin, Ciprofloxacin and Levofloxacin in Serum and Urine against TEM- and SHV-type Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated from Patients with Urinary Tract Infections.

    Science.gov (United States)

    Dalhoff, A; Schubert, S; Vente, A

    2017-02-13

    Background: Pharmacodynamics of finafloxacin, ciprofloxacin and levofloxacin against ESBL-producing Enterobacteriaceae were compared. As quinolones loose activity in acidic media and in particular in urine, their activities were tested in parallel under conventional conditions and in acidic artificial urine.Methods: TEM- and SHV-type ESBL-producing E. coli and K. pneumoniae and their wild-type counterparts were exposed in a modified Grasso model to serum- and urine-concentrations following oral doses of finafloxacin 800mg qd, immediate- release ciprofloxacin 500mg bid, extended release ciprofloxacin-XR 1000mg qd, levofloxacin 500mg qd, or levofloxacin 750mg qd. Urine-concentrations were fitted by compartmental modeling. Bacteria were cultivated in Mueller-Hinton-Broth (MHB) pH 7.2 or 5.8 or in artificial urine pH 5.8. Bacteria were counted two-hourly till 10h and at 24h; the areas under the bacterial count versus time curves were calculated.Results: Finafloxacin eliminated all strains within 2h under any of the conditions studied. Any of the ciprofloxacin or levofloxacin doses was highly active against wild-type strains in MHB, pH 7.2 but lost activity at pH 5.8 and in particular in urine. Viable counts of ESBL-producers were reduced for 6-8h by 3 log10 titers but bacteria regrew thereafter. Ciprofloxacin and levofloxacin were almost inactive against the SVH-producer grown in artificial urine.Conclusions: The use of artificial urine but not conventional media in pharmacodynamic models may mirror the physiology of UTIs more closely. In contrast to ciprofloxacin and levofloxacin, finafloxacin gained activity in this model at an acidic pH and maintained activity in artificial urine and was active against TEM- and SHV-producers.

  2. Sublethal Ciprofloxacin Treatment Leads to Rapid Development of High-Level Ciprofloxacin Resistance during Long-Term Experimental Evolution of Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Jørgensen, Karin Meinike; Wassermann, Tina; Jensen, Peter Østrup

    2013-01-01

    lineages after 240 generations. The genetic basis of resistance was mutations in gyrA (C248T and G259T) and gyrB (C1397A). Cross-resistance to beta-lactam antibiotics was observed in the bacterial populations that evolved during exposure to sublethal concentrations of ciprofloxacin. Our study shows...

  3. Comparative skin dose measurement in the treatment of anal canal cancer: conventional versus conformal therapy.

    Science.gov (United States)

    Devic, Slobodan; Hegyi, Gyorgy; Vuong, Té; Muanza, Thierry; Podgorsak, Ervin B

    2004-06-01

    The subject of this work was to compare the effect of Conventional and Conformal techniques, used for anal canal cancer treatments, on the skin dose deposition. Skin dose was measured on a Rando phantom using XR-T GAFCHROMIC film. A skin surface dose histogram was constructed and a skin dose profile in the sagittal direction of the perineal region was measured, for both techniques. The measured skin dose in the anterior and posterior region of the skin exposed to radiation is from two to ten times higher when using a conventional technique. In the perineal region, an 85% of the prescription isodose line spreads over 25% of the perineum for conformal technique as compared to 65% with conventional techniques. In addition, conformal technique dose profiles confine better the anatomical position of the anal verge than conventional techniques. Results presented in this work confirm clinically observed improvement in the radiation-induced dermatitis when using the conformal technique.

  4. Ciprofloxacin-resistant Salmonella enterica Typhimurium and Choleraesuis from pigs to humans, Taiwan.

    Science.gov (United States)

    Hsueh, Po-Ren; Teng, Lee-Jene; Tseng, Sung-Pin; Chang, Chao-Fu; Wan, Jen-Hsien; Yan, Jing-Jou; Lee, Chun-Ming; Chuang, Yin-Ching; Huang, Wen-Kuei; Yang, Dine; Shyr, Jainn-Ming; Yu, Kwok-Woon; Wang, Li-Shin; Lu, Jang-Jih; Ko, Wen-Chien; Wu, Jiunn-Jong; Chang, Feng-Yee; Yang, Yi-Chueh; Lau, Yeu-Jun; Liu, Yung-Ching; Liu, Cheng-Yi; Ho, Shen-Wu; Luh, Kwen-Tay

    2004-01-01

    We evaluated the disk susceptibility data of 671 nontyphoid Salmonella isolates collected from different parts of Taiwan from March 2001 to August 2001 and 1,261 nontyphoid Salmonella isolates from the National Taiwan University Hospital from 1996 to 2001. Overall, ciprofloxacin resistance was found in 2.7% (18/671) of all nontyphoid Salmonella isolates, in 1.4% (5/347) of Salmonella enterica serotype Typhimurium and in 7.5% (8/107) in S. enterica serotype Choleraesuis nationwide. MICs of six newer fluoroquinolones were determined for the following isolates: 37 isolates of ciprofloxacin-resistant (human) S. Typhimurium (N = 26) and Choleraesuis (N = 11), 10 isolates of ciprofloxacin-susceptible (MIC MIC >0.12 microg/mL). Sequence analysis of the gryA, gyrB, parC, parE, and acrR genes, ciprofloxacin accumulation, and genotypes generated by pulsed-field gel electrophoresis with three restriction enzymes (SpeI, XbaI, and BlnI) were performed. All 26 S. Typhimurium isolates from humans and pigs belonged to genotype I. For S. Choleraesuis isolates, 91% (10/11) of human isolates and 54% (7/13) of swine isolates belonged to genotype B. These two genotypes isolates from humans all exhibited a high-level of resistance to ciprofloxacin (MIC 16-64 mg/mL). They had two-base substitutions in the gyrA gene at codons 83 (Ser83Phe) and 87 (Asp87Gly or Asp87Asn) and in the parC gene at codon 80 (Ser80Arg, Ser80Ile, or Ser84Lys). Our investigation documented that not only did these two S. enterica isolates have a high prevalence of ciprofloxacin resistance nationwide but also that some closely related ciprofloxacin-resistant strains are disseminated from pigs to humans.

  5. Effects of low levels of ciprofloxacin on a chemostat model of the human colonic microflora.

    Science.gov (United States)

    Carman, R J; Woodburn, M A

    2001-06-01

    To study the utility of an in vitro model system for assessing the effect of low concentrations of a fluoroquinolone (FQ) drug on the ecology of the human intestinal microflora, chemostats containing human fecal flora were exposed to 0.43, 4.3, and 43microg of ciprofloxacin (CI) per milliliter. Prior to and during drug exposure, we assayed short-chain fatty acids (SCFA), bacterial populations, and the relative levels of susceptibility of these populations to CI and trovafloxacin (TV), a newer related FQ with increased activity against anaerobes. The degree to which CI affected the chemostat ecology was measured statistically by comparing observed data with the corresponding predicted "no effect" level. No changes in total SCFA were observed; only butyrate was significantly higher at the intermediate and high-dose levels. Enterococci counts and the levels of susceptibility to CI among enterococci were also unaffected. Escherichia coli counts decreased in a dose-dependent manner. Susceptibility levels in E. coli followed no interpretable pattern. Bacteroides fragilis group (BfG) counts decreased significantly following exposure to 43 and 4.3microg/mL CI. Ciprofloxacin susceptibility among the BfG in these chemostats was not determined because the BfG counts were too low (less than 30 colonies per plate) when undiluted chemostat samples were plated. However, within 2 days of exposure to 0.43microg/mL CI, the percentage of BfG resistant to 4microg/mL CI increased to over 95%. Before exposure, all BfG were susceptible to both CI (2microg/mL) and TV (0.25microg/mL). All BfG isolated during exposure were resistant to both CI (4microg/mL) and TV (2microg/mL). Resistance selection in the BfG was unexpected as the MIC(90) of CI for B. fragilis is 8microg/mL. Since the average colon flora is about 20% B. fragilis and other bacteroides, CI may impact the human gut flora even at subtherapeutic levels.

  6. Comparative study of Low-level laser therapy and microcurrent on the healing of skin burns in rats

    Directory of Open Access Journals (Sweden)

    Rodrigo Pegado de Abreu Freitas

    2014-03-01

    This study investigated and compared the effects of low-level laser therapy (LLLT and microcurrent in the burn healing process in Wistar rats. We conducted a randomized controlled study with 30 rats divided into 3 groups (n = 10; control group (CG, laser group (LG and microcurrent group (MG. After thermal damage, 10 applications of 660 nm diode laser were performed in GL and 10 applications of 60 Hz microcurrent (160 μA in MG. The semi-quantitative histological analysis was done using scores (0–3, in sections stained by hematoxylin and eosin and Masson’s trichrome. The results indicated a significant improvement in the fibroblasts proliferation, collagen fibers deposition, neoangiogenesis, and cutaneous appendages regeneration in MG and LG. When microcurrent and LLLT were compared, no difference was detected, except the regeneration and formation of new cutaneous appendages, observed in MG. Despite the similar effects, GM showed faster tissue repair with the formation of skin appendages.

  7. Monte Carlo modelling of photodynamic therapy treatments comparing clustered three dimensional tumour structures with homogeneous tissue structures

    Science.gov (United States)

    Campbell, C. L.; Wood, K.; Brown, C. T. A.; Moseley, H.

    2016-07-01

    We explore the effects of three dimensional (3D) tumour structures on depth dependent fluence rates, photodynamic doses (PDD) and fluorescence images through Monte Carlo radiation transfer modelling of photodynamic therapy. The aim with this work was to compare the commonly used uniform tumour densities with non-uniform densities to determine the importance of including 3D models in theoretical investigations. It was found that fractal 3D models resulted in deeper penetration on average of therapeutic radiation and higher PDD. An increase in effective treatment depth of 1 mm was observed for one of the investigated fractal structures, when comparing to the equivalent smooth model. Wide field fluorescence images were simulated, revealing information about the relationship between tumour structure and the appearance of the fluorescence intensity. Our models indicate that the 3D tumour structure strongly affects the spatial distribution of therapeutic light, the PDD and the wide field appearance of surface fluorescence images.

  8. Comparative efficacy and safety of amlodipine/benazepril combination therapy and amlodipine monotherapy in severe hypertension.

    Science.gov (United States)

    Izzo, J L; Purkayastha, D; Hall, D; Hilkert, R J

    2010-06-01

    This multicentre, double-blind, trial in subjects with severe hypertension compared the efficacy and tolerability of two parallel drug regimens: A/B (amlodipine/benazepril: 5/20 or 10/40 mg daily, if necessary) with A (amlodipine: 5 or 10 mg daily, if necessary). The principal dependent variable was the proportion of patients achieving goal blood pressures (BPamlodipine and benazepril in single-pill combinations is more effective than titration of amlodipine alone for rapid BP control in patients with severe hypertension.

  9. Comparative Effects of Statin Therapy versus Renin-Angiotensin System Blocking Therapy in Patients with Ischemic Heart Failure Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Won, Jumin; Hong, Young Joon; Jeong, Myung Ho; Park, Hyuk Jin; Kim, Min Chul; Kim, Woo Jin; Kim, Hyun Kuk; Sim, Doo Sun; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun

    2016-05-01

    Statins and renin-angiotensin system (RAS) blockers are key drugs for treating patients with an acute myocardial infarction (AMI). This study was designed to show the association between treatment with statins or RAS blockers and clinical outcomes and the efficacy of two drug combination therapies in patients with ischemic heart failure (IHF) who underwent revascularization for an AMI. A total of 804 AMI patients with a left ventricular ejection fraction <40% who undertook percutaneous coronary interventions (PCI) were analyzed using the Korea Acute Myocardial Infarction Registry (KAMIR). They were divided into four groups according to the use of medications [Group I: combination of statin and RAS blocker (n=611), Group II: statin alone (n=112), Group III: RAS blocker alone (n=53), Group IV: neither treatment (n=28)]. The cumulative incidence of major adverse cardiac and cerebrovascular events (MACCEs) and independent predictors of MACCEs were investigated. Over a median follow-up study of nearly 1 year, MACCEs had occurred in 48 patients (7.9%) in Group I, 16 patients (14.3%) in Group II, 3 patients (5.7%) in Group III, 7 patients (21.4%) in Group IV (p=0.013). Groups using RAS blocker (Group I and III) showed better clinical outcomes compared with the other groups. By multivariate analysis, use of RAS blockers was the most powerful independent predictor of MACCEs in patients with IHF who underwent PCI (odds ratio 0.469, 95% confidence interval 0.285-0.772; p=0.003), but statin therapy was not found to be an independent predictor. The use of RAS blockers, but not statins, was associated with better clinical outcomes in patients with IHF who underwent PCI.

  10. Effectiveness and Safety of S-1-Based Therapy Compared with 5-Fluorouracil-Based Therapy for Advanced Colorectal Cancer: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jiaxiang Ye

    2014-01-01

    Full Text Available Objectives. The aim of our study was to compare the efficacy and safety of S-1-based therapy (SBT versus 5-fluorouracil-based therapy (FBT for advanced colorectal cancer (ACRC. Methods. A meta-analysis of all eligible randomized controlled trials (RCTs was performed using RevMan 5.1.0 software. Results. A total of 1625 patients from twelve RCTs including 820 patients in the SBT group and 805 patients in the FBT group were available for analysis. The meta-analysis of overall survival (hazards ratio HR = 0.94, 95% CI = 0.80–1.10, progression-free survival (HR = 1.03, 95% CI = 0.91–1.18, and overall response rate (odds ratio OR = 1.23, 95% CI = 1.00–1.53 showed no statistical significance between SBT group and FBT group. The statistically significant differences in the meta-analysis indicated less incidence of graded 3-4 neutropenia (OR = 0.49, 95% CI = 0.35–0.68 and nausea/vomit (OR = 0.41, 95% CI = 0.23–0.72 in the SBT group, and there was no statistically significant difference in the incidence of grade 3-4 anemia, thrombocytopenia, leucopenia, diarrhea, and treatment-related deaths between two groups. Conclusions. SBT had similar efficacy and better safety than FBT and was an attractive alternative to FBT for patients of ACRC, but further investigations in different populations would be needed to confirm it.

  11. Comparing complementary alternative treatment for chronic shoulder pain of myofascial origin: Collateral meridian therapy versus local tender area-related meridians therapy.

    Science.gov (United States)

    Pan, Ru-Yu; Hsu, Yung-Chi; Wong, Chih-Shung; Lin, Shinn-Long; Li, Tsung-Ying; Cherng, Chen-Hwan; Ko, Shan-Chi; Yeh, Chun-Chang

    2016-08-01

    The aim of this study was to compare the short-term outcomes between 2 different treatments for unilateral chronic shoulder pain of myofascial origin, that is, local tender area related meridians (LTARMs) treatment and collateral meridian therapy (CMT), which were performed 6 times over a period of 4 weeks.Seventy patients with unilateral shoulder pain of chronic myofascial origin were enrolled. The patients were randomly assigned to 2 different treatment groups: 1 group received CMT (n = 35) and the other received LTARM (n = 35). Before and after the 2 treatment processes, all patients rated their overall pain intensity on a visual analogue scale (VAS) and a validated 13-question shoulder pain and disability index (SPADI) questionnaire was used to measure shoulder pain and functional impairment after therapy for 4 weeks.After CMT, the pain intensity was reduced after CMT. VAS score is reduced from 5.90 ± 2.07 (a mean of 5.90 and standard deviation of 2.07) to 3.39 ± 1.2. This was verified by the SPADI pain subscale scores (from 0.58 ± 0.193 to 0.33 ± 0.14). The pain-relief effect of CMT was significantly better than that of LTARM (VAS score from 5.78 ± 1.64 to 4.58 ± 1.40; P myofascial origin than the LTARM treatment, where treatment with the former resulted in better functional recovery after 4 weeks than the latter.

  12. Targeted Therapies Compared to Dacarbazine for Treatment of BRAFV600E Metastatic Melanoma: A Cost-Effectiveness Analysis

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    Vanessa Shih

    2015-01-01

    Full Text Available Purpose. Two BRAFV600E targeted therapies, dabrafenib and vemurafenib, have received US approval for treatment of metastatic melanoma in BRAFV600E patients, a mutation that affects ~50% of patients. We evaluated the cost-effectiveness of BRAF inhibitors and traditional chemotherapy for treatment of metastatic melanoma. Methods. A Markov model was developed using a societal perspective. Transition probabilities were derived from two Phase III registration trials comparing each BRAF inhibitor against dacarbazine. Costs were obtained from literature, national databases, and Medicare fee schedules. Utilities were obtained from published literature. Deterministic and probabilistic sensitivity analyses were run to test the impact of uncertainties. Results. The incremental cost-effectiveness ratio of dabrafenib was $149,035/QALY compared to dacarbazine. Vemurafenib was dominated by dabrafenib. Probabilistic sensitivity analysis showed that, at a willingness-to-pay (WTP threshold of ≤$100,000/QALY, dacarbazine was the optimal treatment in ~85% of simulations. At a WTP threshold of ≥$150,000/QALY, dabrafenib was the optimal treatment. Conclusion. Compared with dacarbazine, dabrafenib and vemurafenib were not cost-effective at a willingness-to-pay threshold of $100,000/QALY. Dabrafenib is more efficient compared to vemurafenib. With few treatment options, dabrafenib is an option for qualifying patients if the overall cost of dabrafenib is reduced to $30,000–$31,000 or a WTP threshold of ≥$150,000/QALY is considered. More comparative data is needed.

  13. Analysis of the membrane proteome of ciprofloxacin-resistant macrophages by stable isotope labeling with amino acids in cell culture (SILAC.

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    Nancy E Caceres

    Full Text Available Overexpression of multidrug transporters is a well-established mechanism of resistance to chemotherapy, but other changes may be co-selected upon exposure to drugs that contribute to resistance. Using a model of J774 macrophages made resistant to the fluoroquinolone antibiotic ciprofloxacin and comparing it with the wild-type parent cell line, we performed a quantitative proteomic analysis using the stable isotope labeling with amino acids in cell culture technology coupled with liquid chromatography electrospray ionization Fourier transform tandem mass spectrometry (LC-ESI-FT-MS/MS on 2 samples enriched in membrane proteins (fractions F1 and F2 collected from discontinuous sucrose gradient. Nine hundred proteins were identified with at least 3 unique peptides in these 2 pooled fractions among which 61 (F1 and 69 (F2 showed a significantly modified abundance among the 2 cell lines. The multidrug resistance associated protein Abcc4, known as the ciprofloxacin efflux transporter in these cells, was the most upregulated, together with Dnajc3, a protein encoded by a gene located downstream of Abcc4. The other modulated proteins are involved in transport functions, cell adhesion and cytoskeleton organization, immune response, signal transduction, and metabolism. This indicates that the antibiotic ciprofloxacin is able to trigger a pleiotropic adaptative response in macrophages that includes the overexpression of its efflux transporter.

  14. Therapeutic songwriting in music therapy, Part II: Comparing the literature with practice across diverse clinical populations

    DEFF Research Database (Denmark)

    Baker, Felicity; Wigram, Tony; Stott, Dave

    2009-01-01

    . Responses to a 21-question on-line survey were obtained from 419 professional music therapists practicing in 29 countries which focused on approaches to songwriting within their practice with a single clinical population. Results suggest that in general, the literature provides good representation for what...... is occurring in clinical practice. Generally, songs were composed with individual clients in single sessions, with lyrics created prior to the music. Clinicians had a significant role in creating the music with improvised and pre-determined musical structures being equally employed.  Chi-square or comparable......  Exact tests (Fisher-Freeman-Halton) were applied to the data and significant associations were found according to clinical populations particularly with respect the number of sessions required to complete a song, approaches to composing lyrics and music, the context with which songwriting was employed...

  15. Ciprofloxacin toxicity and its co-metabolic removal by a freshwater microalga Chlamydomonas mexicana.

    Science.gov (United States)

    Xiong, Jiu-Qiang; Kurade, Mayur B; Kim, Jung Rae; Roh, Hyun-Seog; Jeon, Byong-Hun

    2017-02-05

    This study evaluated the toxicity and cellular stresses of ciprofloxacin (CIP) and its co-metabolic removal in a freshwater microalga Chlamydomonas mexicana. The toxicological effects of CIP on C. mexicana were assessed by studying the growth and biochemical characteristics of the microalga including total chlorophyll, carotenoid content, malondialdehyde (MDA) and superoxide dismutase (SOD) activity. The calculated effective concentration (EC50) of CIP on C. mexicana was 65±4mgL(-1) at 96h. The growth of C. mexicana was significantly inhibited at increased concentrations of CIP, showing 36±1, 75±3. and 88±3% inhibition at 40, 60 and 100mgL(-1) CIP, respectively, compared to the control after 11days of cultivation. The total chlorophyll, carotenoid, MDA and SOD activity were significantly increased as a result of relatively high concentrations of CIP stress. C. mexicana showed 13±1% removal of CIP (2mgL(-1)) after 11days of cultivation; however, the addition of an electron donor (sodium acetate, 4gL(-1)) highly enhanced the removal of CIP (2mgL(-1)) by>3-fold after 11days. Kinetic studies showed that removal of CIP followed a first-order model (R(2) 0.94-0.97) with the apparent rate constants (k) ranging from 0.0121 to 0.079 d(-1).

  16. In vivo and in vitro chondrotoxicity of ciprofloxacin in juvenile rats

    Institute of Scientific and Technical Information of China (English)

    Ping LI; Neng-neng CHENG; Bin-yan CHEN; Yong-ming WANG

    2004-01-01

    AIM: To study the relationship between chondrotoxicity and toxicokinetics of ciprofloxacin (CPFX). METHODS: Rats, 4-week old, were treated with CPFX 0, 400, 800, and 1200 mg/kg ig once daily on seven consecutive days. The knee joint cartilage was examined histopathologically. The concentration of CPFX in venous blood and knee joint cartilage samples were determined by a microbioassay using Escherichia coli 44102. The effects of CPFX on proliferation of chondrocytes and secretion of soluble proteoglycans were determined with 3-(4,5-dimethylthiazol2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and 1,9-dimethylmethylene blue (DMB) assay, respectively. RESULTS:Cartilage was severely lesioned after treatment with CPFX 800 or 1200 mg/kg for 7 d, such as matrix swelling and loss of chondrocytes. The thickness of cartilage was significantly decreased compared with the control group. The maximum serum concentration (Cmax), the area under the plasma concentration-time curve (AUC0-∞), and concenmg.h.L-1, and 20.3±3.5 μg.g-1 after oral administration of CPFX 800 or 1200 mg/kg on d 1, respectively. The data on d 6 were similar with that on d 1. CPFX inhibited proliferation of chondrocytes and the secretion of soluble proteoglycans. CONCLUSION: CPFX concentrations in serum and cartilage could provide a better basis for risk assessment.

  17. Bioactive/Natural Polymeric Scaffolds Loaded with Ciprofloxacin for Treatment of Osteomyelitis.

    Science.gov (United States)

    Mostafa, Amany A; El-Sayed, Mayyada M H; Mahmoud, Azza A; Gamal-Eldeen, Amira M

    2016-08-12

    Local delivery of antibiotic into injured bone is a demand. In this work, different scaffolds of chitosan (C) with or without bioactive glass (G) were prepared using the freeze-drying technique in 2:1, 1:1, and 1:2 weight ratios. Chitosan scaffolds and selected formulas of chitosan to bioglass were loaded with ciprofloxacin in 5%, 10%, and 20% w/w. Scaffold morphology showed an interconnected porous structure, where the glass particles were homogeneously dispersed in the chitosan matrix. The kinetic study confirmed that the scaffold containing 1:2 weight ratio of chitosan to glass (CG12) showed optimal bioactivity with good compromise between Ca and P uptake capacities and Si release rate. Chitosan/bioactive glass scaffolds showed larger t 50 values indicating less burst drug release followed by a sustained drug release profile compared to that of chitosan scaffolds. The cell growth, migration, adhesion, and invasion were enhanced onto CG12 scaffold surfaces. Samples of CG12 scaffolds with or without 5% drug induced vascular endothelial growth factor (VEGF), while those containing 10% drug diminished VEGF level. Only CG12 induced the cell differentiation (alkaline phosphatase activity). In conclusion, CG12 containing 5% drug can be considered a biocompatible carrier which would help in the localized osteomyelitis treatment.

  18. Long-Term Effect of Ciprofloxacin on Testicular Tissue: Evidence for Biochemical and Histochemical Changes

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    Karim Mardani

    2013-01-01

    Full Text Available Background: This research studied the effect of ciprofloxacin (CPFX on spermatogenesis. Weaimed to estimate the effect of CPFX on serum levels of testosterone, LH and FSH.Materials and Methods: In this experimental study, a total of 24 mice were assigned to controlshamand test groups. We subdivided the test group into low (206 mg/kg and high (412 mg/kg doseCPFX groups. Control-sham animals received carboxymethyl cellulose (CMC. All animals weretreated orally for 45 days. Cytoplasmic carbohydrate, lipid accumulation, cytoplasmic lipase andalkaline phosphatase (ALP ratios were examined. Serum levels of luteinizing hormone (LH, folliclestimulating hormone (FSH and testosterone were measured in the control and test groups.Results: The spermatogenesis cell series exhibited low numbers of cells with periodic acid Schiff(PAS-positive cytoplasm and higher numbers of cells with lipid-positive foci. The tissue to ALPratio and germinal epithelium (GE lipase synthesis increased in CPFX-treated animals. In contrastto the CPFX groups, control animals showed normal cytoplasmic carbohydrate, lipid, lipase andALP ratios in all cellular layers. In the CPFX-treated groups there was a significantly lower serumtestosterone level compared with the control group. The serum levels of FSH and LH in high dosetreatedanimals decreased.Conclusion: Our results suggest that following long time CPFX administration major alterationsoccur in GE intracytoplasmic biochemistry, which may lead to loss of physiological function andultimately result in fertility problems. CPFX is able to imbalance serum levels of gonadotropins andtestosterone levels by affecting Leydig cells.

  19. Pharmacokinetic and pharmacodynamic efficacy of intrapulmonary administration of ciprofloxacin for the treatment of respiratory infections.

    Science.gov (United States)

    Chono, Sumio; Tanino, Tomoharu; Seki, Toshinobu; Morimoto, Kazuhiro

    2007-04-01

    The pharmacokinetic and pharmacodynamic efficacy of intrapulmonary administration of ciprofloxacin (CPFX) for the treatment of respiratory infections caused by pathogenic microorganisms resisting sterilization systems of alveolar macrophages (AMs) was evaluated by comparison with an oral administration. The time-courses of the concentration of CPFX in AMs and lung epithelial lining fluid (ELF) following intrapulmonary administration of CPFX solution to rats (200 microg/kg) were markedly higher than that following oral administration (10 mg/kg). The time-course of the concentrations of CPFX in plasma following intrapulmonary administration was markedly lower than that in AMs and ELF. These results indicate that intrapulmonary administration is more effective in delivering CPFX to AMs and ELF, compared with oral administration, in spite of a low dose and it avoids distribution of CPFX to the blood. In addition, the antibacterial effects of CPFX in AMs and ELF following intrapulmonary administration were evaluated by pharmacokinetics/pharmacodynamics analysis. The concentration of CPFX in AMs and ELF-time curve (AUC)/minimum inhibitory concentration of CPFX (MIC) ratio and the maximum concentration of CPFX in AMs and ELF (Cmax)/MIC ratio were markedly higher than the effective values. The present study indicates that intrapulmonary administration of CPFX is an effective technique for the treatment of respiratory infections.

  20. Development and characterization of in-situ gel for ophthalmic formulation containing ciprofloxacin hydrochloride.

    Science.gov (United States)

    Makwana, S B; Patel, V A; Parmar, S J

    2016-01-01

    In situ gels are systems which are applied as solutions or suspensions and are capable of undergoing rapid sol-to-gel transformation triggered by external stimulus such as temperature, pH etc. on instillation. The aim of the present study was to formulate and evaluate pH responsive in-situ gel for ophthalmic delivery. Ciprofloxacin hydrochloride is popularly used as a broad spectrum antibiotic in the treatment of corneal ulcers of ocular infections. However, rapid dilution on instillation, wash out, poor retention of drug concentration delimit the therapeutic benefits of the drug when used in form of conventional eye drops. Sodium alginate, an ophthalmic gel forming mucoadhesive polymer was chosen as polymer which undergoes instantaneous gel formation due to formation of calcium alginate by virtue of its interaction with divalent cation (Ca(+2)) present in lachrymal fluid. Hydroxy Propyl Methyl Cellulose (HPMC K4M and E5 0LV) was further incorporated as a viscosity enhancer in order to achieve the desired consistency so as to facilitate sustained drug release. The developed formulations were evaluated for clarity, pH measurement, gelling capacity, drug content, rheological study, and in vitro drug release. Thus, in situ gel based systems containing gums can be a valuable approach for ophthalmic drug delivery when compared to conventional systems.

  1. Formulation and evaluation of taste-masked ciprofloxacin bioadhesive dental films

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    Iman Ibrahim Soliman

    2013-01-01

    Full Text Available Ciprofloxacin is a broad-spectrum anti-infective agent of the fluoroquinolons. It has activity against periodontal pathogens. Saccharin is one of the most widely used artificial sweetening agents. The complex of ciprofloxacin saccharinate was prepared to improve organoleptic properties of ciprofloxacin and it was characterized using fourier transform infrared analysis, differential scanning calorimetric, photomicrographs, solubility determination of the complex and ultraviolet-scanning in different media as well as determination of the actual drug content. Eight formulations of ciprofloxacin saccharinate bioadhesive dental films were prepared using chitosan, carbopol 934, and hydroxypropyl methyl cellulose (HPMC. The prepared films were evaluated for their physic-mechanical properties including film thickness, weight uniformity, and tensile strength, folding endurance, surface pH, and percentage elongation. In addition, mucoadhesive performance of films, drug content and in vitro release of ciprofloxacin from different films were determined. The best formulations were selected and were subjected to stability study at 40΀C and 75% relative humidity for 3 months and microbiological test. Results revealed that the use of mixture of carbopol and HPMC with chitosan improved physical and chemical properties of the prepared films. Microbiological results showed that, F 7 had the highest inhibition zone which may be due to the presence of high concentration of carbopol 934 that leads to high mucoadhesive time.

  2. Activity of ciprofloxacin and azithromycin on biofilms produced in vitro by Haemophilus influenzae

    Institute of Scientific and Technical Information of China (English)

    WANG Dong; WANG Ying; LIU You-ning

    2009-01-01

    Background It is recognized that Haemophilus influenzae isolated from patients with otitis media forms biofilms both in vitro and in vivo, suggesting that biofilm formation in vivo might play an important role in the pathogenesis and chronicity of otitis media, but the effect of antibiotics on biofilm has not been well studied. We investigated the impact of ciprofloxacin and azithromycin on bacterial biofilms formed by Haemophilus influenzae in vitro in this study.Methods Eleven strains of Haemophilus influenzae were isolated from sputum specimens collected from patients with acute exacerbation of chronic obstructive pulmonary diseases. Formation of bacterial biofilm was examined by crystal violet assay and a scanning electron microscope. Alterations of biofilms were measured under varying concentrations of azithromycin and ciprofloxacin.Results Striking differences were observed among strains with regard to the ability to form biofilm. Typical membrane-like structure formed by bacterial cells and extracellular matrix was detected. Initial biofilm synthesis was inhibited by azithromycin and ciprofloxacin at concentrations higher than two-fold minimal inhibitory concentration.Disruption of mature biofilms could be achieved at relatively higher concentration, and ciprofloxacin displayed more powerful activity.Conclusions Haemophilus influenzae is capable of forming biofilm in vitro. Sufficient dosage might control early formation of biofilms. Ciprofloxacin exerts better effects on breakdown of biofilm than azithromycin at conventional concentration in clinics.

  3. Potentiation of antimicrobial activity of ciprofloxacin by Pelargonium graveolens essential oil against selected uropathogens.

    Science.gov (United States)

    Malik, Tripti; Singh, Padma; Pant, Shailja; Chauhan, Nirpendra; Lohani, Hema

    2011-08-01

    The recent approach of using herbs and antibiotics in combination constitutes a strategy to overcome the problems of resistance and side effects associated with conventional antibiotics. In the present study, the antimicrobial effect of Pelargonium graveolens L' Hér essential oil in combination with ciprofloxacin was evaluated on uropathogens, namely, Klebsiella pneumoniae KT2, Proteus mirabilis PRT3 and Staphylococcus aureus ST2. Minimum inhibitory concentrations of P. graveolens essential oil and ciprofloxacin were determined by the microbroth dilution method and further, the interaction between these two agents was studied by a checkerboard method. The fractional inhibitory concentration index (FICI) was calculated to be 0.375 for both K. pneumoniae KT2 and P. mirabilis PRT3, while for S. aureus ST2 it was found to be 0.5. The values of FICI for the tested microorganisms were found to be ≤0.5, which indicates synergism between P. graveolens essential oil and ciprofloxacin. The concave shaped curve in the isobolograms also depicted a synergistic effect of P. graveolens essential oil and ciprofloxacin against the tested microorganisms. Hence, the synergistic action of P. graveolens essential oil and ciprofloxacin may be applied for the treatment of UTIs, which have hitherto been treated by using only synthetic drugs.

  4. Pharmacokinetic/pharmacodynamic based dosing of ciprofloxacin in complicated urinary tract infections

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    Ana Sabo

    2015-08-01

    Full Text Available Ciprofloxacin is often used in treatment of complicated urinary tract infections in areas with high rates of resistance to first line agents. The aim of this study was to evaluate efficacy of ciprofloxacin in standard dosing regimens in treatment of complicated urinary tract infections. Plasma concentration curves were simulated and minimum inhibitory concentration (MIC and post-antibiotic effect were determined. Ciprofloxacin MIC ranged from 0.0156 for Gram-negative and to 0.125-0.5 µg/mL for Gram-positive bacteria. Both dosing regimens were suitable for eradication of Gram-negative bacteria, with slight supremacy of 750 mg/12 hours over 500 mg/12 hours dosing regimen. Even though all strains were fully susceptible to ciprofloxacin, pharmaco-kinetic/pharmacodynamic parameters did not meet target thresholds for pathogens with MIC over 0.1-0.2 µg/mL regardless of the administered dose. Ciprofloxacin remains an excellent choice for treatment of complicated urinary tract infections caused by Gram-negative bacteria, but in infection caused by Gram-positive strains, deeper analysis is necessary in order to achieve optimal results.

  5. Antibacterial Derivatives of Ciprofloxacin to Inhibit Growth of Necrotizing Fasciitis Associated Penicillin Resistant Escherichia coli

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    Ronald Bartzatt

    2013-01-01

    Full Text Available Escherichia coli (E. coli is associated with necrotizing fasciitis (type I and can induce enough damage to tissue causing hypoxia. Three ester derivatives of the broad-spectrum antibiotic ciprofloxacin were placed into bacteria culture simultaneously with the parent ciprofloxacin (drug 1 to ascertain the level of antibacterial activity. The n-propyl (drug 2, n-pentyl (drug 3, and n-octyl (drug 4 esters of ciprofloxacin were synthesized under mixed phase conditions and by microwave excitation. The formation of ester derivatives of ciprofloxacin modified important molecular properties such as Log P and polar surface area which improves tissue penetration, yet preserved strong antibacterial activity. The Log P values for drugs 1, 2, 3, and 4 became −0.701, 0.437, 1.50, and 3.02, respectively. The polar surface areas for drugs 1, 2, 3, and 4 were determined to be 74.6 Angstroms2, 63.6 Angstroms2, 63.6 Angstroms2, and 63.6 Angstroms2, respectively. These values of Log P and polar surface area improved tissue penetration, as indicated by the determination of dermal permeability coefficient (Kp and subsequently into the superficial fascial layer. All drugs induced greater than 60% bacterial cell death at concentrations less than 1.0 micrograms/milliliter. The ester derivatives of ciprofloxacin showed strong antibacterial activity toward penicillin resistant E. coli.

  6. Comparing Supervised Exercise Therapy to Invasive Measures in the Management of Symptomatic Peripheral Arterial Disease

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    Thomas Aherne

    2015-01-01

    Full Text Available Peripheral arterial disease (PAD is associated with considerable morbidity and mortality. Consensus rightly demands the incorporation of supervised exercise training (SET into PAD treatment protocols. However, the exact role of SET particularly its relationship with intervention requires further clarification. While supervised exercise is undoubtedly an excellent tool in the conservative management of mild PAD its use in more advanced disease as an adjunct to open or endovascular intervention is not clearly defined. Indeed its use in isolation in this cohort is incompletely reported. The aim of this review is to clarify the exact role of SET in the management of symptomatic PAD and in particular to assess its role in comparison with or as an adjunct to invasive intervention. A systematic literature search revealed a total 11 randomised studies inclusive of 969 patients. All studies compared SET and intervention with monotherapy. Study results suggest that exercise is a complication-free treatment. Furthermore, it appears to offer significant improvements in patients walk distances with a combination of both SET and intervention offering a superior walking outcome to monotherapy in those requiring invasive measures.

  7. Comparative study between the effects of isolated manual therapy techniques and those associated with low level laser therapy on pain in patients with temporomandibular dysfunction

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    Juliana Cristina Frare

    2008-01-01

    Full Text Available Objective: This study sought to evaluate the pain condition in patients with temporomandibular dysfunction after applying manual therapy techniques and those associated with this low level laser therapy. Methods: The study involved 20 patients with temporomandibular dysfunction, divided randomly into two groups: G1 (n = 10, formed by 7 women and 3 men, average age 28.2 years (± 7, treated with manual therapy techniques and G2 (n = 10, formed by 8 women and 2 men, with average age 24.01 (± 6.04, treated with the combination of manual therapy techniques and low level laser therapy. The patients were treated three times a week for four consecutive weeks. The memorandum of manual therapy techniques based on Chaintow,Makofsky and Bienfaint was used. For low level laser therapy GaAs laser (904 nm, 6 J/cm2, 0.38 mW/cm2 was used, applied at 4pre-auricular points. To analyze the pain level, the visual analog pain scale was used. For data analysis the Student’s-t and Wilcoxon tests were used, both with significance level of 5% (p <0.05.Results: There was significant reduction (p <0.05 in the level of pain in both groups treated, but in G2 the significance was higher.Conclusion: Manual therapy techniques, either alone or associated with low level laser therapy showed satisfactory results for pain control in patients with temporomandibular dysfunction.

  8. A Comparative Study of Retinal Function in Rabbits after Panretinal Selective Retina Therapy versus Conventional Panretinal Photocoagulation

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    Young Gun Park

    2015-01-01

    Full Text Available Purpose. This study evaluates functional changes in electroretinographic findings after selective retina therapy (SRT compared to panretinal photocoagulation (PRP in rabbits. Methods. The right eyes of 12 Chinchilla rabbits received 200 laser treatment spots. The right eyes of six rabbits received SRT (SRT group, whereas the other six animals were treated using PRP on the right eye (PRP group. The eyes were investigated using full-field ERG 1 hour and 3 weeks after treatment. Histologic exam to assess the tissue response of lasers was performed on 3 weeks. Results. No significant changes in the mean ROD or CR b-wave amplitudes of the SRT lesions were evident, compared to baseline, 1 h after laser treatment (p=0.372 and 0.278, resp.. In addition, the OPs and 30 Hz flickers of the SRT lesions were not significantly altered (p=0.17 and 0.243, resp.. At 3 weeks, similar results were found. Comparing the two groups, the ROD b-wave amplitude was reduced in the PRP and SRT groups to 60.04±4.2% and 92.32±6.43% of baseline (p<0.001. Histologically, there was no visible photoreceptor alterations on week 3. Conclusions. SRT in rabbit eyes induced less functional loss than PRP in both rod-mediated retinal function and cone-mediated retinal function. In addition, SRT irradiated eyes had no functional loss compared to its control.

  9. INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia

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    Gilmore Rose

    2010-01-01

    Full Text Available Abstract Background Congenital hemiplegia is the most common form of cerebral palsy (CP accounting for 1 in 1300 live births. These children have limitations in capacity to use the impaired upper limb and bimanual coordination deficits which impact on daily activities and participation in home, school and community life. There are currently two diverse intensive therapy approaches. Traditional therapy has adopted a bimanual approach (BIM training and recently, constraint induced movement therapy (CIMT has emerged as a promising unimanual approach. Uncertainty remains about the efficacy of these interventions and characteristics of best responders. This study aims to compare the efficacy of CIMT to BIM training to improve outcomes across the ICF for school children with congenital hemiplegia. Methods/Design A matched pairs randomised comparison design will be used with children matched by age, gender, side of hemiplegia and level of upper limb function. Based on power calculations a sample size of 52 children (26 matched pairs will be recruited. Children will be randomised within pairs to receive either CIMT or BIM training. Both interventions will use an intensive activity based day camp model, with groups receiving the same dosage of intervention delivered in the same environment (total 60 hours over 10 days. A novel circus theme will be used to enhance motivation. Groups will be compared at baseline, then at 3, 26 and 52 weeks following intervention. Severity of congenital hemiplegia will be classified according to brain structure (MRI and white matter fibre tracking, cortical excitability using Transcranial Magnetic Stimulation (TMS, functional use of the hand in everyday tasks (Manual Ability Classification System and Gross Motor Function Classification System (GMFCS. Outcomes will address neurovascular changes (functional MRI, functional connectivity, and brain (reorganisation (TMS, body structure and function (range of motion, spasticity

  10. Addition of gemcitabine to standard therapy in locally advanced cervical cancer: A randomized comparative study

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    Sanjoy Roy

    2011-01-01

    Full Text Available Background: The concurrent chemoradiotherapy for cervical cancer treatment is well accepted since 1999. This randomized, phase III trial aimed to observe if any improved outcome could be obtained capitalizing on the synergistic activity of gemcitabine, cisplatin, XRT. Materials and Methods: Stage IIB-IIIB, 18-70 years of age, KPS score ≥70, were randomized to control group and study group. Control group received cisplatin 40 mg/m 2 weekly with concurrent XRT, followed by brachytherapy and study group received gemcitabine 125 mg/m 2 weekly top of the same control group treatment. The primary end point was pathological response and toxicities along with patient compliance to treatment, late reactions, DFS and OS. Fifty patients were randomized between two arms. Results: The complete response in study and control arm was 96% and 88% respectively. Toxicities was significantly high in the study group compared to control group [leucopenia (P=0.015, skin reaction (P=0.03 and bleeding (P=0.019]. Local recurrence rate: 8% in study arm, none in control arm. The distant failure prevailed in control arm (20% vs. 8%. On a median follow up of 21 months in control arm, the DFS was 73% whereas 83% in study arm in 16 months (P=0.69. OS in the study arm was 100% and 84.5% in the control arm (P=0.14. Conclusions: If the toxicity can be managed adequately in the combination chemo radiation group, it may produce an improvement in response. Survival benefit can also be obtained by introducing gemcitabine to cisplatin as radio sensitizer.

  11. Cardiovascular safety of combination therapies with incretin-based drugs and metformin compared with a combination of metformin and sulphonylurea in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Mogensen, U. M.; Andersson, C.; Fosbøl, E. L.

    2014-01-01

    with metformin were safe compared with conventional combinations of glucose-lowering therapy. Use of incretin-based therapy may be target for strategies to lower CV risk in type 2 diabetes, although it should be recognized that the multivariable analysis may not have fully accounted for important baseline......AIM: Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) agonists are widely used in combinations with metformin in the treatment of type 2 diabetes; however, data on long-term safety compared with conventional combination therapies are limited. METHODS: Danish individuals...... differences....

  12. COMPARATIVE STUDY OF EFFICACY OF LOCAL STEROID INJECTION AND EXTRACORPOREAL SHOCKWAVE THERAPY IN THE TREATMENT OF PLANTAR FASCITIS

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    Rajan

    2014-04-01

    Full Text Available INTRODUCTION: Plantar fasciitis is a common condition causing misery to lot of patients. The etiology and treatment of plantar fasciitis are poorly understood. The results from such treatments vary considerably, and there is no consensus of opinion on the best method. MATERIAL AND METHODS: We conducted a controlled trial in our institute to compare the results of local steroid injections & the use of Extra-corporeal shock wave therapy (ESWT for managing plantar fasciitis. 200 patients with 240 painful heels were evaluated. All patients with moderate to severe heel pain who had already taken ten days of unsatisfactory treatment with oral NSAIDS were divided in two main groups. Group A of 100 patients received 1000 impulses of shock waves in three sessions at weekly interval. In Group B of 100 patients up to three local injections of 40 mg methyl prednisone mixed with 1 ml. of 2% lignocaine were given at biweekly interval. Pain assessment was done using VAS scale and the results were evaluated at six weeks, three months and six months after the completion of the therapy. CONCLUSIONS: There was a significant difference between two groups of patients being treated. The group B patients had significantly greater improvement in pain scale and early return to daily activities

  13. Comparative Analysis of Human Mesenchymal Stem Cells from Umbilical Cord, Dental Pulp, and Menstrual Blood as Sources for Cell Therapy

    Directory of Open Access Journals (Sweden)

    Huaijuan Ren

    2016-01-01

    Full Text Available Although mesenchymal stem cells (MSCs based therapy has been considered as a promising tool for tissue repair and regeneration, the optimal cell source remains unknown. Umbilical cord (UC, dental pulp (DP, and menstrual blood (MB are easily accessible sources, which make them attractive candidates for MSCs. The goal of this study was to compare the biological characteristics, including morphology, proliferation, antiapoptosis, multilineage differentiation capacity, and immunophenotype of UC-, DP-, and MB-MSCs in order to provide a theoretical basis for clinical selection and application of these cells. As a result, all UC-, DP-, and MB-MSCs have self-renewal capacity and multipotentiality. However, the UC-MSCs seemed to have higher cell proliferation ability, while DP-MSCs may have significant advantages for osteogenic differentiation, lower cell apoptosis, and senescence. These differences may be associated with the different expression level of cytokines, including vascular endothelial growth factor, fibroblast growth factor, keratinocyte growth factor, and hepatocyte growth factor in each of the MSCs. Comprehensively, our results suggest DP-MSCs may be a desired source for clinical applications of cell therapy.

  14. Treatment duration of febrile urinary tract infection (FUTIRST trial: a randomized placebo-controlled multicenter trial comparing short (7 days antibiotic treatment with conventional treatment (14 days

    Directory of Open Access Journals (Sweden)

    Kuijper Ed J

    2009-08-01

    Full Text Available Abstract Background Current guidelines on the management of urinary tract infection recommend treating febrile urinary tract infection or acute pyelonephritis with antimicrobials for at least 14 days. Few randomized trials showed the effectiveness of treatment durations of 5 to 7 days but this has only been studied in young previously healthy women. Methods/Design A randomized placebo-controlled double-blind multicenter non-inferiority trial in which 400 patients with community acquired febrile urinary tract infection will be randomly allocated to a short treatment arm (7 days of ciprofloxacin or 7 days of empirical β-lactams ± gentamicin intravenously with early switch to oral ciprofloxacin followed by 7 days of blinded placebo or standard treatment arm (7 days of ciprofloxacin or 7 days of empirical β-lactams ± gentamicin intravenously with early switch to oral ciprofloxacin followed by 7 days of blinded ciprofloxacin. The study is performed in the Leiden region in which one university hospital, 6 general hospitals and 32 primary health care centers are clustered. Patients eligible for randomization are competent patients aged 18 years or above with a presumptive diagnosis of acute pyelonephritis as defined by the combination of fever, one or more symptoms of urinary tract infection and a positive urine nitrate test and/or the presence of leucocyturia. Exclusion criteria are known allergy to fluoroquinolones, female patients who are pregnant or lactating, polycystic kidney disease, permanent renal replacement therapy, kidney transplantation, isolation of ciprofloxacin-resistant causal uropathogen, renal abscess, underlying chronic bacterial prostatitis, metastatic infectious foci and inability to obtain follow-up. The primary endpoint is the clinical cure rate through the 10- to 18-day post-treatment visit. Secondary endpoints are the microbiological cure rate 10- to 18-day post-treatment, the 30- and 90-day overall mortality rate, the

  15. Comparative Efficacy and Acceptability of Anti-TNF-Alpha Therapy in Ankylosing Spondylitis: A Mixed-Treatments Comparison

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    Yehua Wang

    2016-09-01

    Full Text Available Background: Tumor necrosis factor α (TNFα antagonists, namely, golimumab, adalimumab, infliximab, etanercept and certolizumab have been prescribed to alleviate and treat ankylosing spondylitis (AS. However, the lack of comparative evidence does not enable us to make constructive recommendations particularly for AS patient populations. Methods: Eligible controlled trials regarding the above 5 anti-TNFα therapies were searched electronically through PubMed, Embase and Cochrane until April 1, 2015. Odds ratios (ORs were estimated and compared for efficacy (ASAS20, ASAS40, ASAS5/6 responses and ASAS partial remission and acceptability (serious adverse effects (SAE among the anti-TNFα reagents. Results: Totally, 25 trials with 2989 participants were incorporated in this mixed treatment comparison. All the 5 TNFα blockers achieved better ASAS20, ASAS40, ASAS5/6 and ASAS-PR responses than the placebo. Furthermore, there was no significant distinction existed among inter-drug comparisons, except that unfavorable effects induced by certolizumab seemed to be less severe than those by etanercept (OR = 0.22, 95% CI: 0.05-0.93. Apart from that, etanercept was estimated to arrive at the most favorable ASAS20 response (90.6% and SAE (83.6%, while infliximab seemed to accomplish the best ASAS40 (83.6% and ASAS-PR responses (77.3%. In addition, adalimumab was estimated to rank the highest ASAS5/6 response (75.0%. Conclusions: Etanercept, infliximab and adalimumab might be prioritized among the commonly recognized 5 anti-TNFα therapies specific for AS patients, though existing evidence did not suffice to confirm significant superiority among the above 5 anti-TNFα reagent.

  16. Effects of ceftazidime and ciprofloxacin on biofilm formation in Proteus mirabilis rods.

    Science.gov (United States)

    Kwiecińska-Piróg, Joanna; Bogiel, Tomasz; Gospodarek, Eugenia

    2013-10-01

    Proteus mirabilis rods are one of the most commonly isolated species of the Proteus genus from human infections, mainly those from the urinary tract and wounds. They are often related to biofilm structure formation. The bacterial cells of the biofilm are less susceptible to routinely used antimicrobials, making the treatment more difficult. The aim of this study was to evaluate quantitatively the influence of ceftazidime and ciprofloxacin on biofilm formation on the polyvinyl chloride surface by 42 P. mirabilis strains isolated from urine, purulence, wound swab and bedsore samples. It has been shown that ceftazidime and ciprofloxacin at concentrations equal to 1/4, 1/2 and 1 times their MIC values for particular Proteus spp. strains decrease their ability to form biofilms. Moreover, ciprofloxacin at concentrations equal to 1/4, 1/2 and 1 times their MIC values for particular P. mirabilis strains reduces biofilm formation more efficiently than ceftazidime at the corresponding concentration values.

  17. Comparative effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in advanced gastric cancer: A meta-analysis of randomized controlled trials

    Science.gov (United States)

    Zhu, Yanjie; Huang, Jiale; Liu, Yanna; Zhao, Liying; Li, Zhijia; Liu, Hao; Wang, Qi-long; Qi, Xiaolong

    2016-01-01

    Background & Aims Platinum-based drugs are the most significant chemotherapy for advanced gastric cancer. The study aims to compare the efficacy and safety of oxaliplatin-based therapy versus cisplatin-based therapy in patients with advanced gastric cancer. Materials and Methods An adequate literature search in EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) was conducted. Phase II or III randomized controlled trials (RCTs) that compared effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in patients with advanced gastric cancer were eligible. The primary endpoint was overall response rate (ORR), progression free survival (PFS) and overall survival (OS). The second endpoint was the adverse events. Results Five phase II or III RCTs involving a total of 2,046 patients were identified. The results showed that there were no significant difference in ORR (OR = 1.17, 95% CI = 0.98–1.40, p = 0.08, I2 = 0%), PFS (HR = 0.92, 95% CI = 0.84–1.01, p = 0.09, I2 = 0%) and OS (HR = 0.91, 95% CI = 0.82–1.01, p = 0.07, I2 = 0%) between oxaliplatin-based therapy and cisplatin-based therapy. In addition, oxaliplatin-based therapy had lower risk of neutropenia, anemia, nausea, alopecia, thromboembolism, stomatitis and creatinine increased at all grades, and neutropenia, anemia, leukopenia and alopecia at 3–4 grades than cisplatin-based therapy. However, oxaliplatin-based therapy was associated with increased risk of neurosensory toxicity and thrombocytopenia. Conclusions Our meta-analysis showed that there were no significant difference in ORR, PFS and OS between oxaliplatin-based therapy and cisplatin-based therapy. The oxaliplatin-based therapy could generally decrease the risk of adverse effects except neurosensory toxicity and thrombocytopenia. PMID:27166187

  18. Cost-effectiveness of radiotherapy during surgery compared with external radiation therapy in the treatment of women with breast cancer

    Directory of Open Access Journals (Sweden)

    Hedie Mosalanezhad

    2016-04-01

    Full Text Available Introduction: Intraoperative radiation therapy device (IORT is one of the several options for partial breast irradiation. IORT is sent to the tumor bed during surgery and can be replaced with conventional standard therapy (EBRT. The aim of this study was to evaluate the safety and effectiveness of IORT machine compared with EBRT and to determine the dominant option in terms of the cost-effectiveness. Method: This study was conducted in two phases; the first phase was a comprehensive review of the electronic databases search that was extracted after extraction and selection of the articles used in this article on effectiveness outcomes. Data collection form was completed by professionals and experts to estimate the cost of treatment, intraoperative radiotherapy and radiotherapy cost when using external radiation therapy process; direct costs were considered from the perspective of service provider and they were calculated in the second phase to determine the option of cost-effective ICER. Excel software was used for data analysis and sensitivity analysis was performed to determine the strength of the results of cost-effectiveness. Results:18 studies were selected but only 8 of them were shown to have acceptable quality. The consequences like “rate of cancer recurrence”, “seroma”, “necrosis”, “toxic”, “skin disorders and delayed wound healing” and “spread the pain” were among the consequences used in the selected articles. The total costs for each patient during a course of treatment for EBRT and IORT were estimated 1398 and $5337.5, respectively. During the analysis, cost-effectiveness of the consequences of cancer recurrence, seroma, necrosis and skin disorders and delayed wound healing ICER was calculated. And IORT was found to be the dominant supplier in all cases. Also, in terms of implications of toxicity and prevalence of pain, IORT had a lower cost and better effectiveness and consequently the result was more cost

  19. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; Heide, Uulke A. van der; Herk, Marcel van [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-03-15

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade ≥1, ≥2, and ≥3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P<.001) with IG-IMRT for anorectum, anal canal, and bladder. The mean dose to the anorectum was 34.4 Gy versus 47.3 Gy (P<.001), 23.6 Gy versus 44.6 Gy for the anal canal (P<.001), and 33.1 Gy versus 43.2 Gy for the bladder (P<.001). Significantly lower grade ≥2 toxicity was observed for proctitis, stool frequency ≥6/day, and urinary frequency ≥12/day. IG-IMRT resulted in significantly lower overall RTOG grade ≥2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade ≥2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions.

  20. Population pharmacokinetics of ciprofloxacin in neonates and young infants less than three months of age.

    Science.gov (United States)

    Zhao, Wei; Hill, Helen; Le Guellec, Chantal; Neal, Tim; Mahoney, Sarah; Paulus, Stephane; Castellan, Charlotte; Kassai, Behrouz; van den Anker, Johannes N; Kearns, Gregory L; Turner, Mark A; Jacqz-Aigrain, Evelyne

    2014-11-01

    Ciprofloxacin is used in neonates with suspected or documented Gram-negative serious infections. Currently, its use is off-label partly because of lack of pharmacokinetic studies. Within the FP7 EU project TINN (Treat Infection in NeoNates), our aim was to evaluate the population pharmacokinetics of ciprofloxacin in neonates and young infants <3 months of age and define the appropriate dose in order to optimize ciprofloxacin treatment in this vulnerable population. Blood samples were collected from neonates treated with ciprofloxacin and concentrations were quantified by high-pressure liquid chromatography-mass spectrometry. Population pharmacokinetic analysis was performed using NONMEM software. The data from 60 newborn infants (postmenstrual age [PMA] range, 24.9 to 47.9 weeks) were available for population pharmacokinetic analysis. A two-compartment model with first-order elimination showed the best fit with the data. A covariate analysis identified that gestational age, postnatal age, current weight, serum creatinine concentration, and use of inotropes had a significant impact on ciprofloxacin pharmacokinetics. Monte Carlo simulation demonstrated that 90% of hypothetical newborns with a PMA of <34 weeks treated with 7.5 mg/kg twice daily and 84% of newborns with a PMA ≥34 weeks and young infants receiving 12.5 mg/kg twice daily would reach the AUC/MIC target of 125, using the standard EUCAST MIC susceptibility breakpoint of 0.5 mg/liter. The associated risks of overdose for the proposed dosing regimen were <8%. The population pharmacokinetics of ciprofloxacin was evaluated in neonates and young infants <3 months old, and a dosing regimen was established based on simulation.

  1. Ciprofloxacin residues in municipal biosolid compost do not selectively enrich populations of resistant bacteria.

    Science.gov (United States)

    Youngquist, Caitlin P; Liu, Jinxin; Orfe, Lisa H; Jones, Stephen S; Call, Douglas R

    2014-12-01

    Biosolids and livestock manure are valuable high-carbon soil amendments, but they commonly contain antibiotic residues that might persist after land application. While composting reduces the concentration of extractable antibiotics in these materials, if the starting concentration is sufficiently high then remaining residues could impact microbial communities in the compost and soil to which these materials are applied. To examine this issue, ciprofloxacin was added to biosolid compost feedstock to achieve a total concentration of 19 ppm, approximately 5-fold higher than that normally detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS) (1 to 3.5 ppm). This feedstock was placed into mesh bags that were buried in aerated compost bays. Once a week, a set of bags was removed and analyzed (treated and untreated, three replicates of each; 4 weeks). Addition of ciprofloxacin had no effect on the recovery of resistant bacteria at any time point (P = 0.86), and a separate bioassay showed that aqueous extractions from materials with an estimated 59 ppm ciprofloxacin had no effect on the growth of a susceptible strain of Escherichia coli (P = 0.28). Regression analysis showed that growth of the susceptible strain of E. coli can be reduced given a sufficiently high concentration of ciprofloxacin (P < 0.007), a result that is consistent with adsorption being the primary mechanism of sequestration. While analytical methods detected biologically significant concentrations of ciprofloxacin in the materials tested here, the culture-based methods were consistent with the materials having sufficient adsorptive capacity to prevent typical concentrations of ciprofloxacin residues from selectively enriching populations of resistant bacteria.

  2. [Ciprofloxacin by the intravenous route in the treatment of respiratory infections].

    Science.gov (United States)

    Mangiarotti, P; Manara, G; Bianchi, L; Piccioni, P D; Grassi, C

    1989-01-01

    A clinical trial was performed to evaluate the efficacy of ciprofloxacin by iv administration in the treatment of respiratory infections. Twenty-two in-patients affected with acute lower respiratory tract infections, mainly infectious exacerbations of chronic obstructive lung disease (COLD), were treated with ciprofloxacin at the daily dosage of 400 mg iv, in two administrations. Overall clinical results were satisfactory (15 patients cured, 7 patients improved). Concerning bacteriological results, pathogen eradication was achieved in 83.3% of cases. Tolerability was good: no adverse events were observed.

  3. An Evaluation of Ciprofloxacin Pharmacokinetics in Critically Ill Patients undergoing Continuous Veno-venous Haemodiafiltration

    LENUS (Irish Health Repository)

    Spooner, Almath M

    2011-08-04

    Abstract Background The study aimed to investigate the pharmacokinetics of intravenous ciprofloxacin and the adequacy of 400 mg every 12 hours in critically ill Intensive Care Unit (ICU) patients on continuous veno-venous haemodiafiltration (CVVHDF) with particular reference to the effect of achieved flow rates on drug clearance. Methods This was an open prospective study conducted in the intensive care unit and research unit of a university teaching hospital. The study population was seven critically ill patients with sepsis requiring CVVHDF. Blood and ultrafiltrate samples were collected and assayed for ciprofloxacin by High Performance Liquid Chromatography (HPLC) to calculate the model independent pharmacokinetic parameters; total body clearance (TBC), half-life (t1\\/2) and volume of distribution (Vd). CVVHDF was performed at prescribed dialysate rates of 1 or 2 L\\/hr and ultrafiltration rate of 2 L\\/hr. The blood flow rate was 200 ml\\/min, achieved using a Gambro blood pump and Hospal AN69HF haemofilter. Results Seventeen profiles were obtained. CVVHDF resulted in a median ciprofloxacin t1\\/2 of 13.8 (range 5.15-39.4) hr, median TBC of 9.90 (range 3.10-13.2) L\\/hr, a median Vdss of 125 (range 79.5-554) L, a CVVHDF clearance of 2.47+\\/-0.29 L\\/hr and a clearance of creatinine (Clcr) of 2.66+\\/-0.25 L\\/hr. Thus CVVHDF, at an average flow rate of ~3.5 L\\/hr, was responsible for removing 26% of ciprofloxacin cleared. At the dose rate of 400 mg every 12 hr, the median estimated Cpmax\\/MIC and AUC0-24\\/MIC ratios were 10.3 and 161 respectively (for a MIC of 0.5 mg\\/L) and exceed the proposed criteria of >10 for Cpmax\\/MIC and > 100 for AUC0-24\\/MIC. There was a suggestion towards increased ciprofloxacin clearance by CVVHDF with increasing effluent flow rate. Conclusions Given the growing microbial resistance to ciprofloxacin our results suggest that a dose rate of 400 mg every 12 hr, may be necessary to achieve the desired pharmacokinetic

  4. Synthesis, Crystal Structure, and Hirshfeld Surface Analysis of Ciprofloxacin-Salicylic Acid Molecular Salt

    OpenAIRE

    Ravikumar Nagalapalli; Shankar Yaga Bheem

    2014-01-01

    In the present study, ciprofloxacin-salicylic acid molecular salt has been synthesized and preliminarily characterized by FT-IR spectroscopy. The single crystal X-ray diffraction (SCXRD) reveals the proton transfer from carboxylic acid group of salicylic acid to piperazine moiety in ciprofloxacin confirming the formation of new molecular salt. The molecular packing of the molecular salt is mainly supported by N+–H⋯O−, O–H⋯O, C–H⋯F, C–H⋯π, and π-π interactions. The 3D Hirshfeld surfaces and th...

  5. Synthesis, Crystal Structure, and Hirshfeld Surface Analysis of Ciprofloxacin-Salicylic Acid Molecular Salt

    Directory of Open Access Journals (Sweden)

    Ravikumar Nagalapalli

    2014-01-01

    Full Text Available In the present study, ciprofloxacin-salicylic acid molecular salt has been synthesized and preliminarily characterized by FT-IR spectroscopy. The single crystal X-ray diffraction (SCXRD reveals the proton transfer from carboxylic acid group of salicylic acid to piperazine moiety in ciprofloxacin confirming the formation of new molecular salt. The molecular packing of the molecular salt is mainly supported by N+–H⋯O−, O–H⋯O, C–H⋯F, C–H⋯π, and π-π interactions. The 3D Hirshfeld surfaces and the associated 2D fingerprint plots were investigated for intermolecular hydrogen bonding interactions.

  6. Ciprofloxacin-resistant Escherichia coli in Central Greece: mechanisms of resistance and molecular identification

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    Mavroidi Angeliki

    2012-12-01

    Full Text Available Abstract Background Fluoroquinolone resistant E. coli isolates, that are also resistant to other classes of antibiotics, is a significant challenge to antibiotic treatment and infection control policies. In Central Greece a significant increase of ciprofloxacin-resistant Escherichia coli has occurred during 2011, indicating the need for further analysis. Methods A total of 106 ciprofloxacin-resistant out of 505 E. coli isolates consecutively collected during an eight months period in a tertiary Greek hospital of Central Greece were studied. Antimicrobial susceptibility patterns and mechanisms of resistance to quinolones were assessed, whereas selected isolates were further characterized by multilocus sequence typing and β-lactamase content. Results Sequence analysis of the quinolone-resistance determining region of the gyrA and parC genes has revealed that 63% of the ciprofloxacin-resistant E. coli harbored a distinct amino acid substitution pattern (GyrA:S83L + D87N; ParC:S80I + E84V, while 34% and 3% carried the patterns GyrA:S83L + D87N; ParC:S80I and GyrA:S83L + D87N; ParC:S80I + E84G respectively. The aac (6’-1b-cr plasmid-mediated quinolone resistance determinant was also detected; none of the isolates was found to carry the qnrA, qnrB and qnrS. Genotyping of a subset of 35 selected ciprofloxacin-resistant E. coli by multilocus sequence typing has revealed the presence of nine sequence types; ST131 and ST410 were the most prevalent and were exclusively correlated with hospital and health care associated infections, while strains belonging to STs 393, 361 and 162 were associated with community acquired infections. The GyrA:S83L + D87N; ParC:S80I + E84V substitution pattern was found exclusively among ST131 ciprofloxacin-resistant E. coli. Extended-spectrum β-lactamase-positive ST131 ciprofloxacin-resistant isolates produced CTX-M-type enzymes; eight the CTX-M-15 and one the CTX-M-3 variant. CTX-M-1 like and KPC-2 enzymes were detected

  7. Formation of hydroxyl radicals contributes to the bactericidal activity of ciprofloxacin against Pseudomonas aeruginosa biofilms

    DEFF Research Database (Denmark)

    Jensen, Peter Ø.; Briales, Alejandra; Brochmann, Rikke Prejh;

    2014-01-01

    induction of cytotoxic hydroxyl radicals (OH˙) during antibiotic treatment of planktonically grown cells may contribute to action of the commonly used antibiotic ciprofloxacin on P. aeruginosa biofilms. For this purpose, WT PAO1, a catalase deficient ΔkatA and a ciprofloxacin resistant mutant of PAO1 (gyr...

  8. Molecular analysis of ciprofloxacin resistance among non-typhoidal Salmonella with reduced susceptibility to ciprofloxacin isolated from patients at a tertiary care hospital in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Karunakaran, Rina; Tay, Sun Tee; Rahim, Fairuz Fadzilah; Lim, Bee Bee; Puthucheary, Savithri D

    2014-01-01

    We investigated the prevalence of non-typhoidal Salmonella (NTS) with "reduced susceptibility to ciprofloxacin" (RS-Cip) (minimum inhibitory concentration [MIC], 0.12-1.0 μg/mL) as well as their resistance genes in 75 NTS isolates (53 from stool, 21 from blood, and 1 from urine) from patients at a tertiary care Malaysian hospital between January and December 2009. RS-Cip was detected in 24/75 (32.0%) isolates. Using the ciprofloxacin MIC interpretive criteria for Salmonella in the Clinical and Laboratory Standards Institute 2013 guidelines, 51/75 (68.0%) isolates were found to be sensitive, 22/75 (29.3%) were intermediate, and 2/75 (2.7%) were resistant to ciprofloxacin. The 24 isolates that were intermediate or resistant to ciprofloxacin were the same isolates categorized as having RS-Cip. Among the 23 tested isolates with RS-Cip, the qnrS gene was detected in 17/23 (73.9%) and single gyrA mutations were detected in 6/23 (26.1%) (Asp87Tyr [n = 3], Asp87Asn [n = 2], and Ser83Phe [n = 1]). A parC (Thr57Ser) mutation was detected in 13/23 (56.5%) isolates, coexisting with either a qnrS gene or a gyrA mutation. The high incidence of the qnrS gene among isolates with RS-Cip needs to be monitored because qnr genes can spread via plasmids and aid in the emergence of increased resistance levels.

  9. A comparative study of influential factors correlating with early and late hypothyroidism after 131Ⅰtherapy for Graves' disease

    Institute of Scientific and Technical Information of China (English)

    WANG Ren-fei; TAN Jian; ZHANG Gui-zhi; MENG Zhao-wei; ZHENG Wei

    2010-01-01

    Background 131Ⅰ therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after 131Ⅰ treatment for Graves' disease (GD) and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.Methods Five hundred GD patients (144 males, 356 females; age (41.2±12.3) years) received 131Ⅰ treatment for the first time. The therapeutic procedure was carried out as the following: undergoing 131Ⅰ uptake test to obtain maximum of thyroid uptake value and effective half-life (EHL) time; estimating the thyroid's weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating 131Ⅰtherapeutic dosage; per os uptake of the determined 131Ⅰ dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, 131Ⅰ dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.Results The incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after 131Ⅰ treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of 131Ⅰ, EHL time and thyroid microsome antibody (TMAb), etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and

  10. Comparative assessment of two Artemisinin based combination Therapies in the treatment of Uncomplicated Malaria among University students in Nigeria

    Directory of Open Access Journals (Sweden)

    Okonta Matthew J

    2013-06-01

    Full Text Available Background: In line with the recommendation of artemisininbased combination therapy (ACT by WHO in the effective treatment of uncomplicated malaria, African nations including Nigeria changed their malaria treatment policy to combination therapies. To date, about 15 African nations adopted artesunate /amodiaquine (AA as their first line agent while Nigeria adopted artemether /lumefantrine (AL. Objective: The objective of this study is to compare the treatment outcome among patients treated with AA to those treated with AL for acute uncomplicated malaria. Method: The study was conducted at Nnamdi Azikiwe University campuses using quantitative methods. Two hundered and ninety six patients were randomly allocated to one of two treatment group- AA and AL with 148 patients per group. All the patients were educated about the drugs and adherence. Adherence and treatment outcomes including parasite clearance and the drugs’ effects on biochemical parameters among others were assessed by follow up visits on third, seventh, fourteenth and twenty eighth-day post treatment. Data were analysed using Cox Regression model on SPSS 17.0. Result: Both drugs were well adhered to and tolerated. One case of Steven Johnson-like reaction was observed with AL. Fever resolution and parasite clearance was similar in both groups with adequate clinical and parasitological response (ACPR by day 28 for AL and AA being 70.3% and 85.1% respectively. Conclusion: Our findings is in favour of higher efficacy of AA with respect to their ACPR. More controlled studies will be needed to ascertain the adoption of AL as first line drug in malaria treatment in Nigeria.

  11. Early and Delayed Antiretroviral Therapy (ART) Result in Comparable Reductions in CD8+ T Cell Exhaustion Marker Expression.

    Science.gov (United States)

    Rutishauser, Rachel; Hartogensis, Wendy; Deguit, Christian D; Krone, Melissa; Hoh, Rebecca; Hecht, Rick; Pilcher, Christopher D; Bacchetti, Peter; Deeks, Steven G; Hunt, Peter W; McCune, Joseph M

    2017-03-23

    In untreated HIV infection, CD8+ T cell exhaustion (i.e., decreased proliferative and effector capacity) is associated with high levels of expression of co-inhibitory receptors, including PD-1, TIGIT, CD160, and 2B4. This is evident for both HIV-specific and non-HIV-specific CD8+ T cells. Antiretroviral therapy (ART) initiated during chronic infection decreases but may not completely normalize the expression of such "exhaustion markers." Compared to initiation of ART later in the course of disease, initiation soon after infection reduces some parameters of chronic inflammation and adaptive immune dysfunction. However, it is not known if Early ART (e.g., initiated within the first six months after HIV infection) versus Delayed ART (e.g., initiated during chronic infection) preferentially reduces expression of exhaustion markers. We evaluated exhaustion marker expression on subsets of circulating effector and memory CD8+ T cells at longitudinal pre- and post-ART (two and five years on ART) time points from n=19 (Early ART) and n=23 (Delayed ART) individuals. Prior to ART, TIGIT and CD160 were expressed on a statistically significantly higher proportion of effector and transitional memory cells from individuals in the Delayed ART group: the timing of ART initiation, however, did not consistently affect the expression of the exhaustion markers once viral suppression was achieved. Understanding which factors do and do not regulate aspects of CD8+ T cell exhaustion, including the expression of exhaustion markers, is critical to inform the rational design of CD8+ T cell-based therapies to treat HIV, for which CD8+ T cell exhaustion remains an important barrier to efficacy.

  12. Magnetic Resonance Imaging–Guided versus Surrogate-Based Motion Tracking in Liver Radiation Therapy: A Prospective Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Paganelli, Chiara, E-mail: chiara.paganelli@polimi.it [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Seregni, Matteo; Fattori, Giovanni [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Summers, Paul [Division of Radiology, Istituto Europeo di Oncologia, Milano (Italy); Bellomi, Massimo [Division of Radiology, Istituto Europeo di Oncologia, Milano (Italy); Department of Health Sciences, Università degli Studi di Milano, Milano (Italy); Baroni, Guido; Riboldi, Marco [Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano (Italy); Bioengineering Unit, CNAO Foundation, Pavia (Italy)

    2015-03-15

    Purpose: This study applied automatic feature detection on cine–magnetic resonance imaging (MRI) liver images in order to provide a prospective comparison between MRI-guided and surrogate-based tracking methods for motion-compensated liver radiation therapy. Methods and Materials: In a population of 30 subjects (5 volunteers plus 25 patients), 2 oblique sagittal slices were acquired across the liver at high temporal resolution. An algorithm based on scale invariant feature transform (SIFT) was used to extract and track multiple features throughout the image sequence. The position of abdominal markers was also measured directly from the image series, and the internal motion of each feature was quantified through multiparametric analysis. Surrogate-based tumor tracking with a state-of-the-art external/internal correlation model was simulated. The geometrical tracking error was measured, and its correlation with external motion parameters was also investigated. Finally, the potential gain in tracking accuracy relying on MRI guidance was quantified as a function of the maximum allowed tracking error. Results: An average of 45 features was extracted for each subject across the whole liver. The multi-parametric motion analysis reported relevant inter- and intrasubject variability, highlighting the value of patient-specific and spatially-distributed measurements. Surrogate-based tracking errors (relative to the motion amplitude) were were in the range 7% to 23% (1.02-3.57mm) and were significantly influenced by external motion parameters. The gain of MRI guidance compared to surrogate-based motion tracking was larger than 30% in 50% of the subjects when considering a 1.5-mm tracking error tolerance. Conclusions: Automatic feature detection applied to cine-MRI allows detailed liver motion description to be obtained. Such information was used to quantify the performance of surrogate-based tracking methods and to provide a prospective comparison with respect to MRI

  13. A Comparative Study of Group Behavioral Activation and Cognitive Therapy in Reducing Subsyndromal Anxiety and Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Mehdi Soleimani

    2015-10-01

    Full Text Available Objective: This study compared the effectiveness of two group treatments, behavioral activation (BA and cognitive therapy (CT, in reducing subsyndromal anxiety and depressive symptoms in a sample of Iranian university students.Method: Twenty-seven Iranian university students who scored 18 or higher on the depression subscale and 16 or higher on the anxiety subscale of the Depression, Anxiety, and Stress Scale (DASS-42 were randomly assigned into treatment groups. One group received 8 sessions of BA (n = 14, and the other received 8 sessions of group CT (n = 13.Result: Analysis of covariance revealed that the BA group had a significantly greater reduction in depressive symptoms than the CT group. However, there were no significant differences between the two groups in the levels of anxiety, stress symptoms or functional impairment after treatment.Conclusion: This study found evidence for the effectiveness of BA in reducing anxiety, depressive and stress symptoms and functional impairment compared to CT. BA was more effective than CT in improving depressive symptoms and was as effective as CT in decreasing anxiety, stress and functional impairment. BA is also a cost-effective intervention, particularly in group formats.

  14. Cost-effectiveness of biological therapy compared with methotrexate in the treatment for rheumatoid arthritis in Colombia.

    Science.gov (United States)

    Valle-Mercado, Carolina; Cubides, Maria-Fernanda; Parra-Torrado, Monica; Rosselli, Diego

    2013-12-01

    The objectives of the study are to develop a cost-effectiveness model comparing biological therapy (BT) with methotrexate (MTX) alone, in the treatment for rheumatoid arthritis (RA), combining clinical and quality-of-life data from international trials with local costs and local epidemiological data. We designed a six-month cycle Markov model with five functional states, based on Health Assessment Questionnaire, with patients initiating treatment in any of the predefined states, based on a sample of 150 local RA patients. Simulations ran for 10 and 20 years, and for the whole life span. Utilities, in quality-adjusted life years (QALY), were taken from international literature. Discount rate was 3 % for costs and utilities. We calculated direct and indirect costs using a combination of international and local data. Results are presented as incremental cost-effectiveness ratios (ICER). ICERs in euros per QALY were 143,072 for 10 years; 139,332 for 20 years; and 137,712 for the whole life span. Total costs with MTX were lower than with BT, despite higher out of pocket, productivity, and complication costs. Under conventional thresholds, and for the "average" RA patient, BT would not be cost-effective in Colombia. BT compared to MTX provides more QALYs, but at a high cost. When ICERs were estimated for Colombia, BT would not be cost-effective. We propose different thresholds for different conditions, perhaps prioritizing chronic diseases that lead to disability.

  15. Novel biopolymers as implant matrix for the delivery of ciprofloxacin: biocompatibility, degradation, and in vitro antibiotic release.

    Science.gov (United States)

    Fulzele, Suniket V; Satturwar, Prashant M; Dorle, Avinash K

    2007-01-01

    The purpose of this study was to investigate the in vitro-in vivo degradation and tissue compatibility of three novel biopolymers viz. polymerized rosin (PR), glycerol ester of polymerized rosin (GPR) and pentaerythritol ester of polymerized rosin (PPR) and study their potential as implant matrix for the delivery of ciprofloxacin hydrochloride. Free films of polymers were used for in vitro degradation in PBS (pH 7.4) and in vivo in rat subcutaneous model. Sample weight loss, molecular weight decline, and morphological changes were analyzed after periodic intervals (30, 60, and 90 days) to monitor the degradation profile. Biocompatibility was evaluated by examination of the inflammatory tissue response to the implanted films on postoperative days 7, 14, 21, and 28. Furthermore, direct compression of dry blends of various polymer matrices with 20%, 30%, and 40% w/w drug loading was performed to investigate their potential for implant systems. The implants were characterized in terms of porosity and ciprofloxacin release. Biopolymer films showed slow rate of degradation, in vivo rate being faster on comparative basis. Heterogeneous bulk degradation was evident with the esterified products showing faster rates than PR. Morphologically all the films were stiff and intact with no significant difference in their appearance. The percent weight remaining in vivo was 90.70 +/- 6.2, 85.59 +/- 5.8, and 75.56 +/- 4.8 for PR, GPR, and PPR films respectively. Initial rapid drop in Mw was demonstrated with nearly 20.0% and 30.0% decline within 30 days followed by a steady decline to nearly 40.0% and 50.0% within 90 days following in vitro and in vivo degradation respectively. Biocompatibility demonstrated by acute and subacute tissue reactions showed minimal inflammatory reactions with prominent fibrous encapsulation and absence of necrosis demonstrating good tissue compatibility to the extent evaluated. All implants showed erosion and increase in porosity that affected the drug

  16. Ciprofloxacin Derivatives Affect Parasite Cell Division and Increase the Survival of Mice Infected with Toxoplasma gondii

    Science.gov (United States)

    Martins-Duarte, Erica S.; Dubar, Faustine; Lawton, Philippe; França da Silva, Cristiane; C. Soeiro, Maria de Nazaré; de Souza, Wanderley; Biot, Christophe; Vommaro, Rossiane C.

    2015-01-01

    Toxoplasmosis, caused by the protozoan Toxoplasma gondii, is a worldwide disease whose clinical manifestations include encephalitis and congenital malformations in newborns. Previously, we described the synthesis of new ethyl-ester derivatives of the antibiotic ciprofloxacin with ~40-fold increased activity against T. gondii in vitro, compared with the original compound. Cipro derivatives are expected to target the parasite’s DNA gyrase complex in the apicoplast. The activity of these compounds in vivo, as well as their mode of action, remained thus far uncharacterized. Here, we examined the activity of the Cipro derivatives in vivo, in a model of acute murine toxoplasmosis. In addition, we investigated the cellular effects T. gondii tachyzoites in vitro, by immunofluorescence and transmission electron microscopy (TEM). When compared with Cipro treatment, 7-day treatments with Cipro derivatives increased mouse survival significantly, with 13–25% of mice surviving for up to 60 days post-infection (vs. complete lethality 10 days post-infection, with Cipro treatment). Light microscopy examination early (6 and 24h) post-infection revealed that 6-h treatments with Cipro derivatives inhibited the initial event of parasite cell division inside host cells, in an irreversible manner. By TEM and immunofluorescence, the main cellular effects observed after treatment with Cipro derivatives and Cipro were cell scission inhibition - with the appearance of ‘tethered’ parasites – malformation of the inner membrane complex, and apicoplast enlargement and missegregation. Interestingly, tethered daughter cells resulting from Cipro derivatives, and also Cipro, treatment did not show MORN1 cap or centrocone localization. The biological activity of Cipro derivatives against C. parvum, an apicomplexan species that lacks the apicoplast, is, approximately, 50 fold lower than that in T. gondii tachyzoites, supporting that these compounds targets the apicoplast. Our results show

  17. Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

    Science.gov (United States)

    Magri, Vittorio; Montanari, Emanuele; Škerk, Višnja; Markotić, Alemka; Marras, Emanuela; Restelli, Antonella; Naber, Kurt G; Perletti, Gianpaolo

    2011-01-01

    We previously demonstrated the safety and efficacy of fluoroquinolone–macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500- or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week−1) with ciprofloxacin at the rate of 750 mg day−1 for 4 weeks rather than at 500 mg day−1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone–macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation. PMID:21765442

  18. Fluoroquinolone-macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

    Institute of Scientific and Technical Information of China (English)

    Vittorio Magri; Emanuele Montanari; Vi(s)nja (S)kerk; Alemka Markoti(c); Emanuela Marras; Antonella Restelli; Kurt G Naber; Gianpaolo Perletti

    2011-01-01

    We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis (CBP).The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg,thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort,respectively).Combined administration of azithromycin (1500 mg week-1) with ciprofloxacin at the rate of 750 mg day-1 for 4 weeks rather than at 500 mg day-1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%.A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups.Ejaculatory pain,haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups,but the latter subsided more promptly in the Cipro-750 cohort.In total,59 Cipro-750 patients showed mild-to-severn erectile dysfunction (ED) at baseline,while 22 patients had no ED on microbiological eradication and throughout the follow-up period.In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation,including pain,voiding disturbances and sexual dysfunction.A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks.Our results are open to further prospective validation.

  19. A comparative evaluation of skeletal, dental, and soft tissue changes with skeletal anchored and conventional facemask protraction therapy

    Science.gov (United States)

    Tripathi, Tulika; Rai, Priyank; Singh, Navneet; Kalra, Shilpa

    2016-01-01

    Objective: To cephalometrically evaluate and compare the skeletal, dentoalveolar, and soft tissue changes after maxillary protraction with skeletally anchored and conventional facemask. Methods: The data for the study were collected from the pre- and post-treatment records of patients of maxillary retrusion treated with skeletally anchored and conventional facemask therapy. Twenty subjects were included in the study and were categorized into two groups, namely skeletal anchored maxillary protraction (SAMP) group with the mean age of 10.10 ± 1.1 years and conventional facemask maxillary protraction (CFMP) group with the mean age of 9.90 ± 1.1 years. Pre and post-treatment lateral cephalograms were assessed. Results: The data were analyzed by Mann–Whitney test and Wilcoxon signed-rank test. The mean duration of treatment in SAMP group and CFMP group was 5.8 months and 10 months, respectively. The mean forward displacement of the maxilla (vertical point A) was 3.40 ± 1.07 mm in SAMP group and 2.80 ± 0.79 mm in CFMP group. The mandible showed downward and backward rotation in both the groups with more rotation in CFMP group. A significant increase in maxillary incisor inclination was seen in CFMP group as compared to SAMP group. A significant decrease was found in mandibular incisor inclination in both the treatment groups. The soft tissue changes corresponded to underlying skeletal tissue. Conclusions: SAMP is proven to be a better treatment modality as compared to CFMP for achieving true skeletal changes and minimal dental changes in cases with developing skeletal Class III with maxillary retrusion. PMID:27556021

  20. A STUDY OF COMPARATIVE EFFEICIENCY OF ORAL MINI PULSE THERAPY VERSUS ORAL ACITRET IN IN GENARALISED LICHEN PLANUS

    Directory of Open Access Journals (Sweden)

    Guru Prasad

    2015-10-01

    Full Text Available BACKGROUND: Lichen planus is a chronic inflammatory disease that effects skin, mucous membranes, hair and nails. There are several drugs both topical and systemic for the treatment of lichen planus. AIMS AND OBJECTIVES: Present study was done to compare the efficacy between oral mini pulse therapy with betamethasone and with acetretin in the management of generalised lichen planus. MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen plan us, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Vis h akhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups. Group1 patients were treated with 0.1 mg/kg of oral betamethasone given on 2 consecutive days in a week till 8 weeks and tapered. Group 2 patients were treated with 0.5 mg/kg of acetretin for 8 weeks and tapered. INCLUSION CRITERIA: All pa tients of age group in between 11 - 60 years , of either sex, suffering f rom lichen planus of duration > 3 months, and women in group 2 who were in reproductive age group on two methods of contraception were included. EXCLUSION CRITERIA: Pregnant and lactating women, in Group 1: patients suffering from diabetes, hypertension, peptic ulcer disease, renal, hepatic, heart disease or tuberculosis, in Group 2: patients with abnormal lipid profile, diabetes, hypertension, renal, liver or heart disease were excluded. RESULTS: out of 60 patients enrolled in study, 2 patients from group 1 and 5 patients from group 2 were dropped from study and results were concluded. Majority of patients were in age group of 31 - 60 (78.3% with male to female ratio of 2.1:1.Group 1 patient s at the end of 8 weeks response was seen in 92.8%, with relapse rate of 15.38% after 6 months of follow up. Group 2 patients at end of 8 weeks response was seen in 72 % with relapse

  1. Analysis of ciprofloxacin by a simple high-performance liquid chromatography method.

    Science.gov (United States)

    Wu, Shihn-Sheng; Chein, Chih-Yuan; Wen, Yen-Hsia

    2008-07-01

    A simple and sensitive high-performance liquid chromatographic method is described for the quantitative analysis of ciprofloxacin in pharmaceuticals and human plasma. The method employs reversed-phase chromatography using an RP-C18 column with an isocratic mobile phase of acetonitrile-2% acetic acid aqueous solution (16:84, v/v), umbelliferone as an internal standard, and a flow rate of 1.0 mL/min. The UV detector is set at 280 nm. The limit of detection is 0.25 microM (S/N = 3, injection volume = 10 microL). The regression equations are linear (r > 0.9999) over a range between 0.51 approximately 130 microM for the pharmaceutical analysis of ciprofloxacin and 0.51 approximately 64.8 microM for the biological analysis of ciprofloxacin in human plasma. The intra- and inter-day relative standard deviation and relative error are less than 3.39% and 5.71%, respectively. All the recoveries are greater than 93.8%. This method is successfully applied in a pharmacokinetic study of a volunteer who receives a 500 mg ciprofloxacin tablet.

  2. Mechanisms of Reduced Susceptibility to Ciprofloxacin in Escherichia coli Isolates from Canadian Hospitals

    Directory of Open Access Journals (Sweden)

    Patricia J Baudry-Simner

    2012-01-01

    Full Text Available OBJECTIVE: To determine whether plasmid-mediated quinolone resistance (PMQR determinants play a role in the increasing resistance to fluoroquinolones among Escherichia coli isolates in Canadian hospitals, and to determine the mechanisms of reduced susceptibility to ciprofloxacin in a recent collection of 190 clinical E coli isolates.

  3. Luminescence screening of enrofloxacin and ciprofloxacin residues in swine liver after dispersive liquid - liquid microextraction cleanup

    Science.gov (United States)

    A rapid luminescence method was developed to screen residues of enrofloxacin (ENRO) and its metabolite, ciprofloxacin (CIPRO), in swine liver. Target analytes were extracted in acetonitrile-2.5% trifluoroacetic acid-NaCl, cleaned up by dispersive liquid-liquid microextraction (DLLME), and finally de...

  4. Ciprofloxacin treatment of bacterial peritonitis associated with chronic ambulatory peritoneal dialysis caused by Neisseria cinerea.

    Science.gov (United States)

    Taegtmeyer, M; Saxena, R; Corkill, J E; Anijeet, H; Parry, C M

    2006-08-01

    Bacterial peritonitis is a well-recognized complication of chronic ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. We present a case of peritonitis due to an unusual pathogen, Neisseria cinerea, unresponsive to the standard intraperitoneal (i.p.) vancomycin and gentamicin, which responded rapidly to oral ciprofloxacin.

  5. ENHANCEMENT OF DISSOLUTION RATE OF CIPROFLOXACIN BY USING VARIOUS SOLID DISPERSION TECHNIQUES

    Directory of Open Access Journals (Sweden)

    Brahmaiah Bonthagarala*, Leela Madhuri Pola and Sreekanth Nama

    2013-11-01

    Full Text Available The aim of this research wok is to formulate and evaluate Ciprofloxacin solid dispersions system by using the different techniques. This will increase the solubility of the drug or Ciprofloxacin and give the immediate release of the drug from the formulations. The main objective is to formulate a drug product as immediate release oral solid dosage form of Ciprofloxacin solid dispersion system which is considered to be stable, robust quality and enhanced dissolution rate. To optimize the method of manufacture by formulate the Ciprofloxacin solid dispersion system by various techniques like Physical mixing, Co-grinding, Kneading and solvent evaporation techniques. The disintegrating agent used in the present study is Crosscarmellose sodium. Among the four different techniques used for preparation of solid dispersions solvent evaporation technique has shown the increase in dissolution rate that is the Trail-5 was found to have a faster solubility and dissolution property which was prepared by using Crosscarmellose sodium as a disintegrant in the ratio of 1:1.

  6. Posttreatment Changes in Escherichia coli Antimicrobial Susceptibility Rates Among Diarrheic Patients Treated with Ciprofloxacin

    Science.gov (United States)

    2005-06-01

    normal microflora of oral antibiotics for treatment of urinary tract infections. J. Antimicrob. Che- mother. 46(Suppl. 1):41–48, 63–65. 6. Farmer, J...Infect. Dis. 26:341–345. 9. Holt, H. A., D. A. Lewis, L. O. White, S. Y. Bastable, and D. S. Reeves. 1986. Effect of oral ciprofloxacin on the

  7. Reinforcement of the bactericidal effect of ciprofloxacin on Pseudomonas aeruginosa biofilm by hyperbaric oxygen treatment

    DEFF Research Database (Denmark)

    Kolpen, Mette; Mousavi, Nabi; Sams, Thomas

    2016-01-01

    of O2-depleted biofilms may thus improve susceptibility to ciprofloxacin possibly by restoring aerobic respiration. We tested such a strategy using reoxygenation of O2-depleted P. aeruginosa strain PAO1 agarose-embedded biofilms by hyperbaric oxygen treatment (HBOT) (100% O2, 2.8bar), enhancing...

  8. SINGLE-DOSE VERSUS 3-DAY PROPHYLAXIS WITH CIPROFLOXACIN IN TRANSURETHRAL SURGERY - A CLINICAL-TRIAL

    NARCIS (Netherlands)

    BIJL, W; JANKNEGT, RA

    1993-01-01

    in 235 patients who underwent transurethral surgery, perioperative oral ciprofloxacin prophylaxis was given as a single dose 500 mg versus a 3-day regimen. Out of 180 evaluable patients, 84 received a single dose and 96 received a 3-day course. In the single dose prophylaxis group there were 5 failu

  9. Ciprofloxacin and probiotic Escherichia coli Nissle add-on treatment in active ulcerative colitis

    DEFF Research Database (Denmark)

    Petersen, Andreas Munk; Mirsepasi, Hengameh; Halkjær, Sofie Ingdam;

    2014-01-01

    BACKGROUND AND AIM: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. The probiotic bacterium Escherichia coli Nissle 1917 (EcN) has been used to maintain and induce clinical remission in UC. Our aim was to test the effect of Ciprofloxacin and/or orally administered EcN as add...

  10. Everolimus-Based Therapy versus Chemotherapy among Patients with HR+/HER2- Metastatic Breast Cancer: Comparative Effectiveness from a Chart Review Study.

    Science.gov (United States)

    Li, Nanxin; Hao, Yanni; Xie, Jipan; Lin, Peggy L; Koo, Valerie; Ohashi, Erika; Wu, Eric Q

    2015-01-01

    Objective. To compare the real-world effectiveness of everolimus-based therapy and chemotherapy in postmenopausal women with hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Methods. This retrospective chart review examined a nationwide sample of postmenopausal HR+/HER2- mBC women in community-based oncology practices. Patients received everolimus-based therapy or chemotherapy for mBC between 07/01/2012 and 04/15/2013, after failure of a non-steroidal aromatase inhibitor. Overall survival (OS), progression-free survival (PFS), and time on treatment (TOT) were compared using Kaplan-Meier analysis and Cox proportional hazards models adjusting for line of therapy and baseline characteristics. Results. 234 and 137 patients received everolimus-based therapy and chemotherapy. Patients treated with everolimus-based therapy tended to have less aggressive mBC than patients treated with chemotherapy. Multivariate-adjusted Cox models showed that everolimus-based therapy was associated with significantly longer OS [hazard ratio (HR) = 0.37, 95% confidence interval (CI): 0.22-0.63], PFS (HR = 0.70, 95% CI = 0.50-0.97), and TOT (HR = 0.34, 95% CI: 0.25-0.45) than chemotherapy. Adjusted comparative effectiveness results were generally consistent across lines of therapy. Conclusion. In this retrospective chart review of postmenopausal HR+/HER2- mBC patients, treatment with everolimus-based therapy was associated with longer OS, PFS, and TOT than chemotherapy.

  11. Catalase Expression Is Modulated by Vancomycin and Ciprofloxacin and Influences the Formation of Free Radicals in Staphylococcus aureus Cultures.

    Science.gov (United States)

    Wang, Ying; Hougaard, Anni B; Paulander, Wilhelm; Skibsted, Leif H; Ingmer, Hanne; Andersen, Mogens L

    2015-09-01

    Detection of free radicals in biological systems is challenging due to their short half-lives. We have applied electron spin resonance (ESR) spectroscopy combined with spin traps using the probes PBN (N-tert-butyl-α-phenylnitrone) and DMPO (5,5-dimethyl-1-pyrroline N-oxide) to assess free radical formation in the human pathogen Staphylococcus aureus treated with a bactericidal antibiotic, vancomycin or ciprofloxacin. While we were unable to detect ESR signals in bacterial cells, hydroxyl radicals were observed in the supernatant of bacterial cell cultures. Surprisingly, the strongest signal was detected in broth medium without bacterial cells present and it was mitigated by iron chelation or by addition of catalase, which catalyzes the decomposition of hydrogen peroxide to water and oxygen. This suggests that the signal originates from hydroxyl radicals formed by the Fenton reaction, in which iron is oxidized by hydrogen peroxide. Previously, hydroxyl radicals have been proposed to be generated within bacterial cells in response to bactericidal antibiotics. We found that when S. aureus was exposed to vancomycin or ciprofloxacin, hydroxyl radical formation in the broth was indeed increased compared to the level seen with untreated bacterial cells. However, S. aureus cells express catalase, and the antibiotic-mediated increase in hydroxyl radical formation was correlated with reduced katA expression and catalase activity in the presence of either antibiotic. Therefore, our results show that in S. aureus, bactericidal antibiotics modulate catalase expression, which in turn influences the formation of free radicals in the surrounding broth medium. If similar regulation is found in other bacterial species, it might explain why bactericidal antibiotics are perceived as inducing formation of free radicals.

  12. Accumulation of ciprofloxacin and lomefloxacinin fluoroquinolone-resistant strains of Escherichia coli

    Institute of Scientific and Technical Information of China (English)

    夏培元; 冯萍; 钟利; 吕晓菊; 雷秉钧

    2002-01-01

    Objective To evaluate the role of outer membrane protein (Omp) F-deficiency and active efflux in the accumulation of hydrophilic fluoroquinolones ciprofloxacin (CPLX) and lomefloxacin (LMLX) in resistant E. coli strains. Methods Fluoroquinolone accumulation in bacteria and the effect of active efflux were measured by a fluorescence method. The outer membrane proteins of the bacteria were analysed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). E. coli strains in this study included control strains JF701 and JF703 that are OmpC- or OmpF-deficient mutants of E. coli K-12, respectively, and the fluoroquinolone susceptible strain the fluoroquinolone susceptible strain of Escherichia coli (Ecs) and its in vitroselected resistant strains R2 and R256, and the clinical resistant isolates R5 and R6. Results The steady-state accumulation concentration of each drug in Ecs appeared to be the same as in JF701, while in the OmpF- deficient strain JF703, it was 1/5 CPLX or 1/2 LMLX lower than that in JF701, but JF703 was still susceptible to fluoroquinolones. On the other hand, compared with susceptible strains, a 2- to 10-fold decrease in the accumulation of each drug was found in the resistant strains except R2, in which the accumulation was slightly higher than in JF703. After the addition of 2,4-dinitrophenol (DNP), accumulation of each drug increased, especially in resistant strains, indicating that the function of the active efflux (pump) system in these bacteria had been enhanced dramatically. Furthermore, both OmpF and OmpC in Ecs, OmpF-deficiency in R2 and R256 and OmpC-deficiency in R5 and R6 were observed.Conclusion The decreased accumulation of hydrophilic fluoroquinolones in E. coli involved OmpF-deficiency and active efflux (pump), and the latter may be an important factor.

  13. A comparative study between the imaging system and the optical tracking system in proton therapy at CNAO

    CERN Document Server

    Desplanques, Maxime; Fontana, Giulia; Pella, Andrea; Riboldi, Marco; Fattori, Giovanni; Donno, Andrea; Baroni, Guido; Orecchia, Roberto

    2013-01-01

    The synergy between in-room imaging and optical tracking, in co-operation with highly accurate robotic patient handling represents a concept for patient-set-up which has been implemented at CNAO (Centro Nazionale di Adroterapia Oncologica). In-room imaging is based on a double oblique X-ray projection system; optical tracking consists of the detection of the position of spherical markers placed directly on the patient’s skin or on the immobilization devices. These markers are used as external fiducials during patient positioning and dose delivery. This study reports the results of a comparative analysis between in-room imaging and optical tracking data for patient positioning within the framework of high-precision particle therapy. Differences between the optical tracking system (OTS) and the imaging system (IS) were on average within the expected localization accuracy. On the first 633 fractions for head and neck (H&N) set-up procedures, the corrections applied by the IS, after patient positioning usin...

  14. Identification of novel targets for antiangiogenic therapy by comparing the gene expressions of tumor and normal endothelial cells

    Science.gov (United States)

    Otsubo, Tsuguteru; Hida, Yasuhiro; Ohga, Noritaka; Sato, Hideshi; Kai, Toshihiro; Matsuki, Yasushi; Takasu, Hideo; Akiyama, Kosuke; Maishi, Nako; Kawamoto, Taisuke; Shinohara, Nobuo; Nonomura, Katsuya; Hida, Kyoko

    2014-01-01

    Targeting tumor angiogenesis is an established strategy for cancer therapy. Because angiogenesis is not limited to pathological conditions such as cancer, molecular markers that can distinguish between physiological and pathological angiogenesis are required to develop more effective and safer approaches for cancer treatment. To identify such molecules, we determined the gene expression profiles of murine tumor endothelial cells (mTEC) and murine normal endothelial cells using DNA microarray analysis followed by quantitative reverse transcription–polymerase chain reaction analysis. We identified 131 genes that were differentially upregulated in mTEC. Functional analysis using siRNA-mediated gene silencing revealed five novel tumor endothelial cell markers that were involved in the proliferation or migration of mTEC. The expression of DEF6 and TMEM176B was upregulated in tumor vessels of human renal cell carcinoma specimens, suggesting that they are potential targets for antiangiogenic intervention for renal cell carcinoma. Comparative gene expression analysis revealed molecular differences between tumor endothelial cells and normal endothelial cells and identified novel tumor endothelial cell markers that may be exploited to target tumor angiogenesis for cancer treatment. PMID:24602018

  15. A systematic comparative evaluation of 90Y-labeled bifunctional chelators for their use in targeted therapy.

    Science.gov (United States)

    Chakravarty, Rubel; Chakraborty, Sudipta; Dash, Ashutosh

    2014-02-01

    This paper describes a systematic comparative evaluation of five commonly used bifunctional chelators, namely,p-isothiocyanato benzyl derivatives of diethylenetriaminepentacetic acid (DTPA-NCS), trans-cyclohexyl diethylenetriaminepentaceticacid (CHX-A″-DTPA-NCS), 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA-NCS), 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA-NCS), and 3,6,9,15-tetraazabicyclo [9.3.1]pentadeca-1(15),11,13-triene-3,6,9-triacetic acid (PCTA-NCS), on the basis of their ability to complex 90Y at room temperature, in vitro and in vivo stability and clearance pattern in biological system. The results of the experiments carried out revealed that CHX-A″-DTPA-NCS was the most promising option as it could be radiolabeled with 90Y at room temperature with highest specific activity and demonstrated high in vitro stability in human serum and in presence of challenging metal ions commonly present inhuman plasma. The clearance pattern in Swiss mice revealed that 90Y-CHX- A″-DTPA-NCS cleared through the kidneys with minimum retention in any other major organ. Thus, the use of cyclohexyl-DTPA based bifunctional chelators would increase the scope of making 90Y-labeled agents suitable for targeted therapy.

  16. Long-term effect of exercise therapy in patients with osteoarthritis: a randomized controlled trial comparing two different physiotherapy interventions.

    NARCIS (Netherlands)

    Pisters, M.; Veenhof, C.; Schellevis, F.; Bakker, D. de; Dekker, J.

    2011-01-01

    Purpose: To determine if behavioural graded activity (BGA) results in better long-term effectiveness (5 years after inclusion) than usual exercise therapy (UC; usual care) in patients with OA of the hip or knee. Relevance: The positive effects of exercise therapy in patients with osteoarthritis seem

  17. Comparative study of four advanced 3d-conformal radiation therapy treatment planning techniques for head and neck cancer.

    Science.gov (United States)

    Herrassi, Mohamed Yassine; Bentayeb, Farida; Malisan, Maria Rosa

    2013-04-01

    For the head-and-neck cancer bilateral irradiation, intensity-modulated radiation therapy (IMRT) is the most reported technique as it enables both target dose coverage and organ-at-risk (OAR) sparing. However, during the last 20 years, three-dimensional conformal radiotherapy (3DCRT) techniques have been introduced, which are tailored to improve the classic shrinking field technique, as regards both planning target volume (PTV) dose conformality and sparing of OAR's, such as parotid glands and spinal cord. In this study, we tested experimentally in a sample of 13 patients, four of these advanced 3DCRT techniques, all using photon beams only and a unique isocentre, namely Bellinzona, Forward-Planned Multisegments (FPMS), ConPas, and field-in-field (FIF) techniques. Statistical analysis of the main dosimetric parameters of PTV and OAR's DVH's as well as of homogeneity and conformity indexes was carried out in order to compare the performance of each technique. The results show that the PTV dose coverage is adequate for all the techniques, with the FPMS techniques providing the highest value for D95%; on the other hand, the best sparing of parotid glands is achieved using the FIF and ConPas techniques, with a mean dose of 26 Gy to parotid glands for a PTV prescription dose of 54 Gy. After taking into account both PTV coverage and parotid sparing, the best global performance was achieved by the FIF technique with results comparable to that of IMRT plans. This technique can be proposed as a valid alternative when IMRT equipment is not available or patient is not suitable for IMRT treatment.

  18. A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, F.J.; Bunn, P.A. Jr.; Steinberg, S.M.; Stocker, J.L.; Ihde, D.C.; Fischmann, A.B.; Glatstein, E.J.; Schechter, G.P.; Phelps, R.M.; Foss, F.M.; (National Cancer Institute-Navy Medical Oncology Branch, Bethesda, MD (USA))

    1989-12-28

    Mycosis fungoides is a T-cell lymphoma that arises in the skin and progresses at highly variable rates. Nonradomized studies have suggested that early aggressive therapy may improve the prognosis in this usually fatal disease. We studied 103 patients with mycosis fungoides, who, after complete staging, were randomly assigned to receive either combination therapy, consisting of 3000 cGy of electron-beam radiation to the skin combined with parenteral chemotherapy with cyclophosphamide, doxorubicin, etoposide, and vincristine (n = 52) or sequential topical treatment (n = 51). The prognostic factors were well balanced in the two groups. Combined therapy produced considerable toxicity: 12 patients required hospitalization for fever and transient neutropenia, 5 had congestive heart failure, and 2 were later found to have acute nonlymphocytic leukemia. Patients receiving combined therapy had a significantly higher rate of complete response, documented by biopsy, than patients receiving conservative therapy (38 percent vs. 18 percent; P = 0.032). After a median follow-up of 75 months, however, there was no significant difference between the treatment groups in disease-free or overall survival. We conclude that early aggressive therapy with radiation and chemotherapy does not improve the prognosis for patients with mycosis fungoides as compared with conservative treatment beginning with sequential topical therapies.

  19. A Comparative Study of the Management of Stage 2 hypertension by Combined therapy with Losartan, Amlodipine and Hydrochlorothiazide

    Directory of Open Access Journals (Sweden)

    Reza Jafarzadeh Esfehani

    2012-09-01

    Full Text Available Background: The most effective and accurate treatment of hypertensive patients reduces cardiovascular events and improves the quality of life. Objective: This study compared the efficacy and safety of combined (combination therapy with an angiotensin-receptor blocker (ARB a calcium-channel blocker (CCB (Losartan / Amloidipine 50/10mg vs maximal combination doses of ARB with hydrochlorothiazide (Losartan /HCTZ 100/25 mg and maximal combination doses of CCB with HCTZ (Amlodipine /HCTZ 10/25 mg in the management of stage 2 hypertension. Methods: This randomized clinical trial (RTC comprised 478 hypertensive patients with mean age 50.5±5.21 years, and took place between January 2010 and December 2011 in Vasei Hospital clinic in Sabzevar. Antihypertensive drugs were washed out after 5 days of discontinuation of drugs and the patients with mean blood pressure in sitting position ≥ 160 and <200 mmHg in systole and ≥ 100 and <110 mmHg in diastole were randomized into three groups: Losartan / Amlodipine 50/10 mg (n =164 , Losartan / HCTZ 100/25 mg (n =155 and Amlodipine / HCTZ 10/25 mg (n =159. The end point was reaching the blood pressure below 140/90 within 56 days of treatment in each group. Results: There was a significant difference in systolic blood pressure reductions between treatment groups (P<0.001 and also there was a significant difference between groups in reducing diastolic blood pressure (P<0.01. The highest systolic and diastolic blood pressure reduction respectively was found in Amlodipine/losartane and losartane/HTCZ group. The ANCOVA analysis revealed that only treatment regimen had a significant effect (P=0.01 and other factor including Age, Gender, Diabetes Mellitus, Smoking and High serum cholesterol didn’t have significant effect on blood pressure reduction. Conclusion: ARB/CCB combination therapy reduced blood pressure more effectively than the maximal doses of ARB or CCB with HCTZ in stage 2 hypertensive patients within

  20. Accelerated hypofractionated radiation therapy compared to conventionally fractionated radiation therapy for the treatment of inoperable non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Amini Arya

    2012-03-01

    Full Text Available Abstract Background While conventionally fractionated radiation therapy alone is an acceptable option for poor prognostic patients with unresectable stage III NSCLC, we hypothesized that accelerated hypofractionated radiotherapy will have similar efficacy without increasing toxicity. Methods This is a retrospective analysis of 300 patients diagnosed with stage III NSCLC treated between 1993 and 2009. Patients included in the study were medically or surgically inoperable, were free of metastatic disease at initial workup and did not receive concurrent chemotherapy. Patients were categorized into three groups. Group 1 received 45 Gy in 15 fractions over 3 weeks (Accelerated Radiotherapy (ACRT while group 2 received 60-63 Gy (Standard Radiation Therapy 1 (STRT1 and group 3 received > 63 Gy (Standard Radiation Therapy (STRT2. Results There were 119 (39.7% patients in the ACRT group, 90 (30.0% in STRT1 and 91 (30.3% in STRT2. More patients in the ACRT group had KPS ≤ 60 (p 5% (p = 0.002, and had stage 3B disease (p Conclusions Despite the limitations of a retrospective analysis, our experience of accelerated hypofractionated radiation therapy with 45 Gy in 15 fractions appears to be an acceptable treatment option for poor performance status patients with stage III inoperable tumors. Such a treatment regimen (or higher doses in 15 fractions should be prospectively evaluated using modern radiation technologies with the addition of sequential high dose chemotherapy in stage III NSCLC.

  1. Individual cognitive-behavioral therapy and behavioral couples therapy in alcohol use disorder: A comparative evaluation in community-based addiction treatment centers

    NARCIS (Netherlands)

    E. Vedel; P.M.G. Emmelkamp; G.M. Schippers

    2008-01-01

    Background: Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning. Behavioral Couples Therapy (BCT) for alcohol dependence, studied as an adjunct to individual outpatient counseling, has shown to be effective in decreasing alcohol consum

  2. In vitro and in vivo evaluation of [{sup 18}F]ciprofloxacin for the imaging of bacterial infections with PET

    Energy Technology Data Exchange (ETDEWEB)

    Langer, Oliver; Brunner, Martin; Zeitlinger, Markus; Mueller, Ulrich; Lackner, Edith; Joukhadar, Christian; Mueller, Markus [Medical University Vienna, Division of Clinical Pharmacokinetics, Department of Clinical Pharmacology, Vienna (Austria); Ziegler, Sophie; Minar, Erich [Medical University Vienna, Division of Angiology, Department of Internal Medicine II, Vienna (Austria); Dobrozemsky, Georg [Medical University Vienna, Department of Nuclear Medicine, Vienna (Austria); Medical University Vienna, Department of Biomedical Engineering and Physics, Vienna (Austria); Mitterhauser, Markus; Wadsak, Wolfgang; Dudczak, Robert; Kletter, Kurt [Medical University Vienna, Department of Nuclear Medicine, Vienna (Austria)

    2005-02-01

    The suitability of the{sup 18}F-labelled fluoroquinolone antibiotic ciprofloxacin ([{sup 18}F]ciprofloxacin) for imaging of bacterial infections with positron emission tomography (PET) was assessed in vitro and in vivo. For the in vitro experiments, suspensions of various E. colistrains were incubated with different concentrations of [{sup 18}F]ciprofloxacin (0.01-5.0 {mu}g/ml) and radioactivity retention was measured in a gamma counter. For the in vivo experiments, 725 {+-} 9 MBq [{sup 18}F]ciprofloxacin was injected intravenously into four patients with microbiologically proven bacterial soft tissue infections of the lower extremities and time-radioactivity curves were recorded in infected and uninfected tissue for 5 h after tracer injection. Binding of [{sup 18}F]ciprofloxacin to bacterial cells was rapid, non-saturable and readily reversible. Moreover, bacterial binding of the agent was similar in ciprofloxacin-resistant and ciprofloxacin-susceptible clinical isolates. These findings suggest that non-specific binding rather than specific binding to bacterial type II topoisomerase enzymes is the predominant mechanism of bacterial retention of the radiotracer. PET studies in the four patients with microbiologically proven bacterial soft tissue infections demonstrated locally increased radioactivity uptake in infected tissue, with peak ratios between infected and uninfected tissue ranging from 1.8 to 5.5. Radioactivity was not retained in infected tissue and appeared to wash out with a similar elimination half-life as in uninfected tissue, suggesting that the kinetics of [{sup 18}F]ciprofloxacin in infected tissue are governed by increased blood flow and vascular permeability due to local infection rather than by a binding process. Taken together, our results indicate that [{sup 18}F]ciprofloxacin is not suited as a bacteria-specific infection imaging agent for PET. (orig.)

  3. HIV-infected individuals who delay, decline, or discontinue antiretroviral therapy: Comparing clinic- and peer-recruited cohorts

    Directory of Open Access Journals (Sweden)

    Marya eGwadz

    2014-07-01

    Full Text Available A substantial proportion of persons living with HIV/AIDS (PLHA delay, decline, or discontinue antiretroviral therapy (ART when it is medically indicated (40-45%, largely African Americans and Latinos/Hispanics. This study explores the feasibility of locating PLHA who are not on ART (PLHA-NOA through clinics and peer referral; compares the two cohorts on multi-level barriers to ART; and examines readiness to initiate/reinitiate ART, a predictor of treatment outcomes. We recruited adult HIV-infected African American and Latino/Hispanic PLHA-NOA through HIV hospital clinics and peer referral in 2012-13. Participants engaged in structured one-hour assessments with reliable/valid measures on barriers to ART. We found recruitment through peers (63.2%, 60/95 was more feasible than in clinics (36.8%, 35/90. Participants were 48.0 years old and had lived with HIV for 14.7 years on average, and 56.8% had taken ART previously. Most (61.1% were male and African American (76.8%, and 23.2% were Latino/Hispanic. Peer-recruited participants were older, had lived with HIV longer, were less engaged in HIV care, and were more likely to have taken ART previously. The cohorts differed in reasons for discontinuing ART. Levels of ART knowledge were comparable between cohorts (68.5% correct, and there were no differences in attitudes toward ART (e.g., mistrust, which were in the neutral range. In bivariate linear regression, readiness for ART was negatively associated with physician mistrust (B=-10.4, and positively associated with self-efficacy (B=5.5, positive outcome expectancies (B=6.3, beliefs about personal necessity of ART (B=17.5, and positive internal norms (B=7.9. The present study demonstrates the feasibility of engaging this vulnerable population through peer referral. Peer-recruited PLHA evidence particularly high rates of risk factors compared those in clinics. Interventions to support ART initiation and continuation are sorely needed for both subgroups.

  4. Superior Effectiveness of Zidovudine Compared With Tenofovir When Combined With Nevirapine-based Antiretroviral Therapy in a Large Nigerian Cohort

    Science.gov (United States)

    Scarsi, Kimberly K.; Eisen, Geoffrey; Darin, Kristin M.; Meloni, Seema T.; Rawizza, Holly E.; Tchetgen Tchetgen, Eric J.; Agbaji, Oche O.; Onwujekwe, Daniel I.; Gashau, Wadzani; Nkado, Reuben; Okonkwo, Prosper; Murphy, Robert L.; Kanki, Phyllis J.

    2016-01-01

    Background. Despite sparse efficacy data, tenofovir–emtricitabine or tenofovir–lamivudine plus nevirapine is used in many resource-constrained settings. Methods. This retrospective cohort study included patients initiating nevirapine-based antiretroviral therapy (ART) with either tenofovir–emtricitabine or lamivudine (tenofovir group) or zidovudine–lamivudine (zidovudine group). Clinical, virologic, and immunologic evaluations were performed at baseline and every 6 months. Virologic failure was defined as 2 consecutive human immunodeficiency virus (HIV)-RNA values >1000 copies/mL. Patients were included from ART initiation until time of failure, regimen switch, discontinuation, or last HIV-RNA measurement. Cox proportional hazards regression was used to model factors influencing time to failure. Bias due to dependent censoring was investigated via inverse probability weighted pooled logistic regression. Results. A total of 5547 patients were evaluated; 1484 (26.8%) were in the tenofovir group and 4063 (73.2%) were in the zidovudine group. In the adjusted model, tenofovir regimen (hazard ratio [HR], 1.47; 95% confidence interval [CI], 1.21–1.79) and higher baseline log10 HIV-RNA (HR, 1.15; 95% CI, 1.03–1.28) were associated with virologic failure. Higher baseline log10 CD4+ cell count (HR, 0.50; 95% CI, .40–.63) and increasing age (HR, 0.98; 95% CI, .97–.99) decreased the risk of virologic failure. Inverse probability weighting results were consistent with the primary analysis. Conclusions. Compared with zidovudine–lamivudine, the use of tenofovir–lamivudine or emtricitabine in combination with nevirapine was a strong predictor of virologic failure in our cohort, which was not explained by other risk factors or criteria for regimen selection. PMID:26561532

  5. [An open randomized comparative trial of efficacy and safety of selective alpha-adrenoblocker setegis (terazosin) in therapy of patients with chronic bacterial prostatitis].

    Science.gov (United States)

    Trapeznikova, M F; Morozov, A P; Dutov, V V; Urenkov, S B; Pozdniakov, K V; Bychkova, N V

    2007-01-01

    An open randomized comparative trial of setegis (terazosine) has shown good subjective and objective results in patients with chronic bacterial prostatitis. The drug is well tolerated and produces insignificant side effects. It is also demonstrated that combined therapy with alpha-adrenoblockers is more effective that monotherapy with antibacterial drugs in patients with bacterial prostatitis.

  6. The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia : a randomised controlled trial

    NARCIS (Netherlands)

    Vink, A. C.; Zuidersma, M.; Boersma, F.; de Jonge, P.; Zuidema, S. U.; Slaets, J. P. J.

    2013-01-01

    Objective This study aimed to compare the effects of music therapy with general recreational day activities in reducing agitation in people with dementia, residing in nursing home facilities. Methods In a randomised controlled design, residents with dementia (n=94) were allocated to either music the

  7. A monocentric retrospective study comparing pulse cyclophosphamide therapy versus low dose rituximab in the treatment of refractory autoimmune hemolytic anemia in adults.

    Science.gov (United States)

    Fu, Rong; Yan, Siyang; Wang, Xiaoming; Wang, Guojin; Qu, Wen; Wang, Huaquan; Wu, Yuhong; Liu, Hong; Song, Jia; Guan, Jin; Xing, Limin; Ruan, Erbao; Li, Lijuan; Liu, Hui; Shao, Zonghong

    2016-10-01

    This retrospective study aims at confirming the efficacy and safety of low dose rituximab and pulse cyclophosphamide in the treatment of refractory AIHA in adults and making comparison of the two. Forty-nine adult patients with refractory AIHA have been enrolled. Results showed low dose rituximab combined with steroid therapy (group B) got more CR (78.9 %, 15/19) compared to that in intermittent intravenous cyclophosphamide combined with steroid therapy (group A) (42.1 %, 8/19) (P = 0.04) at 6 months after treatment. The hemoglobin level in group B was higher than group A at the time point of 1 month (P = 0.02) after treatments. The RFS in group A was 87.9 % at 6 months and 82.7 % at 12 months, which were no significant difference with group B (91.1 % at 6 months and 86.0 % at 12 months) (P = 0.81). Both the two therapies were well tolerated with pulmonary infections as the most common side effects. In conclusion, low dose rituximab combined with steroid therapy presents to be a better choice in the treatment of refractory AIHA in adults comparing with pulse cyclophosphamide therapy.

  8. Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up

    OpenAIRE

    Ko, Dong-Yeob; Kim, Ki-Ho; Song, Ki-Hoon

    2014-01-01

    Background Few studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin. Objective We retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans. Methods A total of 222 facial AKs in 58 patients were included in this ...

  9. A Comparative Study On The Action Potential Simulation (APS Therapy And The Routine Physiotherapy Protocol In Knee Osteoarthritisin Elderly People

    Directory of Open Access Journals (Sweden)

    Abbas Rahimi

    2012-04-01

    Full Text Available Background and Aim: Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS Therapy and the routine physiotherapy (PT protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis. Materials and Methods: 69 patients (62 females & 7 males with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old and the routine PT protocol (n=32, mean age: 61±14 years old groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up. The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded.Results: In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P<0.05. Visual Analogue Pain Scale (VAPS indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P<0.05. It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P<0.05. A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4.Conclusion: The

  10. Non-Monotonic Survival of Staphylococcus aureus with Respect to Ciprofloxacin Concentration Arises from Prophage-Dependent Killing of Persisters

    Science.gov (United States)

    Sandvik, Elizabeth L.; Fazen, Christopher H.; Henry, Theresa C.; Mok, Wendy W.K.; Brynildsen, Mark P.

    2015-01-01

    Staphylococcus aureus is a notorious pathogen with a propensity to cause chronic, non-healing wounds. Bacterial persisters have been implicated in the recalcitrance of S. aureus infections, and this motivated us to examine the persistence of S. aureus to ciprofloxacin, a quinolone antibiotic. Upon treatment of exponential phase S. aureus with ciprofloxacin, we observed that survival was a non-monotonic function of ciprofloxacin concentration. Maximal killing occurred at 1 µg/mL ciprofloxacin, which corresponded to survival that was up to ~40-fold lower than that obtained with concentrations ≥ 5 µg/mL. Investigation of this phenomenon revealed that the non-monotonic response was associated with prophage induction, which facilitated killing of S. aureus persisters. Elimination of prophage induction with tetracycline was found to prevent cell lysis and persister killing. We anticipate that these findings may be useful for the design of quinolone treatments. PMID:26593926

  11. Non-Monotonic Survival of Staphylococcus aureus with Respect to Ciprofloxacin Concentration Arises from Prophage-Dependent Killing of Persisters

    Directory of Open Access Journals (Sweden)

    Elizabeth L. Sandvik

    2015-11-01

    Full Text Available Staphylococcus aureus is a notorious pathogen with a propensity to cause chronic, non-healing wounds. Bacterial persisters have been implicated in the recalcitrance of S. aureus infections, and this motivated us to examine the persistence of S. aureus to ciprofloxacin, a quinolone antibiotic. Upon treatment of exponential phase S. aureus with ciprofloxacin, we observed that survival was a non-monotonic function of ciprofloxacin concentration. Maximal killing occurred at 1 µg/mL ciprofloxacin, which corresponded to survival that was up to ~40-fold lower than that obtained with concentrations ≥ 5 µg/mL. Investigation of this phenomenon revealed that the non-monotonic response was associated with prophage induction, which facilitated killing of S. aureus persisters. Elimination of prophage induction with tetracycline was found to prevent cell lysis and persister killing. We anticipate that these findings may be useful for the design of quinolone treatments.

  12. Ciprofloxacin non-susceptible Streptococcus pyogenes due to mutations in parC gene and its homology analysis

    Institute of Scientific and Technical Information of China (English)

    张晓飞

    2013-01-01

    Objective To investigate the resistant mechanism of Streptococcus pyogenes to ciprofloxacin and its homology.Methods Forty-eight isolates of Streptococcus pyogenes were collected from patients diagnosed with scarflet fever

  13. Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006

    Science.gov (United States)

    Kirkcaldy, Robert D.; Gift, Thomas L.; Owusu-Edusei, Kwame; Weinstock, Hillard S.

    2014-01-01

    Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts. In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level. We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006. We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection. These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance. PMID:24655615

  14. Synthesis and Evaluation of Ciprofloxacin-Nitroxide Conjugates as Anti-Biofilm Agents

    Directory of Open Access Journals (Sweden)

    Anthony D. Verderosa

    2016-06-01

    Full Text Available As bacterial biofilms are often refractory to conventional antimicrobials, the need for alternative and/or novel strategies for the treatment of biofilm related infections has become of paramount importance. Herein, we report the synthesis of novel hybrid molecules comprised of two different hindered nitroxides linked to the piperazinyl secondary amine of ciprofloxacin via a tertiary amine linker achieved utilising reductive amination. The corresponding methoxyamine derivatives were prepared alongside their radical-containing counterparts as controls. Subsequent biological evaluation of the hybrid compounds on preformed P. aeruginosa flow cell biofilms divulged significant dispersal and eradication abilities for ciprofloxacin-nitroxide hybrid compound 10 (up to 95% eradication of mature biofilms at 40 μM. Importantly, these hybrids represent the first dual-action antimicrobial-nitroxide agents, which harness the dispersal properties of the nitroxide moiety to circumvent the well-known resistance of biofilms to treatment with antimicrobial agents.

  15. Determination of ciprofloxacin in pharmaceutical formulations using HPLC Method with UV Detection

    Directory of Open Access Journals (Sweden)

    R Scherer

    2014-01-01

    Full Text Available A simple, specific, accurate and rapid reversed phase high performance liquid chromatographic method was validated for the determination of the content of ciprofloxacin in three pharmaceuticals forms: generic, similar and compounded. The results of the validation showed that the method was highly efficient for quantification of ciprofloxacin in the matrices evaluated. The recovery rates were between 97.4 to 104.3 %, and the relative standard deviations were lower than 5 % for repeatability, and lower than 5.15 % for intermediate precision. The limits of detection, quantification and practical, were 0.11, 0.35 and 1.56 μg/ml, respectively. All compounded samples were approved with in the quality control; however, one generic and one similar sample presented above allowed level.

  16. Recurrent drug-induced liver injury (DILI) with ciprofloxacin and amoxicillin/clavulanic.

    Science.gov (United States)

    Moreno, Luís; Sánchez-Delgado, Jordi; Vergara, Mercedes; Casas, Meritxell; Miquel, Mireia; Dalmau, Blai

    2015-12-01

    Ciprofloxacin and amoxicillin/clavulanic are two widely used antibiotics due to their high efficacy and few side effects. While the percentage of hepatotoxicity of these antibiotics is low, their frequent use has led to a progressive increase in the number of cases. Both antibiotics have been associated with a wide variety of hepatotoxic reactions, from a slight rise of transaminases to fulminant hepatitis. Once hepatotoxicity secondary to a drug appears, the first step is to discontinue the drug. Physicians may opt to administer an alternative treatment with a different chemical structure. It should be borne in mind, however, that different chemical structures may also cause recurrent drug-induced liver injuries (DILI). We present the case of a patient who consecutively developed DILI due to ciprofloxacin and amoxicillin/clavulanic.

  17. Analysis of gyrA and parC mutations in enterococci from environmental samples with reduced susceptibility to ciprofloxacin

    DEFF Research Database (Denmark)

    Petersen, A.; Jensen, Lars Bogø

    2004-01-01

    in Enterococcus faecalis and Enterococcus faecium related to reduced susceptibility were identical to mutations detected in E jaecalis and E. faecium of clinical origin. A minimal inhibitory concentration of 8 mug ml(-1) to ciprofloxacin was not associated with any mutations in the gyrA and parC gene...... of Enterococcus casseliflavus and Enterococcus gallinarum. These two species may be intrinsically less susceptible to ciprofloxacin....

  18. Targeted next generation sequencing for the detection of ciprofloxacin resistance markers using molecular inversion probes

    Science.gov (United States)

    2016-07-06

    amplified whole genome extracted DNA to more accurately determine the assay LOD. Linear regression was utilized to fit data to a line and...Dr. Luther Lindler 8, and F. tularensis wildtype and ciprofloxacin resistance mutants were obtained from Dr. David Kulesh 4. DNAs were extracted ...spiked extracted whole blood was used in lieu of bacterial DNA . DNA concentration was quantified utilizing Qubit dsDNA BR and HS assay kits (Life

  19. Qualitative analysis of controlled release ciprofloxacin/carbopol 934 mucoadhesive suspension

    Directory of Open Access Journals (Sweden)

    Subhashree Sahoo

    2011-01-01

    Full Text Available Mucoadhesive polymeric (carbopol 934 suspension of ciprofloxacin was prepared by ultrasonication and optimized with the aim of developing an oral controlled release gastro-retentive dosage form. The qualitative analysis of the formulation was performed by fourier transform infrared spectroscopy (FTIR, Raman spectroscopy, X-ray powder diffraction (XRD, and scanning electron microscopy (SEM analyses. FTIR (400 cm-1 to 4000 cm-1 region and Raman (140 to 2400 cm-1 region Spectroscopic studies were carried out and the spectra were used for interpretation. XRD data of pure drug, polymer and the formulation were obtained using a powder diffractometer scanned from a Bragg′s angle (2q of 10° to 70°. The dispersion of the particle was observed using SEM techniques. The particle size distribution and aspect ratio of particles in the polymeric suspension were obtained from SEM image analysis. The results from FTIR and Raman spectroscopic analyses suggested that, in formulation, the carboxylic groups of ciprofloxacin and hydroxyl groups of C934 undergo a chemical interaction leading to esterification and hydrogen bonding. The XRD data suggested that the retention of crystalline nature of ciprofloxacin in the formulation would lead to increase in stability and drug loading; decrease in solubility; and delay in release of the drug from polymeric suspension with better bioavailability and penetration capacity. The SEM image analysis indicated that, in the formulation maximum particles were having aspect ratio from 2 to 4 and standard deviation was very less which provided supporting evidences for homogeneous, uniformly dispersed, stable controlled release ciprofloxacin suspension which would be pharmaceutically acceptable.

  20. Inhibition of Mild Steel Corrosion in Hydrochloric Acid Solution by Ciprofloxacin Drug

    OpenAIRE

    2013-01-01

    The inhibition of mild steel corrosion in hydrochloric acid solution by ciprofloxacin drug as an eco-friendly and commercially available inhibitor was studied at room temperature by weight loss technique. It was found that the test drug has a promising inhibitory action against corrosion of mild steel in the medium investigated. The inhibition efficiency was found to increase with a corresponding increase in the concentration of the inhibitor. It was also found that the adsorption as well as ...

  1. Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin.

    OpenAIRE

    Frost, R W; Lasseter, K C; Noe, A J; Shamblen, E C; Lettieri, J T

    1992-01-01

    This study was designed to determine the effects of an aluminum hydroxide antacid and a calcium carbonate antacid on the bioavailability of ciprofloxacin (Cipro). Cipro (750 mg) was administered orally to 12 healthy volunteers in a three-way randomized crossover design. The three treatments included Cipro alone, four 850-mg calcium carbonate tablets taken 5 min before Cipro, and three 600-mg aluminum hydroxide tablets taken 5 min before Cipro. The relative bioavailability of Cipro when given ...

  2. Comparative effectiveness of oral drug therapies for lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and network meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xinghuan Wang

    Full Text Available Lower urinary tract symptoms (LUTS due to benign prostatic hyperplasia (BPH are common in elder men and a number of drugs alone or combined are clinically used for this disorder. But available studies investigating the comparative effects of different drug therapies are limited. This study was aimed to compare the efficacy of different drug therapies for LUTS/BPH with network meta-analysis.An electronic search of PubMed, Cochrane Library and Embase was performed to identify randomized controlled trials (RCTs comparing different drug therapies for LUTS/BPH within 24 weeks. Comparative effects were calculated using Aggregate Data Drug Information System. Consistency models of network meta-analysis were created and cumulative probability was used to rank different therapies.A total 66 RCTs covering seven different therapies with 29384 participants were included. We found that α-blockers (ABs plus phosphodiesterase 5 inhibitors (PDE5-Is ranked highest in the test of IPSS total score, storage subscore and voiding subscore. The combination therapy of ABs plus 5α-reductase inhibitors was the best for increasing maximum urinary flow rate (Qmax with a mean difference (MD of 1.98 (95% CI, 1.12 to 2.86 as compared to placebo. ABs plus muscarinic receptor antagonists (MRAs ranked secondly on the reduction of IPSS storage subscore, although monotherapies including MRAs showed no effect on this aspect. Additionally, PDE5-Is alone showed great effectiveness for LUTS/BPH except Qmax.Based on our novel findings, combination therapy, especially ABs plus PDE5-Is, is recommended for short-term treatment for LUTS/BPH. There was also evidence that PDE5-Is used alone was efficacious except on Qmax. Additionally, it should be cautious when using MRAs. However, further clinical studies are required for longer duration which considers more treatment outcomes such as disease progression, as well as basic research investigating mechanisms involving PDE5-Is and other

  3. Dependence of transformation product formation on pH during photolytic and photocatalytic degradation of ciprofloxacin.

    Science.gov (United States)

    Salma, Alaa; Thoröe-Boveleth, Sven; Schmidt, Torsten C; Tuerk, Jochen

    2016-08-05

    Ciprofloxacin (CIP) is a broad-spectrum antibiotic with five pH dependent species in aqueous medium, which makes its degradation behavior difficult to predict. For the identification of transformation products and prediction of degradation mechanisms, a new experimental concept making use of isotopically labeled compounds together with high resolution mass spectrometry was successfully established. The utilization of deuterated ciprofloxacin (CIP-d8) facilitated the prediction of three different degradation pathways and the corresponding degradation products, four of which were identified for the first time. Moreover, two molecular structures of previously reported transformation products were revised according to the mass spectra and product ion spectra of the deuterated transformation products. Altogether, 18 transformation products have been identified during the photolytic and photocatalytic reactions at different pH values (3, 5, 7 and 9). In this work the influence of pH on both reaction kinetics and degradation mechanism was investigated for direct ultraviolet photolysis (UV-C irradiation) and photocatalysis (TiO2/UV-C). It could be shown that the removal rates strongly depended on pH with highest removal rates at pH 9. A comparison with those at pH 3 clearly indicated that under acidic conditions ciprofloxacin cannot be easily excited by UV irradiation. We could confirm that the first reaction step for both oxidative treatment processes is mainly defluorination, followed by degradation at the piperazine ring of CIP.

  4. Ciprofloxacin conjugated zinc oxide nanoparticle: A camouflage towards multidrug resistant bacteria

    Indian Academy of Sciences (India)

    Prasun Patra; Shouvik Mitra; Nitai Debnath; Panchanan Pramanik; Arunava Goswami

    2014-04-01

    Gradual development of antibiotic resistant bacteria is producing severe global threat. Newer strategies are now being employed in order to control the microbial infections and to reduce the mortality as well as infection rates. Herein we describe successful synthesis of ZnO nanoparticles (ZNP) under microwave assisted condition followed by functionalization with ciprofloxacin, an antibiotic, using EDC/NHS chemistry. Successful conjugation of ciprofloxacin was confirmed by FTIR spectra. Ciprofloxacin-conjugated ZnO nanoparticles (ZN-CIP) exhibited excellent antibacterial activity against clinically isolated multidrug resistant bacterial strains of Escherichia coli, Staphylococcus aureus and Klebsiella sp. ZNP were small in size with particle size distribution 18–20 nm as obtained from transmission electron microscope (TEM). Surface topology was obtained from atomic force microscopic (AFM) image and x-ray diffraction confirmed that ZNP possessed hexagonal crystal structure. A concentration of 10 g/mL of ZN-CIP was a benchmark concentration. During evaluation of minimum inhibitory concentration (MIC) values, similar concentration of antibiotic was incapable of producing antibacterial activity.

  5. Response of the freshwater Alga chlorella vulgaris to trichloroisocyanuric acid and ciprofloxacin.

    Science.gov (United States)

    Nie, Xiangping; Wang, Xiang; Chen, Jufang; Zitko, Vladimir; An, Taichen

    2008-01-01

    The effects of trichloroisocyanuric acid (TCCA) and ciprofloxacin (CPFX) on the freshwater alga Chlorella vulgaris were assessed by toxicity bioassays and by the values of biomarkers in phase I and phase II. The biomarkers included growth rate, concentration of chlorophyll a, activities of 7-ethoxyresorufin-O-dealkylases (EROD), glutathione S-transferase (GST), catalase (CAT), and total glutathione (GSH). Ciprofloxacin was a weaker growth inhibitor than TCCA but, at a concentration of greater than 12.5 mg/L, decreased the growth of C. vulgaris. Concentration of chlorophyll a showed a similar trend. The 96-h median effective concentration (EC50; i.e., 50% reduction in growth relative to the control) of CPFX was 20.6 mg/L. Trichloroisocyanuric acid was a strong growth inhibitor and, at concentrations of greater than 0.80 mg/L, caused 100% inhibition on 24-h exposure. The 96-h EC50 of TCCA was 0.313 mg/L. Ciprofloxacin and TCCA affected the phase I and phase II enzyme activities differently. On exposure to CPFX, both EROD and GSH decreased at low CPFX concentrations (12.5 mg/L), and CAT and GST exhibited induction at low concentrations and inhibition at high concentrations. In TCCA exposure, GST activity was significantly stimulated, and GSH concentration was increased. Catalase activity increased only at TCCA concentrations of greater than 0.12 mg/L, and no change in EROD activity was observed.

  6. Short-term prophylaxis with ciprofloxacin in extended 16-core prostate biopsy

    Directory of Open Access Journals (Sweden)

    Renato Caretta Chambó

    2015-02-01

    Full Text Available Objective To evaluate the safety, efficacy and possible complications of 16-core transrectal prostate biopsies using two doses of ciprofloxacin for prophylaxis of infectious complications. Materials and Methods Sixteen-core prostate biopsies were performed on a number of patients with different signs of potential prostate cancer. Complications were assessed both during the procedure and one week later. After the procedure, urine samples were collected for culture. The rate of post-biopsy complications, hospital visits and hospitalizations were also analyzed. Ciprofloxacin (500 mg was administered two hours before, and eight hours after the procedure. Results The overall rate of post-biopsy complications was 87.32%, being 5.4% of those considered major complications due to hemorrhage, or to urinary retention. Eight patients required hospital treatment post-biopsy. Fever occurred in just one patient (0.29%. There was no incidence of orchitis, epididymitis, prostatitis, septicemia, hospitalization, or death. The urine culture showed positive results in five patients (2.15%. Conclusion One-day prophylaxis with ciprofloxacin proved to be safe and effective in the prevention of infectious complications following 16-core prostate biopsies.

  7. Thermal Behaviour of Some New Polyoxometalate Complexes of Ciprofloxacin with Keggin-type Heteropoly Acids

    Institute of Scientific and Technical Information of China (English)

    WANG Dun-jia; FANG Zheng-dong; HAN De-yan

    2005-01-01

    Four polyoxometalate complexes, (CPFX·HCl)3H4SiW12O40, (CPFX·HCl)3H3PW12O40, (CPFX·HCl)3H3PMo12O40 and (CPFX·HCl)4H4SiMo12O40, were prepared from ciprofloxacin hydrochloride(CPFX·HCl) reacting with HnXM12O40·nH2O(X=P,Si; M=W,Mo) in an aqueous solution, and characterized by elemental analysis, IR spectrometry and TG-DTA. The IR spectrum confirms the presence of Keggin-type anions of heteropoly acids and the characteristic functional groups of ciprofloxacin. The TG/DTA curves show that their thermal decomposition is a multi-step process including simultaneous collapse of the Keggin-type structure. At first, these compounds had a mass loss of water molecules, then several other mass losses occurred due to the decomposition of ciprofloxacin hydrochloride and its fragments with the degradation of Keggin anions. The end product of decomposition is the mixture of WO3(or MoO3) and SiO2(or P2O5), identified by X-ray diffraction and IR spectroscopy. The possible thermal decomposition mechanisms of these complexes are proposed. This study exemplified that the thermal stability of the complexes containing tungsten is much better than that of the complexes containing molybdenum.

  8. Effect of a three month course of ciprofloxacin on the outcome of reactive arthritis

    Science.gov (United States)

    Yli-Kerttula, T; Luukkainen, R; Yli-Kerttula, U; Mottonen, T; Hakola, M; Korpela, M; Sanila, M; Parviainen, J; Uksila, J; Vainionpaa, R; Toivanen, A

    2000-01-01

    BACKGROUND—Treatment of reactive arthritis (ReA) with antibiotics has so far remained controversial. Eradication of the causative microbe appears logical, but short term antibiotic treatment has no beneficial effect on the outcome of ReA.
OBJECTIVE—To evaluate the effect of a three month course of ciprofloxacin on ReA.
METHODS—In a randomised, double blind, placebo controlled trial, between December 1992 and February 1996, 71 patients with acute ReA triggered by a gastrointestinal or a urogenital infection were randomly assigned to receive ciprofloxacin 500 mg or placebo twice daily for three months. Patients were assessed at study entry, at 6 weeks, 3 months, 6 months, and 12 months. Sixty two patients were valid for the efficacy analysis. The primary outcome measures were erythrocyte sedimentation rate, number of swollen joints, patients self assessment, and complete recovery.
RESULTS—Adverse events were mostly mild and occurred in both treatment groups. There were no statistically significant differences in any of the primary or secondary efficacy variables between the study groups at baseline or during the 12 month follow up. All primary outcome measures indicated that the condition of the patients improved during the study.
CONCLUSION—Both groups tended to recover. Ciprofloxacin, given as a three month course, had no advantage over placebo treatment.

 PMID:10873968

  9. Serum bactericidal activity from intravenous ciprofloxacin and azlocillin given alone and in combination to healthy subjects.

    Science.gov (United States)

    Orlando, P L; Barriere, S L; Hindler, J A; Frost, R W

    1990-01-01

    Ciprofloxacin plus azlocillin have been shown to exhibit in vitro synergy versus a variety of organisms, including Pseudomonas aeruginosa. This study examined this interaction in vivo, testing serum bactericidal activity (SBA) in six healthy male subjects after intravenous administration of ciprofloxacin 4 mg/kg (C), azlocillin 60 mg/kg (A), and the two simultaneously (C/A). Eight different organisms were tested: four isolates of P. aeruginosa with varying susceptibilities to C and A, and one isolate each of Escherichia coli (EC), Staphylococcus aureus (SA) Serratia marcescens (SM), and Klebsiella pneumoniae (KP), all of which were susceptible to both drugs. Blood samples were collected at the end of 30-min infusions and at 4 and 8 hr. Reciprocal titers were plotted versus time and area under the bactericidal titer curve (AUBC) calculated to assess antibacterial interactions. Results indicated that P. aeruginosa-1 (PA-1), EC, and KP were synergistically killed by C/A. AUBC for PA-1 were C = 36, A = 11, C/A = 144, p less than 0.05. AUBC for EC were C = 1059, A = 180, C/A = 1504, p = 0.05. AUBC for KP were C = 327, A = 97, C/A = 584, p = 005. Additive effects were demonstrated versus all of the other organisms except Serratia marcescens, where an indifferent effect was observed. Ciprofloxacin plus azlocillin may be a useful combination of the treatment of selected Gram-negative bacillary infections.

  10. DETERMINATION OF SOLUBILITY AND THERMOPHYSICAL PROPERTIES OF TETRACYCLINE HYDROCHLORIDE AND CIPROFLOXACIN ANTIBIOTICS IN DIFFERENT SOLVENTS SYSTEM

    Directory of Open Access Journals (Sweden)

    Prakash Chandra Pal

    2014-04-01

    Full Text Available In this research article, we have described to establish a comparison between the solubility of the hydrochloride and non-hydrochlorideforms of ciprofloxacin and tetracycline in relevant solvents. For that purpose the solubility ofciprofloxacin and tetracycline were measured in water, methanol, propanol,and acetone, in the temperature range between 293.20 and 323.20 K for ciprofloxacin and between 288.20and 303.20 K for tetracycline. The solubility of the hydrochloride form in water is about 2 orders of magnitude higherthan those of the respective base forms. In acetone, we see the opposite effect. For methanol and propanolthe influence of the hydrochloride group of the antibiotic on the solubility in the alcohol is much smaller thanfor water and acetone. The experimental data was correlated with good results using two different activitycoefficient models, NRTL and UNIQUAC, with UNIQUAC giving better results, particularly for ciprofloxacin.The performance of COSMO-RS model to describe the studied systems was also evaluated.The dependence of these properties with temperature are shown. Theresults are interpreted in terms of solute-solvent interaction

  11. Herb-Drug Interaction: Effects of Relinqing® Granule on the Pharmacokinetics of Ciprofloxacin, Sulfamethoxazole, and Trimethoprim in Rats

    Science.gov (United States)

    Lu, Yuan; Xie, YuMin; Pan, Jie; Sun, Jia; Li, YueTing; Chen, SiYing; Li, YongJun

    2016-01-01

    Relinqing granule (RLQ) is the best-selling Chinese patent drug for treatment of urinary system diseases. In this study, the effects of RLQ on the pharmacokinetics of ciprofloxacin, sulfamethoxazole, and trimethoprim in SD rats were investigated. Rats were randomly divided into control group 1, control group 2, RLQ group 1, and RLQ group 2. RLQ group 1 and RLQ group 2 were treated orally with RLQ for 7 days, and rats were treated with the same volume of water in control group 1 and control group 2. Then, RLQ group 1 and control group 1 were given intragastrically ciprofloxacin on day 8, while RLQ group 2 and control group 2 were given intragastrically sulfamethoxazole and trimethoprim on day 8. Blood samples were collected and determined. There was no significant influence of pharmacokinetic parameters of trimethoprim on two groups. But some pharmacokinetic parameters of ciprofloxacin and sulfamethoxazole in RLQ pretreated rats were evidently altered (P < 0.05), which indicated that absorption of ciprofloxacin and sulfamethoxazole in RLQ pretreated rats was significantly affected. It indicated the coadministration of RLQ would have an influence on the efficacy of ciprofloxacin and sulfamethoxazole, and the doses of ciprofloxacin tablet and compound sulfamethoxazole tablet need adjustment. PMID:27688790

  12. Herb-Drug Interaction: Effects of Relinqing® Granule on the Pharmacokinetics of Ciprofloxacin, Sulfamethoxazole, and Trimethoprim in Rats

    Directory of Open Access Journals (Sweden)

    Yuan Lu

    2016-01-01

    Full Text Available Relinqing granule (RLQ is the best-selling Chinese patent drug for treatment of urinary system diseases. In this study, the effects of RLQ on the pharmacokinetics of ciprofloxacin, sulfamethoxazole, and trimethoprim in SD rats were investigated. Rats were randomly divided into control group 1, control group 2, RLQ group 1, and RLQ group 2. RLQ group 1 and RLQ group 2 were treated orally with RLQ for 7 days, and rats were treated with the same volume of water in control group 1 and control group 2. Then, RLQ group 1 and control group 1 were given intragastrically ciprofloxacin on day 8, while RLQ group 2 and control group 2 were given intragastrically sulfamethoxazole and trimethoprim on day 8. Blood samples were collected and determined. There was no significant influence of pharmacokinetic parameters of trimethoprim on two groups. But some pharmacokinetic parameters of ciprofloxacin and sulfamethoxazole in RLQ pretreated rats were evidently altered (P < 0.05, which indicated that absorption of ciprofloxacin and sulfamethoxazole in RLQ pretreated rats was significantly affected. It indicated the coadministration of RLQ would have an influence on the efficacy of ciprofloxacin and sulfamethoxazole, and the doses of ciprofloxacin tablet and compound sulfamethoxazole tablet need adjustment.

  13. Co-administration of ginseng and ciprofloxacin ameliorates epididymo-orchitis induced alterations in sperm quality and spermatogenic cells apoptosis following infection in rats.

    Science.gov (United States)

    Eskandari, M; Ghalyanchi Langeroudi, A; Zeighami, H; Rostami, A; Kazemi, M; Eyni, H; Shokri, S

    2017-04-01

    Korean red ginseng (KRG) may be a beneficial adjuvant along with ciprofloxacin to ameliorate devastating effects of epididymo-orchitis (EO) on male fertility. This study intends to assay the effects of KRG and ciprofloxacin on sperm quality and spermatogenic cells apoptosis in EO rats. We divided 54 adult rats into nine groups (n = 6 rats per group): control (CO), sham-operated (SH), EO (E); ciprofloxacin (C), EO-ciprofloxacin (EC), KRG (G), EO-KRG (EG), ciprofloxacin-KRG (CG) and EO-ciprofloxacin-KRG (ECG). We administered ciprofloxacin and KRG 48 hr after the Escherichia coli (E. coli) injection for 10 days. Bilateral orchiectomy was performed after one sperm cycle (14 days) following the last treatment with ciprofloxacin and KRG. Total and progressive motility of E, C and EC groups decreased. However, motility is improved in CG and ECG in comparison with these groups. The E group induced negative changes in the architecture of testes tissue and dramatic increase in apoptosis indices. Interestingly, co-administration of ciprofloxacin and KRG has dramatically improved Miller's and Johnsen's scores and decreased the apoptosis indices of animals in the ECG group. Combined treatment of ciprofloxacin and KRG may improve the quality of spermatozoa and attenuated apoptosis indices in the ECG group.

  14. The Comparative Effectiveness of Cognitive Processing Therapy for Male Veterans Treated in a VHA Posttraumatic Stress Disorder Residential Rehabilitation Program

    Science.gov (United States)

    Alvarez, Jennifer; McLean, Caitlin; Harris, Alex H. S.; Rosen, Craig S.; Ruzek, Josef I.; Kimerling, Rachel

    2011-01-01

    Objective: To examine the effectiveness of group cognitive processing therapy (CPT) relative to trauma-focused group treatment as usual (TAU) in the context of a Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) residential rehabilitation program. Method: Participants were 2 cohorts of male patients in the same program…

  15. Reducing Relapse and Recurrence in Unipolar Depression: A Comparative Meta-Analysis of Cognitive-Behavioral Therapy's Effects

    Science.gov (United States)

    Vittengl, Jeffrey R.; Clark, Lee Anna; Dunn, Todd W.; Jarrett, Robin B.

    2007-01-01

    Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that…

  16. Comparative efficiency of oxygen therapy in patients (smokers and non-smokers with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    E.G. Zarubina and I.O. Prokhorenko

    2012-09-01

    Full Text Available The decrease in clinical efficacy of oxygen therapy takes place in patients suffering from chronic pulmonary obstructive disease who continue smoking even if the intensity of smoking is getting lower. It is explained by the damage of oxygen utilization regardless of normalization of arterial blood saturation indices and perfusion oxygen saturation indices in blood flow.

  17. Comparative efficacy of oxygen therapy in patients (smokers and non-smokers with chronic pulmonary obstructive disease

    Directory of Open Access Journals (Sweden)

    Starodumov N.I.

    2011-06-01

    Full Text Available The decrease in clinical efficacy of oxygen therapy takes place in patients suffering from chronic pulmonary obstructive disease who continue smoking even if the intensity of smoking is getting lower. It is explained by the damage of oxygen utilization regardless of normalization of arterial blood saturation indices and perfusion oxygen saturation indices in blood flow

  18. Do Self-Statements Enhance the Effectiveness of Virtual Reality Exposure Therapy? A Comparative Evaluation in Acrophobia

    NARCIS (Netherlands)

    Krijn, M.; Emmelkamp, P.M.G.; Olafsson, R.P.; Schuemie, M.J.; Van der Mast, C.A.P.G.

    2007-01-01

    There is a clear need for more detailed analysis of the role of cognitive self-statements in virtual reality exposure therapy (VRET). To date, no research on this topic has been done. The primary aim of this study was to investigate whether coping self-statements would enhance the effectiveness of V

  19. Application of Neem Gum for Aqueous Film Coating of Ciprofloxacin Tablets

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    A P Kulkarni

    2013-05-01

    Full Text Available Summary. At present the pharmaceutical industry and academia are focusing on the use of natural materials and resources for development of pharmaceutical product. In previous study, neem gum (NG, obtained from Azadirachata indica plant revealed satisfactory film forming ability. The present study evaluates the application potential of neem gum, as an aqueous film coating material, using ciprofloxacin hydrchloride (drug as a model drug. Initial study of physical mixture indicated absence of chemical interaction in between drug and NG. Aqueous coating solution of NG was optimized and consisted of neem gum (13.34%w/w, triethyl citrate (1.25%w/w, talc (0.25%w/w and titanium dioxide (0.17%w/w. The coating parameters such as pan revolutions (rpm, inlet air pressure, inlet temperature, and pan load were optimized. The uncoated and coated tablets were evaluated for hardness, disintegration time, dissolution, drug content. The coated tablets were subjected to accelerated stability conditions for 1 month and the results were compared with marketed drug tablet. Any coating defects, except surface roughness, were absent in case of NG coated tablets. NG coated tablets depicted satisfactory mechanical strength. Dissolution study of NG coated tablets depicted 90% of drug release in 10 minutes and 100% of drug release at 30minutes. Accelerated storage conditions didn’t affect the tablet hardness and % drug release. The coating process efficiency, coating uniformity and loss on drying confirmed that the coating solution was optimum and coating parameters were robust. Industrial relevance. A paradigm shift, from organic solvent-based to water-based film coating of pharmaceutical dosage forms, apparent in pharmaceutical industries, is due to Government regulation, high cost of the organic solvents, safety issues associated with the use of organic solvents. Currently, the commercially available edible coatings utilize synthetic cellulosic polymers namely

  20. Redox-responsive biodegradable PEGylated nanographene oxide for efficiently chemo-photothermal therapy: a comparative study with non-biodegradable PEGylated nanographene oxide.

    Science.gov (United States)

    Xiong, Honglian; Guo, Zhouyi; Zhang, Wen; Zhong, Huiqing; Liu, Songhao; Ji, Yanhong

    2014-09-05

    Nanographene oxide (NGO) with a non-sheddable poly(ethylene glycol) (PEG) coating has been used for chemo-photothermal therapy. However, the drug release of PEGylated NGO (NGO-PEG) with an amine bond is adversely affected by the diffusion barrier effect of PEG shells. Here, we developed a simple new method for the preparation of biodegradable PEGylated NGO conjugates (NGO-SS-PEG) with cleavable disulfide bonds for rapid drug release and more efficiently chemo-photothermal therapy. The glutathione (GSH)-induced and photothermal-mediated intracellular release of doxorubicin (DOX) from NGO-SS-PEG was studied in A549 cells using confocal laser scanning microscopy and flow cytometry analysis. In vivo cytotoxicity experiments were performed on chemo-photothermal therapy. Furthermore, we presented a comparative study of intracellular drug release and biological efficacy between NGO-SS-PEG/DOX and NGO-PEG/DOX. The results demonstrated that the rapid drug release from the NGO-SS-PEG conjugates with sheddable PEG was triggered upon the stimulus of high GSH levels inside A549 cells. Interesting, the DOX release mediated by the photothermal effect from the NGO-SS-PEG conjugates was found to be more obvious than that for NGO-PEG. Additionally, NGO-SS-PEG showed a higher efficacy than NGO-PEG for anti-tumor therapy compared with NGO-PEG. Thus, NGO-SS-PEG can improve therapeutic efficacy and is an attractive drug nanocarrier.

  1. Effect of Ciprofloxacin on the Immune Response of Growing Piglets to Streptococcosis suis

    Institute of Scientific and Technical Information of China (English)

    QING Liu-ting; YUAN Zong-hui

    2003-01-01

    24 seven-week-old hybrid healthy pigs (weighted 25.5?.4 kg ) from a source were randomly allotted to four groups (six each): the blank group, the negative group, the positive group and the test group. Pigs in the negative group and the test group were developed into a typical subacute Streptococcosis suis by inoculating subcutaneously 0.45 billion of pure living Streptococcus suis (type C55126) per kilogram body weight. Pigs in the positive group and the test group were intravenously injected ciprofloxacin (5 mg kg1 of BW) for 8 consecutive days (twice daily). Pigs in the blank group and positive group were inoculated with a placebo (0.85% NaCl). Some immunity parameters were tested on day 0, 7, 14, 21 and 28 after inoculation. Total leukocytes were counted with microscope. Differential leukocyte counts were performed on Giemsa-stained blood smears. The effect on the nitroblue tetrazolium (NBT) reduction of neutrophil was used to determine its phagocytic ability. Lymphocyte proliferation was determined by using the mitogens PHA. The total serum IgG concentration was measured by radial single immunodiffusion. A 50% hemolytic test was used to investigate the complement activity in serum. Whereas, a phytohemagglutinin (PHA) skin test was used to investigate in vivo immunity. We got the following results: Ciprofloxacin can retard the clinical signs of an increase of leukocyte counts, a large percent of lymphocytes and a relative percentage decrease of neutrophis. Ciprofloxacin could promote nitroblue tetrazolium (NBT) reduction by neutrophil. Though there was no obvious difference (P>0.05) between the test group and the negative group, the interaction of both Streptococcosis suis and ciprofloxacin was significantly different(P0.05) between the test group and the blank group. Delayed-type hypersensitivity (DTH) to PHA was increased in diseased animals after receiving the treatment with ciprofloxacin. Owing to the difference of interaction (P<0.01, on day 21, 28 after

  2. Plasma and interstitial fluid pharmacokinetics of enrofloxacin, its metabolite ciprofloxacin, and marbofloxacin after oral administration and a constant rate intravenous infusion in dogs.

    Science.gov (United States)

    Bidgood, T L; Papich, M G

    2005-08-01

    Enrofloxacin and marbofloxacin were administered to six healthy dogs in separate crossover experiments as a single oral dose (5 mg/kg) and as a constant rate IV infusion (1.24 and 0.12 mg/h.kg, respectively) following a loading dose (4.47 and 2 mg/kg, respectively) to achieve a steady-state concentration of approximately 1 microg/mL for 8 h. Interstitial fluid (ISF) was collected with an in vivo ultrafiltration device at the same time period as plasma to measure protein unbound drug concentrations at the tissue site and assess the dynamics of drug distribution. Plasma and ISF were analyzed for enrofloxacin, its active metabolite ciprofloxacin, and for marbofloxacin by high performance liquid chromatography (HPLC). Lipophilicity and protein binding of enrofloxacin were higher than for marbofloxacin and ciprofloxacin. Compared to enrofloxacin, marbofloxacin had a longer half-life, higher Cmax, and larger AUC(0-infinity) in plasma and ISF after oral administration. Establishing steady state allowed an assessment of the dynamics of drug concentrations between plasma and ISF. The ISF and plasma-unbound concentrations were similar during the steady-state period despite differences in lipophilicity and pharmacokinetic parameters of the drugs.

  3. In vitro production of biofilm in a flow cell system in a strain of Pseudomonas aeruginosa and Staphylococcus aureus and determination of efficiency of ciprofloxacin against them

    Directory of Open Access Journals (Sweden)

    Soham Gupta

    2011-01-01

    Full Text Available Background: Microorganisms develop biofilm on various medical devices. The process is particularly relevant in public health since biofilm associated organisms are much more resistant to antibiotics and have a potential to cause infections in patients with indwelling medical devices. Materials and Methods: To determine the efficiency of an antibiotic against the biofilm it is inappropriate to use traditional technique of determining Minimum Inhibitory Concentration (MIC on the free floating laboratory phenotype. Thus we have induced formation of biofilm in two strains (Pseudomonas aeruginosa and Staphylococcus aureus, which showed heavy growth of biofilm in screening by Tube method in a flow cell system and determined their antibiotic susceptibility against ciprofloxacin by agar dilution method in the range (0.25 mg/ml to 8 mg/ml. The MIC value of ciprofloxacin for the biofilm produced organism was compared with its free form and a standard strain as control on the same plates. Observations: Both the biofilm produced strains showed a higher resistance (MIC > 8 mg/ml than its free form, which were 2 μg/ml for Pseudomonas aeruginosa and 4 mg/ml for Staphylococcus aureus. Thus biofilm can pose a threat in the patient treatment.

  4. Ciprofloxacin HCl-loaded calcium carbonate nanoparticles: preparation, solid state characterization, and evaluation of antimicrobial effect against Staphylococcus aureus.

    Science.gov (United States)

    Maleki Dizaj, Solmaz; Lotfipour, Farzaneh; Barzegar-Jalali, Mohammad; Zarrintan, Mohammad-Hossein; Adibkia, Khosro

    2017-05-01

    Ciprofloxacin HCl-loaded calcium carbonate (CaCO3) nanoparticles were prepared via a w/o microemulsion method and characterized by dynamic light scattering, scanning electron microscopy, X-ray powder diffraction (XRPD) analysis, differential scanning calorimetry (DSC), and Fourier transform infrared spectroscopy (FTIR). The in vitro drug release profiles as well as antimicrobial effect against Staphylococcus aureus (S. aureus) were also evaluated. The antibacterial effect was studied using serial dilution technique to determine the minimum inhibitory concentration (MIC) of the nanoparticles and was confirmed by streak cultures. The mean particle size, drug loading and entrapment efficiency were calculated to be 116.09 nm, 20.49% and 44.05%, respectively. PXRD and FTIR studies confirmed that both vaterite and calcite polymorphs of CaCO3 were formed during the preparation process. In vitro release profiles of the nanoparticles showed slow release pattern for 12 h. The drug-loaded nanoparticles showed similar MICs against S. aureus compared to untreated drug. However, a preserved antimicrobial effect was observed for drug-loaded nanoparticles compared to untreated drug after 2 days of incubation.

  5. Reducing Relapse and Recurrence in Unipolar Depression: A Comparative Meta-Analysis of Cognitive–Behavioral Therapy's Effects

    OpenAIRE

    2007-01-01

    Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive–behavioral therapies (CT) aimed at preventing relapse–recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse–recur (29% within 1 year and 54% within 2 years). These rates appear co...

  6. Protocol for the saMS trial (supportive adjustment for multiple sclerosis: a randomized controlled trial comparing cognitive behavioral therapy to supportive listening for adjustment to multiple sclerosis

    Directory of Open Access Journals (Sweden)

    McCrone Paul

    2009-08-01

    Full Text Available Abstract Background Multiple Sclerosis (MS is an incurable, chronic, potentially progressive and unpredictable disease of the central nervous system. The disease produces a range of unpleasant and debilitating symptoms, which can have a profound impact including disrupting activities of daily living, employment, income, relationships, social and leisure activities, and life goals. Adjusting to the illness is therefore particularly challenging. This trial tests the effectiveness of a Cognitive Behavioural intervention compared to Supportive Listening to assist adjustment in the early stages of MS. Methods/Design This is a two arm randomized multi-centre parallel group controlled trial. 122 consenting participants who meet eligibility criteria will be randomly allocated to receive either Cognitive Behavioral Therapy or Supportive Listening. Eight one hour sessions of therapy (delivered over a period of 10 weeks will be delivered by general nurses trained in both treatments. Self-report questionnaire data will be collected at baseline (0 weeks, mid-therapy (week 5 of therapy, post-therapy (15 weeks and at six months (26 weeks and twelve months (52 weeks follow-up. Primary outcomes are distress and MS-related social and role impairment at twelve month follow-up. Analysis will also consider predictors and mechanisms of change during therapy. In-depth interviews to examine participants' experiences of the interventions will be conducted with a purposively sampled sub-set of the trial participants. An economic analysis will also take place. Discussion This trial is distinctive in its aims in that it aids adjustment to MS in a broad sense. It is not a treatment specifically for depression. Use of nurses as therapists makes the interventions potentially viable in terms of being rolled out in the NHS. The trial benefits from incorporating patient input in the development and evaluation stages. The trial will provide important information about the

  7. Treatment failure in a typhoid patient infected with nalidixic acid resistant S. enterica serovar Typhi with reduced susceptibility to Ciprofloxacin: a case report from Cameroon

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    Asonganyi Etienne DN

    2005-06-01

    Full Text Available Abstract Background Fluoroquinolones or third generation cephalosporins are the drugs of choice for the treatment of typhoid fever. Treatment failure with fluoroquinolones has been reported in Asia and Europe. We report a case of ciprofloxacin treatment failure in typhoid fever in Cameroon. Case presentation A 29-year-old female patient with suspected typhoid fever from Kumba, Cameroon, yielded growth of Salmonella enterica serovar Typhi in blood culture. The isolate was resistant to nalidixic acid but sensitive to ciprofloxacin by disc diffusion test. However, the patient did not respond to treatment with ciprofloxacin, although the isolate was apparently susceptible to ciprofloxacin. Conclusion Treatment failure with ciprofloxacin in our case indicates the presence of nalidixic acid resistant S. enterica serovar Typhi (NARST with reduced susceptibility to ciprofloxacin in Cameroon (Central Africa.

  8. Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: a comparative dosimetric planning study

    Energy Technology Data Exchange (ETDEWEB)

    Gorayski, Peter; Fitzgerald, Rhys; Barry, Tamara [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Burmeister, Elizabeth [Nursing Practice Development Unit, Princess Alexandra Hospital and Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Queensland (Australia); Foote, Matthew [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Diamantina Institute, University of Queensland, Brisbane, Queensland (Australia)

    2014-06-15

    Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN. Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared. IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose. Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI.

  9. Comparing Effects of Medication Therapy and Exercise Training with Diet on Liver enzyme Levels and Liver Sonography in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD

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    Azadeh Nabizadeh Haghighi

    2016-03-01

    Full Text Available Background & Objectives: Non-alcoholic fatty liver disease, characterized by the deposition of fat in liver cells, can cause fibrosis, cirrhosis, and liver cell damage if not controlled. The aim of this study is to compare the effects of medication therapy and exercise training with diet on liver enzyme levels and liver sonography in patients with non-alcoholic fatty liver disease (NAFLD. Materials & Methods :In this quasi-experimental study, female patients with non-alcoholic fatty liver were randomly divided into two groups: medication therapy (n = 10 and exercise therapy (n = 10 for 8 weeks. During this period, the exercise group performed exercise training three days a week for 90 minutes per session. The drug was given to the medication group. In both groups, the diet was 500 calories less than their daily energy. Before and after intervention, blood tests and liver sonography were executed. All statistical analyses were done using SPSS for Windows version 20. Comparisons between and within groups were performed by Student's t-test and Wilcoxon test on paired and unpaired data. P < 0.05 was considered statistically significant. Results :In both groups, liver enzyme levels and disease severity in sonography reduced significantly (p<0.05. Conclusion: The findings of the present research showed that both methods of therapy have the same effect on reducing the severity of NAFLD.

  10. Comparing the Effects of Drug Therapy, Perceptual Motor Training, and Both Combined on the Motor Skills of School-Aged Attention Deficit Hyperactivity Disorder Children.

    Science.gov (United States)

    Taft Yazd, Susan Nasiri; Ayatizadeh, Farahnaz; Dehghan, Faezeh; Machado, Sergio; Wegner, Mirko

    2015-01-01

    The purpose of this research was to compare the effects of drug therapy, perceptual motor training and a combination of drug therapy and perceptual motor training on gross and fine motor skills of 6 to 12 year-old Iranian attention deficit hyperactivity disorder children. Thirty-six attention deficit hyperactivity disorder children currently under treatment in three Iranian psychological-neurological clinics participated in this research study. Participants were sampled from the accessible population and randomly assigned to three experimental groups (n = 12 each). The Conners Parent Rating Scale was used to classify the children and the Bruininks-Oseretsky Test of Motor Proficiency was administered before and after a three month treatment/ training session. Participants in the first experimental group received drug therapy (including methylphenidate). In the second group participants took part in 18 sessions of perceptual-motor skill training for six consecutive weeks, and in the third group children received both interventions. The results indicated that interventions using perceptual-motor training alone or in combination with a drug therapy significantly improved both gross and fine motor skills over a period of six weeks. Participants in the drug-only group showed no improvement in motor performance.

  11. Do Self-Statements Enhance the Effectiveness of Virtual Reality Exposure Therapy? A Comparative Evaluation in Acrophobia

    OpenAIRE

    Krijn, M.; Emmelkamp, P.M.G.; Olafsson, R.P.; Schuemie, M. J.; van der Mast, C. A. P. G.

    2007-01-01

    There is a clear need for more detailed analysis of the role of cognitive self-statements in virtual reality exposure therapy (VRET). To date, no research on this topic has been done. The primary aim of this study was to investigate whether coping self-statements would enhance the effectiveness of VRET. In a randomized crossover design, 26 patients with acrophobia (DSM-IV diagnosis of specific phobia) were randomly assigned to two sessions of VRET followed by two sessions of VRET plus coping ...

  12. Two-way and three-way approaches to ultra high performance liquid chromatography-photodiode array dataset for the quantitative resolution of a two-component mixture containing ciprofloxacin and ornidazole.

    Science.gov (United States)

    Dinç, Erdal; Ertekin, Zehra Ceren; Büker, Eda

    2016-09-01

    Two-way and three-way calibration models were applied to ultra high performance liquid chromatography with photodiode array data with coeluted peaks in the same wavelength and time regions for the simultaneous quantitation of ciprofloxacin and ornidazole in tablets. The chromatographic data cube (tensor) was obtained by recording chromatographic spectra of the standard and sample solutions containing ciprofloxacin and ornidazole with sulfadiazine as an internal standard as a function of time and wavelength. Parallel factor analysis and trilinear partial least squares were used as three-way calibrations for the decomposition of the tensor, whereas three-way unfolded partial least squares was applied as a two-way calibration to the unfolded dataset obtained from the data array of ultra high performance liquid chromatography with photodiode array detection. The validity and ability of two-way and three-way analysis methods were tested by analyzing validation samples: synthetic mixture, interday and intraday samples, and standard addition samples. Results obtained from two-way and three-way calibrations were compared to those provided by traditional ultra high performance liquid chromatography. The proposed methods, parallel factor analysis, trilinear partial least squares, unfolded partial least squares, and traditional ultra high performance liquid chromatography were successfully applied to the quantitative estimation of the solid dosage form containing ciprofloxacin and ornidazole.

  13. Brief cognitive behavioral therapy compared to general practitioners care for depression in primary care: a randomized trial

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    Bockting Claudi LH

    2010-10-01

    Full Text Available Abstract Background Depressive disorders are highly prevalent in primary care (PC and are associated with considerable functional impairment and increased health care use. Research has shown that many patients prefer psychological treatments to pharmacotherapy, however, it remains unclear which treatment is most optimal for depressive patients in primary care. Methods/Design A randomized, multi-centre trial involving two intervention groups: one receiving brief cognitive behavioral therapy and the other receiving general practitioner care. General practitioners from 109 General Practices in Nijmegen and Amsterdam (The Netherlands will be asked to include patients aged between 18-70 years presenting with depressive symptomatology, who do not receive an active treatment for their depressive complaints. Patients will be telephonically assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I to ascertain study eligibility. Eligible patients will be randomized to one of two treatment conditions: either 8 sessions of cognitive behavioral therapy by a first line psychologist or general practitioner's care according to The Dutch College of General Practitioners Practice Guideline (NHG- standaard. Baseline and follow-up assessments are scheduled at 0, 6, 12 and 52 weeks following the start of the intervention. Primary outcome will be measured with the Hamilton Depression Rating Scale-17 (HDRS-17 and the Patient Health Questionnaire-9 (PHQ-9. Outcomes will be analyzed on an intention to treat basis. Trial Registration ISRCTN65811640

  14. Adsorption of ciprofloxacin, bisphenol and 2-chlorophenol on electrospun carbon nanofibers: in comparison with powder activated carbon.

    Science.gov (United States)

    Li, Xiaona; Chen, Shuo; Fan, Xinfei; Quan, Xie; Tan, Feng; Zhang, Yaobin; Gao, Jinsuo

    2015-06-01

    Carbon nanofibers (CNFs) were prepared by electrospun polyacrylonitrile (PAN) polymer solutions followed by thermal treatment. For the first time, the influence of stabilization procedure on the structure properties of CNFs was explored to improve the adsorption capacity of CNFs towards the environmental pollutants from aqueous solution. The adsorption of three organic chemicals including ciprofloxacin (CIP), bisphenol (BPA) and 2-chlorophenol (2-CP) on electrospun CNFs with high surface area of 2326m(2)/g and micro/mesoporous structure characteristics were investigated. The adsorption affinities were compared with that of the commercial powder activated carbon (PAC). The adsorption kinetics and isotherms showed that the maximum adsorption capacities (qm) of CNFs towards the three pollutants are sequenced in the order of CIP>BPA>2-CP, which are 2.6-fold (CIP), 1.6-fold (BPA) and 1.1-fold (2-CP) increase respectively in comparison with that of PAC adsorption. It was assumed that the micro/mesoporous structure of CNFs, molecular size of the pollutants and the π electron interaction play important roles on the high adsorption capacity exhibited by CNFs. In addition, electrostatic interaction and hydrophobic interaction also contribute to the adsorption of CNFs. This study demonstrates that the electrospun CNFs are promising adsorbents for the removal of pollutants from aqueous solutions.

  15. 心理分析学派的游戏治疗理论与儿童中心学派的游戏治疗理论的对比研究%Comparative study between play therapy of psychoanalysis and play therapy of children-center

    Institute of Scientific and Technical Information of China (English)

    郑洪利

    2002-01-01

    This paper analyzes comparatively characteristic and representative play therapy of psychoanalysis and play therapy of children center about human nature personality,therapeutic relationships and therapeutic method etc.Which have a special significance of giving us a better knowledge and grasp about the theory and practice of play therapy.

  16. Bovine herpesvirus tegument protein VP22 enhances thymidine kinase/ganciclovir suicide gene therapy for neuroblastomas compared to herpes simplex virus VP22.

    Science.gov (United States)

    Qiu, Zhaohua; Harms, Jerome S; Zhu, Jun; Splitter, Gary A

    2004-04-01

    Herpesvirus tegument protein VP22 can enhance the effect of therapeutic proteins in gene therapy, such as thymidine kinase (tk) and p53; however, the mechanism is unclear or controversial. In this study, mammalian expression vectors carrying bovine herpesvirus 1 (BHV-1) VP22 (BVP22) or herpes simplex virus type 1 (HSV-1) VP22 (HVP22) and equine herpesvirus type 4 (EHV-4) tk (Etk) were constructed in order to evaluate and compare the therapeutic potentials of BVP22 and HVP22 to enhance Etk/ganciclovir (Etk/GCV) suicide gene therapy for neuroblastomas by GCV cytotoxicity assays and noninvasive bioluminescent imaging in vitro and in vivo. BVP22 enhanced Etk/GCV cytotoxicity compared to that with HVP22 both in vitro and in vivo. However, assays utilizing a mixture of parental and stably transfected cells indicated that the enhancement was detected only in transfected cells. Thus, the therapeutic potential of BVP22 and HVP22 in Etk/GCV suicide gene therapy in this tumor system is not due to VP22 delivery of Etk into surrounding cells but rather is likely due to an enhanced intracellular effect.

  17. An observational retrospective/horizontal study to compare oxygen-ozone therapy and/or global postural re-education in complicated chronic low back pain.

    Science.gov (United States)

    Apuzzo, Dario; Giotti, Chiara; Pasqualetti, Patrizio; Ferrazza, Paolo; Soldati, Paola; Zucco, Gesualdo M

    2014-01-01

    Acute low back pain (LBP) is the fifth most common reason for physician visits and about nine out of ten adults experience back pain at some point in their life. In a large number of patients LBP is associated with disc herniation (DH). Recently, oxygen-ozone (O2O3) therapy has been used successfully in the treatment of LBP, reducing pain after the failure of other conservative treatments. The aim of this study was to assess the effects of O2O3 therapy in back pain rehabilitation, comparing three groups of patients suffering from chronic back pain associated with DH submitted to three different treatments: intramuscular O2O3 infiltrations, global postural An observational retrospective/horizontal study to compare oxygen-ozone therapy and/or global postural re-education in complicated chronic low back pain re-education (GPR), or a combination of the two (O2O3+GPR). The data show that pain severity before treatment was significantly lower in the patients treated with GPR alone (VAS score 7.4) than in the O2O3+GPR patients (VAS score 8.5) and the O2O3 patients (VAS score 8.6). At the end of treatment, pain severity was lower in the O2O3 patients than in the GPR-alone patients. After some years of follow-up only the difference between O2O3+GPR and GPR-alone remained significant.

  18. Cognitive function in Stage 5 chronic kidney disease patients on hemodialysis: no adverse effects of lanthanum carbonate compared with standard phosphate-binder therapy.

    Science.gov (United States)

    Altmann, P; Barnett, M E; Finn, W F

    2007-02-01

    Patients with Stage 5 chronic kidney disease who have hyperphosphatemia require treatment with phosphate binders to lower serum phosphorus levels. Existing binders are effective but may be associated with important safety disadvantages. Lanthanum carbonate is a phosphate binder with demonstrated efficacy, safety, and tolerability in clinical trials. Changes in cognitive function were evaluated over time using the Cognitive Drug Research computerized cognitive assessment system (Simple Reaction Time, Digit Vigilance Task, Choice Reaction Time, Numeric Working Memory, and Delayed Picture Recognition) in 360 hemodialysis patients who were enrolled in a 2-year, multicenter, comparative study of lanthanum carbonate versus standard therapy. A decline in cognitive function from baseline was observed in both groups. The deterioration in cognitive function was similar in both the lanthanum carbonate and standard therapy groups. One parameter - Numeric Working Memory - showed a statistically significant between-group difference in favor of lanthanum carbonate (P=0.02). Given the magnitude of the changes, however, and the differences that were observed at baseline between treatment groups, the clinical significance of this difference is doubtful. This study demonstrates that cognitive function deteriorates in hemodialysis patients over a 2-year time period. Use of lanthanum carbonate as a phosphate binder does not adversely affect cognitive function compared with standard therapy.

  19. The evaluation of susceptibility of clinical and environmental Nontuberculosis mycobacterium isolated from Isfahan to Ciprofloxacin by Agar dilution method

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    Tooba Radaei

    2013-01-01

    Full Text Available Introduction: Ciprofloxacin is a fluoroquinolone antibiotic which is active against mycobacteria and functions by inhibiting DNA gyrase and topoisomerase IV enzymes. Resistance to ciprofloxacin and other fluoroquinolones may evolve rapidly, even during a course of treatment. Nowadays, mycobacteria exhibit resistance worldwide and usage of the fluoroquinolones, particularly in nontuberculous mycobacteria disease, has complicated the related treatments. Materials and methods: A total of 39 clinical and environmental isolates of NTM from microbial collections of Isfahan Microbiology Department and Tuberculosis center were obtained. The isolates were investigated by primary conventional methods consisting of colony characteristics, pigmentation, growth temperature, rate of growth and Ziehl–Neelsen staining. The susceptibility of isolates to the concentrations of 1, 2 and 4 µg/ml of ciprofloxacin was determined by agar dilution method according to the CLSI guideline.Results: Thirty nine isolates were identified by phenotypic tests. The frequency of isolates was as follow: M. fortuitum; 25 cases, M. gordonae; 10 cases, M. smegmatis; 1 case, M.‏conceptionense; 1 case and M. abscessus; 2 cases. All isolates except Mycobacterium abscessus were sensitive to all three concentrations of 1, 2 and 4 µg/ml ciprofloxacin.Discussion and conclusion: Due to the sensitivity of environmental nontuberculous mycobacteria isolates (except M. abscessus and clinical isolates including M. fortuitum and M.‏gordonae to ciprofloxacin, this antibiotic could be regarded as the original drug in the treatment of these infections.

  20. Association between fluoroquinolone usage and a dramatic rise in ciprofloxacin-resistant Streptococcus pneumoniae in Canada, 1997-2006.

    Science.gov (United States)

    Adam, Heather J; Hoban, Daryl J; Gin, Alfred S; Zhanel, George G

    2009-07-01

    This study evaluated the prevalence of fluoroquinolone usage and investigated the association between usage and resistance in respiratory isolates of Streptococcus pneumoniae in Canada. Fluoroquinolone susceptibility testing was conducted on S. pneumoniae collected from 25 medical centres across Canada over nine study years. Fluoroquinolone prescriptions and consumption figures were derived from data in the IMS Health, Canada CompuScript Audit. Between 1997 and 2006, 11825 S. pneumoniae isolates were collected. Ciprofloxacin resistance rates increased significantly (P or = 65 years). Outpatient ciprofloxacin and respiratory fluoroquinolone prescriptions increased by 55.6% (38.2 prescriptions/1000 population to 59.4 prescriptions/1000 population; Pfluoroquinolone consumption increased by 10.6% [1.1 defined daily doses (DDDs)/1000/day to 1.2 DDDs/1000/day; P=0.02] and 38.2% (0.5 to 0.7 DDDs/1000/day; P=0.02), respectively, from 2001 to 2006. A strong association between ciprofloxacin use and resistance (R(2)=0.89) was identified. Fluoroquinolone resistance in S. pneumoniae increased significantly in Canada from 1997 to 2006 in conjunction with increased ciprofloxacin and respiratory fluoroquinolone consumption. Ciprofloxacin usage appears to be the biggest driver of resistance; however, total fluoroquinolone usage is also important.

  1. Genetic Diversity among Ciprofloxacin Resistant Enterococcus faecalis Isolated from Clinical Specimens with Pulsed-Field Gel Electrophoresis (PFGE Method

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    Moinian M

    2013-03-01

    Full Text Available Abstract Background and objective: Resistance to ciprofloxacin among Enterococcus faecalis (E.f isolates especially in UTI makes difficulties for treatment. In this study, the genetic diversity using PFGE method and detection of resistance genes including parC, gyrA , gyrB and parE among ciprofloxacin resistant E.f isolated from clinical specimens, are determined. Materials and methods: A total of 384 entreococcal isolates were collected from 6 hospitals and 3 private laboratories in Tehran and 50 ciprofloxacin resistant E.f isolates were obtained. Identification of species and resistance genes were done by PCR method. Antimicrobial and minimum inhibitory concentration (MICs tests were assayed with standard methods and finally genotyping was accomplished using PFGE method. Results: The range of ciprofloxacin MICs was 16 to 512 µg/ml. All of these isolates contained parC, 98 % gyrA , gyrB and 80 % parE genes. PFGE analysis, grouped 50 strains in 11 common types and 7 single types. The P4, P9 and P10 genotypes were shared between hospital and community isolates. Conclusion: According to these results the E.f isolates showed high clonal diversity. Because of the ciprofloxacin high MICs level among common pulsotypes we concluded that they have various distributions which may be due to highly transmission of resistant genes among enterococci. Indeed the colonized patients with these resistant isolates are reservoir for releasing of the resistant genes to community which requires more surveillance programs.

  2. Simulated microgravity affects ciprofloxacin susceptibility and expression of acrAB-tolC genes in E. coli ATCC25922.

    Science.gov (United States)

    Xu, Bingxin; Li, Chenglin; Zheng, Yanhua; Si, Shaoyan; Shi, Yuhua; Huang, Yuling; Zhang, Jianzhong; Cui, Yan; Cui, Yimin

    2015-01-01

    As a representative fluoroquinolone antibacterial, ciprofloxacin is frequently used to treat infections caused by bacteria such as E. coli. It is much meaningful to explore ciprofloxacin susceptibility and investigate a possible mechanism of drug susceptibility changes in E. coli ATCC25922 exposed to the environmental stress of simulated microgravity. The subculture of E. coli lasted for 7 days under simulated microgravity conditions (SMG) and normal microgravity (NG) conditions. On the 8th day, the cultures were divided into three groups: (1) NG group (continuous NG cultures); (2) SMG group (continuous SMG cultures); (3) SMCNG group (simulated microgravity change into normal gravity cultures). Ciprofloxacin (a final concentration of 0.125 μg/ml) sensitivity and expression of acrAB-tolC genes were detected in E. coli cells. The count and percentage of viable cells in the SMG cultures bacteria exposed to ciprofloxacin were higher than that in NG cultures and reduced to the levels of NG group when they were subcultivated from SMG to NG. The expressions of efflux pump genes (acrA, acrB and tolC) were upregulated in SMG culture and downregulated to the levels of NG group when they were subcultivated from SMG to NG. Susceptibility to ciprofloxacin and expression of acrAB-tolC genes in E. coli could be reversibly affected by SMG conditions. Over expression of efflux pump genes acrAB-tolC perhaps played an important role in decreased CIP susceptibility under SMG.

  3. In vitro bactericidal activity of amoxicillin, gentamicin, rifampicin, ciprofloxacin and trimethoprim-sulfamethoxazole alone or in combination against Listeria monocytogenes.

    Science.gov (United States)

    Boisivon, A; Guiomar, C; Carbon, C

    1990-03-01

    The in vitro bactericidal activity of amoxicillin, gentamicin, rifampicin, ciprofloxacin and trimethoprim-sulfamethoxazole alone or in combination was determined against seven strains of Listeria monocytogenes by the killing curve method. Amoxicillin plus gentamicin was the most rapidly bactericidal combination, whereas trimethoprim-sulfamethoxazole was less bactericidal at 6 h but as bactericidal at 24 h. The combination of trimethoprim-sulfamethoxazole with either amoxicillin, ciprofloxacin or rifampicin did not result in antagonism, but the combinations were no more active than trimethoprim-sulfamethoxazole alone. The interaction of amoxicillin with rifampin was fairly antagonistic (1 log10 difference). The combination of amoxicillin and ciprofloxacin, although producing antagonism during the first 6 h, was more active at 24 h than amoxicillin alone and prevented the regrowth observed with ciprofloxacin alone. Ciprofloxacin and rifampicin interacted antagonistically during the first 6 h, and the combination was not very bactericidal (3 log10) but prevented the emergence of mutants, as observed with each drug alone, when used at concentrations greater than the MICs for the strain tested. These regimens merit evaluation in in vivo models of Listeria monocytogenes meningitis.

  4. (68) Ga-labeled Ciprofloxacin Conjugates as Radiotracers for Targeting Bacterial Infection.

    Science.gov (United States)

    Satpati, Drishty; Arjun, Chanda; Krishnamohan, Repaka; Samuel, Grace; Banerjee, Sharmila

    2016-05-01

    With an aim of developing a bacteria-specific molecular imaging agent, ciprofloxacin has been modified with a propylamine spacer and linked to two common bifunctional chelators, p-SCN-Bz-DOTA and p-SCN-Bz-NOTA. The two ciprofloxacin conjugates, CP-PA-SCN-Bz-DOTA (1) and CP-PA-SCN-Bz-NOTA (2), were radiolabeled with (68)Ga in >90% radiochemical yield and were moderately stable in vitro for 4 h. The efficacy of (68)Ga-1 and (68)Ga-2 has been investigated in vitro in Staphylococcus aureus cells where bacterial binding of the radiotracers (0.9-1.0% for (68)Ga-1 and 1.6-2.3% for (68)Ga-2) could not be blocked in the presence of excess amount of unlabeled ciprofloxacin. However, uptake of radiotracers in live bacterial cells was significantly higher (p 68)Ga-1 and (68)Ga-2 was tested in vivo in rats where the infected muscle-to-inflamed muscle ((68)Ga-1: 2 ± 0.2, (68)Ga-2: 3 ± 0.5) and infected muscle-to-normal muscle ratios ((68)Ga-1: 3 ± 0.4, (68)Ga-2: 6.6 ± 0.8) were found to improve at 120 min p.i. Fast blood clearance and renal excretion was observed for both the radiotracers. The two (68)Ga-labeled infection targeting radiotracers could discriminate between bacterial infection and inflammation in vivo and are worthy of further detailed investigation as infection imaging agents at the clinical level.

  5. Rheological behavior and stability of ciprofloxacin suspension: Impact of structural vehicles and flocculating agent

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    Eskandar Moghimipour

    2013-01-01

    Full Text Available Ciprofloxacin is a fluoroquinolone and is used against a broad spectrum of gram-negative and gram-positive bacteria. The aim of the study is to investigate the effect of structural vehicles and other formulating factors on physical stability and rheological behavior of ciprofloxacin suspension. To formulate the suspensions, the effect of glycerin and polysorbate 80 as wetting agents was evaluated. Then to achieve controlled flocculation, different concentrations of sodium chloride and calcium chloride were added. After choosing suitable wetting and flocculating agents, structural vehicles such as sodium carboxyl methyl cellulose (NaCMC, hydroxypropylmethylcellulose (HPMC and Veegum were evaluated. Physical stability parameters such as sedimentation volume, the degree of flocculation and the ease of redispersion of the suspensions and growth of crystals were evaluated. After incorporation of structural vehicles, the rheological properties of formulations containing were also studied to find out their rheological behavior. According to the results, suspension containing glycerin (0.2% w/v and sodium chloride (0.05% w/v as wetting agent and flocculating agent, respectively, were the most stable formulations regarding their F and N. Microscopic observations showed the growth of crystals in ciprofloxacin suspension in formulation without excipients and the minimum amount of crystal growth was seen in suspension containing NaCMC (0.25% w/v, Veegum (0.1% w/v and NaCl (0.05% w/v. Rheological studies showed that almost all of the formulations had psuedoplastic behavior with different degree of thixotropy. The formulation containing NaCMC (0.25% w/v, Veegum (0.1% w/v and NaCl (0.05% w/v was the most stable formulation. It may be concluded that by altering the amount ratios of formulation factors, the best rheological behavior and the most proper thixotropy may be achieved.

  6. Infrared multiple photon dissociation spectroscopy of ciprofloxacin: Investigation of the protonation site

    Energy Technology Data Exchange (ETDEWEB)

    Bodo, E. [Dip. Di Chimica, Universita di Roma ' La Sapienza' , p.le A. Moro 5, 00185 Rome (Italy); Ciavardini, A. [Dip. di Chimica e Tecnologie del Farmaco, Universita di Roma ' ' La Sapienza' ' , p.le A. Moro 5, 00185 Rome (Italy); Dip. di Scienze e Tecnologie Chimiche, Universita di Roma ' ' Tor Vergata' ' , via della Ricerca Scientifica, 00133 Rome (Italy); Giardini, A.; Paladini, A. [CNR - IMIP, Tito Scalo (PZ) (Italy); Piccirillo, S., E-mail: picciril@uniroma2.it [Dip. di Scienze e Tecnologie Chimiche, Universita di Roma ' ' Tor Vergata' ' , via della Ricerca Scientifica, 00133 Rome (Italy); Rondino, F. [ENEA, C.R. Casaccia, (UTT-MAT), Via Anguillarese, 301, 00123 Rome (Italy); Scuderi, D. [Laboratoire de Chimie Physique, Universite Paris Sud 11, UMR 8000, Orsay (France)

    2012-04-04

    Highlights: Black-Right-Pointing-Pointer IRMPD spectroscopy of protonated ciprofloxacin electrosprayed from methanol solution. Black-Right-Pointing-Pointer Quantum chemical calculations to identify the possible isomers differing in the protonation site. Black-Right-Pointing-Pointer Bands are assigned to the isomer protonated. Black-Right-Pointing-Pointer Bands are assigned to the isomer protonated at the piperazinyl amino group. - Abstract: The vibrational spectrum of isolated protonated ciprofloxacin was recorded in the range 1100-2000 cm{sup -1} by means of infrared multiple photon dissociation (IRMPD) spectroscopy. The spectrum was obtained by electrospraying a methanol solution of ciprofloxacin in a Paul ion trap, coupled to the tunable IR radiation of a free electron laser. This spectroscopic study has been complemented by quantum chemical calculations at the DFT and MP2 levels of theory to identify the possible structures present under our experimental conditions. Several low-energy isomers with protonation occurring at the piperazinyl amino group and at the carbonyl group are predicted in the energy range 0-84 kJ mol{sup -1}. A good agreement between the measured IRMPD spectrum and the calculated absorption spectrum is observed for the isomer protonated at the piperazinyl amino group. This isomer is calculated at MP2 level of theory to lie about 76 kJ/mol above the most stable isomer which is protonated at the quinone carbonyl group. This discrepancy can be rationalized by assuming that the protonation at the piperazinyl amino group, typical of the zwitterionic form that is found in protic solvents, is retained in the ESI process. The vibrational bands observed in the IRMPD spectrum are assigned to normal modes of the isomer protonated at the piperazinyl amino group, with deviations of less than 20 cm{sup -1} between measured and calculated frequencies.

  7. Development of cost effective biodegradable implants of ciprofloxacin hydrochloride in treatment of osteomyelitis

    Directory of Open Access Journals (Sweden)

    Ashish Y Pawar

    2013-01-01

    Full Text Available In the present study, an attempt has been made to formulate and evaluate a sustained release implant of ciprofloxacin HCl with biodegradable, cost-effective polymer chitosan. osteomyelitis is one of the oldest disease, which is still in existence and difficult to treat, the prevalence of which is increasing day-by-day. The treatment of osteomyelitis requires large doses of antibiotics administered by systemic routes for a period of 4-5 weeks, however, the parenteral route suffered from many disadvantages and also some limitations. Ciprofloxacin hydrochloride has been the most widely used fluoroquinolone for multi-bacterial bone infection because the minimal inhibitory concentration of ciprofloxacin HCl is low, and it has good penetration properties in most of the tissues and bone. Biodegradable polymers like poly (lactic-co-glycolic acid (PLGA and Polycaprolactone (PCL were widely studied as a carrier for implant but their use is limited because of high-cost and are not easily available. The cross-linking of chitosan was carried out with sodium citrate and cross-linked chitosan (CC was used as a carrier. The effect of different proportion of chitosan and effect of drug loading on the drug release kinetics has been studied. An in vitro result shows that prolonged release was observed with higher drug loading. The CC5 implant containing 50% w/w polymer retards the drug release for more than 5 weeks. Furthermore, from in vivo study it is found that the optimized formulation CC5 is biocompatible and implant is not causing any foreign body reaction or hypersensitivity in the body of animal. The CC was found to have excellent release retarding properties and can be used as cost-effective, biodegradable sustained release matrices for designing of implant.

  8. Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Dekker Joost

    2009-02-01

    Full Text Available Abstract Background Patients with Chronic Tension Type Headache (CTTH report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles. We present the design of a randomised clinical trial (RCT evaluating the effectiveness of manual therapy (MT compared to usual care by the general practitioner (GP in patients with CTTH. Methods and design Patients are eligible for participation if they present in general practice with CTTH according to the classification of the International Headache Society (IHS. Participants are randomised to either usual GP care according to the national Dutch general practice guidelines for headache, or manual therapy, consisting of mobilisations (high- and low velocity techniques, exercise therapy for the cervical and thoracic spine and postural correction. The primary outcome measures are the number of headache days and use of medication. Secondary outcome measures are severity of headache, functional status, sickness absence, use of other healthcare resources, active cervical range of motion, algometry, endurance of the neckflexor muscles and head posture. Follow-up assessments are conducted after 8 and 26 weeks. Discussion This is a pragmatic trial in which interventions are offered as they are carried out in everyday practice. This increases generalisability of results, but blinding of patients, GPs and therapists is not possible. The results of this trial will contribute to clinical decision making of the GP regarding referral to manual therapy in patients with chronic tension headache.

  9. Severe Rhabdomyolysis Associated with Simvastatin and Role of Ciprofloxacin and Amlodipine Coadministration

    Science.gov (United States)

    De Schryver, Nicolas; Wittebole, Xavier; Van den Bergh, Peter; Haufroid, Vincent; Goffin, Eric; Hantson, Philippe

    2015-01-01

    Simvastatin is among the most commonly used prescription medications for cholesterol reduction and the most common statin-related adverse drug reaction is skeletal muscle toxicity. Multiple factors have been shown to influence simvastatin-induced myopathy. In addition to age, gender, ethnicity, genetic predisposition, and dose, drug-drug interactions play a major role. This is particularly true for drugs that are extensively metabolized by cytochrome P450 (CYP)3A4. We describe a particularly severe case of rhabdomyolysis after the introduction of ciprofloxacin, a weak CYP3A4 inhibitor, in a patient who previously tolerated the simvastatin-amlodipine combination. PMID:25883814

  10. Antitubercular and fluorescence studies of copper(II) complexes with quinolone family member, ciprofloxacin

    Science.gov (United States)

    Kharadi, G. J.

    2011-09-01

    Four new mixed-ligand complexes of Cu(II) with ciprofloxacin (Cip) and uninegative bidentate ligands have been synthesized and characterized. The structure of mixed-ligand complexes was investigated using spectroscopic method, physicochemical and elemental analyses. The fluorescence spectra of complexes show red shift, which may be due to the chelation by the ligands to the metal ion. It enhances ligand ability to accept electrons and decreases the electron transition energy. Antimycobacterial screening of ligand and its copper compound against Mycobacterium tuberculosis shows clear enhancement in the antitubercular activity upon copper complexation.

  11. Acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    Pathoom Sukkaromdee; Viroj Wiwanitkit

    2016-01-01

    The sterile pyuria is an interesting problem in urology. Acute gross sterile pyuria is not a common clinical problem and is difficult to make a correct diagnosis. Here, the authors reported a case of acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection. The patient developed problem after complete course of 7-day acute upper urinary tract treatment. The patient was observed with cloudy whitish urine that had never seen before. The urinalysis showed sterile pyuria. This case was treated by conservative method and the problem was resolved within 7 days.

  12. Vanishing bile duct and Stevens-Johnson syndrome associated with ciprofloxacin treated with tacrolimus

    Institute of Scientific and Technical Information of China (English)

    Gokhan Okan; Serpil Yaylaci; Onder Peker; Sabahattin Kaymakoglu; Murat Saruc

    2008-01-01

    Stevens-Johnson syndrome (SJS) is a serious and potentially life-threatening disease. Vanishing bile duct syndrome (VBDS) is a rare cause of progressive cholestasis. Both syndromes are mostly related with drugs. We report a case of a patient withciprofloxacin-induced SJS and acute onset of VBDS,and reviewed the related literature. It is the first case of ciprofloxacin-induced VBDS successfully treatedwith tacrolimus. This case reminds physicians of the importance of drug reactions, their severity, techniques for diagnosis and methods of management.

  13. Density and Optical Properties of {Ciprofloxacin Hydrochloride + Aqueous-Ethanol} Mixtures at 30°C

    Directory of Open Access Journals (Sweden)

    S. D. Deosarkar

    2016-01-01

    Full Text Available The paper deals with the calculation of molar refraction (RM and polarizability (α of antibiotic drug ciprofloxacin hydrochloride (c = 0.001–0.029 mol·dm−3 solutions in ethanol-water mixtures of different compositions (30, 50, and 70% v/v from measured density (ρ and refractive index (n at 30°C. The effect of drug concentration and composition of ethanol-water mixtures on density and optical properties of drug solutions has been described.

  14. Comparing two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the hypofractionated treatment of high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Yartsev Slav

    2008-01-01

    Full Text Available Abstract Background To compare two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the setting of hypofractionated high-risk prostate cancer treatment. Methods 3DCRT and dIMRT/Helical Tomotherapy(HT planning with 10 CT datasets was undertaken to deliver 68 Gy in 25 fractions (prostate and simultaneously delivering 45 Gy in 25 fractions (pelvic lymph node targets in a single phase. The paradigms of pelvic vessel targeting (iliac vessels with margin are used to target pelvic nodes and conformal normal tissue avoidance (treated soft tissues of the pelvis while limiting dose to identified pelvic critical structures were assessed compared to 3DCRT controls. Both dIMRT/HT and 3DCRT solutions were compared to each other using repeated measures ANOVA and post-hoc paired t-tests. Results When compared to conformal pelvic vessel targeting, conformal normal tissue avoidance delivered more homogenous PTV delivery (2/2 t-test comparisons; p dose, 1–3 Gy over 5/10 dose points; p Conclusion dIMRT/HT nodal and pelvic targeting is superior to 3DCRT in dose delivery and critical structure sparing in the setting of hypofractionation for high-risk prostate cancer. The pelvic targeting paradigm is a potential solution to deliver highly conformal pelvic radiation treatment in the setting of nodal location uncertainty in prostate cancer and other pelvic malignancies.

  15. Effect of Exercise Therapy Compared with Arthroscopic Surgery on Knee Muscle Strength and Functional Performance in Middle-Aged Patients with Degenerative Meniscus Tears

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2015-01-01

    OBJECTIVE: The aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears. DESIGN: A total of 82 patients (mean age, 49 yrs; 35% women......) with a symptomatic, unilateral, magnetic resonance imaging-verified degenerative meniscus tear and no or mild radiographic osteoarthritis were randomly assigned to a supervised neuromuscular and strength exercise program or arthroscopic partial meniscectomy. Outcomes assessed 3 mos after intervention initiation were...... group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18-33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements (P ≤ 0.002) in all other measured variables, with moderate to large effect sizes (0...

  16. Do self-statements enhance the effectiveness of virtual reality exposure therapy? A comparative evaluation in acrophobia.

    Science.gov (United States)

    Krijn, M; Emmelkamp, P M G; Olafsson, R P; Schuemie, Martijn J; van der Mast, Charles A P G

    2007-06-01

    There is a clear need for more detailed analysis of the role of cognitive self-statements in virtual reality exposure therapy (VRET). To date, no research on this topic has been done. The primary aim of this study was to investigate whether coping self-statements would enhance the effectiveness of VRET. In a randomized crossover design, 26 patients with acrophobia (DSM-IV diagnosis of specific phobia) were randomly assigned to two sessions of VRET followed by two sessions of VRET plus coping self-statements, or the other way around: first two sessions of VRET plus coping self-statements followed by two sessions of VRET. Results showed that VRET, regardless of addition of coping self-statements, decreased anxiety of heights, decreased avoidance of height situations, and improved attitudes towards heights. However, at 6-month follow-up, most gains during treatment were not fully retained.

  17. The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression

    Directory of Open Access Journals (Sweden)

    Preschl Barbara

    2011-12-01

    Full Text Available Abstract Background Although numerous efficacy studies in recent years have found internet-based interventions for depression to be effective, there has been scant consideration of therapeutic process factors in the online setting. In face-to face therapy, the quality of the working alliance explains variance in treatment outcome. However, little is yet known about the impact of the working alliance in internet-based interventions, particularly as compared with face-to-face therapy. Methods This study explored the working alliance between client and therapist in the middle and at the end of a cognitive-behavioral intervention for depression. The participants were randomized to an internet-based treatment group (n = 25 or face-to-face group (n = 28. Both groups received the same cognitive behavioral therapy over an 8-week timeframe. Participants completed the Beck Depression Inventory (BDI post-treatment and the Working Alliance Inventory at mid- and post- treatment. Therapists completed the therapist version of the Working Alliance Inventory at post-treatment. Results With the exception of therapists' ratings of the tasks subscale, which were significantly higher in the online group, the two groups' ratings of the working alliance did not differ significantly. Further, significant correlations were found between clients' ratings of the working alliance and therapy outcome at post-treatment in the online group and at both mid- and post-treatment in the face-to-face group. Correlation analysis revealed that the working alliance ratings did not significantly predict the BDI residual gain score in either group. Conclusions Contrary to what might have been expected, the working alliance in the online group was comparable to that in the face-to-face group. However, the results showed no significant relations between the BDI residual gain score and the working alliance ratings in either group. Trial registration ACTRN12611000563965

  18. Mathematical model for the growth of P. aeruginosa and four mutator strains in sub-MIC concentration of Ciprofloxacin

    DEFF Research Database (Denmark)

    Philipsen, Kirsten Riber; Christiansen, Lasse Engbo; Madsen, Henrik;

    growing under sub-MIC Ciprofloxacin concentration (0.1 μg/ml), in order to describe the growth pattern under the presence of antibiotic. Data available for the modelling process is bioscreen measurements of the bacterial content as a function of time for each bacteria strain growing in LB media...... parameters are estimated from data using a Maximum Likelihood approach. We introduce a new expression for multiple substrate dependent growth in LB media, which is identified by a method first introducing the growth as a random walk in the model. From the bioscreen measurement we found a change in the growth...... pattern under the presence of Ciprofloxacin. In most cases the presence of Ciprofloxacin resulted in a longer lag phase, a period of growth followed by a transition phase and then a second period of growth. We have developed a new mathematical model using a multi substrate approach, which will be able...

  19. Ciprofloxacin Ophthalmic

    Science.gov (United States)

    ... gentle pressure. Wipe any excess liquid from your face with a tissue. If you are to use more than one ... the remaining fingers of that hand against your face. Tilt your head ... to 2 minutes. With a tissue, wipe any excess ointment from the eyelids and ...

  20. Resistencia de Neisseria gonorrhoeae a ciprofloxacina según hábitos sexuales Ciprofloxacin resistance of Neisseria gonorrhoeae according to sexual habits

    Directory of Open Access Journals (Sweden)

    Susana García

    2008-10-01

    heterosexual men. The gonorrhea prevalence in MSM and heterosexual men was 0.091(91/1000 and the Neisseria gonorrhoeae ciprofloxacin resistant (CRNG was 20% in MSM and 3.8% in heterosexual men (p: 0.0416. Thirteen out of 106 isolates from 11 MSM and 2 heterosexual men were CRNG. Six out of eleven MSM had urethritis, one also carried Neisseria gonorrhoeae in rectum and 5 patients were asymptomatic carriers (rectum 2, pharynx 2, urethra 1. No epidemiological relation was found among the patients. Two heterosexual men had urethritis. The 8 symptomatic men were treated with ciprofloxacin but treatment failed in all of them. These patients and the asymptomatic ones were treated with ceftriaxone, 500 mg IM. The post treatment microbiological controls were negative. The CRNG isolates had ciprofloxacin MIC between 2 and 32 (µg/ml, all were negative to penicillinase, 4 out of 13 were chromosomally resistant to penicillin (MIC: 1 µg/ml. The MICs (µg/ml ranges for several antimicrobial agents were: penicillin: 0.016-1; tetracycline: 0.125-2; ceftriaxone: 0.004-0.008; erythromycin: 0.032-2; azithromycin: 0.032-0.5; spectinomycin: 8-32. Due to the high level of ciprofloxacin-resistant N. gonorrhoeae isolated from MSM in our hospital, another antimicrobial agent for empirical therapy should be used in these patients.

  1. A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow.

    Science.gov (United States)

    Crowther, M A A; Bannister, G C; Huma, H; Rooker, G D

    2002-07-01

    We undertook a prospective, randomised study to compare the analgesic effect of injection of steroid and of extracorporeal shock-wave therapy (ESWT) for the treatment of tennis elbow. Group 1 received a single injection of 20 mg of triamcinolone with lignocaine while group 2 received 2000 shock waves in three sessions at weekly intervals. After six weeks there was a significant difference between the groups with the mean pain score for the injection group falling from 66 to 21 compared with a decrease from 61 to 35 in the shock-wave group (p = 0.05). After three months, 84% of patients in group 1 were considered to have had successful treatment compared with 60% in group 2. In the medium term local injection of steroid is more successful and 100 times less expensive than ESWT in the treatment of tennis elbow.

  2. Synthesis of ciprofloxacin-conjugated poly (L-lactic acid polymer for nanofiber fabrication and antibacterial evaluation

    Directory of Open Access Journals (Sweden)

    Parwe SP

    2014-03-01

    Full Text Available Sharad P Parwe, Priti N Chaudhari, Kavita K Mohite, Balaji S Selukar, Smita S Nande, Baijayantimala Garnaik Polymer Science and Engineering Division, National Chemical Laboratory, Pune, India Abstract: Ciprofloxacin was conjugated with polylactide (PLA via the secondary amine group of the piperazine ring using PLA and 7-(4-(2-Chloroacetyl piperazin-1-yl-1-cyclopropyl-6-fluoro-1, 4-dihydro-4-oxoquinoline-3-carboxylic acid. Zinc prolinate, a biocompatible catalyst was synthesized, characterized, and used in ring opening polymerization of L-lactide. Five different kinds of OH-terminated poly(L-lactide (two-, three-, four-, six-arm, star-shaped homopolymers were synthesized by ring opening polymerization of L-lactide in the presence of dodecanol, glycerol, pentaerythritol, dipentaerythritol as initiator and zinc prolinate as a catalyst. The structures of the polymers and conjugates were thoroughly characterized by means of gel permeation chromatography, matrix-assisted laser desorption/ionization – time of flight mass spectrometry, and nuclear magnetic resonance spectroscopy. PLA (molecular weight =100,000 and ciprofloxacin conjugated PLA were used for fabrication of nonwoven nanofiber mat (diameter ranges; 150–400 nm having pore size (62–102 nm using electrospinning. The microbiological assessment shows that the release of ciprofloxacin possesses antimicrobial activity. The drug-release behavior of the mat was studied to reveal potential application as a drug delivery system. The result shows that the ciprofloxacin release rates of the PLA conjugate nonwoven nanofiber mat could be controlled by the drug loading content and the release medium. The development of a biodegradable ciprofloxacin system, based on nonwoven nanofiber mat, should be of great interest in drug delivery systems. Keywords: zinc prolinate, ciprofloxacin conjugated polylactides, CP-PLA, electrospinning, nonwoven nanofibers, drug release, antibacterial activity, MDR

  3. Emergence of ciprofloxacin-resistant extended-spectrum β-lactamase-producing enteric bacteria in hospital wastewater and clinical sources.

    Science.gov (United States)

    Maheshwari, Meenu; Yaser, Nawar Hadi; Naz, Suraiya; Fatima, Mansha; Ahmad, Iqbal

    2016-06-01

    This study aimed to evaluate the incidence of ciprofloxacin-resistant extended-spectrum β-lactamase (ESBL)-producing enteric bacteria in hospital wastewater and clinical sources. Enteric bacteria, mainly Escherichia coli, were isolated from clinical sources (urinary tract and gastrointestinal tract infections; 80 isolates) and hospital wastewater (103 isolates). The antibiotic resistance profile and ESBL production of the isolates were investigated by disc diffusion assay and combined disc diffusion test, respectively. Plasmid profiling was performed by agarose gel electrophoresis, and elimination of resistance markers was performed by a plasmid curing experiment. Antibiotic susceptibility testing revealed a high incidence of β-lactam resistance, being highest to ampicillin (88.0%) followed by amoxicillin, ceftriaxone, cefpodoxime, cefotaxime, aztreonam, cefepime and ceftazidime. Among the non-β-lactam antibiotics, the highest resistance was recorded to nalidixic acid (85.7%). Moreover, 50.8% of enteric bacteria showed resistance to ciprofloxacin. Among 183 total enteric bacteria, 150 (82.0%) exhibited multidrug resistance. ESBL production was detected in 78 isolates (42.6%). A significantly higher incidence of ciprofloxacin resistance was observed among ESBL-producing enteric bacteria both in clinical (P=0.0015) and environmental isolates (P=0.012), clearly demonstrating a close association between ESBL production and ciprofloxacin resistance. Plasmid profiling of selected ESBL-positive strains indicated the presence of one or more plasmids of varying sizes. Plasmid curing resulted in loss of ciprofloxacin and cefotaxime resistance markers simultaneously from selected ESBL-positive isolates, indicating the close relationship of these markers. This study revealed a common occurrence of ciprofloxacin-resistant ESBL-producing enteric bacteria both in hospital wastewater and clinical sources, indicating a potential public health threat.

  4. Hollow mesoporous carbon as a near-infrared absorbing carrier compared with mesoporous carbon nanoparticles for chemo-photothermal therapy.

    Science.gov (United States)

    Li, Xian; Yan, Yue; Lin, Yuanzhe; Jiao, Jian; Wang, Da; Di, Donghua; Zhang, Ying; Jiang, Tongying; Zhao, Qinfu; Wang, Siling

    2017-05-15

    In this study, hollow mesoporous carbon nanoparticles (HMCN) and mesoporous carbon nanoparticles (MCN) were used as near-infrared region (NIR) nanomaterials and drug nanocarriers were prepared using different methods. A comparison between HMCN and MCN was performed with regard to the NIR-induced photothermal effect and drug loading efficiency. The results of NIR-induced photothermal effect test demonstrated that HMCN-COOH had a better photothermal conversion efficacy than MCN-COOH. Given the prominent photothermal effect of HMCN-COOH in vitro, the chemotherapeutic drug DOX was chosen as a model drug to further evaluate the drug loading efficiencies and NIR-triggered drug release behaviors of the nanocarriers. The drug loading efficiency of DOX/HMCN-COOH was found to be up to 76.9%, which was higher than that of DOX/MCN-COOH. In addition, the use of an 808nm NIR laser markedly increased the release of DOX from both carbon carriers in pH 5.0 PBS and pH 7.4 PBS. Cellular photothermal tests involving A549 cells demonstrated that HMCN-COOH had a much higher photothermal efficacy than MCN-COOH. Cell viability experiments and flow cytometry were performed to evaluate the therapeutic effect of DOX/HMCN-COOH and the results obtained demonstrated that DOX/HMCN-COOH had a synergistic therapeutic effect in cancer treatment involving a combination of chemotherapy and photothermal therapy.

  5. Comparative in vivo study of precursors of PpIX (ALA and MAL) used topically in photodynamic therapy

    Science.gov (United States)

    Rego, Raquel F.; Inada, Natalia M.; Ferreira, Juliana; Araújo-Moreira, Fernando M.; Bagnato, Vanderlei S.

    2009-06-01

    The efficacy of Photodynamic Therapy (PDT) combined with aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) in treatment of cancer has been studied for over ten years. However, there is no established dose for the topical use of these drugs in PDT. The purpose of this study was the comparison of induced PDT response of ALAsense (5-aminolevulinic acid - ALA) and Metvix (methyl aminolevulinate - MAL). Depth of necrosis induced by PDT was analyzed in normal liver of male Wistar rats, using different light doses and topical application of both PpIX precursors - ALA and MAL. PDT was performed with a diode laser at 630 nm with different doses of light (20, 50, 100 and 200 J/cm2), and intensity of 250 mW/cm2. Depth of necrosis analysis was used to calculate the threshold dose for each drug. The results showed that MAL-PDT presented a better response than ALA-PDT, mainly due to formulation differences. Moreover, the ability of the ALA PpIX production was more efficient.

  6. Ciprofloxacin causes persister formation by inducing the TisB toxin in Escherichia coli.

    Directory of Open Access Journals (Sweden)

    Tobias Dörr

    2010-02-01

    Full Text Available Bacteria induce stress responses that protect the cell from lethal factors such as DNA-damaging agents. Bacterial populations also form persisters, dormant cells that are highly tolerant to antibiotics and play an important role in recalcitrance of biofilm infections. Stress response and dormancy appear to represent alternative strategies of cell survival. The mechanism of persister formation is unknown, but isolated persisters show increased levels of toxin/antitoxin (TA transcripts. We have found previously that one or more components of the SOS response induce persister formation after exposure to a DNA-damaging antibiotic. The SOS response induces several TA genes in Escherichia coli. Here, we show that a knockout of a particular SOS-TA locus, tisAB/istR, had a sharply decreased level of persisters tolerant to ciprofloxacin, an antibiotic that causes DNA damage. Step-wise administration of ciprofloxacin induced persister formation in a tisAB-dependent manner, and cells producing TisB toxin were tolerant to multiple antibiotics. TisB is a membrane peptide that was shown to decrease proton motive force and ATP levels, consistent with its role in forming dormant cells. These results suggest that a DNA damage-induced toxin controls production of multidrug tolerant cells and thus provide a model of persister formation.

  7. Effect of ciprofloxacin and chloramphenicol on humoral immune response elicited by bovine albumin encapsulated in niosomes

    Institute of Scientific and Technical Information of China (English)

    MADANJitender; KAUSHIKDinesh; SARDANASatish; MISHRADn

    2007-01-01

    The aim is to evaluate the effect of ciprofloxacin and chloramphenicol on anti-BSA antibody production triggered by bovine albumin encapsulated in non-ionic surfactant vesicle, niosomes. Reverse phase evaporation method was adopted to entrap the antigen in colloidal carrier composed of Span 80 and Span 85 followed by simultaneous characterization for particle size, entrapment efficiency and in vitro release. The protein content was determined by Bradford method using UV Visible Spectrophotometer at 595 nm. Humoral immune response was measured in terms of systemic IgG antibody titre by ELISA method. Experimental data indicated that 7∶3 molar ratio of Span 80 and cholesterol based niosomal formulation possessed maximum (39.8±2.9)% of soluble protein.Ciprofloxacin markedly (P<0.05) decreased the antibody titre. In contrast, chloramphenicol did not reduce the antibody titre significantly in comparison to control group (P>0.05). It is necessary to explore the effect of a vaccine antigen when a candidate is medicated with a therapeutic agent, which might help in programming a new drug management and vaccination programme.

  8. Magnetically stimulated ciprofloxacin release from polymeric microspheres entrapping iron oxide nanoparticles

    Directory of Open Access Journals (Sweden)

    Sirivisoot S

    2015-07-01

    Full Text Available Sirinrath Sirivisoot,1 Benjamin S Harrison2 1Biological Engineering Program, Faculty of Engineering, King Mongkut’s University of Technology Thonburi, Bangkok, Thailand; 2Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA Abstract: To extend the external control capability of drug release, iron oxide nanoparticles (NPs encapsulated into polymeric microspheres were used as magnetic media to stimulate drug release using an alternating magnetic field. Chemically synthesized iron oxide NPs, maghemite or hematite, and the antibiotic ciprofloxacin were encapsulated together within polycaprolactone microspheres. The polycaprolactone microspheres entrapping ciprofloxacin and magnetic NPs could be triggered for immediate drug release by magnetic stimulation at a maximum value of 40%. Moreover, the microspheres were cytocompatible with fibroblasts in vitro with a cell viability percentage of more than 100% relative to a nontreated control after 24 hours of culture. Macrophage cell cultures showed no signs of increased inflammatory responses after in vitro incubation for 56 hours. Treatment of Staphylococcus aureus with the magnetic microspheres under an alternating (isolating magnetic field increased bacterial inhibition further after 2 days and 5 days in a broth inhibition assay. The findings of the present study indicate that iron oxide NPs, maghemite and hematite, can be used as media for stimulation by an external magnetic energy to activate immediate drug release. Keywords: antibacterial, maghemite, hematite, Staphylococcus aureus

  9. Ciprofloxacin Controlled-Solid Lipid Nanoparticles: Characterization, In Vitro Release, and Antibacterial Activity Assessment

    Science.gov (United States)

    2017-01-01

    The objective of this research was to formulate ciprofloxacin (CIP) in solid lipid nanoparticles (SLNs) in an attempt to develop a controlled drug delivery system. An ultrasonic melt-emulsification method was used for preparing CIP-loaded SLNs. Key findings included that SLNs were successfully produced with average particle sizes ranging from 165 to 320 nm and polydispersity index in the range of 0.18–0.33. High entrapment efficiency values were reported in all formulations. The atomic force scanning microscopic images showed spherical shape with the size range closer to those found by the particle size analyzer. CIP release exhibited controlled-release behavior with various lipids. Ciprofloxacin solid lipid nanoparticles formula containing stearic acid (CIPSTE) displayed the strongest burst effect and the most rapid release rate. The release data revealed a better fit to the Higuchi diffusion model. After storing the CIPSTE formula at room temperature for 120 days, no significant difference in particle size and zeta potential was found. CIP-loaded SLNs exhibited superior antibacterial activity. Incorporation of CIP into SLNs leads to controlled release and a superior antibacterial effect of CIP. PMID:28194408

  10. Synthesis and characterization of molecularly imprinted polymers for recognition of ciprofloxacin

    Institute of Scientific and Technical Information of China (English)

    Pengyan LIU; Lei LIU; Li ZHANG; Ning JIANG; Zhanli LIU; Yun WANG

    2008-01-01

    A molecularly imprinted polymer (MIP), with special molecule recognition properties of ciprofloxacin (CIP), was prepared by thermal polymerization in which ciprofloxacin acted as template molecule, α-methacrylic acid (MAA) acted as functional monomer and trimethy-lolpropane trimethylacrylate (TRIM) acted as crosslin-ker. The optimized ratio was determined to be n(CIP): n (MMA):n(TRIM) = 1:6:16 by investigation of the effects of different concentrations of functional monomer and the crosslinker on the MIP's recognition properties. Equilibrium binding experiment was used to investigate the adsorption dynamics, the binding ability to template molecule and the substrate selectivity. Scatchard analysis was used to study the MIP's binding characteristic to tem-plate molecule. The results indicated that MIP has higher adsorption ability and selectivity. The equilibrium distri-bution coefficient KD was 41.64 and the separation factor α was 1.62. Scatchard analysis showed that two different kinds of binding sites were produced in the polymer matrix and their dissociation constants were calculated to be Kd1= 5.249×10-5 mol·L-1, Kd2=2.237×10-3mol·L-1.

  11. Controlled Release of Ciprofloxacin from Core-Shell Nanofibers with Monolithic or Blended Core.

    Science.gov (United States)

    Zupančič, Špela; Sinha-Ray, Sumit; Sinha-Ray, Suman; Kristl, Julijana; Yarin, Alexander L

    2016-04-04

    Sustained controlled drug release is one of the prominent contributions for more successful treatment outcomes in the case of several diseases. However, the incorporation of hydrophilic drugs into nanofibers, a promising novel delivery system, and achieving a long-term sustained release still pose a challenging task. In this work we demonstrated a robust method of avoiding burst release of drugs and achieving a sustained drug release from 2 to 4 weeks using core-shell nanofibers with poly(methyl methacrylate) (PMMA) shell and monolithic poly(vinyl alcohol) (PVA) core or a novel type of core-shell nanofibers with blended (PVA and PMMA) core loaded with ciprofloxacin hydrochloride (CIP). It is also shown that, for core-shell nanofibers with monolithic core, drug release can be manipulated by varying flow rate of the core PVA solution, whereas for core-shell nanofibers with blended core, drug release can be manipulated by varying the ratios between PMMA and PVA in the core. During coaxial electrospinning, when the solvent from the core evaporates in concert with the solvent from the shell, the interconnected pores spanning the core and the shell are formed. The release process is found to be desorption-limited and agrees with the two-stage desorption model. Ciprofloxacin-loaded nanofiber mats developed in the present work could be potentially used as local drug delivery systems for treatment of several medical conditions, including periodontal disease and skin, bone, and joint infections.

  12. Effect of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy to sertraline in controlling suicidal ideation in patients with depression: A comparative study

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash Sahoo

    2016-04-01

    Full Text Available Background: Omega-3 fatty acids and 5-hydroxytryptophan have been gaining attention as promising alternative treatment for depressive illness. These agents are given as as add on treatment to conventional antidepressant drugs. The present study was carried out to evaluate efficacy of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy in controlling suicidal ideation in depressive patients on sertraline.Methods: This was a prospective, open label, randomized, parallel group study conducted in department of Psychiatry. Ninety treatment naïve patients (18-65 years age were divided into 3 groups of 30 each. Group I: Sertraline, Group II: Sertraline plus omega-3 fatty acids, Group III: Sertraline plus 5-hydroxytryptophan. Suicidal ideations were assessed with Beck’s scale for suicidal ideation (BSI at weeks 0, 4 and 8. Data were analyzed using repeated measures ANOVA (SPSS version 20.0. Post hoc analysis was done using Bonferroni test.Results: Baseline parameters in patients of all groups were comparable. Administration of sertraline resulted in reduction of Beck’s scale for suicidal ideation scores as compared to baseline. Addition of omega-3 fatty acids and 5-hydroxytryptophan also showed reduction in BSI scores. Effect of sertraline monotherapy was more as compared to omega-3 fatty acids or 5-hydroxytryptophan as add on therapy, which was statistically significant (p value < 0.05.Conclusion: Both omega-3 fatty acids and 5-hydroxytryptophan produce significant effect in controlling suicidal ideations in patients with depression.

  13. Multiple drug therapy--a comparative study with 2 tier and 3 tier combination of rifampicin, clofazimine, DDS, INAH and thiacetazone in lepromatous cases.

    Science.gov (United States)

    Kundu, S K; Ghosh, S; Hazra, S; Chaudhury, S

    1981-04-01

    A comparative study with 2 tier and 3 tier combination of Rifampicin, Clofazimine, DDS, INAH and Thiacetazone was conducted on fifty lepromatous leprosy cases for varying periods. Assessment showed that 2 tier combination of clofazimine and DDS produced good results but the cost stood in the way; whereas 3 tier combination of DDS, thiacetazone and INAH also yielded good results with much less expenses to be incurred by the patients. Whether therapy with this 3 tier combination could be continued for a longer period with sustained improvement is yet to be assessed by further studies for a considerable period.

  14. Combination Intravenous and Intra-Articular Tranexamic acid compared with Intravenous Only Administration and No Therapy in Total Knee Arthroplasty: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Chris Buntting

    2016-07-01

    This study supports the existing literature and suggests that the use of IV Tranexamic acid alone or in combination with intra-articular dose in TKA may reduce the requirement for transfusion (Level IV evidence. Furthermore, this study suggests that the use of tranexamic acid as a combination of Intravenous and intra-articular administration has no effect on range of motion, or medical complications during hospital stay. Although it was not a statistically significant finding, our study suggested a trend towards a greater reduction in haemoglobin and haematocrit fall in the combination therapy group when compared to IV Tranexamic acid alone

  15. Identifying randomized controlled trials of cognitive therapy for depression: comparing the efficiency of Embase, Medline and PsycINFO bibliographic databases.

    Science.gov (United States)

    Watson, R J; Richardson, P H

    1999-12-01

    This study sought to compare the sensitivity and precision of Embase, Medline and PsycINFO bibliographic database searches for randomized controlled trials of cognitive therapy for depression. Searches in each database combined with a hand search in five selected journals formed the total pool against which each search was assessed. Sensitivities of standard searches (index terms only) were 68%, 84% and 38% in Embase, Medline and PsycINFO respectively. Sensitivities of expert searches (index and free text terms) were 76%, 97% and 65% for Embase, Medline and PsycINFO respectively. Medline appears to be the most efficient at identifying articles describing psychological treatment evaluation.

  16. Zero order and signal processing spectrophotometric techniques applied for resolving interference of metronidazole with ciprofloxacin in their pharmaceutical dosage form.

    Science.gov (United States)

    Attia, Khalid A M; Nassar, Mohammed W I; El-Zeiny, Mohamed B; Serag, Ahmed

    2016-02-01

    Four rapid, simple, accurate and precise spectrophotometric methods were used for the determination of ciprofloxacin in the presence of metronidazole as interference. The methods under study are area under the curve, simultaneous equation in addition to smart signal processing techniques of manipulating ratio spectra namely Savitsky-Golay filters and continuous wavelet transform. All the methods were validated according to the ICH guidelines where accuracy, precision and repeatability were found to be within the acceptable limits. The selectivity of the proposed methods was tested using laboratory prepared mixtures and assessed by applying the standard addition technique. So, they can therefore be used for the routine analysis of ciprofloxacin in quality-control laboratories.

  17. In vitro–in vivo studies of the quantitative effect of calcium, multivitamins and milk on single dose ciprofloxacin bioavailability

    Directory of Open Access Journals (Sweden)

    Baishakhi Dey

    2015-12-01

    Full Text Available Ciprofloxacin, commonly used in India as an anti-microbial for prolonged use in chronic and non-specific indications, may affect the bioavailability of the drug. The drug prescribed is commonly taken with multivitamins, calcium and milk. A simple and reliable analytical methodology obtaining a correlation with in vivo urinary excretion studies using UV and HPLC and in vitro dissolution studies (IVIVC has shown a significant increase in elimination rate of ciprofloxacin co-administered with multivitamins, calcium and milk. Appreciable IVIVC results proved that dissolution studies could serve as an alternative to in vivo bioavailability and also support bio-waivers.

  18. In vitro-in vivo studies of the quantitative effect of calcium, multivitamins and milk on single dose ciprofloxacin bioavailability

    Institute of Scientific and Technical Information of China (English)

    Baishakhi Dey; Prakash Katakam; Fathi H. Assaleh; Babu Rao Chandu; Shanta Kumari Adiki; Analava Mitra

    2015-01-01

    Ciprofloxacin, commonly used in India as an anti-microbial for prolonged use in chronic and non-specific indications, may affect the bioavailability of the drug. The drug prescribed is commonly taken with multivitamins, calcium and milk. A simple and reliable analytical methodology obtaining a correlation with in vivo urinary excretion studies using UV and HPLC and in vitro dissolution studies (IVIVC) has shown a significant increase in elimination rate of ciprofloxacin co-administered with multivitamins, calcium and milk. Appreciable IVIVC results proved that dissolution studies could serve as an alternative to in vivo bioavailability and also support bio-waivers.

  19. Influence of subinhibitory concentrations of cefotaxime, imipenem and ciprofloxacin on adhesion of Escherichia coli strains to polystyrene.

    Science.gov (United States)

    Zalas-Wiecek, Patrycja; Gospodarek, Eugenia; Piecyk, Katarzyna

    2011-01-01

    The present study investigated the ability of sub MICs of cefotaxime, imipenem and ciprofloxacin to interfere with adhesion of E. coli strains to polystyrene (selected polymer used in studies on microorganisms' adhesion). It was observed that cefotaxime and imipenem at 1/2 and 1/4 MICs decreased the adherence of E. coli strains to polystyrene significantly. 1/2, 1/4 and 1/8 MICs of ciprofloxacin generally decreased the adhesive properties of E. coli strains, but two E. coli strains showed a noticeable enhancement of adhesion after incubation at sub MICs of this antibiotic.

  20. Zero order and signal processing spectrophotometric techniques applied for resolving interference of metronidazole with ciprofloxacin in their pharmaceutical dosage form

    Science.gov (United States)

    Attia, Khalid A. M.; Nassar, Mohammed W. I.; El-Zeiny, Mohamed B.; Serag, Ahmed

    2016-02-01

    Four rapid, simple, accurate and precise spectrophotometric methods were used for the determination of ciprofloxacin in the presence of metronidazole as interference. The methods under study are area under the curve, simultaneous equation in addition to smart signal processing techniques of manipulating ratio spectra namely Savitsky-Golay filters and continuous wavelet transform. All the methods were validated according to the ICH guidelines where accuracy, precision and repeatability were found to be within the acceptable limits. The selectivity of the proposed methods was tested using laboratory prepared mixtures and assessed by applying the standard addition technique. So, they can therefore be used for the routine analysis of ciprofloxacin in quality-control laboratories.

  1. Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Manoochehr Azkhosh

    2016-12-01

    Full Text Available Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran.Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group. One group received acceptance and commitment group therapy (Twelve 90-minute sessions and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance.Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P<0.05 and that acceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility.Conclusion: The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

  2. A simple and sensitive high-performance liquid chromatography method for determination of ciprofloxacin in bioavailability studies of conventional and gastroretentive prolonged-release formulations

    Directory of Open Access Journals (Sweden)

    Jaber Emami

    2016-01-01

    Conclusion: This validated HPLC method was successfully used for the determination of ciprofloxacin in human plasma following oral administration of controlled release formulation, conventional immediate-release tablets and when administered concomitantly with divalent and trivalent cations such as aluminum-, magnesium-, or calcium-containing products under which the bioavailability of ciprofloxacin is significantly reduced.

  3. Draft Genome Sequence of Salmonella enterica Serovar Typhi IMR_TP298/15, a Strain with Intermediate Susceptibility to Ciprofloxacin, Isolated from a Typhoid Outbreak

    Science.gov (United States)

    Hii, Shirley Yi Fen; Hashim, Rohaidah

    2017-01-01

    ABSTRACT Salmonella enterica serovar Typhi with reduced susceptibility to ciprofloxacin is increasingly being reported globally. An outbreak caused by Salmonella Typhi with decreased ciprofloxacin susceptibility has not been reported before in Malaysia. We present here the annotated draft genome of a Salmonella Typhi strain involved in a typhoid outbreak. PMID:28254988

  4. Draft Genome Sequence of Salmonellaenterica Serovar Typhi IMR_TP298/15, a Strain with Intermediate Susceptibility to Ciprofloxacin, Isolated from a Typhoid Outbreak.

    Science.gov (United States)

    Ahmad, Norazah; Hii, Shirley Yi Fen; Hashim, Rohaidah; Issa, Rahizan

    2017-03-02

    Salmonella enterica serovar Typhi with reduced susceptibility to ciprofloxacin is increasingly being reported globally. An outbreak caused by Salmonella Typhi with decreased ciprofloxacin susceptibility has not been reported before in Malaysia. We present here the annotated draft genome of a Salmonella Typhi strain involved in a typhoid outbreak.

  5. Comparative Study of the Clonidin and Propranolol Effect in the Prevention of Hemodynamic Changes after Electroconvulsive Therapy

    Directory of Open Access Journals (Sweden)

    A. Moradi

    2009-04-01

    Full Text Available Introduction & Objective: ECT is an inevitable therapy for many of psychiatric patients. During ECT severe hemodynamic changes occur which may cause dangerous cardiovascular complications especially in elderly patients with cardiac disease and may lead to arrhythmia,ischemia and myocardial infarction. The purpose of this study was to show the effect of clonidin and propranolol on the prevention of hemodynamic changes following the ECT.Materials & Methods: This study was a controlled double blind clinical trial which was carried out on 31 patients ASA I, II hospitalized in psychiatry ward of Hamadan Sina hospital who were in need of ECT. In order to increase the accuracy of the study the personal factors on the drug metabolism were omitted and the chosen patients were given ECT three times separately with the interval of 48 hours. Two hours before every ECT clonidin (0.2 mg, propranolol (40 mg and placebo (vitamin c were administered and after each ECT the hemodynamic parameters including systolic blood pressure, diastolic blood pressure, rate pressure product and ECG were measured at certain intervals and recorded on information forms and then analyzed by SPSS 9 soft ware. Results: The result of this study showed that the average changes of hemodynamic parameters in different times occurred in all groups significantly(p<0.001. Following ECT, arrhythmia in control group has been plentiful in comparison with the other two groups, and the changes were statistically meaningful (p=0.001.Conclusion: We concluded that the modifying hemodynamic changes and decrease of arrhythmia taking the drugs in comparison with placebo have been more effective and of the two drugs, propranolol has been more effective on the prevention of hemodynamic changes after ECT.

  6. Quantitative and qualitative assessment of real world data comparative effectiveness research of systemic therapies in lung oncology: A systematic review

    NARCIS (Netherlands)

    Peters, Bas J.M.|info:eu-repo/dai/nl/304824585; Janssen, Vivi E.M.T.; Schramel, Franz M.; van de Garde, Ewoudt M.W.|info:eu-repo/dai/nl/304841528

    2016-01-01

    Introduction The growing interest in comparative effectiveness research (CER) based on data from routine clinical practice also extends towards lung oncology. Although CER studies using real world data (RWD) have the potential to assist clinical decision-making, concerns about the quality and validi

  7. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

    2015-03-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  8. Comparative efficacy of psychological therapies for improving mental health and daily functioning in irritable bowel syndrome: A systematic review and meta-analysis.

    Science.gov (United States)

    Laird, Kelsey T; Tanner-Smith, Emily E; Russell, Alexandra C; Hollon, Steven D; Walker, Lynn S

    2017-02-01

    Previous meta-analyses have shown that psychotherapy improves gastrointestinal symptoms in adults with irritable bowel syndrome (IBS); however, the impact on functioning in daily activities is unknown. Meta-analysis was used to estimate the effect of psychotherapy on mental health and daily functioning in adults with IBS. An extensive literature search located 28 eligible randomized controlled trials (RCTs) providing outcome data for mental health and 18 RCTs providing data for daily functioning. Compared to a mixed group of control conditions, psychotherapy produced significantly greater improvements to mental health (d-=0.41) and daily functioning (d-=0.43). Cognitive behavior therapy (CBT) was evaluated in the largest number of trials (21 trials), followed by hypnosis (4 trials), psychodynamic (3 trials), and relaxation (2 trials). The psychotherapeutic modalities were comparable with respect to their effect on mental health. CBT produced the greatest improvements to daily functioning, and this effect was significantly larger than that produced by relaxation therapy. These results have important clinical implications for treatment of adults with IBS.

  9. A study on the Efficacy of Muscle Energy Technique as compared to Conventional Therapy on Lumbar Spine Range of Motion in Chronic Low Back Pain of Sacroiliac Origin

    Directory of Open Access Journals (Sweden)

    Supreet Bindra

    2013-10-01

    Full Text Available Sacroiliac joint dysfunction is a term often used to describe pain in and around the region of the joint that is presumed to be due to biomechanical disorders of the joint. Despite of high incidence, the contribution of sacroiliac joint to low back pain has been a matter of controversy. Physical therapists routinely assess spinal range of motion in patients with low back pain and believe that spinal range of motion and disability are closely linked. The present study was aimed to determine the relative efficacy of Muscle Energy Technique as compared to Conventional Therapy on lumbar spine range of motion in chronic low back pain of Sacroiliac origin. It was found that the subjects who were treated with Muscle Energy Technique showed greater improvements in lumbar spine range of motion as compared to Conventional Therapy Group. As far as reduction in pain and disability are concerned both the groups showed almost similar results. The study concluded that sacroiliac joint dysfunction affects lumbar spine range of motion and is a significant contributor to chronic low back pain.

  10. Non-contact low-frequency ultrasound therapy compared with UK standard of care for venous leg ulcers: a single-centre, assessor-blinded, randomised controlled trial.

    Science.gov (United States)

    White, Judith; Ivins, Nicola; Wilkes, Antony; Carolan-Rees, Grace; Harding, Keith G

    2016-10-01

    'Hard-to-heal' wounds are those which fail to heal with standard therapy in an orderly and timely manner and may warrant the use of advanced treatments such as non-contact low-frequency ultrasound (NLFU) therapy. This evaluator-blinded, single-site, randomised controlled trial, compared NLFU in addition to UK standard of care [SOC: (NLFU + SOC)] three times a week, with SOC alone at least once a week. Patients with chronic venous leg ulcers were eligible to participate. All 36 randomised patients completed treatment (17 NLFU + SOC, 19 SOC), and baseline demographics were comparable between groups. NLFU + SOC patients showed a -47% (SD: 38%) change in wound area; SOC, -39% (38%) change; and difference, -7·4% [95% confidence intervals (CIs) -33·4-18·6; P = 0·565]. The median number of infections per patient was two in both arms of the study and change in quality of life (QoL) scores was not significant (P = 0·490). NLFU + SOC patients reported a substantial mean (SD) reduction in pain score of -14·4 (14·9) points, SOC patients' pain scores reduced by -5·3 (14·8); the difference was -9·1 (P = 0·078). Results demonstrated the importance of high-quality wound care. Outcome measures favoured NLFU + SOC over SOC, but the differences were not statistically significant. A larger sample size and longer follow-up may reveal NLFU-related improvements not identified in this study.

  11. Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Heller, G.V.; Parker, J.A.; Silverman, K.J.; Royal, H.D.; Kolodny, G.M.; Paulin, S.; Braunwald, E.; Markis, J.E.

    1987-02-01

    Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients. In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of perfusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening. In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore, there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement.

  12. Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Bonnema, Steen Joop

    2007-01-01

    OBJECTIVE: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules. DESIGN: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized...... at inclusion and at 1, 3 and 6 months after treatment. RESULTS: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the (131)I group (P=0.0025). In the ILP group, mean thyroid nodule volume reduction was 44+/-5% (s.e.m.; P

  13. Melamine modified P25 with heating method and enhanced the photocatalytic activity on degradation of ciprofloxacin

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Huiqin [School of Materials Science & Engineering, Jiangsu University, Zhenjiang 212013 (China); Li, Jinze; Ma, Changchang [School of Chemistry & Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China); Guan, Qingfeng [School of Materials Science & Engineering, Jiangsu University, Zhenjiang 212013 (China); Lu, Ziyang [School of Chemistry & Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China); Huo, Pengwei, E-mail: huopw1@163.com [School of Chemistry & Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China); Yan, Yongsheng [School of Chemistry & Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China)

    2015-02-28

    Highlights: • We demonstrated the as-prepared photocatalyst of g-C{sub 3}N{sub 4}-TiO{sub 2} with the commercial TiO{sub 2} (P25) composited melamine under ball milling and calcined. • The enhanced photocatalytic performance could be mainly attributed to the suitable band gap structure with heterojunction of CN-P25. • The possible photocatalytic mechanism of g-C{sub 3}N{sub 4}/P25 under visible light irradiation is proposed. - Abstract: The graphitic carbon nitride (g-C{sub 3}N{sub 4}), as one photocatalyst which possess the suitable band gap, is better for modified TiO{sub 2} and enhanced photocatalytic degradation of organic pollutants. In this work, the g-C{sub 3}N{sub 4}/TiO{sub 2} were successfully prepared via directly calcined the mixture of melamine and P25. The as-prepared g-C{sub 3}N{sub 4}/TiO{sub 2} photocatalysts were characterized by X-ray diffraction (XRD), transmission electron microscope (TEM) and high resolution electron microscopy (HRTEM), Raman and Fourier transform-infrared spectroscopy (FT-IR). The photocatalytic performances of g-C{sub 3}N{sub 4}/TiO{sub 2} composites were investigated by degradation of ciprofloxacin. The results showed that the g-C{sub 3}N{sub 4} and P25 were successfully composited, and the bond of C–N was well formed, the calcined temperature for as-prepared photocatalysts and the ratio of melamine and P25 were important to the degradation rate of ciprofloxacin. When the mixture of melamine and P25 with 1:2, and calcined temperature at 600 °C, the degradation rate of ciprofloxacin could reach 95% in 60 min. The enhanced photocatalytic performances could be mainly attributed to the suitable band gap structure with heterojunction of CN-P25. Finally, the possible transferred processes of photoelectrons and photoholes were proposed.

  14. Comparative evaluation of the wound-healing potency of recombinant bFGF and ski gene therapy in rats.

    Science.gov (United States)

    Peng, Yan; Li, Ping; Zhao, Zi-Ai; Chen, Lei; Zhao, Xiao-Guang; Chen, Xing; Zhao, Yan; Xiong, Ren-Ping; Ning, Ya-Lei; Yang, Nan; Ye, Jian; Zhou, Yuan-Guo

    2016-08-01

    We previously demonstrated that cellular Sloan-Kettering Institute (c-Ski) played a dual role, both promoting wound healing and alleviating scar formation. However, its mechanism and therapeutic effects are not clear, especially compared with widely used treatments, such as basic fibroblast growth factor (bFGF) administration. However, Ski treatment led to an even shorter healing time and a more significant reduction in scar area than bFGF treatment. The mechanism underlying this difference was related to a reduced inflammatory response, more rapid re-epithelialization, less collagen after healing and a greater reduction in the proportion of alpha-smooth muscle actin and SMemb-positive cells after Ski treatment. These results not only confirm that Ski plays a dual role in promoting healing and reducing scarring but also suggest that Ski yields better treatment effects than bFGF, indicating better potential therapeutic effects in wound repair.

  15. The results of comparative analysis of angiogenic and laser therapy for diabetic macular edema in diabetes type 2

    Directory of Open Access Journals (Sweden)

    I. V. Vorobieva

    2014-07-01

    Full Text Available Purpose: To compare the results of laser treatment and intravitreal ranibizumab injections in patients with DME consistent with the level of VEGF A in tear fluid.Methods: The progress of visual acuity, retinal thickness and light sensivity after laser treatment and ranibizumab intravitreal injection has been assessed.Results: One month after the treatment the main effect of laser was the decrease of retinal thickness, whereas after ranibizumab — the increase of visual acuity. The significant decrease of VEGF A level in tear fluid was found only in ranibizumab group.Conclusion: Laser treatment of DME leads to permanent retinal thickness decrease and insignificant functional improvement in comparison with ranibizumab IV injection, which leads to temporary morphological and functional improvement.

  16. Structural features of piperazinyl-linked ciprofloxacin dimers required for activity against drug-resistant strains of Staphylococcus aureus.

    Science.gov (United States)

    Kerns, Robert J; Rybak, Michael J; Kaatz, Glenn W; Vaka, Flamur; Cha, Raymond; Grucz, Richard G; Diwadkar, Veena U

    2003-07-07

    We previously demonstrated that piperazinyl-linked fluoroquinolone dimers possess potent antibacterial activity against drug-resistant strains of Staphylococcus aureus. In this study, we report the preparation and evaluation of a series of incomplete dimers toward ascertaining structural features of piperazinyl-linked ciprofloxacin dimers that render these agents refractory to fluoroquinolone-resistance mechanisms in Staphylococcus aureus.

  17. Levonorgestrel-releasing intrauterine system (Mirena in compare to medroxyprogesterone acetate as a therapy for endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    Fariba Behnamfar

    2014-01-01

    Full Text Available Background: This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial. Materials and Methods: A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally for 12 days a month for 3 months. Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression. Results: Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients, versus 70.4% (19 of 27 patients in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients and 22.2% (6 of 27 patients in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15. Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05. Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013. Conclusion: Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone.

  18. South Asia as a Reservoir for the Global Spread of Ciprofloxacin-Resistant Shigella sonnei: A Cross-Sectional Study

    Science.gov (United States)

    Pham Thanh, Duy; De Lappe, Niall; Cormican, Martin; Howden, Benjamin P.; Wangchuk, Sonam; Bodhidatta, Ladaporn; Nguyen Thi Nguyen, To; Thompson, Corinne N.; Phu Huong Lan, Nguyen; Voong Vinh, Phat; Ha Thanh, Tuyen; Turner, Paul; Sar, Poda; Thwaites, Guy; Thomson, Nicholas R.; Holt, Kathryn E.; Baker, Stephen

    2016-01-01

    Background Antimicrobial resistance is a major issue in the Shigellae, particularly as a specific multidrug-resistant (MDR) lineage of Shigella sonnei (lineage III) is becoming globally dominant. Ciprofloxacin is a recommended treatment for Shigella infections. However, ciprofloxacin-resistant S. sonnei are being increasingly isolated in Asia and sporadically reported on other continents. We hypothesized that Asia is a primary hub for the recent international spread of ciprofloxacin-resistant S. sonnei. Methods and Findings We performed whole-genome sequencing on a collection of 60 contemporaneous ciprofloxacin-resistant S. sonnei isolated in four countries within Asia (Vietnam, n = 11; Bhutan, n = 12; Thailand, n = 1; Cambodia, n = 1) and two outside of Asia (Australia, n = 19; Ireland, n = 16). We reconstructed the recent evolutionary history of these organisms and combined these data with their geographical location of isolation. Placing these sequences into a global phylogeny, we found that all ciprofloxacin-resistant S. sonnei formed a single clade within a Central Asian expansion of lineage III. Furthermore, our data show that resistance to ciprofloxacin within S. sonnei may be globally attributed to a single clonal emergence event, encompassing sequential gyrA-S83L, parC-S80I, and gyrA-D87G mutations. Geographical data predict that South Asia is the likely primary source of these organisms, which are being regularly exported across Asia and intercontinentally into Australia, the United States and Europe. Our analysis was limited by the number of S. sonnei sequences available from diverse geographical areas and time periods, and we cannot discount the potential existence of other unsampled reservoir populations of antimicrobial-resistant S. sonnei. Conclusions This study suggests that a single clone, which is widespread in South Asia, is likely driving the current intercontinental surge of ciprofloxacin-resistant S. sonnei and is capable of establishing

  19. Multi-drug resistance and reduced susceptibility to ciprofloxacin among Salmonella enterica serovar Typhi isolates from the Middle East and Central Asia

    Directory of Open Access Journals (Sweden)

    B.A. Rahman

    2014-07-01

    Full Text Available Typhoid fever is common in developing countries, with an estimated 120 million infections and 700 000 annual deaths, worldwide. Fluoroquinolones have been the treatment of choice for infection with multidrug-resistant (MDR Salmonella enterica serovar Typhi (S. Typhi. However, alarming reports of fluoroquinolone-resistance and failure of typhoid fever treatment have recently been published. To determine the proportion of S. Typhi isolates with reduced susceptibility to ciprofloxacin (RSC from six countries in the Middle East and Central Asia, 968 S. Typhi isolates collected between 2002 and 2007 from Egypt, Uzbekistan, Pakistan, Qatar, Jordan and Iraq were tested for antibiotic susceptibility to five antibiotics using the disc-diffusion method. MDR was defined as resistance to amicillin, chloramphenicol and trimethoprim-sulfamethoxazole. The E-test was employed to determine the MIC of ciprofloxacin only. Nalidixic acid resistance was evaluated as a marker for RSC. Interpretations were made according to CLSI guidelines. MDR strains were considerably more prevalent in Iraq (83% and Pakistan (52% compared with the other countries studied (13–52%. Nearly all isolates were susceptible (99.7% to ceftriaxone. RSC was detected in a total of 218 isolates (22%, mostly from Iraq (54/59, 92%, Uzbekistan (98/123, 80%, Qatar (23/43, 54% and Pakistan (31/65, 47%. Many of these (21% were also MDR. Use of nalidixic acid resistance as an indicator for RSC was 99% sensitive and 98% specific. This study reinforces the need for routine antimicrobial susceptibility surveillance of enteric fever isolates and close review of current therapeutic policies in the region.

  20. A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women

    Science.gov (United States)

    Aslami, Elahe; Alipour, Ahmad; Najib, Fatemeh Sadat; Aghayosefi, Alireza

    2017-01-01

    ABSTRACT Background: Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women. Methods: The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. .The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of multivariate analysis of variance test and tracking Tokey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (Pdepression scores decreased in the intervention group, but it increased in the control group. Conclusion: Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

  1. Effect of spinal manipulative therapy with stretching compared with stretching alone on full-swing performance of golf players: a randomized pilot trial☆

    Science.gov (United States)

    Costa, Soraya M.V.; Chibana, Yumi E.T.; Giavarotti, Leandro; Compagnoni, Débora S.; Shiono, Adriana H.; Satie, Janice; Bracher, Eduardo S.B.

    2009-01-01

    Abstract Objective There has been a steady growth of chiropractic treatment using spinal manipulative therapy (SMT) that aims to increase the performance of athletes in various sports. This study evaluates the effect of SMT by chiropractors on the performance of golf players. Methods Golfers of 2 golf clubs in São Paulo, Brazil, participated in this study. They were randomized to 1 of 2 groups: Group I received a stretch program, and group II received a stretch program in addition to SMT. Participants in both groups performed the same standardized stretching program. Spinal manipulative therapy to dysfunctional spinal segments was performed on group II only. All golfers performed 3 full-swing maneuvers. Ball range was considered as the average distance for the 3 shots. Treatment was performed after the initial measurement, and the same maneuvers were performed afterward. Each participant repeated these procedures for a 4-week period. Student t test, Mann-Whitney nonparametric test, and 1-way analysis of variance for repeated measures with significance level of 5% were used to analyze the study. Results Forty-three golfers completed the protocol. Twenty participants were allocated to group I and 23 to group II. Average age, handicap, and initial swing were comparable. No improvement of full-swing performance was observed during the 4 sessions on group I (stretch only). An improvement was observed at the fourth session of group II (P = .005); when comparing the posttreatment, group II had statistical significance at all phases (P = .003). Conclusions Chiropractic SMT in association with muscle stretching may be associated with an improvement of full-swing performance when compared with muscle stretching alone. PMID:19948307

  2. Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study

    Directory of Open Access Journals (Sweden)

    Khatri N

    2014-05-01

    Full Text Available Nasreen Khatri, Elsa Marziali, Illia Tchernikov, Nancy ShepherdRotman Research Institute, Toronto, ON, CanadaBackground: The primary objective of this pilot study was to demonstrate reliable adherence to a group cognitive behavioral (CBT therapy protocol when delivered using on-line video conferencing as compared with face-to-face delivery of group CBT. A secondary aim was to show comparability of changes in subject depression inventory scores between on-line and face-to-face delivery of group CBT.Methods: We screened 31 individuals, 18 of whom met the criteria for a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition diagnosis of mood and/or anxiety disorder. All qualifying participants had the necessary equipment (computer, webcam, Internet for participation in the study, but could exercise their preference for either the on-line or face-to-face format. Eighteen completed the 13 weekly session intervention program (ten face-to-face; eight video conferencing. We coded adherence to protocol in both intervention formats and generated pre–post changes in scores on the Beck Depression Inventory Second Edition (BDI-II for each participant.Results: Application of the CBT protocol coding system showed reliable adherence to the group CBT intervention protocol in both delivery formats. Similarly, qualitative analysis of the themes in group discussion indicated that both groups addressed similar issues. Pre–post intervention scores for the BDI-II were comparable across the two delivery formats, with 60% of participants in each group showing a positive change in BDI-II severity classification (eg, from moderate to low symptoms.Conclusion: This pilot study demonstrates that group CBT could be delivered in a technology-supported environment (on-line video conferencing and can meet the same professional practice standards and outcomes as face-to-face delivery of the intervention program.Keywords: psychotherapy, gerontology, mood

  3. Spectrophotometric and chemometric methods for determination of imipenem, ciprofloxacin hydrochloride, dexamethasone sodium phosphate, paracetamol and cilastatin sodium in human urine

    Science.gov (United States)

    El-Kosasy, A. M.; Abdel-Aziz, Omar; Magdy, N.; El Zahar, N. M.

    2016-03-01

    New accurate, sensitive and selective spectrophotometric and chemometric methods were developed and subsequently validated for determination of Imipenem (IMP), ciprofloxacin hydrochloride (CIPRO), dexamethasone sodium phosphate (DEX), paracetamol (PAR) and cilastatin sodium (CIL) in human urine. These methods include a new derivative ratio method, namely extended derivative ratio (EDR), principal component regression (PCR) and partial least-squares (PLS) methods. A novel EDR method was developed for the determination of these drugs, where each component in the mixture was determined by using a mixture of the other four components as divisor. Peak amplitudes were recorded at 293.0 nm, 284.0 nm, 276.0 nm, 257.0 nm and 221.0 nm within linear concentration ranges 3.00-45.00, 1.00-15.00, 4.00-40.00, 1.50-25.00 and 4.00-50.00 μg mL- 1 for IMP, CIPRO, DEX, PAR and CIL, respectively. PCR and PLS-2 models were established for simultaneous determination of the studied drugs in the range of 3.00-15.00, 1.00-13.00, 4.00-12.00, 1.50-9.50, and 4.00-12.00 μg mL- 1 for IMP, CIPRO, DEX, PAR and CIL, respectively, by using eighteen mixtures as calibration set and seven mixtures as validation set. The suggested methods were validated according to the International Conference of Harmonization (ICH) guidelines and the results revealed that they were accurate, precise and reproducible. The obtained results were statistically compared with those of the published methods and there was no significant difference.

  4. Side Effects of Ciprofloxacin%环丙沙星的不良反应研究

    Institute of Scientific and Technical Information of China (English)

    邝志坚

    2001-01-01

    A review with 30 references is given on side effects of ciprofloxacin including toxity to gastro-intestinal system,central nerve system, hemal system,endocrine system and skeletal-muscle system,the allergic reaction,photosenstivity rection,the drug fever,the hepatic and the renal dysfunction etc.%综述了环丙沙星引起胃肠反应、中枢神经系统反应、血液系统的反应、肝肾功能损害、变态反应、内分泌系统反应、药物热、光敏反应、关节肌肉组织反应及其它等。

  5. Photochemical degradation of ciprofloxacin in UV and UV/H₂O₂ process: kinetics, parameters, and products.

    Science.gov (United States)

    Guo, Hong-Guang; Gao, Nai-Yun; Chu, Wen-Hai; Li, Lei; Zhang, Yong-Ji; Gu, Jin-Shan; Gu, Yu-Liang

    2013-05-01

    Photochemical degradation of fluoroquinolone ciprofloxacin (CIP) in water by UV and UV/H₂O₂ were investigated. The degradation rate of CIP was affected by pH, H₂O₂ dosage, as well as the presence of other inorganic components. The optimized pH value and H₂O₂ concentration were 7.0 and 5 mM. Carbonate and nitrate both impeded CIP degradation. According to liquid chromatography-tandem mass spectrometry analysis, four and 16 products were identified in UV and UV/H₂O₂ system, respectively. Proposed degradation pathways suggest that reactions including the piperazinyl substituent, quinolone moiety, and cyclopropyl group lead to the photochemical degradation of CIP. Toxicity of products assessed by Vibrio qinghaiensis demonstrated that UV/H₂O₂ process was more capable on controlling the toxicity of intermediates in CIP degradation than UV process.

  6. Comparative study of the microvascular blood flow in the intestinal wall, wound contraction and fluid evacuation during negative pressure wound therapy in laparostomy using the V.A.C. abdominal dressing and the ABThera open abdomen negative pressure therapy system.

    Science.gov (United States)

    Lindstedt, Sandra; Malmsjö, Malin; Hlebowicz, Joanna; Ingemansson, Richard

    2015-02-01

    This study aimed to compare the changes in microvascular blood flow in the small intestinal wall, wound contraction and fluid evacuation, using the established V.A.C. abdominal dressing (VAC dressing) and a new abdominal dressing, the ABThera open abdomen negative pressure therapy system (ABThera dressing), in negative pressure wound therapy (NPWT). Midline incisions were made in 12 pigs that were subjected to treatment with NPWT using the VAC or ABThera dressing. The microvascular blood flow in the intestinal wall was measured before and after the application of topical negative pressures of −50, −75 and −125mmHg using laser Doppler velocimetry. Wound contraction and fluid evacuation were also measured. Baseline blood flow was defined as 100% in all settings. The blood flow was significantly reduced to 64·6±6·7% (P blood flow was significantly reduced to 39·6±6·7% (P blood flow could be observed between the two groups. The ABThera system afforded significantly better fluid evacuation from the wound, better drainage of the abdomen and better wound contraction than the VAC dressing.

  7. Meta-analysis comparing maintenance strategies with continuous therapy and complete chemotherapy-free interval strategies in the treatment of metastatic colorectal cancer.

    Science.gov (United States)

    Zhao, Lei; Wang, Jing; Li, Huihui; Che, Juanjuan; Cao, Bangwei

    2016-05-31

    There is as yet no consensus as to the best choice among the three treatment options (maintenance, complete chemotherapy-free intervals [CFIs], and continuous) for metastatic colorectal cancer (CRC). We performed a meta-analysis of six trials (N = 2, 454 patients) to compare the safety and efficacy of those three treatment strategies. Maintenance appeared to offer an advantage over CFI with respect to progression-free survival (PFS) (hazard ratio [HR]: 0.53, 95% confidence interval [CI], 0.40-0.69). PFS and overall survival (OS) were comparable between the maintenance and continuous strategies (HR: 1.18, 95% CI, 0.96-1.46; HR: 1.05, 95% CI, 0.98-1.27, respectively), as was OS between the maintenance and CFI strategies (HR: 0.84; 95% CI, 0.70-1.00). The incidence of grade 3/4 toxicity, including neutropenia, neuropathy, hand-foot syndrome and fatigue, was lower with maintenance than with continuous therapy. A maintenance regimen utilizing bevacizumab-based doublets appeared to confer a slight advantage over bevacizumab monotherapy with respect to PFS (P = 0.011). Maintenance appeared to reduce cumulative grade 3/4 toxicity as compared to the continuous strategy, while showing comparable efficacy. Bevacizumab-based doublets appeared to be of particular value in patients with metastatic CRC.

  8. The excretion and environmental effects of amoxicillin, ciprofloxacin, and doxycycline residues in layer chicken manure.

    Science.gov (United States)

    Peng, Ping-cai; Wang, Yan; Liu, Long-yong; Zou, Yong-de; Liao, Xin-di; Liang, Juan-boo; Wu, Yin-bao

    2016-05-01

    The excretion rates and ecological risk to the environment of three commonly used veterinary antibiotics (VAs), amoxicillin, ciprofloxacin, and doxycycline, in layer hen manure during the application and withdrawal periods were investigated in a study consisting of a control group fed with VA-free basal diet and nine treatment groups consisted of three levels (200 mg/kg, 100 mg/kg, and 50 mg/kg) of amoxicillin (AMX), ciprofloxacin (CIP), or doxycycline (DOC). Each treatment group was replicated seven times with three layer hens per replication. Results of the study showed that the average excretion rates of AMX in the 200, 100, and 50 mg/kg groups were 67.88, 55.82, and 66.15%, respectively, while those for CIP and DOC were 47.84, 51.85, and 44.87% and 82.67, 94.39, and 95.72%, respectively. The concentrations of the above veterinary drugs in manure decreased sharply in the withdrawal period (7, 28, and 10 d, respectively), for AMX, DOC, and CIP. Neither AMX nor DOC was detected in the manure after the withdrawal period. In contrast to AMX and DOC, the excretion rate of CIP was significantly lower and thus had a longer residence time. Ecological risk study, estimated using hazard quotient values, showed that AMX in the 100 and 50 mg/kg groups posed no risk to the environment after d 1 of withdrawal, while CIP in the 50 mg/kg group posed no risk to the environment from d 5 of withdrawal. CIP in the 200 and 100 mg/kg groups required 10 d withdrawal in order to pose no risk to the environment. In contrast, DOC residue during withdrawal in the manure posed no risk to the environment, thus making it more environmentally safe.

  9. Emergence of Ciprofloxacin-Resistant Salmonella enterica Serovar Typhi in Italy.

    Science.gov (United States)

    García-Fernández, Aurora; Gallina, Silvia; Owczarek, Slawomir; Dionisi, Anna Maria; Benedetti, Ildo; Decastelli, Lucia; Luzzi, Ida

    2015-01-01

    In developed countries, typhoid fever is often associated with persons who travel to endemic areas or immigrate from them. Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi. Because of the emergence of antimicrobial resistance to standard first-line drugs, fluoroquinolones are the drugs of choice. Resistance to ciprofloxacin by this Salmonella serovar represents an emerging public health issue. Two S. enterica ser. Typhi strains resistant to ciprofloxacin (CIP) were reported to the Italian surveillance system for foodborne and waterborne diseases (EnterNet-Italia) in 2013. The strains were isolated from two Italian tourists upon their arrival from India. A retrospective analysis of 17 other S. enterica ser. Typhi strains isolated in Italy during 2011-2013 was performed to determine their resistance to CIP. For this purpose, we assayed for susceptibility to antimicrobial agents and conducted PCR and nucleotide sequence analyses. Moreover, all strains were typed using pulsed-field gel electrophoresis to evaluate possible clonal relationships. Sixty-eight percent of the S. enterica ser. Typhi strains were resistant to CIP (MICs, 0.125-16 mg/L), and all isolates were negative for determinants of plasmid-mediated quinolone resistance. Analysis of sequences encoding DNA gyrase and topoisomerase IV subunits revealed mutations in gyrA, gyrB, and parC. Thirteen different clonal groups were detected, and the two CIP-resistant strains isolated from the individuals who visited India exhibited the same PFGE pattern. Because of these findings, the emergence of CIP-resistant S. enterica ser. Typhi isolates in Italy deserves attention, and monitoring antibiotic susceptibility is important for efficiently managing cases of typhoid fever.

  10. Potential for Improved Intelligence Quotient Using Volumetric Modulated Arc Therapy Compared With Conventional 3-Dimensional Conformal Radiation for Whole-Ventricular Radiation in Children

    Energy Technology Data Exchange (ETDEWEB)

    Qi, X. Sharon, E-mail: xqi@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Stinauer, Michelle; Rogers, Brion [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Madden, Jennifer R. [Department of Neuro-Oncology, The Children' s Hospital, Aurora, Colorado (United States); Wilkening, Greta N. [Department of Pediatrics, The Children' s Hospital, Aurora, Colorado (United States); Liu, Arthur K. [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States)

    2012-12-01

    Purpose: To compare volumetric modulated arc therapy (VMAT) with 3-dimensional conformal radiation therapy (3D-CRT) in the treatment of localized intracranial germinoma. We modeled the effect of the dosimetric differences on intelligence quotient (IQ). Method and Materials: Ten children with intracranial germinomas were used for planning. The prescription doses were 23.4 Gy to the ventricles followed by 21.6 Gy to the tumor located in the pineal region. For each child, a 3D-CRT and full arc VMAT was generated. Coverage of the target was assessed by computing a conformity index and heterogeneity index. We also generated VMAT plans with explicit temporal lobe sparing and with smaller ventricular margin expansions. Mean dose to the temporal lobe was used to estimate IQ 5 years after completion of radiation, using a patient age of 10 years. Results: Compared with the 3D-CRT plan, VMAT improved conformality (conformity index 1.10 vs 1.85), with slightly higher heterogeneity (heterogeneity index 1.09 vs 1.06). The averaged mean doses for left and right temporal lobes were 31.3 and 31.7 Gy, respectively, for VMAT plans and 37.7 and 37.6 Gy for 3D-CRT plans. This difference in mean temporal lobe dose resulted in an estimated IQ difference of 3.1 points at 5 years after radiation therapy. When the temporal lobes were explicitly included in the VMAT optimization, the mean temporal lobe dose was reduced 5.6-5.7 Gy, resulting in an estimated IQ difference of an additional 3 points. Reducing the ventricular margin from 1.5 cm to 0.5 cm decreased mean temporal lobe dose 11.4-13.1 Gy, corresponding to an estimated increase in IQ of 7 points. Conclusion: For treatment of children with intracranial pure germinomas, VMAT compared with 3D-CRT provides increased conformality and reduces doses to normal tissue. This may result in improvements in IQ in these children.

  11. Comparative Effectiveness of Second-Line Targeted Therapies for Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-Analysis of Real-World Observational Studies.

    Directory of Open Access Journals (Sweden)

    Daniel Y Heng

    Full Text Available The optimal sequencing of targeted therapies for metastatic renal cell carcinoma (mRCC is unknown. Observational studies with a variety of designs have reported differing results. The objective of this study is to systematically summarize and interpret the published real-world evidence comparing sequential treatment for mRCC.A search was conducted in Medline and Embase (2009-2013, and conference proceedings from American Society of Clinical Oncology (ASCO, ASCO Genitourinary Cancers Symposium (ASCO-GU, and European Society for Medical Oncology (ESMO (2011-2013. We systematically reviewed observational studies comparing second-line mRCC treatment with mammalian target of rapamycin inhibitors (mTORi versus vascular endothelial growth factor (VEGF tyrosine kinase inhibitors (TKI. Studies were evaluated for 1 use of a retrospective cohort design after initiation of second-line therapy, 2 adjustment for patient characteristics, and 3 use of data from multiple centers. Meta-analyses were conducted for comparisons of overall survival (OS and progression-free survival (PFS.Ten studies reported OS and exhibited significant heterogeneity in estimated second-line treatment effects (I2 = 68%; P = 0.001. Four of these were adjusted, multicenter, retrospective cohort studies, and these showed no evidence of heterogeneity (I2 = 0%; P = 0.61 and a significant association between second-line mTORi (>75% everolimus and longer OS compared to VEGF TKI (>60% sorafenib (HR = 0.82, 95% CI: 0.68 to 0.98 in a meta-analysis. Seven studies comparing PFS showed significant heterogeneity overall and among the adjusted, multicenter, retrospective cohort studies. Real-world observational data for axitinib outcomes was limited at the time of this study.Real-world studies employed different designs and reported heterogeneous results comparing the effectiveness of second-line mTORi and VEGF TKI in the treatment of mRCC. Within the subset of adjusted

  12. Is robotic arm stereotactic body radiation therapy “virtual high dose ratebrachytherapy” for prostate cancer? An analysis of comparative effectiveness using published data [corrected].

    Science.gov (United States)

    Zaorsky, Nicholas George; Hurwitz, Mark D; Dicker, Adam P; Showalter, Timothy N; Den, Robert B

    2015-05-01

    High-dose rate brachytherapy (HDR-BT) monotherapy and robotic arm (i.e., CyberKnife) stereotactic body radiation therapy (SBRT) are emerging technologies that have become popular treatment options for prostate cancer. Proponents of both HDR-BT monotherapy and robotic arm SBRT claim that these modalities are as efficacious as intensity-modulated radiation therapy in treating prostate cancer. Moreover, proponents of robotic arm SBRT believe it is more effective than HDR-BT monotherapy because SBRT is non-invasive, touting it as 'virtual HDR-BT.' We perform a comparative effective analysis of the two technologies. The tumor control rates and toxicities of HDR-BT monotherapy and robotic arm SBRT are promising. However, at present, it would be inappropriate to state that HDR-BT monotherapy and robotic arm SBRT are as efficacious or effective as other treatment modalities for prostate cancer, which have stronger foundations of evidence. Studies reporting on these technologies have relatively short follow-up time, few patients and are largely retrospective.

  13. Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial

    Science.gov (United States)

    Azkhosh, Manoochehr; Farhoudianm, Ali; Saadati, Hemn; Shoaee, Fateme; Lashani, Leila

    2016-01-01

    Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance. Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (Paddicts who seek treatment. PMID:28050185

  14. A Randomized Trial (Irish Clinical Oncology Research Group 97-01) Comparing Short Versus Protracted Neoadjuvant Hormonal Therapy Before Radiotherapy for Localized Prostate Cancer.

    LENUS (Irish Health Repository)

    Armstrong, John G

    2010-08-24

    PURPOSE: To examine the long-term outcomes of a randomized trial comparing short (4 months; Arm 1) and long (8 months; Arm 2) neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer. METHODS AND MATERIALS: Between 1997 and 2001, 276 patients were enrolled and the data from 261 were analyzed. The stratification risk factors were prostate-specific antigen level >20 ng\\/mL, Gleason score >\\/=7, and Stage T3 or more. The intermediate-risk stratum had one factor and the high-risk stratum had two or more. Staging was done from the bone scan and computed tomography findings. The primary endpoint was biochemical failure-free survival. RESULTS: The median follow-up was 102 months. The overall survival, biochemical failure-free survival. and prostate cancer-specific survival did not differ significantly between the two treatment arms, overall or at 5 years. The cumulative probability of overall survival at 5 years was 90% (range, 87-92%) in Arm 1 and 83% (range, 80-86%) in Arm 2. The biochemical failure-free survival rate at 5 years was 66% (range, 62-71%) in Arm 1 and 63% (range, 58-67%) in Arm 2. CONCLUSION: No statistically significant difference was found in biochemical failure-free survival between 4 months and 8 months of neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer.

  15. Prediction of treatment discontinuation and recovery from Borderline Personality Disorder: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy.

    Science.gov (United States)

    Arntz, Arnoud; Stupar-Rutenfrans, Snežana; Bloo, Josephine; van Dyck, Richard; Spinhoven, Philip

    2015-11-01

    Knowing what predicts discontinuation or success of psychotherapies for Borderline Personality Disorder (BPD) is important to improve treatments. Many variables have been reported in the literature, but replication is needed and investigating what therapy process underlies the findings is necessary to understand why variables predict outcome. Using data of an RCT comparing Schema Therapy and Transference Focused Psychotherapy as treatments for BPD, variables derived from the literature were tested as predictors of discontinuation and treatment success. Participants were 86 adult outpatients (80 women, mean age 30.5 years) with a primary diagnosis of BPD who had on average received 3 previous treatment modalities. First, single predictors were tested with logistic regression, controlling for treatment type (and medication use in case of treatment success). Next, with multivariate backward logistic regression essential predictors were detected. Baseline hostility and childhood physical abuse predicted treatment discontinuation. Baseline subjective burden of dissociation predicted a smaller chance of recovery. A second study demonstrated that in-session dissociation, assessed from session audiotapes, mediated the observed effects of baseline dissociation on recovery, indicating that dissociation during sessions interferes with treatment effectiveness. The results suggest that specifically addressing high hostility, childhood abuse, and in-session dissociation might reduce dropout and lack of effectiveness of treatment.

  16. Treating Post-traumatic Stress Disorder in patients with Multiple Sclerosis: a randomized controlled trial comparing the efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy.

    Directory of Open Access Journals (Sweden)

    Sara eCarletto

    2016-04-01

    Full Text Available Objective: Multiple Sclerosis (MS is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD. This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS. Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20 and Relaxation Therapy (RT; n = 22. The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale six-months after the treatment.Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety symptoms and to improve Quality of Life (QoL. Conclusions: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition.Trail registration: NCT01743664, https://clinicaltrials.gov/ct2/show/NCT01743664

  17. MECHANISMS OF RESISTANCE TO CIPROFLOXACIN AND GENETIC DIVERSITY OF ESCHERICHIA COLI STRAINS ORIGINATING FROM URINE CULTURES PERFORMED FOR ROMANIAN ADULTS.

    Science.gov (United States)

    Cristea, Violeta Corina; Oprea, Mihaela; Neacşu, Gabriela; Gîlcă, Ramona; Popa, Mircea Ioan; Usein, Codruţa-Romaniţa

    2015-01-01

    Urinary tract infections (UTI) with Escherichia coli are among the most common infections presenting in general practice. Fluoroquinolones (FQs) are relied on for their empirical therapy but recent reports indicate a concerning increase in the percentage of FQ-resistant E. coli isolates in many countries, including Romania. Sixty E. coli strains with ciprofloxacin resistance and cephalosporin susceptibility isolated from urine specimens of non-hospitalized patients during a five-month period (October 2014 - February 2015) were further analyzed to determine the molecular basis of FQ resistance (i.e. mutations in chromosomal gyrA, gyrB, parC genes and presence of plasmid-borne qnrA, qnrB, qnrS, and aac(6'-Ib-cr genes), the phylogenetic background (i.e. phylogenetic groups A, B1, B2, C, D, E, F or clade I), O25b/ST131 status, and genetic relatedness inferred from the XbaI pulsed-field gel electrophoresis (PFGE) profiles as a measure of isolate-specific genetic composition. The PCR-based phylotyping showed that most strains were assigned to non-B2 phylogenetic groups (i.e. group A/21 strains, group B1/14 strains, group B2/10 strains, group C/8 strains, group D/3 strains, group F/4 strains). Already described chromosomal mutations associated to FQ resistance were found, the strains being double gyrA mutants (i.e. Ser83Leu, Asp87Asn) with one or two parC mutations (e.g. Ala56Thr, Ser80Ile, Glu84Gly). Seven percent of the strains harboured plasmid-borne genes qnrS1 (2 strains) and aac(6'-Ib-cr (2 strains). Based on the PCR results, 15% of the strains were members of the O25b/ST131 clone and possessed the gyrA/parC allele combination which is considered as hallmark of H30 subclone. PFGE genotyping revealed a genetically diverse population of FQ-resistant E. coli. ST131 strains displayed more homogeneous PFGE profiles than non-ST131. The ST131 cluster extended to 77.74% similarity versus 60% overall. These findings underscore the need for ongoing surveillance to capture the

  18. Ciprofloxacin Affects Host Cells by Suppressing Expression of the Endogenous Antimicrobial Peptides Cathelicidins and Beta-Defensin-3 in Colon Epithelia

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    Protim Sarker

    2014-07-01

    Full Text Available Antibiotics exert several effects on host cells including regulation of immune components. Antimicrobial peptides (AMPs, e.g., cathelicidins and defensins display multiple functions in innate immunity. In colonic mucosa, cathelicidins are induced by butyrate, a bacterial fermentation product. Here, we investigated the effect of antibiotics on butyrate-induced expression of cathelicidins and beta-defensins in colon epithelial cells. Real-time PCR analysis revealed that ciprofloxacin and clindamycin reduce butyrate-induced transcription of the human cathelicidin LL-37 in the colonic epithelial cell line HT-29. Suppression of LL-37 peptide/protein by ciprofloxacin was confirmed by Western blot analysis. Immunohistochemical analysis demonstrated that ciprofloxacin suppresses the rabbit cathelicidin CAP-18 in rectal epithelia of healthy and butyrate-treated Shigella-infected rabbits. Ciprofloxacin also down-regulated butyrate-induced transcription of the human beta-defensin-3 in HT-29 cells. Microarray analysis of HT-29 cells revealed upregulation by butyrate with subsequent down-regulation by ciprofloxacin of additional genes encoding immune factors. Dephosphorylation of histone H3, an epigenetic event provided a possible mechanism of the suppressive effect of ciprofloxacin. Furthermore, LL-37 peptide inhibited Clostridium difficile growth in vitro. In conclusion, ciprofloxacin and clindamycin exert immunomodulatory function by down-regulating AMPs and other immune components in colonic epithelial cells. Suppression of AMPs may contribute to the overgrowth of C. difficile, causing antibiotic-associated diarrhea.

  19. To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke

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    Batool, Sana; Soomro, Nabila; Amjad, Fareeha; Fauz, Rabia

    2015-01-01

    Objective: To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke. Method: A sample of 42 patients was recruited from the Physiotherapy Department of IPM&R and Neurology OPD of Civil Hospital Karachi through non probability purposive sampling technique. Twenty one patients were placed to each experimental and control groups. Experimental group was treated with Constraint Induced Movement Therapy (CIMT) and control group was treated with motor relearning programme (MRP) for three consecutive weeks. Pre and post treatment measurements were determined by upper arm section of Motor Assessment Scale (MAS) and Self Care item of Functional Independence Measure (FIM) Scale. Results: Intra group analysis showed statistically significant results (p-value<0.05) in all items of MAS in both groups. However, advanced hand activities item of MAS in MRP group showed insignificant result (p-value=0.059). Self-care items of FIM Scale also showed significant result (p-value< 0.05) in both groups except dressing upper body item (p-value=0.059) in CIMT group and grooming and dressing upper body items (p-value=0.059 & 0.063) in MRP group showed insignificant p-values. Conclusion: CIMT group showed more significant improvement in motor function and self-care performance of hemiplegic upper extremity as compared to MRP group in patients with sub-acute stroke assessed by the MAS and FIM scales. Thus CIMT is proved to be more statistically significant and clinically effective intervention in comparison to motor relearning programme among the patients aged between 35-60 years. Further studies are needed to evaluate CIMT effects in acute and chronic post stroke population. PMID:26649007

  20. Comparative Toxicity and Dosimetric Profile of Whole-Pelvis Versus Prostate Bed-Only Intensity-Modulated Radiation Therapy After Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Deville, Curtiland, E-mail: deville@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vapiwala, Neha [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Lin Haibo; Bar Ad, Voichita; Tochner, Zelig; Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2012-03-15

    Purpose: To assess whether whole-pelvis (WP) intensity modulated radiation therapy (IMRT) for prostate cancer (PCa) after prostatectomy is associated with increased toxicity compared to prostate-bed only (PB) IMRT. Methods and Materials: All patients (n = 67) undergoing postprostatectomy IMRT to 70.2 Gy at our institution from January 2006 to January 2009 with minimum 12-month follow-up were divided into WP (n = 36) and PB (n = 31) comparison groups. WP patients received initial pelvic nodal IMRT to 45 Gy. Pretreatment demographics, bladder and rectal dose-volume histograms, and maximum genitourinary (GU) and gastrointestinal (GI) toxicities were compared. Logistic regression models evaluated uni- and multivariate associations between pretreatment demographics and toxicities. Results: Pretreatment demographics including age and comorbidities were similar between groups. WP patients had higher Gleason scores, T stages, and preoperative prostate-specific antigen (PSA) levels, and more WP patients underwent androgen deprivation therapy (ADT). WP minimum (Dmin) and mean bladder doses, bladder volumes receiving more than 5 Gy (V5) and V20, rectal Dmin, and PB bladder and rectal V65 were significantly increased. Maximum acute GI toxicity was Grade 2 and was increased for WP (61%) vs. PB (29%) patients (p = 0.001); there was no significant difference in acute Grade {>=}2 GU toxicity (22% WP vs. 10% PB; p = 0.193), late Grade {>=}2 GI toxicity (3% WP vs. 0% PB; p = 0.678), or late Grade {>=}2 GU toxicity (28% WP vs. 19% PB; p = 0.274) with 25-month median follow-up (range, 12-44 months). On multivariate analysis, long-term ADT use was associated with Grade {>=}2 late GU toxicity (p = 0.02). Conclusion: Despite dosimetric differences in irradiated bowel, bladder, and rectum, WP IMRT resulted only in clinically significant increased acute GI toxicity in comparison to that with PB IMRT, with no differences in GU or late GI toxicity.

  1. Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: randomized controlled trial

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    Nuria eRuffini

    2015-08-01

    Full Text Available Context: Heart Rate Variability (HRV indicates how heart rate changes in response to inner and external stimuli. HRV is linked to health status and it is an indirect marker of the autonomic nervous system (ANS function. Objective: To investigate the influence of osteopathic manipulative treatment (OMT on ANS activity through changes of High Frequency, a heart rate variability index indicating the parasympathetic activity, in healthy subjects, compared with sham therapy and control group.Methods: Sixty-six healthy subjects, both male and female, were included in the present 3-armed randomized placebo controlled within subject cross-over single blinded study. Participants were asymptomatic adults, both smokers and non-smokers and not on medications. At enrollment subjects were randomized in 3 groups: A, B, C. Standardized structural evaluation followed by a patient need-based osteopathic treatment was performed in the first session of group A and in the second session of group B. Standardized evaluation followed by a protocoled sham treatment was provided in the second session of group A and in the first session of group B. No intervention was performed in the two sessions of group C, acting as a time-control. The trial was registered on clinicaltrials.gov identifier: NCT01908920.Main Outcomes Measures: HRV was calculated from electrocardiography before, during and after the intervention, for a total amount time of 25 minutes.Results: OMT engendered a statistically significant increase of parasympathetic activity, as shown by High Frequency rate (p<0.001, and decrease of sympathetic activity, as revealed by Low Frequency rate (p<0.01; results also showed a reduction of Low Frequency/High Frequency ratio (p<0.001 and Detrended fluctuation scaling exponent (p<0.05. Conclusions: Findings suggested that OMT can influence ANS activity increasing parasympathetic function and decreasing sympathetic activity, compared to sham therapy and control group.

  2. Maintaining persistence and adherence with subcutaneous growth-hormone therapy in children: comparing jet-delivery and needle-based devices

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    Spoudeas HA

    2014-09-01

    Full Text Available Helen A Spoudeas,1 Priti Bajaj,2 Nathan Sommerford3 1London Centre for Paediatric Endocrinology, University College London, London, 2Ferring Pharmaceuticals, London, 3Health Informatics Research, Sciensus Ltd, Brighton, UK Purpose: Persistence and adherence with subcutaneous growth hormone (GH; somatropin therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet®, impacts on medication-taking behaviors compared to needle-based devices.Materials and methods: A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton® (somatropin via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients.Results: Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001; this association was observed in both sexes and across age subgroups (≤10 and 11–16 years. The majority (58% of patients using ZomaJet were classed as adherent (n=728. Only 297 patients (5% switched GH brand (n=6,061, and patients tended to use ZomaJet for longer than other devices before switching.Conclusion: It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in

  3. Comparative In Vitro Toxicity Profile of Electronic and Tobacco Cigarettes, Smokeless Tobacco and Nicotine Replacement Therapy Products: E-Liquids, Extracts and Collected Aerosols

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    Manoj Misra

    2014-10-01

    Full Text Available The use of electronic cigarettes (e-cigs continues to increase worldwide in parallel with accumulating information on their potential toxicity and safety. In this study, an in vitro battery of established assays was used to examine the cytotoxicity, mutagenicity, genotoxicity and inflammatory responses of certain commercial e-cigs and compared to tobacco burning cigarettes, smokeless tobacco (SLT products and a nicotine replacement therapy (NRT product. The toxicity evaluation was performed on e-liquids and pad-collected aerosols of e-cigs, pad-collected smoke condensates of tobacco cigarettes and extracts of SLT and NRT products. In all assays, exposures with e-cig liquids and collected aerosols, at the doses tested, showed no significant activity when compared to tobacco burning cigarettes. Results for the e-cigs, with and without nicotine in two evaluated flavor variants, were very similar in all assays, indicating that the presence of nicotine and flavors, at the levels tested, did not induce any cytotoxic, genotoxic or inflammatory effects. The present findings indicate that neither the e-cig liquids and collected aerosols, nor the extracts of the SLT and NRT products produce any meaningful toxic effects in four widely-applied in vitro test systems, in which the conventional cigarette smoke preparations, at comparable exposures, are markedly cytotoxic and genotoxic.

  4. Comparative in vitro toxicity profile of electronic and tobacco cigarettes, smokeless tobacco and nicotine replacement therapy products: e-liquids, extracts and collected aerosols.

    Science.gov (United States)

    Misra, Manoj; Leverette, Robert D; Cooper, Bethany T; Bennett, Melanee B; Brown, Steven E

    2014-10-30

    The use of electronic cigarettes (e-cigs) continues to increase worldwide in parallel with accumulating information on their potential toxicity and safety. In this study, an in vitro battery of established assays was used to examine the cytotoxicity, mutagenicity, genotoxicity and inflammatory responses of certain commercial e-cigs and compared to tobacco burning cigarettes, smokeless tobacco (SLT) products and a nicotine replacement therapy (NRT) product. The toxicity evaluation was performed on e-liquids and pad-collected aerosols of e-cigs, pad-collected smoke condensates of tobacco cigarettes and extracts of SLT and NRT products. In all assays, exposures with e-cig liquids and collected aerosols, at the doses tested, showed no significant activity when compared to tobacco burning cigarettes. Results for the e-cigs, with and without nicotine in two evaluated flavor variants, were very similar in all assays, indicating that the presence of nicotine and flavors, at the levels tested, did not induce any cytotoxic, genotoxic or inflammatory effects. The present findings indicate that neither the e-cig liquids and collected aerosols, nor the extracts of the SLT and NRT products produce any meaningful toxic effects in four widely-applied in vitro test systems, in which the conventional cigarette smoke preparations, at comparable exposures, are markedly cytotoxic and genotoxic.

  5. A phase III randomised, double-blind, parallel-group study comparing SB4 with etanercept reference product in patients with active rheumatoid arthritis despite methotrexate therapy

    Science.gov (United States)

    Emery, Paul; Vencovský, Jiří; Sylwestrzak, Anna; Leszczyński, Piotr; Porawska, Wieslawa; Baranauskaite, Asta; Tseluyko, Vira; Zhdan, Vyacheslav M; Stasiuk, Barbara; Milasiene, Roma; Barrera Rodriguez, Aaron Alejandro; Cheong, Soo Yeon; Ghil, Jeehoon

    2017-01-01

    Objectives To compare the efficacy and safety of SB4 (an etanercept biosimilar) with reference product etanercept (ETN) in patients with moderate to severe rheumatoid arthritis (RA) despite methotrexate (MTX) therapy. Methods This is a phase III, randomised, double-blind, parallel-group, multicentre study with a 24-week primary endpoint. Patients with moderate to severe RA despite MTX treatment were randomised to receive weekly dose of 50 mg of subcutaneous SB4 or ETN. The primary endpoint was the American College of Rheumatology 20% (ACR20) response at week 24. Other efficacy endpoints as well as safety, immunogenicity and pharmacokinetic parameters were also measured. Results 596 patients were randomised to either SB4 (N=299) or ETN (N=297). The ACR20 response rate at week 24 in the per-protocol set was 78.1% for SB4 and 80.3% for ETN. The 95% CI of the adjusted treatment difference was −9.41% to 4.98%, which is completely contained within the predefined equivalence margin of −15% to 15%, indicating therapeutic equivalence between SB4 and ETN. Other efficacy endpoints and pharmacokinetic endpoints were comparable. The incidence of treatment-emergent adverse events was comparable (55.2% vs 58.2%), and the incidence of antidrug antibody development up to week 24 was lower in SB4 compared with ETN (0.7% vs 13.1%). Conclusions SB4 was shown to be equivalent with ETN in terms of efficacy at week 24. SB4 was well tolerated with a lower immunogenicity profile. The safety profile of SB4 was comparable with that of ETN. Trial registration numbers NCT01895309, EudraCT 2012-005026-30. PMID:26150601

  6. 壳聚糖抗菌凝胶联合盐酸环丙沙星栓治疗需氧菌阴道炎疗效分析%Efficacy Analysis on Treatment of Aerobic Vaginitis by Chitosan Antibacte-rial Gel Combined with Ciprofloxacin Hydrochloride Suppositories

    Institute of Scientific and Technical Information of China (English)

    廖小倩; 林秀梅; 叶青剑; 黄敏

    2016-01-01

    目的:探讨壳聚糖抗菌凝胶联合盐酸环丙沙星治疗需氧性阴道炎(AV)的疗效。方法整群选取2015年11月—2016年3月期间该院诊治的82例AV患者随机分为研究组和对照组,研究组41例,对照组41例。研究组给予壳聚糖抗菌凝胶和盐酸环丙沙星栓,对照组给予盐酸环丙沙星栓剂治疗,观察两组疗效。结果治疗7 d后,两组治疗AV的总有效率分别为95.1%和78.0%(P﹤0.05)。结论壳聚糖抗菌凝胶联合盐酸环丙沙星治疗AV效果更好,值得临床推广。%Objective To observe the efficacy of treatment of aerobic vaginitis by chitosan antibacterial gel with ciprofloxacin hydrochloride suppositories. Methords Group selection 82 patients at our hospital from November 2015 to March 2016 with aerobic vaginitis are randomly divided into the research group (41cases) and the control group (41cases). Chitosan antibacterial gel with ciprofloxacin hydrochloride suppositories are administered to the research group while only ciprofloxacin hydrochloride suppositories are administered to the control group, to observe the efficacy of both two groups. Results The total therapy effective rates of the two groups are 95.1% and 78.0%(P﹤0.05), respectively. Conclusion The ap-plication of chitosan antibacterial gel with ciprofloxacin hydrochloride suppositories generates better efficacy in the treat-ment of aerobic vaginitis and is thus worth clinical promotion.

  7. A prospective pilot study comparing combined intravitreal ranibizumab and half-fluence photodynamic therapy with ranibizumab monotherapy in the treatment of neovascular age-related macular degeneration

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    Williams PD

    2012-09-01

    Full Text Available Patrick D Williams,1 David Callanan,1 Wayne Solley,1 Robert L Avery,2 Dante J Pieramici,2 Tom Aaberg31Texas Retina Associates, Dallas, TX, 2California Retina Consultants and Research Foundation, Santa Barbara, CA, 3Retinal Associates, Grand Rapids, MI, USAPurpose: This prospective multi-center pilot study compares the use of half-fluence photodynamic therapy combined with ranibizumab with ranibizumab monothera