Grepafloxacin: pharmacokinetics and tissue penetration.

Pharmacokinetic and tissue penetration studies of grepafloxacin, a new broad-spectrum fluoroquinolone, show that it has useful properties for the treatment of respiratory tract infections. Grepafloxacin has a volume of distribution that is larger than those of many of the other fluoroquinolones and is concentrated in alveolar macrophages, bronchial mucosa and epithelial lining fluid to a greater extent than are certain other fluoroquinolones. Grepafloxacin concentrations achieved in plasma after a 400-mg oral dose are well in excess of those required to inhibit the respiratory pathogens Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis.

Ethnic influence on health and dependency of elderly inner city residents.

The objectives of the study were to assess and compare the social characteristics, prevalence of disease, health needs, dependency and use of health services by elderly people in the different ethnic groups living in an inner city. A prevalence study was conducted using a questionnaire administered to people aged 65 years and over living at home, selected from the registers of inner city general practices in West Birmingham. Contact was made with 736 individuals from the original sample of 1,450 names, and completed questionnaires were obtained from 669 individuals (297 men, 372 women).

Air gun pellets in the sinuses.

Three cases of penetrating sinus injuries due to air gun pellets are presented in order to illustrate the potentially serious consequences of air gun injuries. Primary surgery was performed in all cases. The clinical presentation, methods of accurate pre-operative localization and surgery are discussed.

Pesticide incidents reported to the Health and Safety Executive 1989/90- 1991/92.

1. Data concerning pesticide incidents investigated by the Field Operations Division (FOD) of the Health and Safety Executive (HSE) in Great Britain have been collated for the three year period April 1989 to March 1992. Over this period the HSE investigated 613 incidents concerning pesticides: 338 related to general or environmental complaints not involving human poisoning and 275 were suspected poisoning incidents.

Body fat and stroke: unmasking the hazards of overweight and obesity.

Study Objective: It has been frequently noted that overweight and obesity have a stronger relationship to hypertension and diabetes mellitus than to the risk of stroke. The reason for this observation has not been clear. This study aimed to examine the lifelong relation between body fat and stroke to shed light on why the public health risks of overweight and obesity have tended to be obscured in previous epidemiological studies.

Concentrations of ceftibuten in plasma and the respiratory tract following a single 400 mg oral dose.

Concentrations of ceftibuten in bronchial mucosa, epithelial lining fluid (ELF) and alveolar macrophages were determined from samples taken from 15 subjects at bronchoscopy following a single 400 mg oral dose. Concentrations at all sites were determined using a microbiological assay method which was unaffected by the trans-isomer of ceftibuten. The time from dosage to bronchoscopy ranged from 1.

The Birmingham mummy: the first torticollis in history.

The Birmingham Mummy is of a warrior, 25-35 years of age, from the Graeco-Roman period. He was struck from the front by an arrow, which penetrated the soft tissues of the neck to some depth and lodged in the right infratemporal fossa. It is suggested that the wound became infected and that muscle spasm induced the torticollis which was not fully corrected on mummification.

Screening for drugs of abuse. I: Opiates, amphetamines and cocaine.

(1) In order to provide an efficient and reliable service for drugs of abuse screening in urine, the laboratory should analyse 20-30 samples per week, and the staff should include a scientist with special expertise in the subject. (2) Turnaround times should be between 2-3 days of sample collection. To achieve this aim it may be necessary to make special arrangements for the delivery of samples to the laboratory.

Reporting simplified colonic transit studies using radionuclides: clinician friendly reports.

This study describes a graphic presentation of the results of a simplified segmental colonic transit model. This study requires three sets of images on three consecutive days after intake of indium-111 resin capsule at each time point. The per cent of ingested activity is calculated in each region of the colon and in the faeces.

Renal and diaphragmatic endometriosis de novo associated with hormone replacement therapy.

Endometriosis involving the kidneys is rare. To our knowledge we report the first case in which kidney involvement was the initial manifestation of this condition. Because of previous bilateral oophorectomy the diagnosis of endometriosis was improbable.

Pharmacokinetics and tissue penetration of the new fluoroquinolone grepafloxacin.

A single 400-mg oral dose of grepafloxacin (OPC-17116) was given to each of six healthy male volunteers, and the concentrations of the drug in plasma, cantharides-induced inflammatory fluid, and urine were measured over the subsequent 12 h. The mean peak concentration in plasma of 1.5 micrograms/ml was attained at a mean time of 2.

Smoking and middle ear ciliary beat frequency in otitis media with effusion.

The middle ear mucociliary system has been shown to play an important role in clearing middle ear effusions. There is conflicting epidemiological evidence, however, as to whether exposure to tobacco smoke plays a significant role in persistence of middle ear effusion in patients with otherwise normal mucociliary function. Samples of middle ear mucosa from 33 patients with persistent otitis media with effusion (OME) were taken at myringotomy, together with corresponding nasal brushings.

Lead poisoning from Asian traditional remedies in the West Midlands--report of a series of five cases.

1. Traditional remedies are an unusual, but recognised cause of lead poisoning. Only two cases have previously been reported in this country.

A form of stomatitis induced by excessive peppermint consumption.

This paper reports on a form of stomatitis and glossitis associated with extremely prominent circumvalate papillae in two patients who consumed excessive amounts of mint-flavoured sweets.

Surface morphology of middle ear epithelium in chronic ear disease.

The ultrastructural details of normal middle ear mucosa have been reported in detail in the literature. This study was aimed at investigating the superficial structure of middle ear epithelium with the scanning electron microscope in patients with persistent otitis media with effusion (OME) and chronic suppurative otitis media (CSOM), especially in the light of the authors' recent findings regarding decreased ciliary beat frequency (CBF) in patients exposed to tobacco smoke. Mucosal biopsies were taken from the anterior mesotympanum in four patients with OME and another four patients with CSOM.

Chlamydia pneumoniae.

Chlamydia pneumoniae, a fairly recent addition to the genus Chlamydia, has been shown to cause community-acquired and nosocomial pneumonias, and to be a common infectious agent in human populations throughout the world. It has a wide variety of clinical presentations, and may be associated with ischaemic heart disease. Like other species in the genus, it is difficult to isolate by cell culture: clinical diagnosis therefore rests on other techniques, each of which presents particular problems.

Adenomyoepithelioma of the breast. A case report correlating cytologic and histologic features.

Adenomyoepithelioma is a relatively recently described benign lesion of the breast. Although the histologic features have been well documented, to the best of our knowledge the cytologic features have not been reported. In this paper we present the fine needle aspiration cytologic features of a case of adenomyoepithelioma and correlate them with histology.

A comparative study of risk factors for acute myocardial infarction amongst men of Indo-origin in Trinidad and the UK.

A high cardiovascular mortality rate exists amongst people of Indo-origin in Trinidad (third generation migrants) and the United Kingdom (first generation migrants). To investigate the differences in cardiovascular risk factors in these two populations, we surveyed all male patients of Indo-origin with acute myocardial infarction, admitted over a similar 8-week period to the Coronary Care Units of a district general hospital in Birmingham, United Kingdom and a similar hospital in San Fernando, Trinidad. Nineteen patients (mean age 62.

Radiation doses to those accompanying nuclear medicine department patients: a waiting room survey. EANM Task Group Explaining Risks. European Association of Nuclear Medicine.

In a multi-centre European trial we have assessed the radiation dose to those accompanying patients undergoing nuclear medicine investigations. Dosemeters were first calibrated against each other and then used to measure the radiation dose to the nurse or relative while they were in the waiting room. In departments where there was one waiting room the median radiation dose was 13 microSv, and the corresponding figures for where there were two waiting rooms and where the patients were allowed to leave the department with their nurse or relative were 12 and 11 microSv, respectively.

Have we identified the factors affecting prognosis following coronary artery bypass surgery?

Although coronary artery bypass graft (CABG) surgery has been an established therapeutic alternative for more than 20 years in the palliation of symptoms of ischaemic heart disease, the associated risk factors for subsequent mortality and morbidity in these patients remain unclear. This is pertinent, as CABG surgery does not affect the underlying pathological process and different factors affect the early and late postoperative outcomes. As one objective of CABG surgery is to provide symptomatic relief of angina, it is desirable to identify (and perhaps modify) the factors affecting prognosis and outcome.

Concentration of amoxycillin and clavulanate in lung compartments in adults without pulmonary infection.

Background: The efficacy of an antibiotic is usually predicted from serum levels and MIC90 values for likely pathogens, but in the lung tissue concentrations may be more informative. This study compares concentrations of amoxycillin and clavulanate in serum, epithelial lining fluid (ELF), alveolar macrophages, and bronchial mucosa in 15 adults.

Methods: Amoxycillin 500 mg and clavulanic acid 250 mg were given 1-2 hours before diagnostic bronchoscopy for haemoptysis or radiological abnormality.

The in-vitro activity of FK-037, a new broad spectrum injectable cephalosporin.

The in-vitro activity of the parenteral cephem FK-037 was compared to those of cefpirome, ceftazidime, cefuroxime, cefixime, amoxycillin and co-amoxiclav. Against the Enterobacteriaceae FK-037 was generally > or = 16-fold more active than cefuroxime and two- to four-fold more active than ceftazidime and similar in activity to cefpirome. Pseudomonas aeruginosa displayed similar susceptibilities to ceftazidime and FK-037 (MIC90 4 and 8 mg/L respectively).