Comparison of the topical haemostatic efficacy of nano-micro particles of clinoptilolite and kaolin in a rat model of haemorrhagic injury.

PURPOSE: This study was designed to investigate if the potential haemostatic efficacy of gauze-impregnated clinoptilolite created with nano-technology is as strong as the widely used kaolin to control pulsatile arterial bleeding due to major vascular injury. METHODS: 42 rats were separated into three groups of kaolin, clinoptilolite and control groups. The femoral artery was isolated and active arterial haemorrhage was performed. After 30 s of free arterial haemorrhage, compression was applied with a standard 100 g scale and haemostasis was assessed at the 1st, 3rd and 5th minutes. All groups were observed throughout 60 min for survival without any fluid resuscitation and the mean arterial pressure, pulse, body/surface temperature and arterial blood gas values were measured. RESULTS: In the control group, haemostasis did not develop in any of the 12 rats and the survival rate was 5/12 (41.66 %). In the kaolin group, haemostasis developed in seven rats and of these, bleeding reoccurred in four. The survival rate was 10/13 (76.92 %). In the clinoptilolite group, haemostasis developed in eight rats and bleeding recurred in only one. The survival rate was 100 %. In terms of survival, the clinoptilolite and kaolin groups showed superiority to the control group (p = 0.002, p = 0.082). In the evaluation of recurrent haemorrhaging in the rats with haemostasis, clinoptilolite was observed to provide better coagulation than kaolin. CONCLUSION: A statistically significant difference was determined in clinoptilolite and kaolin group, when they are separately compared with the control group in respect of the effect on MAP, HCO3 (-), lactate, base excess, haemostasis duration and survival rates. The effect of clinoptilolite on haemostasis and survival time was observed to be at least as good as that of kaolin; therefore, clinoptilolite can be used as an active ingredient in a topical haemostat.

In vitro antifungal susceptibility of dermatophyte strains causing tinea pedis and onychomycosis in patients with non-insulin-dependent diabetes mellitus: a case-control study.

BACKGROUND: The efficacy of antifungal treatment may be reduced and/or delayed in diabetic patients. To date, no study has investigated the in vitro antifungal susceptibility of dermatophytes in this patient group. OBJECTIVE: We aimed to determine the dermatophyte species causing tinea pedis and onychomycosis, and in vitro susceptibility of these dermatophytes to terbinafine, itraconazole, and fluconazole in patients with non-insulin-dependent diabetes mellitus. We compared the findings in diabetic patients with those in non-diabetic individuals. MATERIALS AND METHODS: One hundred patients with non-insulin-dependent diabetes mellitus and 100 otherwise healthy controls clinically suspected with tinea pedis and/or onychomycosis were included. Skin scrapings and/or nail clippings were taken and cultured on Sabouraud dextrose agar, mycobiotic agar, and dermatophyte test medium. In vitro antifungal susceptibility tests were carried out according to the Clinical and Laboratory Standards Institute (CLSI) M-38P protocol with some modifications. RESULTS: Fifty-seven samples of 54 diabetics and 50 samples of 50 controls grew dermatophytes. In both groups, Trichophyton rubrum was the most common isolate. Mean MIC values of terbinafine, itraconazole, and fluconazole for all of the isolated dermatophyte strains were similar in two groups (P>0.05). The difference in mean MIC values of three antifungals for T. rubrum and T. mentagrophytes between two groups was not statistically significant (P>0.05). CONCLUSIONS: Dermatophyte types causing tinea pedis and onychomycosis, their frequency patterns, and in vitro activity of three antifungals against dermatophytes in diabetics are similar to the non-diabetics. Terbinafine is the most active agent in vitro in both groups.

Determining in vitro synergistic activities of tigecycline with several other antibiotics against Brucella melitensis using checkerboard and time-kill assays.

Antimicrobial therapy of Brucella spp. infection is difficult because there are relatively few effective treatment regimens, and single-agent therapy has generally been considered inadequate due to unacceptably high relapse rates. tigecycline, the first in a new class of antimicrobials, the glycylcyclines, is a 9-t-butylglycylamido derivate of minocycline. in this study, the in vitro activity of tigecycline in combination with gentamicin, streptomycin, rifampin, co-trimoxazole, levofloxacin, and minocycline was investigated using the checkerboard method to evaluate 16 Brucella melitensis isolates. The time-kill method was used to determine the bactericidal activities of combinations of tigecycline with rifampin, gentamicin, and levofloxacin, which were found (via the checkerboard method) to have a synergistic effect in combinations with tigecycline. Using the checkerboard method, combinations of rifampin, gentamicin, and levofloxacin with tigecycline showed synergistic effects against 5 (31.2%), 3 (18.9%), and 8 (50%) of the isolates. No synergy was observed with tigecycline in combination with minocycline, streptomycin, or co-trimoxazole. tigecycline with gentamicin achieved the earliest complete killing at 4x miC (in 6 h), while complete killing with the other combinations was delayed up to 24 h. the time-kill method showed that the combination of tigecycline and levofloxacin had an antagonistic effect, while the checkerboard method detected synergy and no interaction effects. these data suggest that a combination regimen of tigecycline with gentamicin and rifampin may be a good choice for treating brucellosis.

In vitro antifungal susceptibility patterns of dermatophyte strains causing tinea unguium.

BACKGROUND: Dermatophytes are the major responsible organisms in onychomycosis. Although recent antifungal agents have high success rates in treating this condition, lack of clinical response may occur in 20%. Antifungal drug resistance may be one of the causes of treatment failure. The need for in vitro antifungal drug resistance in daily practice is still under discussion. OBJECTIVE: We aimed to determine the in vitro susceptibility patterns of dermatophytes causing onychomycosis, against the traditionally available systemic antifungal agents terbinafine, itraconazole and fluconazole. METHODS: In total, 100 otherwise healthy patients with suspected onychomycosis were included. Nail clippings were cultured on Sabouraud dexrose agar, mycobiotic agar and dermatophyte test medium. Antifungal susceptibility tests were carried out, mainly following The National Committee for Clinical and Laboratory Standards (M38-P) protocol standard for filamentous fungi. Different concentrations of terbinafine (0.008-8 microg/mL), itraconazole (0.015-16 microg/mL) and fluconazole (0.06-64 microg/mL) were tested. Minimum inhibitory concentration end-point determination was chosen as 100% growth inhibition for terbinafine and 80% for azoles. RESULTS: Of the 100 nail samples, 43% grew dermatophytes. The main causative organism was Trichophyton rubrum (91%) followed by Trichophyton mentagrophytes (9%). Terbinafine had the lowest minimum inhibitory concentration (0.008 microg/mL) followed by itraconazole. Fluconazole showed the greatest variation in minimum inhibitory concentration (0.03-2 microg/mL) and had different susceptibility patterns for the two species. CONCLUSIONS: Of the three antifungals tested, terbinafine had the most potent in vitro antifungal activity against dermatophytes. Antifungal susceptibility tests would be useful to screen antifungal-resistant dermatophyte strains.

Role of heparin on TNF-alpha and IL-6 levels in liver regeneration after partial hepatic resection.

OBJECTIVES: The aim of this study was to investigate the effect of heparin on TNF-alpha and interleukin (IL)-6 levels and the complement system in liver regeneration in a murine model. MATERIALS AND METHODS: 32 Wistar albino female rats weighing between 180 and 250 g were included in the study. The rats were divided into four groups as follows: group 1, treated with partial (50%) hepatectomy and intravenous heparin 1,000 IU/kg in repeated daily doses; group 2, treated with sham operation and intravenous heparin 1,000 IU/kg in repeated daily doses; group 3, treated with partial (50%) hepatectomy, and group 4 (controls), treated with only sham operation. Before the surgical intervention and after a general anesthetic had been administered to all rats, blood was taken from the left ventricle of each rat, and each sample was assessed to determine total complement hemolytic activity (CH(50)/ml). On the 5th postoperative day, blood was taken to assess CH(50) activity and the levels of TNF-alpha and IL-6 via ELISA. Each rat was then killed by decapitation after which gravimetric analysis and immunohistochemical staining for proliferating cell nuclear antigen (PCNA) were performed. RESULTS: Serum CH(50) activity of group 1 was 4% as compared to 51% in group 3 (p = 0.01). The serum TNF-alpha level of group 1 was 43 pg/ml as compared to 86 pg/ml in group 3 (p = 0.002). The serum IL-6 level of group 1 was 19 pg/ml as compared to 44 pg/ml in group 3 (p = 0.02). The serum IL-6 level of group 2 was 4 pg/ml as compared to 44 pg/ml in group 3 (p = 0.005). According to the results of gravimetric analysis, the mean regeneration rate of group 1 was 4.4% as compared to 22% of group 3 (p = 0.001). The mean PCNA index values of group 2 was the highest of all groups (p = 0.01). However, the mean PCNA index value of group 1 was the lowest of all groups (p = 0.01). CONCLUSION: Because of its anti-inflammatory action via the complement system, heparin produced an unfavorable effect on liver regeneration.

Apoptosis and proliferation in gastric epithelium due to Helicobacter pylori: an immunohistochemical and ultrastructural study.

UNLABELLED: The effect of H. pylori infection on gastric epithelial cell apoptosis and proliferation is contradictory. Using immunohistochemistry and electron microscopy, this study sought to demonstrate gastric epithelial changes (ie, apoptosis and proliferation) due to chronic H. pylori infection. METHODS: Eighteen female 6- to 8-week old Swiss Albino mice were inoculated intragastrically with 3 doses of 10(9) CFU/mL H. pylori prepared in a Brucella Broth in 5 days. Nine others served as a control group. At the end of 28 weeks, tissue specimens from the gastric antrum were excised and examined immunohistochemically (epithelial growth factor for regeneration and Caspase-3 for apoptosis) and electron microscopically. Immunohistochemical assessment was performed using the indirect peroxidase-antiperoxidase method. RESULTS: In the H. pylori-infected group, EGF staining in gastric epithelium was found to be decreased significantly compared to that in control group (P < 0.001). Caspase-3 reactivity was commonly observed in surface epithelial cells and glandular epithelial cells in H. pylori-infected group and totally it was statistically significant compared to Caspase-3 staining in control group (P < 0.001). Electron micrograph images demonstrated numerous apoptotic cells with condensed chromatin. CONCLUSION: Chronic H. pylori infection of 28 weeks' duration increases apoptosis in gastric epithelium; however, increased apoptosis does not induce proliferation.

Distinguishability analysis of an induced current EIT system using discrete coils.

The distinguishability of a discrete coil induced current electrical impedance tomography system is analysed. The solution methodology of the forward problem of this system is explained. An optimization procedure using this forward problem solution is developed to find optimum currents that maximize the distinguishability. For the concentric inhomogeneity problem, it is shown that the coil currents can be optimized to focus the current density in any desired location, in the field of view. Optimum coil currents under the constraints of limited peak coil currents and limited total power are determined. Examples that demonstrate the performance of the system are presented.