Calcium sulphate (CaSO
) is a resorbable material that can be used simultaneously as filler of a dead space and as a carrier for the local application of antibiotics. Our aim was to describe the ...systemic exposure and the wound fluid concentrations of vancomycin in patients treated with vancomycin-loaded CaSO
as an adjunct to the routine therapy of bone and joint infections.
A total of 680 post-operative blood and 233 wound fluid samples were available for analysis from 94 implantations performed in 87 patients for various infective indications. Up to 6 g of vancomycin were used. Non-compartmental pharmacokinetic analysis was performed on the data from 37 patients treated for an infection of the hip.
The overall systemic exposure remained within a safe range, even in patients with post-operative renal failure, none requiring removal of the pellets. Local concentrations were approximately ten times higher than with polymethylmethacrylate (PMMA) as a carrier, but remained below reported cell toxicity thresholds. Decreasing concentrations in wound fluid were observed over several weeks, but remained above the common minimum inhibitory concentrations for
up to three months post-operatively.
This study provides the first pharmacokinetic description of the local application of vancomycin with CaSO
as a carrier, documenting slow release, systemic safety and a release profile far more interesting than from PMMA. In particular, considering
data, concentrations of vancomycin active against
l biofilm were seen for several weeks. Cite this article:
2017;99-B:1537-44.
The growing range of drug resistant parasitic nematode populations threatens the sustainability of ruminant farming worldwide. In this context, nutraceuticals, animal feed that provides necessary ...dietary requirements while ensuring parasite control, could contribute to increase farming sustainability in developed and low resource settings. In this study, we evaluated the anthelmintic potential of lupin seed extracts against the major ruminant trichostrongylids, Haemonchus contortus and Teladorsagia circumcincta. In vitro observations showed that seed extracts from commercially available lupin varieties could significantly but moderately inhibit larval migration. This anthelmintic effect was mediated by the seed alkaloid content and was potent against both fully susceptible and multidrug resistant H. contortus isolates as well as a susceptible T. circumcincta isolate. Analytical chemistry revealed a set of four lupanine and sparteine-derivatives with anthelmintic activity, and electrophysiology assays on recombinant nematode acetylcholine receptors suggested an antagonistic mode of action for lupin alkaloids. An in vivo trial in H. contortus infected lupin-fed ewes and goats failed to demonstrate any direct anthelmintic effect of crude lupin seeds but infected lupin-fed goats suffered significantly less parasite-mediated blood losses. Altogether, our findings suggest that the anthelmintic potential of lupin remains limited. However, the potent alkaloids identified could lead to the development of novel drugs or may be used in combination with current anthelmintics to improve their efficacy.
Les arthrites septiques à
Neisseria gonorrhoeae sont mono- ou oligoarticulaires. Elles représentent une cause non rare d'arthrite de l'adulte sexuellement actif. Il faut y penser même en l'absence ...d'urétrite.
Nous rapportons le cas d'une arthrite gonococcique sans urétrite chez un jeune homme, associée à des hémocultures stériles et des cultures positives du liquide articulaire.
Le diagnostic et le traitement précoce de cette pathologie permettent une guérison sans séquelles. L'existence de souches pénicillines–résistantes a justifié les recommandations récentes concernant l'utilisation en première intention d'une céphalosporine de troisième génération.
Septic arthritis caused by
Neisseria gonorrhoeae is mono or pauciarticular. They represent a nonrare cause of arthritis in sexually active adults. He is necessary to think of it even in the absence of urethritis.
We report the case of gonococcal arthritis without urethritis in a young man associated with positive synovial fluid culture and negative blood cultures.
Prompt recognition and treatment of this disease results in cure without aftereffects. The finding of penicillin-resistant organisms reinforces recent recommendations that advanced-generation cephalosporin must be used as initial therapy.
From a sample of 1172 +/- 61 D(+)-->pi(-)pi(+)pi(+) decays, we find gamma(D(+)-->pi(-)pi(+)pi(+))/gamma(D(+)-->K-pi(+)pi(+)) = 0.0311 +/- 0.0018(+0.0016)(-0.0026). Using a coherent amplitude analysis ...to fit the Dalitz plot of these decays, we find strong evidence that a scalar resonance of mass 478(+24)(-23) +/- 17 MeV/c(2) and width 324(+42)(-40) +/- 21 MeV/c(2) accounts for approximately half of all decays.
Using data from FOCUS (E831) experiment at Fermilab, we present a model independent partial-wave analysis of the K−π+ S-wave amplitude from the decay D+→K−π+π+. The S-wave is a generic complex ...function to be determined directly from the data fit. The P- and D-waves are parameterized by a sum of Breit–Wigner amplitudes. The measurement of the S-wave amplitude covers the whole elastic range of the K−π+ system.
Introduction. –
Un grand nombre de tuberculoses actives en France sont liées à la réactivation d'une tuberculose latente. Il semble que la réactivation de tuberculoses latentes puisse être favorisée ...pendant le post-partum par la restitution immunitaire.
Exégèse. –
Nous rapportons trois observations d'infections ostéo-articulaires à
Mycobaterium tuberculosis (deux spondylodiscites et une arthrite sternoclaviculaire) survenues au cours du post-partum chez des femmes non infectées par le VIH. Deux patientes ont bénéficié d'une prise en charge chirurgicale. L'évolution clinique a été favorable pour toutes nos patientes avec un traitement anti-tuberculeux adapté.
Conclusion. –
Il faut savoir évoquer une possible tuberculose ostéo-articulaire devant des douleurs osseuses ne faisant pas leur preuve pendant le post-partum. Nous rappelons les liens existants entre la tuberculose et le post-partum ainsi que les principes de prise en charge de la mère et de l'enfant. Des études épidémiologiques complémentaires mériteraient d'être réalisées. Il paraît de plus nécessaire de renforcer en France les mesures de dépistage de la tuberculose et notamment des formes latentes.
Introduction. –
Most cases of active tuberculosis in France are due to a recurrence of latent tuberculosis. It seems that immunorestitution during the postpartum can contribute to the return of latent tuberculosis.
Exegesis. –
We report three observations of
Mycobacterium tuberculosis osteo-articular infections (two Pott's diseases and one sterno-clavicular arthritis) occurring during the postpartum of women non infected by HIV. Two patients need a surgical treatment. The response to standard tuberculous treatment was favourable and all patients were cured.
Conclusion. –
One must consider osteo-articular tuberculosis when a patient is suffering from osseous pains not proving reliable during the postpartum. We must remind ourselves of the relationships between tuberculosis and postpartum as well as the necessity to the threat both mother and child. Additional epidemiological studies should be realised. It appears necessary to increase in France measures for tracking tuberculosis in particularly about the latent forms.
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