Added value of coronal-T1 W sequence to the lumbar MR imaging protocol for low back pain / Valor de la secuencia coronal-TIW agregada al protocolo de imágenes de resonancia magnética en casos de dolor lumbar

Introduction: Magnetic resonance imaging (MRI) is the most appropriate imaging method to investigate low back pain. As low back pain is very common, a large number of MRI scans are performed. Objective: To evaluate the extraspinal findings and clinical effect of the T1-weighted spin echo (T1 W SE) coronal sequence added to the lumbar MRI protocol for low back pain. Materials and methods: In 2015, we added a T1-weighted (T1W) coronal sequence to our routine lumbar MRI protocol. We retrospectively evaluated 969 lumbar MRI images for low back pain performed with this protocol. The extraspinal MRI findings obtained from them were then grouped as associated with low back pain (Category 1) and not associated with low back pain (Category 2). We also evaluated whether the recorded incidental extraspinal findings could be detected on conventional sagittal and axial images. Results: Ninety-six (63%) of the extraspinal findings were associated with low back pain (Category 1) and 56 (37%), Category 2. Seventy-eight percent of the extraspinal findings were detected only on coronal-T1W images and not on conventional images. Conclusion: Adding coronal-T1W sequence to the routine protocol of lumbar MRI can help to identify extraspinal findings and guide clinical treatment.

Introducción. La resonancia magnética (RM) es el método de imágenes diagnósticas más apropiado para investigar el dolor lumbar. Dado que este es muy común, son muchas las resonancias magnéticas de este tipo que se hacen. Objetivo. Analizar los hallazgos extra espinales que se pueden detectar al agregar la secuencia coronal T1 W al protocolo de imágenes de RM para el dolor lumbar y evaluar su efecto clínico. Materiales y métodos. En el 2015 se agregó una secuencia coronal ponderada en T1W al protocolo de resonancia magnética lumbar de rutina de nuestro hospital. Se evaluaron retrospectivamente 969 imágenes solicitadas en casos de dolor lumbar y realizadas con este protocolo. Los hallazgos obtenidos a partir de dichas imágenes se agruparon luego como asociados con el dolor lumbar (categoría 1) y no asociados con el dolor lumbar (categoría 2). Se evaluó, asimismo, si los hallazgos extra espinales registrados podían detectarse en imágenes axiales y sagitales convencionales. Resultados. Noventa y seis (63 %) de los hallazgos extra espinales se asociaron con lumbalgia (categoría 1) y 56 (37 %) correspondieron a la categoría 2. El 78 % de los hallazgos extra espinales se detectaron solo en imágenes coronales-T1W y no en las convencionales. Conclusión. La secuencia coronal-T1 W agregada al protocolo de rutina de la resonancia magnética lumbar puede ayudar a detectar afectaciones extra espinales y guiar el tratamiento clínico.

The effect of amifostine on bacterial translocation after radiation induced acute enteritis

ABSTRACT PURPOSE: To investigate the effects of amifostine on bacterial translocation and overgrowth in colonic flora after acute radiation enteritis in a rat model. METHODS: Thirty-two female Wistar albino rats were divided into four groups: Group-1 (n=8): only normal saline was administered intraperitoneally. Group-2 (n=8): first serum saline was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. Group-3 (n=8): only amifostine 200 ml/kg was administered intraperitoneally and radiation was not applied. Group-4 (n=8): first amifostine 200 ml/kg was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. On the 5th day after radiation, samples of mesenteric lymph tissues and cecal contents were taken by laparotomy for microbiological culture. RESULTS: Intraperitoneal amifostine administration significantly decreased the bacterial overgrowth related to radiation in colon but did not significantly decrease the bacterial translocation. CONCLUSİON: Although not providing a full protection on the damaged mucosal barrier, amifostine significantly decreased the bacterial overgrowth in the cecal content after high dose radiation. There is a need to find out appropriate amifostine dose under different radiation applications avoiding bacterial translocation in gastrointestinal system.

Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model

ABSTRACT OBJECTIVE: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. METHODS: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. RESULTS: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). CONCLUSION: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.

Avaliação in vitro das características antimicrobianas de sugamadex / In vitro evaluation of antimicrobial features of sugammadex / Evaluación in vitro de las características antimicrobianasdel sugammadex

Justificativa e objetivo: os medicamentos administrados por via intravenosa podem ser contaminados durante as várias fases de produção ou preparação. Sugamadex é uma gama-ciclodextrina modificada. Embora muitas pesquisas sobre os efeitos antibacterianos de uma variedade de ciclodextrinas estejam disponíveis, não há estudos dos efeitos antibacterianos de sugamadex. Este estudo investigou a atividade antimicrobiana in vitro de sugamadex. Materiais e métodos: a atividade antimicrobiana in vitro de sugamadex foi investigada pelo método de microdiluição em meio de cultura. O pH da solução de ensaio foi determinado com o uso de um medidor de pH. Os microrganismos-teste analisados incluíram Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 e Pseudomonas aeruginosa ATCC 27853. Na segunda fase do estudo, 100 mg/mL de sugamadex (50 μg) foram contaminados com microrganismos-teste (50 μg), incluindo S. aureus ATCC 29213, E. fecalis ATCC 29212, E. coli ATCC 25922 e P. aeruginosa ATCC 27853, incubados por 24 horas e, em seguida, a produção bacteriana foi avaliada. Resultados: o pH das soluções da análise variaram entre 7,25 e 6,97. Com o uso do método de microdiluição, sugamadex não apresentou efeito antibacteriano contra S. aureus, E. fecalis, E. coli e P. aeruginosa em qualquer concentração. Na segunda fase do estudo, a produção bacteriana foi observada após 24 horas em 100 mg/mL de sugamadex contaminados com os microrganismos-teste S. aureus, E. fecalis, E. coli e P. aeruginosa. .

Background: Drugs administered by intravenous routes may be contaminated during several stages of production or preparation. Sugammadex is a modified gamma cyclodextrin. While research into the antibacterial effects of varieties of cyclodextrin is available, there are no studies focusing on the antibacterial effects of sugammadex. This study investigates the in vitro antimicrobial activity of sugammadex. Materials and methods: The in vitro antimicrobial activity of sugammadex was investigated using the broth microdilution method. The pH of the test solution was determined using a pH meter. The test microorganisms included Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. In the second phase of the study 100 mg/mL sugammadex (50 μg) was contaminated with test microorganisms (50 μg), including S. aureus ATCC 29213, E. fecalis ATCC 29212, E. coli ATCC 25922 and P. aeruginosa ATCC 27853, left to incubate for 24 h and then the bacterial production in sugammadex was evaluated. Results: The pH of the test solutions ranged between 7.25 and 6.97. Using the microdilution method, sugammadex had no antibacterial effect on S. aureus, E. fecalis, E. coli and P. aeruginosa at any concentration. In the second phase of the study bacterial production was observed after 24 h in 100 mg/mL sugammadex contaminated with the test microorganisms S. aureus, E. fecalis, E. coli and P. aeruginosa. Conclusions: Sugammadex had no antimicrobial effect on the test microorganisms, S. aureus, E. fecalis, E. coli and P. aeruginosa. Care should be taken that sterile conditions are maintained in the preparation of sugammadex; that the same sugammadex preparation not be used for more than one patient; and that storage conditions are adhered to after sugammadex is put into the injector. .

Justificación y objetivo: Los medicamentos administrados por vía intravenosa pueden ser contaminados durante las diversas fases de producción o preparación. El sugammadex es una gamaciclodextrina modificada. Aunque estén disponibles muchas investigaciones sobre los efectos antibacterianos de una variedad de ciclodextrinas, no existen estudios de los efectos antibacterianos del sugammadex. Este estudio investigó la actividad antimicrobiana in vitro del sugammadex. Materiales y métodos: La actividad antimicrobiana in vitro del sugammadex fue investigada por el método de microdilución en medio de cultivo. El pH de la solución de ensayo fue determinado usando un medidor de pH. Los microorganismos testados analizados incluyeron Staphylococcus aureus (S. aureus) (ATCC 29213), Enterococcus faecalis (E. faecalis) (ATCC 29212), Escherichia coli (E. coli) (ATCC 25922) y Pseudomonas aeruginosa (P. aeruginosa) (ATCC 27853). En la segunda fase del estudio, se contaminaron 100 mg/mL de sugammadex (50 µg) con microorganismos testados (50 µg), incluyendo S. aureus (ATCC 29213), E. faecalis (ATCC 29212), E. coli (ATCC 25922) y P. aeruginosa (ATCC 27853), incubados durante 24 h e inmediatamente se calculóla producción bacteriana. Resultados: El pH de las soluciones del análisis varió entre 7,25 y 6,97. Usando el métodode microdilución, el sugammadex no tuvo ningún efecto antibacteriano contra S. aureus, E. faecalis, E. coli y P. aeruginosa en ninguna concentración. En la segunda fase del estudio, la producción bacteriana fue observada después de 24 h en 100 mg/mL de sugammadex contaminados con los microorganismos testados S. aureus, E. faecalis, E. coli y P. aeruginosa. Conclusiones: El sugammadex no presentó ningún efecto antimicrobiano sobre los microorganismos testados S. aureus, E. faecalis, E. coli y P. aeruginosa. ...