ABSTRACT
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a known cause of hyponatremia, caused by excessive ADH secretion which, in turn, leads to water retention. SIADH has been associated with multiple etiologies, one of which is traumatic brain injury (TBI). Most cases of SIADH after TBI describe a course in which hyponatraemia develops several days to weeks after the trauma and then resolves within a few weeks. We demonstrate a case of SIADH after TBI, which persisted several years after initial presentation, but eventually did resolve spontaneously after five years.
Subject(s)
Brain Injuries, Traumatic , Hyponatremia , Inappropriate ADH Syndrome , Brain Injuries, Traumatic/complications , Humans , Inappropriate ADH Syndrome/etiology , VasopressinsABSTRACT
A 63-year-old woman with a kidney transplant was admitted with endocarditis caused by meticillin-resistant Staphylococcus aureus (MRSA). Once her antibiotic therapy had been adjusted to the sensitivity-pattern of the bacterial strain she recovered, without the need for surgical intervention. The isolated S. aureus was typed by multi-locus sequence typing as sequence type 398, a MRSA-strain that has recently been isolated from a high percentage of Dutch pigs. This is the first report of a life-threatening infection with this pig MRSA. This strain is genetically different from the globally dispersed nosocomial MRSA-strains, and also from the strains that have been epidemic for several years in the USA as the causative agent ofcommunity-acquired skin infections. The Dutch Working Group on Infection Prevention (WIP) has recently adjusted its guidelines to halt further spread of this strain, and advises that the population at risk (pig breeders, slaughterhouse personnel and veterinarians) be held in isolation when hospitalised until MRSA colonisation has been excluded. The patient described here, however, did not belong to this population at risk.
Subject(s)
Endocarditis, Bacterial/diagnosis , Staphylococcal Infections/diagnosis , Staphylococcus aureus , Swine Diseases/microbiology , Zoonoses , Animals , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/transmission , Female , Humans , Methicillin Resistance , Middle Aged , Staphylococcal Infections/drug therapy , Staphylococcal Infections/etiology , Staphylococcal Infections/transmission , Staphylococcus aureus/drug effects , Staphylococcus aureus/genetics , Staphylococcus aureus/growth & development , Swine , Swine Diseases/transmissionABSTRACT
A post-column derivatization procedure using OPA and fluorescence detection has been used for the determination of seven aminoglycosides (dibekacin, framycetin, kanamycin, netilmicin, sisomicin, tobramycin and gentamicin) in commercial pharmaceutical formulations. The linearity, precision and detection limits were satisfactory. Recoveries from eye drops, ointments, injections and capsules were comparable (P = 0.05) to those obtained with TLC or microbiological assays. A ruggedness test showed that the method was not sensitive to minor variations in the mobile phase composition, post-column derivatization system or detection wavelength.
Subject(s)
Anti-Bacterial Agents/analysis , Aminoglycosides , Biological Assay , Capsules , Chromatography, High Pressure Liquid , Chromatography, Thin Layer , Ointments , Ophthalmic Solutions , Solutions , Spectrometry, Fluorescence , Spectrophotometry, Ultraviolet , o-PhthalaldehydeABSTRACT
A simple, fast and reliable procedure for the determination of seven major aminoglycosides in commercial formulations (injections, capsules, eye drops, solutions and ointments) is presented. The aminoglycosides are separated on silica gel plates then located with ninhydrin and analysed in situ using a chromatogram spectrophotometer. Linearity tests, repeatability (relative standard deviation congruent to 3.5%) detection limits (60-200 ng) were satisfactory for all the compounds. Recovery data in pharmaceutical formulations (expressed as the percentage of the label claim) from thin-layer chromatography (TLC) and microbiological assays did not give any significant difference (P = 0.05); this result shows that TLC is a reliable method for the determination of aminoglycosides as the drug substance and in pharmaceutical formulations.
