Effect of oral ciprofloxacin on bacterial flora of perineum, urethra, and lower urinary tract in men with spinal cord injury.

A study was performed in 25 men with spinal cord injuries undergoing intermittent catheterization whose urine had > or = 10(5) bacterial colonies/ml to determine efficacy of ciprofloxacin in eradicating susceptible organisms from urine, urethra, and perineum. Cultures were obtained prior to, during, and 5 to 7 days after administration of 500 mg twice daily for 10 days. Organisms in urine were also present in the urethra and/or perineum in 20 cases.

Comparison of MicroScan MICroSTREP, PASCO, and Sensititre MIC panels for determining antimicrobial susceptibilities of Streptococcus pneumoniae.

The MicroScan MICroSTREP MIC panel was compared with PASCO and Sensititre systems against 157 isolates of Streptococcus pneumoniae chosen to include penicillin-susceptible, intermediate, and resistant strains. Arbitration testing was performed by microbroth dilution using National Committee for Clinical Laboratory Standards guidelines. Overall essential agreement of 94-97% and categorical agreement of 91-94% with the reference method was achieved for the three systems.

Heterogeneity in the clonal T cell response. Implications for models of T cell activation and cytokine phenotype development.

The T cell can be defined in the context of two properties--the recognition specificity of the T cell receptor (TCR) heterodimer and the functional response of the T cell after TCR stimulation. Once a particular TCR heterodimer is expressed and successfully selected during thymic development, the antigen specificity is fixed for all the clonal progeny of that cell. In contrast, the potential functional responses that may be generated in response to specific antigen in the postthymic environment are quite extensive.

Shed mediastinal blood transfusion after cardiac operations: a cost-effectiveness analysis.

Background: Cardiac surgical patients consume a significant fraction of the annual volume of allogeneic blood transfused. Scavenged autologous blood may serve as a cost-effective means of conserving donated blood and avoiding transfusion-related complications.

Methods: This study examines 834 patients after cardiac operations at the University of Alabama Hospital.

Comparative in vitro activities of four new fluoroquinolones against Streptococcus pneumoniae determined by Etest.

Clinafloxacin, levofloxacin, sparfloxacin and trovafloxacin were tested by Etest against 188 Streptococcus pneumoniae isolates. Clinafloxacin and trovafloxacin were 2-4-fold more potent than sparfloxacin and 8-fold more than levofloxacin. Two isolates, both serotype 6, with high-level quinolone resistance (> or = 8 micrograms/ml) were detected.

Clinical and laboratory factors underlying refractoriness to platelet transfusions.

Of the spectrum of clinical and laboratory factors responsible for refractoriness to platelet transfusions, some are amenable to intervention, some to circumvention, and others only to acceptance and support for complications. Identification of the likely reason for refractoriness in a given individual patient is critical to determine the optimum management strategy. The blood bank or transfusion service can and perhaps should play a direct role in that strategy through the provision of single donor platelets collected by apheresis.

Causes of refractoriness to platelet transfusion.

Platelet refractoriness is a multifactorial problem that often leads to aggressive measures in an attempt to treat a thrombocytopenic patient. Identification of the underlying causes should allow for prevention and management regimens to improve both transfusion practice and patient outcome. A number of clinical studies have evaluated the relative importance of the various causes of refractoriness.

Compliance with annual urologic evaluations and preservation of renal function in persons with spinal cord injury.

We located 59 persons with spinal cord injury (SCI) who had not been examined for 3-15 years and paid them to undergo evaluation and comparison with 101 controls examined on an annual basis. Renal function during the first year post-injury and at follow-up was measured by radioisotopic scanning to determine effective renal plasma flow (ERPF) and information was obtained regarding occurrence of specific secondary complications. Subjects and controls were alike with respect to demographic characteristics, injury-related variables and occurrence of specific secondary complications.

Pathogenesis of glomerulosclerosis in light chain deposition disease. Role for transforming growth factor-beta.

The glomerulopathy of monoclonal immunoglobulin light chain deposition disease is a progressive disorder characterized by accumulation of monoclonal light chains and matrix proteins in the mesangium. To define the role of light chains in this process, cultured rat mesangial cells were exposed to different light chains and human albumin. Two light chains were purified from the urine of patients who had biopsy-proven light chain deposition disease.

Complications of blood transfusion. How to recognize and respond to noninfectious reactions.

Severe transfusion reactions occur much less often than minor reactions, but it is difficult to discriminate clinically between impending severe reactions and minor reactions. Therefore, whenever a reaction occurs, the transfusion should be discontinued and a laboratory workup initiated to rule out an acute hemolytic transfusion reaction. At a minimum, a direct antiglobulin (Coombs') test should be performed, and specimens obtained before and after transfusion should be assayed for hemoglobinemia and hemoglobinuria.

In situ hybridization for cytokine mRNA with digoxigenin-labeled riboprobes. Sensitivity of detection and double label applications.

A sensitive in situ hybridization procedure using both digoxigenin and 35S-labeled riboprobes is described that allows detection of single T cells expressing cytokine mRNA species in both single and double label formats. Modifications to existing procedures have been developed that allow in situ hybridization to be performed in either fresh frozen tissue sections or cytocentrifuge preparations of cultured cells. For single label studies, the digoxigenin labeling technique is equivalent to 35S labeling for sensitivity of detection and is superior with respect to precise localization and ease of use.

Detection of autoantibodies to amylase by ELISA: comparison of detection of macroamylase and free autoantibody.

New ELISAs for detecting macroamylase or free autoantibodies to amylase were tested with 48 samples that had been characterized by gel chromatography and electrophoresis. The macroamylase ELISA, with anti-IgG or anti-IgA for detection, detected macroamylase in 28 of 33 samples known to contain macroamylase (85% sensitivity), whereas the ELISA for free autoantibody to amylase was positive for only 11 samples. Specificities of both ELISAs were 93%.

Serum concentrations of erythromycin after intravenous infusion in preterm neonates treated for Ureaplasma urealyticum infection.

Erythromycin is receiving renewed attention as an alternative for treatment of neonatal infections caused by Ureaplasma urealyticum because of recently proved abilities of this organism to produce systemic disease in this population. Although erythromycin has been used clinically for almost 40 years, very little is known about its activity in the preterm neonate. Fourteen neonates, birth weights < or = 1500 g and < or = 15 days of age, from whom U.

Multicenter in vitro comparative study of fluoroquinolones after four years of widespread clinical use.

In vitro activities of ciprofloxacin, fleroxacin, lomefloxacin, ofloxacin, and seven other oral antimicrobials including amoxicillin-clavulanic acid (A/C), oxacillin, cefaclor, cefixime, cefuroxime, erythromycin, and trimethoprim-sulfamethoxazole (T/S) were evaluated against 1708 fresh bacterial isolates from four hospital laboratories approximately 4 years after the introduction of ciprofloxacin. T/S and ofloxacin had the lowest MIC90s and greatest percentage of susceptible strains overall, followed by the other three quinolones. Quinolones were the most active drugs tested against Gram-negative bacteria, with little variation in the activity among the four compounds against most species.